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A new study of mortality among young adults born prematurely includes 6.3 million adults under the age of 50 in Norway, Sweden, Finland and Denmark. Among this group, 5.4 per cent were born before term, according to Professor Kari Risnes at the Norwegian University of Science and Technology's (NTNU) Department of Clinical and Molecular Medicine and St. Olavs Hospital.

Researchers used national birth registers and compared them with the cause of death registers that all Scandinavian countries have.

"We already know that preemies have increased mortality in childhood and early adulthood. Now we've confirmed the risk of death from chronic diseases such as heart disease, lung disease and diabetes before the age of 50," says Risnes.

The professor doesn't want the numbers to scare people.

"It's important to remember that most people who are born prematurely do well, and that treatment and follow-up are constantly improving. The significance of the finding is that prematurity is something that follows you through life as a vulnerability to some diseases," Risnes says.

The study shows that the risk of preemies dying before the age of 50 is 40 per cent higher than for the population as a whole.

Researchers found that the risk of dying for individuals born before full gestation and who have chronic heart disease, lung disease or diabetes is twice that of the population as a whole. However, this group has no increased risk of death from cancer and stroke.

"We were surprised to see that the risk of death was higher even in people who were born as late as weeks 37 and 38, only a few weeks before full gestation. Although the extra risk was only about 10 per cent, this group makes up about 15 per cent of all births, and we have to try to map the causal relationships here," she said.

Risnes believes that the results from the study should be factored in when doctors assess the patient's risk of disease and their preventive advice for the patient.

"Our idea is that we should increase awareness in both the general population and among doctors so that the risk can be reduced. We need to recognize that prematurity is a factor to take into account when assessing risk, just like we do with a family history of heart disease, obesity or smoking," Risnes said.

"It's important to be aware of additional factors that increase the risk of cardiovascular disease and diabetes, like high blood pressure, obesity, inactivity and high blood sugar, plus the high levels of all these additional factors that we see more of in premature births," she says.

"These diseases are often preventable. Good treatment is important and can often longterm to maintain a good quality of life and avoid illness and death. We should be identifying lifestyle changes from an early age that reduce the risks, like more physical activity and avoiding obesity and smoking," Risnes said.

One question still to be answered is whether a greater number of premature versus full-term infants develop these chronic diseases, or if they are just generally less well equipped to survive the diseases.

"We need to try to address this question in the next round of research. It may be that the diseases crop up earlier in premature babies. We don't have data on this yet," Risnes says.

In the 1960s and 1970s, only 20 to 30 per cent of the most premature infants reached 15 years of age. Today, their survival rate is over 90 per cent. This means that the strong ones, the survivors, were preemies in Risne's study of adults.

"With better neonatal medicine, the proportion of the population born prematurely is growing," says Risne. She believes it will be important to follow this population closely in terms of risk. In the study, individuals born prematurely around 1980 had a slightly higher risk of cardiovascular disease than those born around 1970.

The study doesn't indicate that the social status of the mother or conditions of upbringing explain the increased risk of mortality. The researchers compared siblings to find out if the excess mortality was due to genetics or socioeconomic conditions.

"We found that risk of death for these diseases was higher for people born prematurely than for their full-term siblings. We concluded that the increased risk can't be fully explained by genes, which siblings have in common, or by socio-economic conditions and living conditions in childhood," says Risnes.

Dying in the first 50 years of life is rare. For 30-year-olds, the risk of dying is one in 1 000 per year, for 50-year-olds the risk rises to two in 1 000. Chronic diseases make up a minor percentage of these deaths. The researchers in the EU study chose to look at cancer, heart disease, stroke, chronic lung disease and diabetes because these are the most common chronic diseases that can be fatal.

In the past, it has been difficult to access other nations' health databases. Risnes is very happy that such access was possible for this study. Robust results are easier to attain with such a large volume of health data. The findings of the study are consistent between countries.

Daily national surveys by Carnegie Mellon University show that while COVID-19 vaccine uptake has increased, the proportion of vaccine-hesitant adults has remained unchanged. The concerns about a side effect remain high, especially among females, Black adults and those with an eligible health condition.

The Delphi Research Group at CMU in partnership with Facebook released its latest survey findings. The analyses show that vaccine hesitancy persists and point to potential tactics to combat it.

"Prior research by the CDC has found that Black and Hispanic adults are the least likely to receive the annual flu vaccine each year," said Alex Reinhart, assistant teaching professor in CMU's Department of Statistics & Data Science and a member of the Delphi Research Group. "Our survey suggests that COVID vaccine hesitancy follows a similar trend."

Reinhart was joined on this report by Facebook research scientists Esther Kim Andy Garcia, Sarah LaRocca and Katherine Morris. Delphi staff, including statistical developer Nat DeFries and survey coordinator Wichada La Motte-Kerr, contributed to the development and analysis of the survey.

The survey tracks daily trends in behaviors and attitudes on issues related to COVID-19 at the state and county level. The surveys of Facebook users are conducted by members of the Delphi Research Group in partnership with Facebook's Data for Good program. The new report consists of responses obtained from more than 1.9 million Americans between Jan. 10 and Feb. 27, 2021.
According to the latest survey results, the proportion of adults who are either vaccinated or willing to get vaccinated increased from 72% to 77%, which is largely attributable to a decrease in non-responses on the survey question. Vaccine hesitancy remained relatively steady at 23%

The researchers note that vaccine hesitancy might be improved by addressing concerns about potential or perceived side effects. Seven out of 10 vaccine-hesitant adults stated they were concerned about side effects.

"When it comes to increasing vaccine acceptance, our global health partners have emphasized that there is not a one size fits all approach," said Kang-Xing (KX) Jin, Facebook's Head of Health. "By understanding geographic and demographic trends in vaccine hesitancy with the help of COVID-19 Symptom Survey, paired with public insights from Facebook about how people are talking about vaccines, public health officials can design and deliver tailored messaging campaigns that resonate with specific audiences within states, counties and communities."

The research team suggests turning to trusted local healthcare professionals to spread the word of vaccine safety and importance. Trust in local healthcare workers among vaccine-hesitant adults has increased significantly in January and February even though trust in other information outlets has remained unchanged or decreased.

"Hesitancy can reflect existing mistrust of medicine, but uptake of the COVID vaccine, just like uptake of the flu vaccine, can also reflect unequal access to healthcare or unequal availability of convenient places to get vaccinated," said Reinhart. "We're looking into this in more detail in newer versions of the survey, which ask specifically about access to the vaccine and specific reasons for not wanting to receive it."

Delphi researchers use the data to perform forecasts of COVID-19 activity at state and county levels, which are reported to the U.S. Centers for Disease Control and Prevention. The COVID-19 Symptom Survey is the largest ongoing COVID-19 data collecting effort in the country, gathering more than 50,000 responses daily and more than 18 million responses total since its launch in April 2020.

Despite guidelines promoting outpatient management of patients with low-risk pulmonary embolism (PE), few patients are currently discharged home from hospital emergency departments in the United States. That is the conclusion of a study titled Outpatient Management of Patients Following Diagnosis of Acute Pulmonary Embolism, published in the March 2021 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

The retrospective cohort study of more than 61,000 patients treated at 740 acute care United States emergency departments during a two-year period sought to determine disposition practices and subsequent health care utilization in patients with acute PE. According to the findings, disposition practice varies widely across hospitals and return emergency department visit rates were high, but most did not result in hospitalization.

The lead author of the study is Lauren M. Westafer, DO, MPH, MS, of the Institute for Healthcare Delivery and Population Science at the University of Massachusetts Medical School and the Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, both in Springfield, Massachusetts.

The findings of the study are discussed with the author in a recent AEM podcast titled Momma I'm Comin Home - for Outpatient Treatment of a Pulmonary Embolism.

PROVIDENCE, R.I. [Brown University] -- The COVID-19 pandemic has had devastating effects in U.S. nursing homes and long-term care facilities, resulting in an estimated 1.2 million infections and 147,000 deaths as of early 2021. Yet even as mortality rates in the general population have decreased over time, little evidence has been uncovered to determine whether nursing home residences have experienced similar reductions.

Now, new data collected and analyzed by researchers at Brown University shows that mortality rates among nursing home residents with COVID-19 declined from March to November 2020, and that the deadliest period of time for nursing home residents followed the pandemic's arrival, when the virus spiked in spring 2020.

The information fills an important evidence gap in accounting for death rates of nursing home residents from COVID over time, the researchers say.

"Understanding the mortality risk from COVID-19 among nursing home residents is critical for identifying the mechanisms that most significantly affect health outcomes in this vulnerable population," said Cyrus Kosar, lead study author and a doctoral candidate in health services, policy and practice in Brown's School of Public Health.

Kosar conducted the analysis with principal investigator and Brown professor Vincent Mor, who has been researching the impact of COVID-19 in nursing homes since the beginning of the pandemic.

Long-term care residents have accounted for approximately 40% of total U.S. deaths from COVID-19. While data showed that mortality rates from the virus in the general population have declined overall, there was no evidence that nursing homes had similarly turned a corner. What's more, the researchers say, some of the factors contributing to reduced mortality rates in the general population, such as improved COVID-19 therapeutics and supportive care in hospitals, are not applicable to nursing home residents, who are often treated in the facilities where they reside instead of being admitted to a hospital.

"There are many different reasons why mortality rates could decrease in the general population," Kosar said. "We wanted to know specifically what was happening in the nursing home setting -- especially since it is hard to argue that there is any risk factor greater for COVID-19 infection and death than being in a nursing home."

The new study, which was published on the web on Thursday, March 11, and will appear in the April issue of Health Affairs, examined nursing home data in large providers of post-acute and long-term care services in 24 states through Nov. 15, 2020. The authors found that among 12,271 nursing home residents with COVID-19, 30-day mortality rates declined from a high of 20.9% in early April to 11.2% in early November.

The share of COVID-19 cases determined to be asymptomatic (and therefore less severe infections with a lower risk of mortality) increased over time, the researchers say, because of improvements in routine surveillance testing and the wider availability of personal protective equipment. Nevertheless, the researchers found that mortality risk declined for both symptomatic and asymptomatic residents, and also for patients with high and low baseline frailty levels.

What was happening, then? Kosar says that when the pandemic first hit nursing homes, the infectious nature of the virus caused it to quickly overwhelm facilities, leaving them unprepared, lacking in PPE and dealing with a high number of very sick patients.

"This was not empirically tested, but my interpretation is that at the very beginning of the pandemic, COVID-19 provided a real shock to the U.S. health care system and nursing homes in particular," Kosar said. "And that shock, unfortunately, cost a lot of lives."

Although more research is needed, the authors note in the study that mortality decreased with the improvements in PPE supply, staff adoption and skill with PPE and knowledge regarding the clinical management of COVID-19.

"The big drop in mortality we saw among nursing home residents, even while the nationwide risk of infection was increasing, speaks to the fact that nursing homes were better able to protect their residents with increased use of PPE and more frequent and rapid testing," said Mor. "This is actually a very positive development."

Although cancers that occur in the gallbladder or bile ducts are rare, their rates are increasing. A recent study provides details on the burden of gallbladder and biliary tract cancer (GBTC) across 195 countries and territories from 1990 to 2017. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society.

Determining GBTC estimates and trends in different global regions can help to guide research priorities and policies for prevention and treatment. With this in mind, a team of scientists examined publicly available information on GBTC from the Global Burden of Disease (GBD) project, an ongoing observational study that provides comprehensive burden levels and trends for all major diseases, injuries, and risk factors by region, sex, country, and age.

Findings from the study indicate that GBTC incidence increased by 76 percent, mortality increased by 65 percent, and disability-adjusted life years increased by 52 percent from 1990 to 2017. The researchers also estimated that, globally, there were 210,878 new cases, 173,974 deaths, and 3,483,046 disability-adjusted life years--the number of years lost from ill-health, disability, or early death--due to GBTC in 2017.

GBTC burden varied by sex, region, and age. Certain risk factors were also evident. Globally, an estimated 20.6 percent and 8.1 percent of GBTC-related deaths in females and males, respectively, were attributed to high body mass index.

"GBTC remains a major health burden worldwide. Our findings may be valuable for policymakers to establish cost-effective methods for the early diagnosis, prevention, and treatment of GBTC, reducing its modifiable risk factors, and reversing the increasing trend," the authors wrote.

Although the GBD Network is the source of the estimates used in this study, the authors of this paper are not members of the GBD collaborator network and were not involved in the production of these estimates. The GBD Network cannot speak to the accuracy of this description of the authors' methods, the fidelity of the reported estimates, or the rigor of the conclusions.

WASHINGTON--One in five adults with type 1 diabetes who require in-hospital treatment of the life-threatening condition diabetic ketoacidosis has an unplanned repeat hospital visit within a month and is twice as likely to die during the second hospitalization, a new study finds. The results, which will be presented at ENDO 2021, the Endocrine Society's annual meeting, also identified several factors that increased the readmission risk for these patients.

Diabetic ketoacidosis, which can occur from insufficient insulin medicine or from an infection, is a dangerous accumulation of acid in the blood due to excess glucose, or blood sugar. When severe, DKA can require hospitalization for fluid replacement and insulin therapy.

"Diabetic ketoacidosis is a feared complication of type 1 diabetes because it can lead to a diabetic coma and death," said the study's lead author, Hafeez Shaka, M.D., an internal medicine resident at John H. Stroger Jr. Hospital of Cook County, Chicago. "But we were surprised to find that the readmission rate after diabetic ketoacidosis treatment is so high."

For adults with type 1 diabetes who received diabetic ketoacidosis treatment in a hospital, the researchers studied the 30-day readmission rate and the factors that raised the risk of hospital readmission. They used a nationally representative data bank, the National Readmissions Database (NRD), the largest all-insurance payer database in the country, according to the Healthcare Cost and Utilization Project, the program that operates it.

Using the 2017 NRD database, Shaka and his colleagues found that 91,401 diabetic ketoacidosis-related hospitalizations involved adults with type 1 diabetes who were alive at discharge from the hospital. The rate of 30-day readmissions primarily due to diabetic ketoacidosis was 20.2 percent, involving 18,553 patients, he reported.

Women were more likely than men to be readmitted, as were patients who left the hospital against medical advice during the first admission. Other risk factors for readmission included having anemia, high blood pressure or chronic kidney disease, Shaka said.

Why women have higher rates of readmission is unclear, Shaka said. For patients who leave the hospital against medical advice, he speculated that they likely do not receive the education about blood sugar control and managing other medical conditions that they would typically get at discharge.

One reason for the high overall readmission rate could be that patients do not follow up with their diabetes care provider for glucose management, Shaka suggested. Individuals who experience diabetic ketoacidosis are at high risk of repeated episodes, he added.

The patients' subsequent admissions not only led to double the chance of in-hospital deaths compared with the first hospitalization. The researchers also found that repeated admissions were, on average, longer and generated significantly higher health care costs.

"Efforts should be channeled toward identifying the risk factors for readmission in hospitalized adult patients with diabetic ketoacidosis as well as ensuring proper discharge planning to decrease the burden of readmissions," Shaka said.

WASHINGTON--A new once-weekly basal insulin injection demonstrated similar efficacy and safety and a lower rate of low blood sugar episodes compared with a daily basal insulin, according to a phase 2 clinical trial. The study results, which will be presented at ENDO 2021, the Endocrine Society's annual meeting, compared an investigational drug called basal insulin Fc (BIF) with insulin degludec, a commercially available long-lasting daily insulin, in patients with type 2 diabetes.

"These study results demonstrate that BIF has promise as a once-weekly basal insulin and could be an advancement in insulin therapy," said Juan Frias, M.D., the study's principal investigator and the medical director of the National Research Institute in Los Angeles, Calif.

The reduced number of injections with weekly insulin may improve adherence to insulin therapy, which could result in better patient outcomes than for daily basal insulins, Frias said. Once-weekly dosing also may increase the willingness of patients with type 2 diabetes to start insulin therapy when oral medication alone no longer gives adequate blood glucose control, he added.

The 32-week clinical trial was conducted in 399 patients and sponsored by Eli Lilly and Company. All patients had type 2 diabetes and were previous users of basal insulin combined with oral antidiabetic medications.

The patients received random assignments to one of three treatment groups: once-weekly injections of BIF at one of two different dosing algorithms (with different goals for fasting blood glucose levels) or the standard once-daily injections of insulin degludec. One fasting glucose target for patients receiving BIF was 140 milligrams per deciliter (mg/dL) or less, and the other was at or below 120 mg/dL. The fasting glucose target for insulin degludec was 100 mg/dL or less.

Compared with insulin degludec, patients taking BIF achieved similar long-term blood glucose control, as measured by hemoglobin A1c, the researchers reported. Study participants had an average A1c of 8.1 percent at the beginning of the study and at the end of the study had an average improvement in A1c of 0.6 percent for BIF and 0.7 percent for insulin degludec, the data showed.

Additionally, BIF use resulted in significantly lower rates of hypoglycemia, or low blood sugar (less than 70 mg/dL). Severe untreated hypoglycemia is a dangerous complication that can cause seizures, loss of consciousness and death. Frias said BIF has "the potential of a flatter and more predictable action than the current daily basal insulins, which may have contributed to the lower rates of hypoglycemia."

Regarding safety, BIF had a generally comparable adverse event profile to that of insulin degludec, he said.

"Based on our promising data, further research with BIF has been initiated in patients with type 1 diabetes and other type 2 diabetes patient populations," Frias said.

WASHINGTON--Some patients with moderate to severe COVID-19 disease seem to experience inflammation of the thyroid gland that is different from thyroid inflammation caused by other viruses, according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

One-third of the study participants still had signs of thyroid inflammation after three months, even though their thyroid function had normalized. The study is following patients to determine whether this inflammation will trigger permanent thyroid dysfunction.

In spring 2020, 15 percent of the COVID-19 patients hospitalized in acute medicine units at Fondazione IRCCS Ca' Granda Policlinico Hospital of Milan in Italy had thyroid hormone alterations due to multi-factorial causes, including thyroid inflammation. In comparison, only 1 percent of hospitalized patients during the same period in 2019 prior to the pandemic had thyroid hormone alterations.

People with thyroiditis, or inflammation of the thyroid gland, triggered by other viruses usually recover thyroid function in the short term. However, there is a long-term increased risk of permanently reduced thyroid function, caused by late-onset effects of viral infection, or by the immune system attacking the thyroid gland, said lead researcher Ilaria Muller, M.D., Ph.D., of the University of Milan in Italy.

She wanted to find out whether the thyroiditis associated with SARS-CoV-2, the virus that causes COVID-19 disease, follows the same pattern as thyroid inflammation caused by other viruses. She started a surveillance program to monitor the thyroid function of patients every three months after being hospitalized for moderate to severe COVID-19 disease. The patients undergo routine blood and ultrasound testing to monitor their thyroid function and signs of inflammation.

Muller found the thyroiditis in people with moderate to severe COVID-19 disease differs from typical thyroiditis in several ways. These include the absence of neck pain, the presence of mild thyroid dysfunction, higher frequency among men and the association with severe COVID-19 disease.

So far, 53 patients have completed the evaluation at three months. All had normal thyroid function.

"After three months, patients' thyroid function has normalized, but signs of inflammation were still present in about one-third of patients," Muller said. "We are continuing to monitor these patients to see what happens during the following months. It is important to know whether SARS-CoV-2 virus has late-onset negative effects on the thyroid gland, in order to promptly diagnose, and eventually treat, the condition."

WASHINGTON--Treatment of hypothyroidism, which results from an underactive thyroid gland, should be individualized and consideration should be given to alternatives to the first-line therapy, including desiccated thyroid extract and combination therapy to replace the body's two main thyroid hormones, thyroxine (T4) and triiodothyronine (T3). Results of their new randomized clinical study are being presented at ENDO 2021, the Endocrine Society's annual meeting.

Combination therapy has been shown to be equally as effective as the standard treatment with levothyroxine alone, researchers say.

"There are now proven good treatment options for the more than one in 10 patients with hypothyroidism who continue to experience symptoms of fatigue, mental fogginess, weight gain and other symptoms despite taking levothyroxine," said the study's principal investigator, Thanh D. Hoang, D.O., a staff endocrinologist at Walter Reed National Military Medical Center in Bethesda, Md.

For some of these patients, Hoang said he has observed dramatic improvement--"a night and day difference"--in thyroid symptoms after they switch to desiccated thyroid extract (DTE), one of the drugs tested in the new study.

Also known as thyroid USP, DTE was the original treatment of hypothyroidism established almost 100 years ago. Unlike levothyroxine, which contains only one form of the thyroid hormone (thyroxine, T4), DTE comes from animal thyroids and contains both of the main thyroid hormones in the body, T4 and triiodothyronine (T3), Hoang said.

Past research from Hoang's group found that DTE safely led to modest weight loss and possible improvement in mental health over levothyroxine.

In their new study, Hoang and colleagues investigated the effectiveness of DTE in reducing thyroid symptoms as well as another combination therapy, levothyroxine plus liothyronine, the pharmaceutical grade version of T4 and T3. Although a few studies have shown that this combination works better than levothyroxine monotherapy in some patients, other studies failed to show superiority. As a result, doctors do not always consider it when patients respond poorly to levothyroxine, Hoang said.

The investigators randomly assigned 75 adults with hypothyroidism to three months' treatment, with one of three drugs: DTE, levothyroxine-liothyronine combination, or levothyroxine alone. At the end of three months, the patients then randomly received a different treatment for three months, and finally took the third drug regimen for the last three months. Neither the patients nor the investigators were aware of which drug the patients were taking. After each treatment arm, patients completed a questionnaire of their thyroid symptoms.

The researchers found no significant difference between any of the three treatments in symptom relief. However, most patients reported a preference for combination therapy over levothyroxine alone, according to Hoang. Among the study participants, 45 percent reportedly preferred DTE over the other two treatments, 32 percent preferred the levothyroxine-liothyronine combination, and 23 percent preferred levothyroxine alone. Patients were more likely to prefer combination therapy if they had Hashimoto's disease, an autoimmune disease that is the most common cause of hypothyroidism in the U.S.

Because Hoang said it would be helpful for doctors to select which patients would initially respond better to a combination treatment than to levothyroxine alone, the researchers are further studying their data to find potential predictors of treatment response.

WASHINGTON--New genetic research suggests men can develop characteristics of polycystic ovary syndrome (PCOS)--a common metabolic and reproductive disorder that affects women. The study was presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

PCOS is a common disorder characterized by irregular menstrual periods, disruption of normal metabolism and elevated testosterone levels. PCOS affects up to 10% of all women of reproductive age. The disorder can lead to obesity, diabetes and cardiovascular disease, which are often life-long conditions.

Men who have genetic risk factors for PCOS face an increased risk of obesity, diabetes and cardiovascular disease as well as male pattern baldness, the study found.

Because men do not have ovaries, the findings show for the first time that the primary cause of PCOS may not be linked to the ovaries.

"The treatment of PCOS is limited by our incomplete understanding of the disorder," said lead researcher Jia Zhu, M.D., of Boston Children's Hospital. "Identifying the different causes for PCOS provides insights into the mechanisms of disease and is the first step in identifying future targets for treatment of the disorder."

The researchers used genetic data from 176,360 men in the United Kingdom to estimate genetic susceptibility for PCOS. They tested for associations with metabolic disorders (obesity, diabetes, and cardiovascular disease) and male-pattern baldness. Men who had a high genetic risk score for PCOS had increased risk of obesity, diabetes, cardiovascular disease and male-pattern baldness.

"By demonstrating that genetic risk factors for PCOS are associated with obesity, diabetes and cardiovascular disease and male-pattern baldness in men, we show that these genetic risk factors do not require ovaries to result in the characteristics of PCOS," Zhu said. "Thus, at least in some cases, the reproductive dysfunction of PCOS may be caused by biological mechanisms common to both men and women. Future studies of the genetic risk factors for PCOS could help us to better understand the causes and potential treatment targets for PCOS."

WASHINGTON--A study in mice finds treatment with a molecule called MCB-613 repairs heart tissue after a severe heart attack, preventing damage that can lead to heart failure. The findings are being presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

"This is a remarkable discovery that may lead to effective and safe treatments to prevent the progression to heart failure after a heart attack," said lead researcher Lisa K. Mullany, Ph.D., of Baylor College of Medicine in Houston.

Heart failure after a heart attack is the leading cause of death in humans, and currently there are no definitive therapies other than heart transplantation.

Researchers had previously found that MCB-613 stimulates proteins called steroid receptor coactivators (SRCs). These proteins are responsible for cellular changes and growth during both normal and abnormal tissue growth. After a heart attack, the damaged tissue scars. This results in tissue loss, as well as increased inflammation, scarring and decrease in heart function--all hallmarks of heart failure caused by a heart attack.

In the new study, the researchers were able to show that when mice were given MCB-613 within hours after a heart attack, the molecule decreased inflammation and scarring, and prevented the progressive decrease in heart function.

"Our findings show us that we can directly modulate heart tissue repair to prevent heart failure," Mullany said.

WASHINGTON--People with obesity who are hospitalized with COVID-19 have a significantly higher rate of ICU admissions and longer duration of ICU stay compared to people with a normal body mass index (BMI), according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

"The association between obesity and a more severe clinical course of COVID-19 highlights the vulnerability of this population during the current pandemic and the need for public health efforts to prevent and treat obesity, in the current pandemic and beyond," said lead researcher Yu Mi Kang, M.D., Ph.D., of Yale New Haven Health in New Haven, Conn.

More than 40% of Americans live with obesity, one of the significant risk factors for COVID-19. Kang and colleagues wanted to determine and describe the impact of obesity on the clinical course of COVID-19, compared with individuals who do not have obesity.

The researchers analyzed data from 3,268 adult patients hospitalized with COVID-19 at five hospitals within the Yale New Haven Health System between March and November 2020.

Among hospitalized patients, 43% had obesity, 15.8% died, and 24.2% required ICU-level care. Patients with obesity were 26% more likely to need ICU care overall than patients who did not have obesity. COVID-19 patients with higher body-mass index (BMI) measurements were even more likely to require ICU care. Individuals with severe obesity, or a BMI of 40 or higher, were twice as likely to need ICU care compared with patients with a normal BMI. The study did not find a higher risk of death in people with obesity compared to those with normal BMI.

"Our work underscores the impact of obesity on the course of COVID-19 and emphasizes the need to ensure that obesity is given appropriate consideration for risk stratification, vaccination protocols and in-hospital COVID-19 management," Kang said.

WASHINGTON--Children with poorly controlled type 1 diabetes have a 10 times higher risk of COVID-19-related complications and death compared to those with well-controlled diabetes, according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

"This study shows keeping diabetic children's blood sugar under control is more important than ever during the pandemic," said lead author Manish Raisingani, M.D., of the University of Arkansas for Medical Sciences and Arkansas Children's in Little Rock, Ark. "The findings will help children with type 1 diabetes and their families make better choices about the safety of attending school in person and engaging in other in-person activities during this pandemic."

Some data suggests that adults with type 1 diabetes may have a higher risk of COVID-19 complications and death, but there has been limited research on children. Raisingani analyzed data on children under age 18, using an international database that collects real-time electronic medical records data. The researchers reviewed data on about 2,000 children with type 1 diabetes and COVID-19, as well as more than 300,000 children with COVID-19 who did not have type 1 diabetes.

The study analyzed hemoglobin A1c levels in the children with diabetes. A1c is a simple blood test that measures a person's average blood sugar levels over the past three months. It is the main test to help people manage their diabetes. Higher A1c levels are linked to diabetes complications. The goal for most people with diabetes is an A1c level of 7% or less.?

Raisingani found that in children with A1c levels higher than 9%, the risk of COVID-19 complications was 10 times higher compared with children whose A1c levels were under 7%, indicating well-controlled diabetes. Children with type 1 diabetes and COVID-19 were more likely to die, to require an endotracheal tube to help them breathe, to develop pneumonia, or to develop septic shock, compared with children who had COVID-19 and did not have type 1 diabetes.

"Many parents of children with type 1 diabetes are wondering if it's safe to send their child to school during the pandemic," Raisingani said. "Our findings indicate that if their A1c is high, it would be best to have them attend virtual school, but if it's 7% or under, their risk is similar to other children without type 1 diabetes."

WASHINGTON--Blood glucose levels improved among children and teens with type 1 diabetes during the first 12 weeks of COVID-19 lockdown in the United Kingdom, according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

"The findings demonstrate the difficulties faced by patients and families managing type 1 diabetes around school pressures, meals away from home, social life and peer pressure," said lead researcher Neil Lawrence, M.B.Ch.B., of Sheffield Children's Hospital NHS Foundation Trust in Sheffield, United Kingdom. "Children and families found it easier to manage this disease when they were forced to stay at home. This helps us to understand the pressure that is put on patients and families when trying to live normal busy lives with activities outside of the home. We need to give them extra support at school and when they go out socializing to prevent them from developing unfortunate complications in later life."

U.K. hospitals had to implement many changes in care for individuals with diabetes and other chronic diseases during the global pandemic. The researchers wanted to know if these changes were detrimental to the care of children and adolescents with type 1 diabetes. Some clinicians and families were concerned that remote consultations would result in poorer care.

To investigate this question, the researchers looked at how well 180 children and teens in two U.K. communities controlled their type 1 diabetes in the 12 weeks before the COVID-19 national lockdown was announced on March 23, 2020, compared with the 12 weeks after the lockdown was put in place.

They found a significant improvement in blood glucose measurements in the 12 weeks after the lockdown compared with the 12 weeks before the lockdown. The average blood sugar dropped, long-term blood sugar measurement (HbA1c) dropped, and blood sugar readings showed less variability and a greater time in the range of blood sugar that the researchers asked them to aim for (3.9 to 10mmol/L).

"Managing type 1 diabetes around school, socializing and extra-curricular activities is really challenging, and children with this disease need parents, teachers and other caregivers to communicate well and work as a team to prevent long-term health complications that are caused by poor blood glucose control," Lawrence said. "This gives us important insights into where advice, education and support should be directed, as well as encouraging the use of remote video and phone consultations going forward. These approaches can be beneficial both for families and for clinicians."

WASHINGTON--Women with obesity and polycystic ovarian syndrome (PCOS) are at increased risk of developing type 2 diabetes, according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting. Normal-weight women with PCOS are not at increased risk, the researchers found.

Women with PCOS had a more than three-fold increased risk of developing type 2 diabetes during their lifetime, the study found. This risk was evident only in women who met the criteria for overweight or obesity, but not in lean women.

"We strongly suggest weight management in women with obesity and PCOS in an attempt to reduce this major risk of developing type 2 diabetes," said lead researcher Sarantis Livadas, M.D., Ph.D., of Athens Medical Center in Athens, Greece.

PCOS is a common disorder characterized by irregular menstrual periods, disruption of normal metabolism and excessive hair growth. PCOS affects up to 10% of all women of reproductive age. The disorder can lead to obesity, diabetes and cardiovascular disease, which are often life-long conditions. Between 50%-80% of women with PCOS have obesity, and obesity is known to be a risk factor for diabetes.

The link between PCOS and diabetes has been based on a small number of studies, mostly evaluating women with the condition and obesity.

In the new study, the researchers analyzed 23 previous studies in order to assess the impact of obesity in subsequent type 2 diabetes development in women with PCOS. The studies included a total of 60,336 women with PCOS and 259,444 without the disease. A total of 8,847 women in the studies had type 2 diabetes.

"We conclude that only women with PCOS and obesity have an increased risk for type 2 diabetes development, in contrast to the current notion that all women with PCOS have a significant risk for developing type 2 diabetes," said Livadas. "This finding underscores the impact of early detection of this PCOS population and prompt lifestyle modification to avert the development of type 2 diabetes."