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The Orchestration of Hormones Influences Diabetes and Obesity

Posted By Prucia Buscell, Wednesday, December 23, 2009
Updated: Thursday, February 17, 2011
The hormones that govern metabolism and other vital bodily functions act like "individual musicians playing together in a philharmonic orchestra producing the most melodic, beautiful symphonies," an endocrinologist says. Understanding the complex interplay has already led to a new diabetes therapy, and it may eventually help curtail obesity.

Christian Weyer, MD, studied endocrinology and metabolism at the University of Dusseldorf Medical Center in Germany and worked as a visiting researcher at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) in Phoenix, Arizona. The NIDDKD spent decadesstudying diabetes and obesity among Pima Indians, a population that has the world's highest reported rates of both disorders. In"Hormones in Concert," an article in, Dr. Weyer explains he was intrigued by the complexity and elegance of the way hormonal signaling systems work.

"Some hormones, such as insulin, thyroid hormone, or cortisol, and 'major players', and their deficiency or excess can result in life-threatening metabolic derangements," he writes. "Others, such as calcitronin, pancreatic polypeptide or amylin, can be viewed as complementary signals that enhance or 'fine tune' a tightly regulated metabolic process. In many cases the central nervous system orchestrates and balances these hormonal interactions, serving in the role of conductor."

Dr. Weyer became convinced that people who immediately regain recently lost weightare not just lacking willpower. Instead, they are experiencing what he terms neuroendocrine-mediated metabolic compensation, an involuntary bodily response in which their systems promote weight regain by conserving energy and boosting appetite. For the last decade, Dr. Weyer has worked for Amylin Pharmaceuticals, which produced two new drugs to treat diabetes that were approved by the FDA in 2005.

In studies on overweight rats, Dr. Weyer and colleagues at Amlyn found that the weight of the rodents could be normalized with double and tripple combinations of hormones that did not achieve such results alone. Their theory was that food intake and body weight are regulated by a sophisticated interplay of hormonal signals from fat cells, (leptin) and calls from the pancreas, (amlyn), and gut cells. The syngergistic interaction between amlyn and leptin led to sustained and substantial weight loss in obese rats, he reports. While results of the company's small studies on human volunteers have been encouraging, Dr. Weyer says it may be years before the endocrine solutions are available as therapy for human obesity.

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