Daily Endocrinology Research Analysis
Across endocrinology-related research, a very large prospective cohort links maternal protein intake with opposing risks for mothers and children, a randomized trial shows intranasal insulin does not improve cognition in multiple sclerosis, and multi-database analyses confirm higher incidence of new-onset diabetes after COVID-19. Together, these studies refine preventive nutrition strategies, temper expectations for neuroendocrine repurposing, and reinforce post-infection metabolic surveillance.
Summary
Across endocrinology-related research, a very large prospective cohort links maternal protein intake with opposing risks for mothers and children, a randomized trial shows intranasal insulin does not improve cognition in multiple sclerosis, and multi-database analyses confirm higher incidence of new-onset diabetes after COVID-19. Together, these studies refine preventive nutrition strategies, temper expectations for neuroendocrine repurposing, and reinforce post-infection metabolic surveillance.
Research Themes
- Prenatal nutrition and metabolic programming
- Neuroendocrine therapeutics for cognition
- Post-viral diabetogenesis and risk stratification
Selected Articles
1. Maternal protein intake during pregnancy and obesity risk in mothers and offspring: a prospective cohort study.
In 66,360 pregnancies, lower protein intake (diluted by higher fat/carbohydrate) was linked to higher maternal postpartum weight retention but lower offspring birth weight and BMI z-scores through adolescence. Nonlinear associations around a ~15% protein threshold indicated reduced SGA but increased LGA and childhood overweight/obesity with higher protein, revealing maternal–offspring trade-offs.
Impact: This very large prospective cohort quantifies a macronutrient trade-off between maternal and offspring obesity-related outcomes, providing actionable insights for prenatal nutrition policy and counseling.
Clinical Implications: Prenatal dietary counseling may target a balanced protein proportion near ~15% of energy to minimize postpartum weight retention while avoiding excess LGA and childhood overweight/obesity risk; shared decision-making should weigh maternal and offspring outcomes.
Key Findings
- Lower maternal protein (%) was associated with higher postpartum weight retention at 6 and 18 months.
- Higher protein intake showed nonlinear associations: reduced SGA but increased LGA risk around a ~15% protein threshold.
- Each 5% higher protein was linked to lower substantial PPWR risk (OR 0.90 at 6 mo; 0.88 at 18 mo) but higher childhood OWOB risk at 7 y (OR 1.07) and 11 y (OR 1.11), with no association at 14 y.
Methodological Strengths
- Very large prospective cohort with detailed dietary assessment and multiple maternal/offspring outcomes over up to 14 years.
- Advanced mixture models and restricted cubic splines to capture macronutrient interactions and nonlinearities.
Limitations
- Observational design with potential residual confounding and self-reported dietary intake.
- Findings from a Danish cohort may limit generalizability to diverse populations.
Future Directions: Randomized feeding trials or pragmatic interventions to test protein proportion targets, mechanistic studies on placental and hormonal mediators, and equity-focused replication in diverse populations.
2. Intranasal insulin for improving cognitive function in multiple sclerosis.
In a phase Ib/II randomized, double-blind, placebo-controlled trial in MS, intranasal insulin (10 or 20 IU twice daily for 24 weeks) was safe but did not improve the SDMT or secondary cognitive outcomes versus placebo. The negative efficacy results, despite biologic plausibility, highlight challenges in translating neuroendocrine modulation to clinical benefit in MS.
Impact: A rigorous RCT provides clear negative evidence on a widely discussed neuroendocrine strategy, refining therapeutic development and preventing premature clinical adoption.
Clinical Implications: Current evidence does not support intranasal insulin for MS-related cognitive impairment over 24 weeks; future studies may require longer duration, enriched populations with lower cognitive reserve, biomarker stratification, or alternative endpoints.
Key Findings
- Phase Ib/II RCT (n=105; 69 with follow-up) found no difference in SDMT or secondary cognitive outcomes versus placebo after 24 weeks.
- Intranasal insulin was generally safe and well tolerated; common AEs included headache, rhinorrhea, and dizziness; 13 SAEs were not drug-related; no deaths.
- Stratified randomization by MS subtype; limitations included small sample size for three arms, COVID-era missingness, and potential outcome insensitivity.
Methodological Strengths
- Randomized, double-blind, placebo-controlled design with stratification by MS subtype.
- Safety rigor with detailed adverse event monitoring and multi-dose evaluation.
Limitations
- Small effective sample across three arms and data missingness during COVID-19 may reduce power.
- Outcome measures may have limited sensitivity; 24-week duration may be insufficient to detect changes.
Future Directions: Consider longer trials, cognitive enrichment strategies, pharmacodynamic biomarkers (e.g., CNS insulin signaling), and combination approaches to enhance efficacy.
3. Comparison of the association between COVID-19 and new onset diabetes in a regional and national dataset.
Across three databases, COVID-19 infection was associated with higher incidence of new-onset diabetes, with HRs 3.46 (UKHC) and 2.13 (MarketScan), and elevated risk even in outpatients but especially in hospitalized/treated patients. Type 1 diabetes risk was also elevated (HR 1.61).
Impact: Multi-database concordant evidence strengthens the association between COVID-19 and incident diabetes, informing screening strategies and long-COVID metabolic follow-up.
Clinical Implications: Post-COVID metabolic surveillance should include diabetes screening, with heightened vigilance after hospitalization or severe infection; health systems should prepare for increased diabetes incidence in post-COVID populations.
Key Findings
- COVID-19 infection increased incident diabetes across all datasets with adjusted HRs of 3.46 (UKHC) and 2.13 (MarketScan).
- Risk elevation was observed even in outpatients and was substantially higher in inpatients requiring interventions.
- Type 1 diabetes incidence was also higher in MarketScan (HR 1.61).
Methodological Strengths
- Use of multiple large datasets with distinct populations and control groups including pre-pandemic and COVID-era non-infected comparators.
- Time-to-event modeling with adjusted hazard ratios and inpatient/outpatient stratification.
Limitations
- Retrospective design with potential confounding, ascertainment, and coding biases; exact sample sizes per dataset not provided in the abstract.
- Findings reflect the initial 18 months of the pandemic and may not generalize to later variants or vaccination eras.
Future Directions: Prospective surveillance with laboratory confirmation, glycemic phenotyping, and mechanistic studies of beta-cell and insulin resistance pathways; evaluate mitigation via vaccination and antiviral therapy.