RECENT ADVANCES Advances in endocrinology

New developments in endocrinology, in common with many specialised branches of medicine, have been dominated by advances in molecular genetics. Although these investigations relate to rare single gene disorders, they have resulted in major breakthroughs in many fields of endocrinology, significantly contributing to our understanding of the cellular mechanisms of hormone action. However it is not just the minute detail of single gene disorders and hormone action that has caught the attention of endocrinologists in recent years. This review will also focus on two broader health issues, one epidemiological and the other therapeutic. The studies of Barker and colleagues have introduced the concept that disease in adult life has its origin in the fetal environment, and that this process can be attributed to changes in the programming of fetal endocrine axes. On the therapeutic agenda, the most dramatic advance in endocrinology occurred over a decade ago with the introduction of recombinant human growth hormone (hGH). This created wide interest in the use of growth hormone treatment in growth disorders with or without associated hypopituitarism. It is appropriate therefore to summarise our long term experiences with hGH as the first generation of these children achieve final height. Finally the isolation and characterisation of a new hormone is a rare event in the 1990s. Therefore the discovery of the satiety factor, leptin, initially heralded as a potential cure for obesity, has attracted considerable media as well as scientific interest and merits due consideration in this review.