Among the many advances in endocrinology in the past decade, three have been singled out for discussion: the discovery of cellular receptors, the concept that diabetes is more than one disease, and the newer aspects of pituitary therapy with emphasis on hyperprolactinemic states. Advances in these areas have profoundly altered our current concepts and treatment of disease.
Discovery of Cell Receptors
The identification of cell receptors has been central in increasing our understanding of familial hypercholesterolemia. One form of this disorder seems to result from a defect in low-density lipoprotein (LDL)-cholesterol receptors, which in turn diminishes the cell's ability to internalize cholesterol.1 Since intracellular LDL-cholesterol concentration regulates the feedback suppression of endogenous cholesterol synthesis, this inability to internalize LDL results in unabated production of cholesterol by the cells.It has been estimated that the heterozygous form of familial hypercholesterolemia occurs in one of every 500 people in the general population.