A Message From the Section Chair
At a very basic level, all disease can be viewed as metabolic disease, and all clinical illness can be related to the disruption of normal function by perturbations of metabolic processes. The development of a cataract, the behavioral swings of a manic-depressive patient, the impaired myocardial function after coronary artery occlusion, the progressive dementia of Alzheimer’s disease, and the generalized wasting of endstage AIDS all represent metabolic processes that have gone amuck.
The endocrine system is involved at multiple levels in the maintenance of normal bodily function and in the response to the stresses that threaten the well-being of the whole organism; the endocrine system is oriented toward the preservation of a milieu that permits optimal efficiency of each individual physiologic process (thereby promoting the ultimate survival of the whole being). Homeostatic balance requires innumerable responses of astonishing sophistication and complexity in an ever-changing external and internal environment. Because of the life-maintaining importance of the endocrine system, it is not surprising that some to the most severe disease processes can occur when this regulatory system goes awry. The endocrine system is designed to maintain consistency of fuel and energy and nutrients, and to compensate for damage and stress from virtually any source of pathology. However, when the precipitating pathology is actually within the endocrine system itself, the ability of system to self-correct is extremely limited, and the results can be dire.
The intellectual challenges of better understanding these complexities, and then in applying the new knowledge to patient care, are at the root of all the activities of the Section on Endocrinology and Metabolism at the Wake Forest University School of Medicine.
--K. Patrick Ober, M.D.