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Dr. Harriet Mae Carter, Brisbane (2025)

01/08/2025

Endocrine Metabolism: The "Triangle Relationship" of Fat, Liver, and Blood Vessels
In the field of endocrine metabolism, the interaction between fat, liver, and blood vessels profoundly influences the progression of diabetes, fatty liver disease, and cardiovascular disease. This diagram illustrates the key logic:
1. Fat Cells: Storing Oil and Transmitting Signals
Adipocytes develop from precursor cells. Hypoxia activates FASN, G6PD, and ACC, driving their maturation and accumulation of fat. Simultaneously, adipocytes release extracellular vesicles (EVs), which act like "metabolic couriers" to transmit signals to the liver, blood vessels, and other organs, triggering systemic changes.
2. Liver: The Center Attacked by Fat
EV signals drive the liver's progression from steatohepatitis to fibrosis. Activating "driving forces" like PAI-1 and MMP-7 promotes the progression from fatty liver to hepatitis and then to fibrosis, contributing to the high incidence of liver disease in diabetic patients. Furthermore, when insulin resistance occurs, the TLR4/TRIF pathway is activated, causing monocytes to transform into macrophages, releasing inflammatory factors that exacerbate liver inflammation and affect blood sugar control. III. Blood Vessels: The Terminal Station of Metabolic Disorders
Endothelial damage is the trigger for myocardial and cerebral infarction in patients with metabolic diseases. Abnormal EV signaling and inflammatory factors damage the endothelium, causing blood vessels to harden and narrow, making them more susceptible to thrombosis. This increases the risk of cardiovascular disease in patients with diabetes and fatty liver disease.
IV. Clinical Implications: Breaking the Imbalance to Protect Health
Disease management requires more than just focusing on blood sugar and lipids; attention must also be paid to adipocyte function and blocking harmful EV transmission. Treatment of liver fibrosis requires regulating insulin resistance and combating vascular inflammation. To prevent cardiovascular complications, early improvements in fat metabolism and liver protection can reduce vascular damage.
The fat-liver-blood vessel interaction is the "invisible link" linking endocrine and metabolic diseases. Understanding the diagram can accurately break the cycle of metabolic disorder and safeguard health.

25/02/2025

On the journey of medicine, every breakthrough stems from a reverence and dedication to life. I'm honored to have spent many years in the field of endocrinology and metabolism. This honor belongs to every colleague who has fought alongside me, and even more so to the patients who trust us. In the future, I will continue to protect health with my expertise, ignite hope with my passion, and bring scientific diagnosis and treatment, as well as warm care, to more people.

25/02/2025

Today, we'll introduce you to the endocrine system, the "commander" of metabolism and health. These glands silently regulate key functions of the body, including metabolism, growth, and reproduction!
1. Hypothalamus + Pituitary Gland + Pineal Gland (The Brain's "Control Center")
✅ Hypothalamus: Acts like a "general dispatcher," sensing the body's needs and secreting hormones to regulate the pituitary gland, connecting the nervous and endocrine systems.
✅ Pituitary Gland: Known as the "endocrine command tower," it secretes growth hormone, thyroid-stimulating hormone, and other hormones to regulate glandular functions throughout the body.
✅ Pineal Gland: Secretes melatonin, controlling circadian rhythms (sleep-wake cycles). Staying up late disrupts this rhythm, easily leading to metabolic imbalances!
2. Thyroid Gland + Parathyroid Gland (Metabolic "Speed Regulator")
✅ Thyroid: Secretes thyroid hormones, regulating the body's metabolic rate! Overactive (hyperthyroidism) causes palpitations and weight loss; underactive (hypothyroidism) causes fatigue and weight gain.
✅ Parathyroid Gland: Regulates calcium and phosphorus metabolism, maintaining bone health. Abnormal function can lead to osteoporosis and blood calcium imbalances.
3. Adrenal Glands ("Stress Responders")
Located above the kidneys, they secrete cortisol (for stress response) and adrenaline (for emergency response). Long-term stress and cortisol imbalances can easily lead to obesity and blood sugar abnormalities!
4. Pancreas ("Blood Pressure Regulator")
Tucked away in the abdominal cavity, pancreatic islet cells secrete insulin (for lowering blood sugar) and glucagon (for raising blood sugar). An imbalance between these two hormones leads to diabetes!
5. Go**ds ("Double Housekeepers" of Reproduction and Metabolism)
✅ Ovaries (Female): Secrete estrogen and progesterone, regulating menstruation and fertility, and also influencing fat distribution (female body shape).
✅ Te**es (Male): Secrete androgens, maintaining masculine characteristics, supporting muscle growth, and regulating metabolism.
6. Thymus ("Immune + Endocrine System Crossover")
Primarily involved in immunity, they also secrete thymosin. Gradually shrinking after puberty, they serve as a "bridge" between the immune and endocrine systems. The core role of the endocrine system:
The hormones secreted by these glands act like "chemical messengers" that precisely regulate metabolism (blood sugar, blood lipids, energy expenditure), growth and development, and reproductive function. Malfunctioning of any gland (excessive or insufficient hormone production) can lead to metabolic disorders (such as diabetes, hyperthyroidism/hypothyroidism), reproductive problems (irregular menstruation, infertility), and other conditions.

25/02/2025

Today, I'll break down this diagram of the male and female endocrine systems to understand the metabolic health logic behind the similarities and differences.
1. "Common Commander": Core Glands in the Head
For both men and women, the hypothalamus, pituitary gland, and pineal gland are the "headquarters" of the endocrine system:
✅ Hypothalamus: Like a "smart sensor," it senses changes in blood sugar and body temperature, secreting hormones to regulate the entire body.
✅ Pituitary gland: Called the "hormone commander," it secretes growth hormone, thyroid-stimulating hormone, and other hormones, managing growth, metabolism, and reproduction.
✅ Pineal gland: Secretes melatonin, regulating circadian rhythms (sleep-wake cycles). Staying up late disrupts this hormone, leading to metabolic disorders in both men and women!
2. "Universal Metabolic Regulator": Neck and Abdominal Glands
✅ Thyroid and Parathyroid Glands (Neck):
Thyroid hormones regulate the entire body's metabolic rate. Hyperthyroidism in both men and women causes anxiety and weight loss, while hypothyroidism causes fatigue and weight gain. The parathyroid gland regulates calcium and phosphorus levels, and an imbalance in these levels can lead to osteoporosis.
✅ Thymus (Chest):
Involved in cross-disciplinary immune and endocrine regulation, it atrophies after puberty, linking immunity and metabolism for both men and women.
✅ Adrenal Cortex + Kidneys + Pancreas (Abdomen):
The adrenal cortex secretes cortisol (to cope with stress). Chronic stress can lead to cortisol imbalances in both men and women, leading to obesity and high blood sugar.
The pancreas secretes insulin and glucagon, regulating blood sugar. Diabetes, regardless of gender, is caused by abnormal pancreatic islet function!
III. "Gender-Specific Glands": The Intertwining of Reproduction and Metabolism
✅ Female-Specific: Ovaries + Uterus
The ovaries secrete estrogen and progesterone, which not only control menstruation and fertility but also influence fat distribution (making women more rounded) and bone health. Fluctuations in estrogen levels (such as during menopause) can predispose women to metabolic disorders (weight gain and abnormal blood sugar levels).
✅ Male-Specific: Testicles
The testicles secrete androgens, which maintain masculine characteristics, aid muscle synthesis, and regulate metabolism. Androgen deficiency can lead to muscle loss, fat accumulation, and a slower metabolism in men. IV. "Cooperation and Differences" in the Endocrine System Between Men and Women
Similarities: The core regulatory axis (hypothalamus-pituitary) and basal metabolic glands (thyroid, pancreas, etc.) function logically in a similar way, leading to many common diagnostic and treatment approaches for metabolic disorders (such as diabetes and hyperthyroidism) in both s*xes.
Differences: The s*x hormones secreted by the go**ds (ovaries/testes) contribute to distinct metabolic characteristics in men and women (for example, metabolic changes during menopause are more complex in women). Therefore, gender-specific hormone fluctuations must be considered during diagnosis and treatment.
Doctor’s Reminder:
Regardless of gender, if you experience sudden weight changes, fatigue, menstrual/s*xual dysfunction, or blood sugar fluctuations, do not ignore endocrine issues!

25/02/2025

Appetite and Hunger Hormones
How these hormones regulate our appetite and metabolism!
1. Leptin—the "Satiety Hormone"
Produced by fat cells. When fat stores are plentiful, leptin is secreted into the bloodstream and signals to the brain, "Hey, I'm full of energy! Stop eating!" It helps suppress appetite and maintain energy balance. If leptin resistance develops (common in obesity), the brain loses its "fullness" signal, which can lead to overeating.
2. Ghrelin—the "Hunger Hormone"
Produced by the stomach and intestines. When the stomach is empty, ghrelin levels rise, signaling to the brain, "I'm hungry! Time to eat!" It stimulates appetite and promotes food intake. After a meal, ghrelin levels decrease.
3. Insulin—the "Blood Sugar Regulator"
Produced by the pancreas. After a meal, blood sugar rises, and insulin is released to help muscle and fat cells absorb glucose, thereby lowering blood sugar. They also interact with the brain to regulate appetite—normal insulin signaling helps us feel moderately full.
4. Incretins—"Blood Sugar Helpers"
After eating, incretins are secreted by the intestines and act on the pancreas to stimulate insulin secretion, helping to regulate post-meal blood sugar. Some diabetes medications (such as GLP-1 agonists) exploit this mechanism to aid blood sugar control.

Hormones "Teamwork"
These hormones communicate with each other and the brain, forming a complex regulatory network:

Leptin and ghrelin are like "opposites": one suppresses appetite, the other stimulates it.

Insulin and incretins work together to control post-meal blood sugar and influence satiety.

Why is this so important for metabolism?

Disruptions in these hormones (such as leptin resistance and abnormal ghrelin secretion) are closely linked to obesity, diabetes, and other metabolic diseases. For example:

In obesity, leptin resistance prevents the brain from recognizing "fullness" signals, leading to persistent food cravings. In diabetes, abnormal insulin secretion or action disrupts blood sugar regulation and affects energy metabolism.
As endocrinologists, we frequently assess the function of these hormones when managing weight and blood sugar issues. We use medications or lifestyle interventions (such as diet and exercise) to help restore balance to this hormonal network and improve metabolic health!
Understanding these hormones can help us better control our appetite, manage our weight, and prevent metabolic disease—let's work together to maintain our body's "homeostasis."

25/02/2025

The hospital's corridors bear witness to our race against time. In the diagnosis and treatment of endocrine and metabolic diseases, every precise judgment stems from meticulous attention to detail, and every patient response carries the responsibility of a life entrusted to us. We strive to safeguard metabolic balance with expertise and illuminate the light of health with compassion.

25/02/2025

In the field of endocrinology and metabolism, adipose tissue is more than just a "fat storage depot"! This image reveals the mysterious interplay between immune and metabolic cells within adipose tissue, helping us understand the key mechanisms behind obesity, insulin resistance, and metabolic diseases:
1. Adipose tissue's "residents": A family of cells
The large yellow cells in the image are adipocytes, responsible for storing fat and secreting adipokines (such as leptin and adiponectin, which regulate metabolism); the red lines are blood vessels, responsible for delivering nutrients and signals to adipose tissue; and two types of immune cells:
ATMs (adipose tissue macrophages, pink): the "immune guardians" of adipose tissue, with diverse functions that influence inflammation and metabolism;
Eosinophils (blue-purple): often overlooked immune cells that are actually "hidden regulators" of fat metabolism. II. The "Dialogue" Between Immunity and Metabolism: Key Signal Transmission
The enlarged image in the upper right corner illustrates the core of the communication between adipocytes and immune cells:
✅ IL-4 (yellow triangles): Signals released by immune cells can guide adipocyte ATMs to initiate anti-inflammatory and pro-metabolic responses, acting like a "health switch" for adipocyte ATMs.
✅ CD206/CD301 (black symbols): These are "receiving antennas" on the surface of adipocyte ATMs, specifically capturing signals like IL-4 and initiating subsequent responses.
✅ Arg1 (Arginase 1, indicated by pink arrows): After activation by IL-4, adipocyte ATMs "turn on" Arg1, converting it into an anti-inflammatory metabolic helper.
✅ IL-10 (green squares): Anti-inflammatory factors secreted by converted adipocyte ATMs can reduce adipose tissue inflammation and protect metabolic function.
✅ Adipokines (orange spheres): Metabolic signals secreted by adipocytes, in turn, influence immune cells, forming a "two-way dialogue." 3. Importance to Metabolic Health: Anti-Inflammation = Protecting Metabolism
When adipose tissue is healthy (for example, after exercise, at a normal weight), anti-inflammatory signaling such as IL-4 is active, and ATM exerts its anti-inflammatory effects and secretes IL-10. Adipocytes can then normally secrete beneficial adipokines (such as adiponectin). A good vascular supply ensures smooth metabolism, enhanced insulin sensitivity, and stable blood sugar and lipid profiles.
However, when adipose tissue is under significant stress (for example, from chronic overeating, lack of exercise, or obesity), IL-4 signaling is weakened, and ATM activates its pro-inflammatory role, actively releasing inflammatory factors. This disrupts adipocyte function (for example, low adiponectin levels, leptin resistance) and may cause vascular damage, leading to insulin resistance, diabetes, and hyperlipidemia.
IV. Clinical Implications: Fighting Adipose Inflammation to Protect Metabolism
For endocrinologists, this chart serves as a reminder:
✅ Don't let fat trigger inflammation: Obesity and sedentary lifestyles disrupt the immune-metabolic dialogue, transforming adipose tissue from a healthy exchange platform into an inflammatory battlefield. Therefore, the essence of weight control and increased exercise lies in protecting the immune system within fat.
✅ Anti-inflammatory = Protecting Metabolism: In the future, supplementing IL-4 signaling and activating Arg1 may help obese patients repair adipose immune disorders and improve insulin resistance and fatty liver disease.
✅ Focus on adipokines: Testing for adiponectin (such as adiponectin) can detect metabolic risks earlier than dysglycemia and dyslipidemia.

22/07/2024

Gain new knowledge through exchanges at the forefront of medicine and explore the infinite possibilities in the field of endocrinology and metabolism with colleagues. Every in-depth discussion is aimed at better protecting patients' health.

22/07/2024

From a healthy liver to cirrhosis: How fatty liver disease wreaks havoc step by step.
For those of you who care about metabolic health, today we'll show you the path of fatty liver disease. Hidden within this diagram are the key secrets to the progression from a healthy liver to cirrhosis!

First, the "First Hit":
When we eat too much fat and become obese, adipose tissue goes haywire!
✅ Fat cells frantically release glucose, insulin, and free fatty acids (FFAs),** and secrete a host of inflammatory adipokines and chemokines.
✅ Adiponectin, which is supposed to aid metabolism, decreases.
The result—insulin resistance! Fat continues to accumulate in the liver, leading to NAFLD (non-alcoholic fatty liver disease), the early stages of liver disease.

Next, the "Second Hit":
In the NAFLD stage, the liver is already overflowing with fat (lipid accumulation), but that's not the end!
✅ Accumulated fat can "peroxidize," producing lipotoxicity**, directly damaging the liver.
✅ This then triggers oxidative stress and endoplasmic reticulum stress (ER stress), igniting a "flare-up" of inflammation in the liver and activating various inflammatory pathways.
✅ Kupffer cells in the liver are also "turned on their head": anti-inflammatory M2 cells decrease, while pro-inflammatory M1 cells increase. Inflammation intensifies, and NAFLD escalates into NASH (non-alcoholic steatohepatitis)!
Finally—cirrhosis:
As NASH continues to progress, the liver undergoes repeated inflammation and repair, with fibrosis proliferating rapidly, replacing healthy liver tissue and ultimately leading to cirrhosis. This is the "terminal stage" of liver disease and poses a significant threat to health! In brief:
Fatty liver disease is a two-step metabolic disaster: first, obesity/a high-fat diet causes the liver to accumulate fat (NAFLD). Then, inflammation and oxidative stress fuel the problem, turning it into NASH, which can eventually lead to cirrhosis.
A friendly reminder from endocrinologists:
The metabolic disorders (obesity, insulin resistance, and hyperlipidemia) that endocrinologists manage are the root causes of fatty liver disease! To protect your liver, you must start by controlling your weight, improving insulin resistance, and regulating your blood lipids and blood sugar levels. Intervene early to address this "first blow"; don't wait until liver disease worsens before regretting it!

Dr. Harriet Mae Carter

01/08/2025

25/02/2025

25/02/2025

25/02/2025

25/02/2025

25/02/2025

25/02/2025

22/07/2024

22/07/2024

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