Leonid Poretsky

Leonid Poretsky (born August 7, 1954) is a Russian-born American endocrinologist. His research interests include mechanisms of insulin action in the ovary,[1] endocrinological aspects of AIDS,[2] and clinical outcomes in diabetes.[3][4][5] He has authored over 100 publications and has served on the National Institutes of Health's review committees and on the editorial boards of the Journal of Clinical Endocrinology and Metabolism and other endocrine journals.[6]

Leonid Poretsky
BornAugust 7, 1954
Leningrad, USSR
EducationSt. Petersburg Medical University
Beth Israel Hospital, Boston
Harvard Medical School
OccupationPhysician, endocrinologist
Years active1977–present
EmployerNorthwell Health
OrganizationGerald J. Friedman Diabetes Institute of Lenox Hill Hospital

As of 2014 he is a professor of medicine at Hofstra Northwell School of Medicine in Hempstead, New York, and Chief of the Division of Endocrinology at Lenox Hill Hospital in Manhattan, New York.

Early life, career

Leonid Poretsky was born on August 7, 1954 in Leningrad, Russian SSR.[6] His mother, Nina, was a well known pediatrician from Bobruisk, Belarus who lived and worked in Leningrad.[7] His father was a prominent engineer.[8] Poretsky graduated from First (Pavlov) Medical Institute in Leningrad (now St. Petersburg State Medical University), cum laude in 1977.[6]

He immigrated with his family to the United States in 1979. Upon completing his internal medicine residency program, he began a fellowship in endocrinology and metabolism at Boston’s Beth Israel Hospital (now Beth Israel/Deaconess Medical Center). He also completed a research fellowship in medicine at Harvard Medical School (1983–1985), where he was mentored by Dr. Jeffrey Flier.[6]

Beth Israel Medical Center

While at Beth Israel Medical Center (2000 - 2014), Dr. Poretsky served as Chief of the Division of Endocrinology, Vice-Chairman for Research, and Interim Chairman in the Department of Medicine. He held the Gerald J. Friedman endowed chair in endocrinology and metabolism at Beth Israel Medical Center and was a founding director of the Gerald J. Friedman Diabetes Institute.[6]

Gerald J. Friedman Diabetes Institute is an education, clinical management and research program focused on diabetes which requires no insurance or physician referral. At the institute Poretsky chairs the annual Friedman Fellows Symposia, which present the work of fellows from around the US supported by The Gerald J. and Dorothy R. Friedman New York Foundation for Medical Research.[9]

Lenox Hill Hospital

In September 2014, Dr. Poretsky joined the staff of Lenox Hill Hospital as its Chief of the Division of Endocrinology. He is leading the effort to develop academic and clinical programs. An endocrinology fellowship program was initiated in July 2016 and a new site for the Gerald J. and Dorothy R. Friedman Diabetes Institute at Lenox Hill Hospital opened on August 1, 2016. Another specialized program in the division--Friedman Transgender Health and Wellness Program--opened in 2017. The division has numerous grants from philanthropic organizations, industry and government agencies (New York State Department of Health and the National Institutes of Health). Lenox Hill Hospital is a part of Northwell Health, formerly North Shore – LIJ Health System, a network of hospitals, nursing homes, a medical school, a nursing school, a medical research institute, ambulatory care centers, urgent care centers, a health insurance company, and laboratories.

Dr. Poretsky has regularly appeared in the New York Times Magazine Best Doctors List and the U.S. News & World Report Best Doctors List.[6]

Publishing

Medical texts

Poretsky has authored over 100 publications, and has served on the editorial board of the Journal of Clinical Endocrinology and Metabolism,[6] Journal of Diabetes, and other publications.[6]

He contributed to and edited the comprehensive textbook Principles of Diabetes Mellitus, which has been widely cited,[10] and has gone through three editions so far (2002, 2010 and 2017[10][11][12]). The book covers a wide range of topics on diabetes.[10][11][12]

In 2012 he edited Diabetes Mellitus: A Concise Clinical Guide, which covers "the basics of diagnosis, complications, therapies and prevention of diabetes." The book consists of sections originally published in the second edition of Principles of Diabetes Mellitus.[13]

He is also a series editor for “Contemporary Endocrinology”. (Springer, Inc.)

A comprehensive textbook "Transgender Medicine - Multidisciplinary Approach" co-edited by Leonid Poretsky, MD and Wylie Hembree, MD was published in 2019 (Springer Publishers, Inc.)[14]

Public policy

Poretsky has been vocal in the media about how health care policy can affect patient care. In the 1990s he wrote a letter to the editor of New York Times concerning how Medicaid payment caps can limit physicians' availability to patients.[15] In July 2012 he wrote an op-ed for Forbes which drew comparisons between the bureaucratic behavior of the American healthcare system and that of the Soviet Union's, which he says "collapsed under the weight of its own bureaucratic inefficiencies two decades ago."[16] This article was followed by a scholarly publication on the subject entitled “The sovietization of American medicine: Notes from the front lines”, which appeared in Journal in American Physicians and Surgeons, 2013.[17]

In 2013 he published a letter in the Wall Street Journal talking about inadequate methods used by the government to assess hospital performance[18] and a letter regarding policy changes needed to reduce hospital readmissions.[19] In 2017, he published a letter about Medicare being allowed to compete with private health insurance plans.[20]

Notable research

Insulin in the human ovary

While working as a research fellow at Harvard in the early 1980s, Poretsky became known for discovering, describing and characterizing insulin receptors in the human ovary.[21]

Before his research, the hormone insulin had been known to primarily regulate glucose and other fuel metabolism in the liver, fat, and muscle.[21] His work established the ovary as a target for regulation by insulin, and introduced a new paradigm for the gonadotropic function of insulin.[22]

Poretsky had been researching the causes of hyperandrogenism (high level of male hormones and male features in females) in patients with extreme forms of insulin resistance, for example in people with insulin receptor gene mutations.[21] Subsequently, Poretsky’s work became important for understanding more common disorders, such as polycystic ovary syndrome (PCOS), which affects up to 10% of reproductive age women and is associated with infertility and diabetes.[23] Poretsky’s work helped lead to the use of insulin-sensitizing agents in patients with PCOS.[24][25]

Poretsky and his coworkers also characterized related receptors in the ovary (insulin-like growth factor receptors,[26] peroxisome-proliferator activated receptor-gamma),[27][28] and he conceptualized an insulin-related ovarian regulatory system.[1]

AIDS/HIV

Another line of Poretsky's research involved endocrine manifestations of acquired immunodeficiency syndrome (AIDS), and includes an early review of endocrinological dysfunction in AIDS patients.[29]

Additionally, in 1987 Poretsky was a key member of the team which described a condition called hyporeninemic hypoaldosteronism, which is characterized by deficiency of adrenal hormone aldosterone, in patients with AIDS. This discovery resulted in introduction of treatment with fludrocortisone, which proved to be extremely effective and almost immediately converted most patients with this condition from being unable to stand (because of a severe drop in blood pressure upon standing) to being mobile and more functional.[2]

Poretsky was also key in first describing a type of inflammation of the thyroid (thyroiditis) which is caused by an opportunistic infection of the thyroid gland by an organism which had been known to infect only the lungs of patients with AIDS.[30]

He also studied the metabolism of adrenal hormones cortisol[31] and dehydroepiandrosterone (DHEA)[32][33] in patients with human immunodeficiency virus (HIV).

Clinical studies in diabetes

Poretsky’s other publications address a variety of subjects in diabetes and reproduction. Recent publications include an invited editorial in the Proceedings of the National Academy of Sciences on the role of advanced glycation end products (AGEs) in metabolic disease;[34] a study of the potential new treatment for prevention of diabetic nephropathy (carried out in collaboration with investigators from the Mount Sinai School of Medicine);[35] a review of the role of Vitamin D in human reproduction;[36] and an editorial on the problem of recurrent hospitalizations of patients with diabetes.[37]

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References
  1. Poretsky, L; Cataldo, N; Rosenwaks, Z; Guidice, L (1999). "Insulin-related ovarian regulatory system in health and disease". Endocrine Reviews. 20 (4): 535–582. doi:10.1210/er.20.4.535.
  2. Kalin, MF; Poretsky, L; Seres, DS; Zumoff, B (May 1987). "Hyporeninemic hypoaldosteronism associated with acquired immune deficiency syndrome". Am J Med. 82 (5): 1035–8. doi:10.1016/0002-9343(87)90171-9. PMID 3555065.
  3. Aronoff, S; Rosenblatt, S; Braithwaite, S; Egan, JW; Mathisen, AL; Schneider, RL (November 2000). "The Pioglitazone 001 Study Group (2000). Pioglitazone hydrochloride monotherapy improves glycemic control in the treatment of patients with type 2 diabetes" (PDF). Diabetes Care. 23: 1605–1611. doi:10.2337/diacare.23.11.1605. PMID 11092281.
  4. Brillon, DJ; Sison, CP; Salbe, AD; Poretsky, L (2006). "Reproducibility of a glycemic response to mixed meals in type 2 diabetes mellitus". Hormone and Metabolic Research. 38: 536–542. doi:10.1055/s-2006-949526.
  5. Pittas, AG; Dawson-Hughes, B; Sheehan, P; Rosen, C; Ware, JH; Knowler, WC; Staten, M (2014). "The D2d Research Group (2014). Rationale and design of the vitamin D and type 2 diabetes (D2d) Study: A diabetes prevention study" (PDF). Diabetes Care. 37 (12): 3227–3234. doi:10.2337/dc14-1005. PMC 4237973. PMID 25205139.
  6. "Leonid Poretsky: CV" (PDF). Friedman Diabetes Institute. January 2017. Retrieved 2017-03-09.
  7. "Nina Poretsky M.D." The New York Times. March 2, 2004. Retrieved 2013-04-27.
  8. "Deaths: Ruvim Poretsky". The New York Times. June 18, 2006. Retrieved 2013-03-12.
  9. "Dr. Leonid Poretsky". Friedman Diabetes Institute. Retrieved 2012-01-12.
  10. editor, Leonid Poretsky (2010). Principles of diabetes mellitus (2nd ed.). New York: Springer. p. 3. ISBN 978-0-387-09840-1.CS1 maint: extra text: authors list (link)
  11. Poretsky, Leonid (2002). Principles of Diabetes Mellitus. Springer. p. 20. ISBN 1402071140.
  12. Poretsky, Leonid (2017). Principles of Diabetes Mellitus. Springer. ISBN 978-3-319-18740-2.
  13. Poretsky, Leonid (2012). Diabetes Mellitus: A Concise Clinical Guide. Springer. ISBN 9781461457077.
  14. editor, L. Poretsky & W. Hembree (2019). Transgender medicine-Multidisciplinary Approach (1st ed.). New York: Springer. ISBN 978-3-030-05683-4.CS1 maint: extra text: authors list (link)
  15. Poretsky, Leonid (July 3, 1990). "A Medicaid Proposal". New York Times. Retrieved 2013-04-27.
  16. Poretsky, Leonid (July 3, 2012). "Stop the Sovietization of American Medicine". Forbes. Retrieved 2013-04-27.
  17. Poretsky, L (2013). "The sovietization of American medicine: Notes from the front lines". Journal of American Physicians and Surgeons. 18 (2): 50–54.
  18. Poretsky, Leonid (April 19, 2013). "Physician, Hear Thyself—Why Communication Matters". Wall Street Journal. Retrieved 2013-03-12.
  19. Poretsky, Leonid (May 20, 2013). "Readmissions Often Aren't Culpable Acts". The Wall Street Journal. Retrieved 2013-05-20.
  20. Poretsky, Leonid (January 19, 2017). "Traditional Medicare should be allowed to compete" (PDF). Education Update. Retrieved 2017-01-19.
  21. Poretsky, L; Smith, D; Seibel, M; Pazianos, A; Moses, AC; Flier, JS (1984). "Specific insulin binding sites in human ovary". J Clin Endocrinol Metab. 59 (809–811): 809–11. doi:10.1210/jcem-59-4-809. PMID 6480806.
  22. Poretsky, L; Kalin, M (1987). "The gonadotropic function of insulin". Endocrine Reviews. 8 (2): 132–141. doi:10.1210/edrv-8-2-132. PMID 3301317.
  23. Poretsky, L (2006). "Polycystic ovary syndrome: Increased or preserved ovarian sensitivity to insulin?". J Clin Endocrinol Metab. 91 (8): 2859–2860. doi:10.1210/jc.2006-0317. PMID 16684824.
  24. Bloomgarden, Z; Futterweit, W; Poretsky, L (2001). "Use of insulin sensitizing agents in patients with polycystic ovary syndrome". Endocrine Practice. 7 (4): 279–286. doi:10.4158/EP.7.4.279. PMID 11497481.
  25. Nandi, A; Chen, Z; Patel, R; Poretsky, L (2014). "Polycystic ovary syndrome". Endocrinology and Metabolism Clinics of North America. 43 (1): 123–147. doi:10.1016/j.ecl.2013.10.003. PMID 24582095.
  26. Poretsky, L; Grigorescu, F; Moses, AC; Flier, JS (1985). "Distribution and characterization of the insulin and IGF-1 receptors in the human ovary". J Clin Endocrinol Metab. 61: 728–734. doi:10.1210/jcem-61-4-728.
  27. Seto-Young, D; Paliou, M; Schlosser, J; Avtanski, D; Park, A; Patel, P; Holcomb, K; Chang, P; Poretsky, L (2005). "Thiazolidinedione action in the human ovary: direct effects on steroidogenesis and insulin-like growth factor binding protein-1 (IGFBP-1) production". J Clin Endocrinol Metab. 90: 6099–6105. doi:10.1210/jc.2005-0469.
  28. Seto-Young, D; Avtanski, D; Parikh, G; Suwandhi, P; Strizhevsky, M; Araki, T; Rosenwaks, Z; Poretsky, L (2011). "Rosiglitazone and pioglitazone inhibit estrogen synthesis in human granulosa cells by interfering with androgen binding to aromatase". Horm Metab Res. 43 (4): 250–256. doi:10.1055/s-0030-1270525. PMID 21321839.
  29. Poretsky, L; Maran, A; Zumoff, B (1990). "Endocrinological and metabolic manifestations of AIDS". Mount Sinai Journal of Medicine. 57: 236–241.
  30. Battan, R; Mariuz, P; Raviglione, MD; Sabatini, MT; Mullen, MP; Poretsky, L (1991). "Pneumocystitis carinii infection of the thyroid in a hypothyroid patient with AIDS: Diagnosis by fine needle aspiration biopsy". J Clin Endocrinol Metab. 72 (3): 724–726. doi:10.1210/jcem-72-3-724. PMID 1997526.
  31. Stolyarczyk R, Rubio S, Smolyar D, Young I, Poretsky L (June 1998). "24 hr urinary free cortisol in patients with acquired immune deficiency syndrome". Metabolism. 47 (6): 690–4. doi:10.1016/s0026-0495(98)90032-4. PMID 9627368.
  32. Poretsky, L; Brillon, DJ; Ferrando, S; Chiu, J; McElhiney, M; Ferenczi, A; Sison, CP; Haller, I; Rabkin, J (2006). "Endocrine effects of oral dehydroepiandrosterone (DHEA) in men with HIV infection: A prospective randomized double-blind placebo-controlled trial". Metabolism. 55 (7): 858–870. doi:10.1016/j.metabol.2006.02.013. PMID 16784956.
  33. Romero, CM; Liao, EP; Zumoff, B; Poretsky, L (2011). "Dehydroepianrosterone (DHEA) in Human Immunodeficiency Virus Infection: Prognostic and Therapeutic Aspects.". In Watson, R (ed.). DHEA in Human Health and Aging. Boca Raton, FL: CRC Press. pp. 195–205..
  34. Poretsky, L (2012). "Looking beyond overnutrition for causes of epidemic metabolic disease". Proceedings of the National Academy of Sciences of the United States of America. 109 (39): 15537–15538. Bibcode:2012PNAS..10915537P. doi:10.1073/pnas.1213503109. PMC 3465375. PMID 22984158.
  35. Yubero-Serrano, EM; Woodward, M; Poretsky, L; Vlassara, H; Striker, GE (2015). "Effects of sevelamer carbonate on advanced glycation endproducts and anti-oxidant/pro-oxidant status in patients with diabetes kidney disease". Clinical Journal Am Society Nephrology. 10 (5): 59–66. doi:10.2215/CJN.07750814. PMC 4422240. PMID 25710801.
  36. Nandi, A; Sinha, N; Ong, W; Sonmez, E; Poretsky, L (2016). "Is there a role for Vitamin D in human reproduction?". Horm Mol Biol Clin Invest. 25 (1): 15–28. doi:10.1515/hmbci-2015-0051. PMID 26943610.
  37. Sonmez, H; Kambo, V; Taha, R; Poretsky, L (2016). "Reducing hospital readmissions in patients with diabetes: Developing better strategies". Endocr Pract. 22 (9): 1134–1136. doi:10.4158/EP161315.CO. PMID 27359289.
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