Volume 10 Issue 12, December 2014

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in young Asian adults; however, little is known about the associated clinical characteristics and the prevalence of complications. A recent Asia-wide prospective cohort study has revealed poor metabolic control in patients with young-onset T2DM, indicating more efficient health-care strategies are warranted to manage this vulnerable population.

Polycystic ovary syndrome (PCOS) is associated with anovulatory infertility. Many clinicians focus on the use of assisted reproductive technologies other than medical induction of ovulation. A new study demonstrating that the aromatase inhibitor letrozole is superior to clomiphene citrate (the current first-line therapy) for ovulation induction in women with PCOS returns attention to this area.

Shortening of leukocyte telomeres is considered a molecular marker for ageing and is suggested to be linked with increased risk of cardiovascular and metabolic disease. A large population-based study with 6 years of follow-up by Révész and colleagues reveals that short telomeres, at both baseline and during follow-up, are associated with an increased risk of metabolic abnormalities.

Availability of longitudinal data on the evolution of thyroid nodules and how this progression is influenced by changes in iodine intake is limited. A systematic 11-year follow-up study in Danish adults offers new insights into the relationships between thyroid nodularity, age and iodine intake.

The treatment of patients with acromegaly has progressed to encompass multimodal strategies that can include selective transsphenoidal adenomectomy, radiotherapy and somatostatin analogues. As a result, disease control and survival of these patients has improved.

Hypoglycaemia is a frequent adverse effect of some therapies for diabetes mellitus, and can have serious consequences. This Review describes the epidemiology of hypoglycaemia in adults with diabetes mellitus, principally in those treated with insulin. The consequences of hypoglycaemia are discussed, with particular focus on the cardiovascular and neurological morbidities that can occur.

Branched-chain amino acid (BCAA) levels are increased in individuals with obesity and are associated with worse metabolic health and future insulin resistance. In this Review, Christopher Lynch and Sean Adams discuss whether and how impaired BCAA metabolism might occur in obesity and how perturbations in BCAA levels reflect the insulin resistant and type 2 diabetes mellitus pathophenotypes.

In this Review, the authors explore the interactions between obesity, haematopoiesis and the immune system through systemic effects and changes to the primary haematopoietic environment—the bone marrow niche. They also discuss the effects of adipocytes and adiposity on haematopoietic stem cell and progenitor cell populations, with the goal of understanding how obesity might compromise the core haematopoietic system.

Despite the availability of a wide range of different dietary strategies for weight loss, unhealthy weight gain and obesity are growing problems. This Review discusses the efficacy of changes in dietary macronutrient content for healthy weight loss and weight management. The underlying causes of interindividual variations in response to the same dietary approach are also discussed and the feasibility and potential implications of personalized weight loss strategies is considered.