Volume 11 Issue 6, June 2015

Low doses of two commonly used dietary emulsifiers—carboxymethylcellulose and polysorbate-80—are reported to induce low-grade inflammation, metabolic disorders and increases in body weight in mice. These emulsifiers also promote colitis in mice that are susceptible to this disorder. Interestingly, changes in the gut microbiota were both necessary and sufficient to induce the metabolic alterations.

Type 1 diabetes mellitus (T1DM) is associated with coeliac disease; however, whether coeliac disease influences the risk of microvascular complications in patients with T1DM is unclear. Now, in a new study, coeliac disease has been identified as a risk factor for retinopathy and nephropathy in patients who also have T1DM.

A large meta-analysis of 52 observational studies, conducted in multiple countries, suggests that menopausal hormone therapy (MHT) increases the risk of ovarian cancer. Should women who are taking MHT, either as estrogen alone or as estrogen combined with a progestogen, and their doctors be worried?

In a prospective study of patients with type 1 diabetes mellitus, leisure time physical activity of low intensity at baseline (versus high intensity) was associated with the development and progression of nephropathy. This finding is consistent with previous reports that exercise delays the progression of chronic kidney disease in people with or without diabetes mellitus.

Over the past decade, several multikinase inhibitors have shown considerable effectiveness against metastatic radioiodine-refractory thyroid cancers in early stage clinical trials. On the basis of some remarkable results in a phase III clinical trial, lenvatinib now joins sorafenib as another multikinase inhibitor approved by the FDA for this disease.

For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestational diabetes mellitus is highly relevant.

Islet α cells produce glucagon, which is an important regulator of blood glucose levels under fasting conditions. Dysregulated glucagon secretion is a hallmark of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Here, Campbell and Drucker review current understanding of α cells, as well as glucagon secretion and action in normal physiology and in diabetes mellitus. The consequences of selectively enhancing or attenuating glucagon action for the treatment of T1DM and T2DM are also addressed.

Obesity is associated with inflammatory responses in the brain, particularly the hypothalamus, which could open up new therapeutic targets. This Review will discuss the innate immune response in the hypothalamic neuron–glial circuit to obesity and associated metabolic disorders and propose corresponding strategies for treating obesity.

Chylomicronaemia is a challenging metabolic disorder that presents in two distinct primary forms: rare monogenic early-onset chylomicronaemia and polygenic late-onset chylomicronaemia. In this Review, Amanda Brahm and Robert Hegele discuss the genetic basis of the disorder and present a framework for the diagnosis and treatment of patients with severe hypertriglyceridaemia that results from chylomicronaemia.

Epicardial adipose tissue is a multifaceted fat depot with unique metabolic, thermogenic and mechanical properties. Here, Gianluca Iacobellis reviews the pathophysiology of this distinctive fat depot with regard to its function in health and disease, as well as addressing a role for epicardial fat as a biomarker for cardiometabolic disease and measuring the efficacy of treatments that target metabolic diseases.

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cancer. In this Perspectives article, Xilin Yang and colleagues discuss risk factors (subphenotypes) for cancer in Chinese patients with T2DM, which can lead to drug-subphenotype interactions. The authors also propose plausible biological links between T2DM and cancer and underlying the drug-subphenotype interactions.