Volume 9 Issue 7, July 2013

During the past decade, a plethora of biomarkers have been reported to be associated with incident cardiovascular disease, often in large meta-analyses. A new review of these meta-analyses suggests that many of these studies are subject to substantial bias; therefore, how should we interpret the results, and where do we go from here?

The use of laparoscopic sleeve gastrectomy has increased steadily over the past 10 years. A recent evaluation of its effectiveness by Carlin and colleagues suggests that this type of bariatric surgery is a viable alternative to Roux-en-Y gastric bypass and laparoscopic gastric banding.

Two trials have assessed the use of canakinumab and anakinra in patients with new-onset type 1 diabetes mellitus (T1DM). Although fairly safe, the drugs were not efficacious in terms of halting the decline in β-cell function. Is this the end of the line for targeting IL-1 in T1DM?

At very low glucose levels, the cognitive function of patients with diabetes mellitus and recurrent iatrogenic hypoglycaemia is often better than that of hypoglycaemia-naive individuals. A new study shows that the brain adapts to recurrent hypoglycaemia by increasing uptake of glucose and lactate, with preferential shuttling of glucose to neurons.

A recent nationwide case–control study found that new or continued treatment with systemic, inhaled or intestinal glucocorticoids increased the risk of venous thromboembolism. However, despite efforts to adjust for important covariates, the high potential for residual confounding might invalidate the associations.

A phase II trial has demonstrated that insulin-like growth factor 1 receptor (IGF-1R) blockade in advanced neuroendocrine tumours has no efficacy, despite promising preclinical and phase I clinical trial evidence. These results highlight the challenge of interpreting response results from early phase I safety studies.

This Review highlights the key role of microRNAs and their targets in the maintenance of pregnancy and initiation of term and preterm labour. The authors review data on microRNAs as evolutionarily conserved, hormonally controlled modulators of inflammatory and contractile gene expression in the uterus during pregnancy.

Genetic factors influence obesity risk with numerous variants and genes associated with differences in BMI and obesity. Here, Julia El-Sayed Moustafa and Philippe Froguel outline current knowledge in the field of obesity genetics and discuss how this information might translate into personalized patient care.

In men with classic hypogonadism, testosterone therapy induces a number of beneficial effects. However, in older men with age-related decline in testosterone levels, the clinical benefits and long-term risks of testosterone therapy have not been adequately assessed in large, randomized clinical trials. This Review discusses potential benefits and risks of testosterone therapy in these individuals in the context of incomplete evidence on safety and efficacy.

The success of bariatric surgery, together with emerging data from preclinical studies, illustrates the rationale and feasibility of using two or more agonists for the treatment of obesity and type 2 diabetes mellitus (T2DM). This Review summarizes advances in the science of co-agonist therapy and mechanisms of action for combinations of endocrine hormones that enhance weight loss whilst preserving glucoregulatory efficacy in experimental models of obesity and T2DM.

Vitamin D is the nutrient du jour, yet scant evidence exists for various health claims related to vitamin D. This Perspectives article aims to dispel misconceptions about vitamin D, including discussion of osteoporosis, chronic disease risk, requirements in pregnancy and lactation, and vitamin D deficiency and supplementation.