Volume 11 Issue 2, February 2015

Studies published in 2014 have helped in our understanding of the epigenetic mechanisms by which suboptimal nutritional exposures during in utero development are transmitted to subsequent generations through the maternal and the paternal germlines. Advances include identification of common genetic loci that are vulnerable to the effects of in utero undernutrition and overnutrition, as well as those that are epigenetically modified tissue-wide.

In 2014, two phase II clinical studies reported rapid, impressive increases in BMD in women with low bone mass who were treated with sclerostin inhibitors for 1 year. The antifracture efficacy and tolerability of these new, bone-building therapies are currently being investigated in phase III clinical trials.

In 2014, numerous noteworthy papers focusing on adipose tissue physiology were published. Many of these articles showed the promise of adipose-tissue-targeted approaches for therapeutic intervention in obesity and type 2 diabetes mellitus. Here, we highlight advances in the development and maintenance of brown and/or beige adipocytes and the metabolic implications of inflammation in adipose tissues.

In 2014, many articles focusing on pituitary tumours were published, including studies on genetics, surgery, radiotherapy and medical treatment. This commentary highlights advances in the management of patients with acromegaly, Cushing disease and TSH-secreting tumours. Together, these advances will benefit the care and management of patients with pituitary tumours.

2014 was a good year for developments in automated insulin delivery systems for patients with diabetes mellitus. Clinical trials shifted from research units to the outpatient setting, included both adult and adolescent individuals and were conducted over periods from overnight to 24 h, with improvements seen in time spent in the target glycaemic range and reduced risk of hypoglycaemia.

2014 has seen advances in our understanding of benign and malignant tumours of the adrenal cortex, particularly in Cushing syndrome. Modern genetics has generated a flurry of data. The challenge is to give sense to them; however, the difficulties of collecting the clinical data must not be underestimated.

People with severe mental illness are at increased risk of developing diabetes mellitus. This Review examines the epidemiological association between severe mental illness and diabetes mellitus and the mechanisms underlying this association. The clinical implications of this comorbidity are also explored.

Abdominal obesity is associated with an increased risk of cardiovascular disease, insulin resistance, type 2 diabetes mellitus and all-cause mortality, whereas gluteofemoral obesity has opposing associations. In this Review Fredrik Karpe and Katherine Pinnick discuss the developmental and functional differences between upper-body and lower-body fat depots and provide mechanistic insight into the disease-protective effects of lower-body fat.

During the past 15 years, our understanding of phaeochromocytoma and/or paraganglioma and the management of affected patients and their relatives have been revolutionized. Particular progress has been made in our understanding of the genetic changes underlying these tumours. This Review discusses the key advances that have occurred over this period.

Disordered gastric emptying (also known as gastroparesis) is a complication frequently associated with long-standing type 1 diabetes mellitus and type 2 diabetes mellitus. In this Review, Phillips and colleagues discuss the underlying pathophysiology of gastroparesis in patients with diabetes mellitus. In addition, diagnosis, symptom management and emerging therapies are addressed.