Volume 12 Issue 4, April 2016

The ability of people to resist the consequences of psychological stress and cope effectively with the challenges of life might be associated with reduced risk of future type 2 diabetes mellitus, according to a very large study of young men followed-up into middle age.

Results from a recent randomized controlled trial on vitamin D₃ supplementation suggest that even modestly high doses of vitamin D₃, when given once monthly, might be associated with an increased rate of falls in older people. These findings support the conservative approach of the Institute of Medicine's recommendations of 800 IU of vitamin D₃ per day for older adults.

Since mutations in theRET proto-oncogene were discovered in thyroid carcinoma 20 years ago, research has focused on determining the prevalence of these alterations, their role in disease development and potential clinical applications. In this Review, the authors discuss these findings with respect to the pathogenic, diagnostic and prognostic roles of RETin patients with papillary thyroid carcinoma and medullary thyroid carcinoma.

Bone morphogenetic proteins (BMPs) have been implicated in almost all aspects of bone, cartilage and joint biology. Here, Valerie Salazar and colleagues discuss BMP superfamily signalling in the context of skeletal development and joint morphogenesis, and summarize the status of the BMP pathway as a therapeutic target for treating skeletal trauma and disease.

Diabetic ketoacidosis, hyperglycaemic osmolar state and hypoglycaemia are serious complications of diabetes mellitus. Here, Guillermo Umpierrez and Mary Korytkowski discuss the clinical presentation, precipitating causes, diagnosis and acute management of these diabetic emergencies and suggest practical strategies for their prevention.

Hypophosphatasia — a form of metabolic bone disease characterized by low serum alkaline phosphatase activity — results from loss-of-function mutations in the gene encoding the tissue-nonspecific isoenzyme of alkaline phosphatase (TNSALP). Here, Michael Whyte discusses the aetiology, nosology, pathogenesis, diagnosis and treatment of hypophosphatasia, which is particularly timely given the recently reported successes and approvals of treating the disease using asfotase alfa, a bone-targeted, recombinant TNSALP.