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A recent report has found an association between the methylation status of specific genes in human fetal tissue and the subsequent development of childhood adiposity in two longitudinal cohorts. Would epigenetic analysis at birth, therefore, have utility in identifying future risk of obesity?
Treatment options for osteoporosis are limited for older individuals with chronic kidney disease. A secondary analysis of the FREEDOM trial sheds light on the efficacy and safety of denosumab in patients with impaired kidney function, but underlines that challenges remain in the treatment of osteoporosis in patients with severe chronic kidney disease.
A recent retrospective study assessed the use of adrenal vein sampling (AVS) in conjunction with CT to help in the diagnosis of primary aldosteronism subtypes. On the basis of their findings, Sarlon-Bartoli et al. conclude that AVS is essential in the diagnosis of primary aldosteronism and that all patients, regardless of adrenal CT findings, should undergo AVS prior to surgery.
Despite advances in treating HIV infection, dyslipidemia and accelerated cardiovascular disease are prevalent in this patient population. In the Heart Positive study, Balasubramanyam et al. suggest that fenofibrate and niacin combined with diet and exercise are an effective treatment for dyslipidemia in HIV-infected patients.
Systematic screening studies, performed mainly in patients with diabetes mellitus, have revealed an unexpectedly high prevalence of occult Cushing syndrome. However, a screening strategy is only justified if it is supported by enough evidence of its efficacy and if benefits will outweigh drawbacks. The authors review currently available systematic screening studies for occult Cushing syndrome and assess the indications for and against screening for this condition.
This Review examines the pathogenic interplay between insulin resistance and nonalcoholic fatty liver disease (NAFLD) as well as how NAFLD may predispose individuals to the development of type 2 diabetes mellitus. Furthermore, the effect of NAFLD upon vascular and liver-related morbidity and mortality in patients with type 2 diabetes mellitus is examined and potential treatment strategies are explored.
In this Review, Peggy Cohen-Kettenis and Baudewijntje Kreukels discuss the experience of the Amsterdam Gender Identity Clinic of using gonadotropin-releasing hormone analogs to suppress puberty in adolescents who have gender dysphoria. Although so far outcomes have been positive, more research is needed before their protocol can be widely recommended.
RNA interference (RNAi) is a robust gene silencing mechanism that degrades mRNAs complementary to the antisense strands of double-stranded, short interfering RNAs. This Review describes the current status of research and clinical trials on RNAi-based therapeutics and addresses novel potential targets for the treatment of metabolic disease.
Primary aldosteronism is a common, but underdiagnosed, cause of curable arterial hypertension. This Review provides updated information to enable clinicians to identify patients with primary aldosteronism and for subtype differentiation to identify those with surgically curative forms of the disease.
