Volume 9 Issue 12, December 2013

In a carefully conducted, outstanding example of clinical research, Finkelstein et al. clearly demonstrate the physiological underpinnings for the action of testosterone and the relative roles of its androgenic and estrogenic effects on body composition and sexual function. This study has important clinical implications for testosterone replacement therapy of male hypogonadism.

A recent study shows that inflammation could be the underlying factor that determines the differences in metabolic profiles between subgroups of obesity. An improved understanding and characterization of these subgroups should help to develop innovative approaches to treat obesity.

Strontium ranelate, a therapeutic for osteoporosis, was thought to have a dual mode of action, simultaneously stimulating bone formation and reducing resorption. A recent study casts doubt on this explanation, suggesting instead that it has a mild suppressive effect on bone formation with little effect on bone resorption.

Alefacept, a fusion protein approved for psoriasis, has been trialled in patients with new-onset type 1 diabetes mellitus. However, the withdrawal of the drug from the US market and the unmet primary end point do not raise hope for this drug, even though some secondary end points were met and the study highlighted interesting immunological efficacy.

This Review describes the effects of ERα, AR and RANKL in various cell types involved in bone homeostasis. The authors discuss the implications of findings in animal models for understanding the regulation of trabecular and cortical bone, the integration of hormonal and mechanical signals, as well as the importance of estrogens and androgens in the female versus male skeleton.

Diabetic nephropathy is a major cause of morbidity and a key determinant of mortality in patients with type 1 or type 2 diabetes mellitus. This Review addresses the current classification of the stages of diabetic nephropathy, new approaches to identify biomarkers of diabetic nephropathy and current and potential new treatments for this condition.

Graves disease is the most common cause of hyperthyroidism in areas with sufficient iodine intake. This Review summarizes the advantages and disadvantages of current approaches to diagnosis and treatment of Graves disease. Geographical differences in management of the disease will also be discussed.

Advances in cancer therapy over the past two decades have resulted in more patients surviving for longer after treatment. As many therapies can cause premature ovarian failure (POF), infertility in female cancer patients now needs to be addressed. This Review analyses the options that are currently available to preserve fertility in female patients with cancer and in women at risk of POF.

Emerging data suggest a role for autoimmunity in type 2 diabetes mellitus (T2DM). In this Perspectives, the authors discuss the nature of the immune response in diabetes mellitus and the evidence for an autoimmune component in T2DM and obesity.