Risk factors articles within Nature Reviews Endocrinology

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  • Review Article |

    Statins are widely used to prevent cardiovascular disease, but have been associated with an increased risk of new-onset diabetes mellitus. This Review discusses the evidence for this association, as well as what is known about the potential mechanisms underpinning this effect. The implications for clinical management of individuals at medium-to-high risk of new-onset diabetes mellitus are also discussed.

    • D. John Betteridge
    •  & Rafael Carmena

  • Review Article |

    A subclass of endocrine-disrupting chemicals, so-called 'obesogens', have been proposed to predispose certain individuals to weight gain, despite their efforts to limit caloric intake and increase levels of physical activity. In this Review, Jerrold Heindel and colleagues discuss the experimental and epidemiological findings on obesogens, their modes of action, and their role in the obesity epidemic.

    • Jerrold J. Heindel
    • , Retha Newbold
    •  & Thaddeus T. Schug

  • News & Views |

    In a new study published in The Lancet Diabetes & Endocrinology, metformin use is associated with significantly increased all-cause mortality in patients with type 2 diabetes mellitus and stage 5 chronic kidney disease (CKD). The findings support current recommendations that metformin should not be used in patients with stage 5 CKD.

    • Guntram Schernthaner
    •  & Marie Helene Schernthaner-Reiter

  • Review Article |

    For individuals with diabetes mellitus, the lifetime risk of developing a foot ulcer can be as high as 25%, but these complications are preventable. Here, Bowling and colleagues discuss the mechanisms that lead to foot ulcers in patients with diabetes mellitus. The authors emphasise the need for a multidisciplinary management strategy to prevent and treat diabetic foot complications.

    • Frank L. Bowling
    • , S. Tawqeer Rashid
    •  & Andrew J. M. Boulton

  • Review Article |

    Paget's disease is a disorder of bone that manifests in one or several bones and is initiated by osteoclast-induced osteolytic lesions. In addition to a genetic cause, environmental factors, including measles virus, have been proposed to have a role in the pathogenesis of Paget's disease. Here, Frederick R. Singer discusses the present knowledge and controversies surrounding the aetiology of Paget's disease.

    • Frederick R. Singer

  • News & Views |

    Developmental exposure to endocrine disruptors is suspected to be one of the main factors responsible for the increased incidence of breast cancer in industrialized countries. New data published in the Journal of Clinical Endocrinology and Metabolism show that exposure to dichlorodiphenyltrichloroethane during fetal life is associated with an increased risk of breast cancer.

    • Ana M. Soto
    •  & Carlos Sonnenschein

  • News & Views |

    Fractures are associated with increased mortality in the general population. Now, a new study from a Danish national database has examined mortality after a fracture in patients with diabetes mellitus. Increased age, male sex, alcohol dependency, retinopathy, heart failure and use of glucocorticoids were associated with increased mortality; statin use was associated with a reduced risk of death.

    • Jane A. Cauley

  • Review Article |

    In this Review, Joshua Farr and Sundeep Khosla discuss changes in bone architecture during growth, placing an emphasis on skeletal changes at the distal radius, a clinically relevant site of forearm fractures. The implications of these changes for fracture risk in adolescence and later in life, and the architectural changes in bone with ageing that might contribute to increased fracture risk are also discussed.

    • Joshua N. Farr
    •  & Sundeep Khosla

  • News & Views |

    A massive prospective study that assessed the association between consumption of cereals and mortality has concluded that cereal fibre is a component of whole grains that is potentially protective. This focus on cereal fibre is not fully consonant with plant and human biology and might distract from the aspect of most importance in prediction of chronic disease—the whole grain and its myriad bioactive phytochemical constituents.

    • David R. Jacobs Jr

  • News & Views |

    The use of antibiotics has improved the health of millions of individuals. However, in a new study by Boursi et al. an important and surprising hypothesis is presented: treating infections with repeated antibiotic therapy in early life can increase the risk of developing diabetes mellitus in adulthood.

    • Rémy Burcelin
    •  & Jacques Amar

  • Opinion |

    Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cancer. In this Perspectives article, Xilin Yang and colleagues discuss risk factors (subphenotypes) for cancer in Chinese patients with T2DM, which can lead to drug-subphenotype interactions. The authors also propose plausible biological links between T2DM and cancer and underlying the drug-subphenotype interactions.

    • Xilin Yang
    • , Heung M. Lee
    •  & Juliana C. N. Chan

  • News & Views |

    A large meta-analysis of 52 observational studies, conducted in multiple countries, suggests that menopausal hormone therapy (MHT) increases the risk of ovarian cancer. Should women who are taking MHT, either as estrogen alone or as estrogen combined with a progestogen, and their doctors be worried?

    • Susan R. Davis
    •  & Rodney Baber

  • News & Views |

    Type 1 diabetes mellitus (T1DM) is associated with increased risk of mortality, despite improvements in management of glucose levels and treatment of cardiovascular risk factors. A population-based study of individuals with T1DM and control individuals matched for age and sex has used glycaemic control to characterize the excess risk of overall and cardiovascular mortality.

    • Janet K. Snell-Bergeon
    •  & David M. Maahs

  • News & Views |

    Observational studies suggest that statin treatment has a fracture-preventive effect; however, there is only limited supporting evidence from randomized controlled trials. Now, results from the JUPITER trial show that rosuvastatin treatment does not reduce the risk of fractures and, further, that levels of high sensitivity C-reactive protein are not associated with fracture risk.

    • Peter Vestergaard

  • News & Views |

    Shortening of leukocyte telomeres is considered a molecular marker for ageing and is suggested to be linked with increased risk of cardiovascular and metabolic disease. A large population-based study with 6 years of follow-up by Révész and colleagues reveals that short telomeres, at both baseline and during follow-up, are associated with an increased risk of metabolic abnormalities.

    • Peter M. Nilsson

  • Review Article |

    The prevalence of obesity has increased to epidemic proportions. In the past few years, whether patients with obesity can be metabolically healthy has been debated. This Review discusses the controversy regarding metabolically healthy obesity, as well as the debate regarding the relative importance of fatness versus fitness for overall, and particularly cardiovascular, health.

    • Carl J. Lavie
    • , Alban De Schutter
    •  & Richard V. Milani

  • News & Views |

    The recently published HPS2–THRIVE study has shown that the addition of extended release niacin to statin therapy in patients with well-controlled levels of LDL cholesterol does not reduce the risk of cardiovascular events and might even increase harm. Consequently, the use of niacin to increase levels of HDL cholesterol is not recommended.

    • Sony Tuteja
    •  & Daniel J. Rader

  • Review Article |

    Although important risk factors for coronary heart disease (CHD) are well known, advances in research might facilitate improved risk stratification of patients. This Review discusses the latest developments in metabolic biomarkers of cardiovascular disease, including lipoproteins, homocysteine, calcium metabolism and glycaemic markers. It also discusses whether these biomarkers' associations with CHD are sufficient to improve current risk-stratification metrics.

    • Majken K. Jensen
    • , Monica L. Bertoia
    •  & Kenneth J. Mukamal

  • News & Views |

    Of late, clinical trial data, meta-analyses and observational studies have caused concern that the use of calcium supplements might increase the risk of myocardial infarction and stroke. A new meta-analysis suggests that there is no problem with calcium supplements, but as the analysis includes controversial data omitted from previous analyses, the debate will continue.

    • Ian R. Reid

  • News & Views |

    The prevalence of the metabolic syndrome has increased in tandem with that of obesity. The metabolic syndrome is associated with structural and functional cerebral damage. A new study confirms the association between the metabolic syndrome and reduced brain volume in the absence of diabetes mellitus. Here, we highlight how vascular dysfunction potentially contributes to this brain damage.

    • Henry Rusinek
    •  & Antonio Convit

  • Review Article |

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. This article provides an overview of the pathophysiology, aetiology, diagnosis, and management of the most common presenting features of PCOS, including hyperandrogenism, menstrual irregularity and infertility. Management of cardiometabolic risk, an important concern in these patients, is also discussed.

    • Channa N. Jayasena
    •  & Stephen Franks

  • Review Article |

    Accumulating evidence suggests that common reproductive problems, such as male infertility and testicular cancer, originate during fetal development. In this Review, Anders Juul and colleagues discuss the current knowledge of a variety of male reproductive issues, focusing on the developmental origins of testicular pathologies in the context of male infertility.

    • Anders Juul
    • , Kristian Almstrup
    •  & Niels E. Skakkebæk

  • News & Views |

    The major accident at the Chernobyl nuclear power plant has resulted in an increased risk of thyroid cancer in exposed individuals. A new report attempts to quantify the risk of thyroid cancer associated with living near nuclear facilities; however, the findings are inconclusive due to flaws in the study design.

    • Kiyohiko Mabuchi
    •  & Arthur B. Schneider

  • News & Views |

    A growing body of literature examines the burden of sex-specific risk factors for cardiovascular disease. Women with diabetes mellitus have a higher risk of coronary heart disease than men with diabetes mellitus. A recent study provides strong evidence that women with diabetes mellitus also have an increased risk of stroke.

    • Shaista Malik

  • Review Article |

    The three most prevalent types of osteoporotic fractures occur in the hip, vertebrae and distal forearm. With ageing populations, such fractures contribute to an increasing economic burden on healthcare systems. In this Review, Cauley and colleagues discuss the variation in osteoporotic fracture rates throughout the world, with a specific emphasis on the geographical and ethnic differences both within and between countries.

    • Jane A. Cauley
    • , Didier Chalhoub
    •  & Ghada El-Hajj Fuleihan

  • Review Article |

    GLOW is a large-scale international study of osteoporosis in women. Here, Nelson Watts discusses the findings of the first 3 years of the GLOW study, including data on prevalence and incidence of fractures in different geographical regions, the predictive values of different sites of fracture and various comorbidities, and implications for appropriate therapy of individuals at risk.

    • Nelson B. Watts

  • Review Article |

    This Review outlines the cell and tissue-specific mechanisms that lead to cardiovascular events in patients with type 1 and type 2 diabetes mellitus. The authors discuss how these complications relate to classic cardiovascular risk factors and highlight a common mechanism that might link coronary artery disease to both forms of diabetes mellitus.

    • Markku Laakso
    •  & Johanna Kuusisto

  • News & Views |

    Prediction of fracture risk is increasingly used to guide clinical use of antiosteoporosis drugs. Data from a large primary care prospective study in 10 countries has now been used to generate an empirical composite 5-year fracture risk model based on clinical data (excluding BMD). This model performed better than current widely used models.

    • Roger Bouillon
    •  & Dirk Vanderschueren

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