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Here, Chow and colleagues discuss the endocrine manifestations of mitochondrial diseases, a group of multisystem disorders characterized by great clinical, biochemical and genetic heterogeneity. The authors describe the clinical features, genetic causes and pathological mechanisms underlying these diseases, the understanding of which will be key to developing innovative therapies for these patients.

A new population-based cohort study in patients with type 2 diabetes mellitus has found that systolic blood pressure below the level currently recommended by hypertension guidelines is associated with a lower risk of cardiovascular events than the present threshold. However, whether blood pressure goals should be lowered remains contentious.

In 1998, two children with congenital adrenal insufficiency and early-onset morbid obesity were found to have causative null mutations in POMC. In a new study, therapy with the melanocortin-4 receptor agonist setmelanotide has for the first time brought hope of a normal life to patients with POMC-deficiency.

Diabetes mellitus is associated with an increased risk of fragility fractures. Here, Napoli and colleagues discuss the complex interactions between glucose homeostasis and bone fragility, the epidemiology of fractures in patients with diabetes mellitus and the effects of antidiabetic drugs on bone health.

Polycystic ovary syndrome (PCOS) is associated with adverse metabolic and reproductive outcomes and guidelines recommend early diagnosis, screening and management. However, new stricter definitions of the diagnostic features of polycystic ovaries on ultrasonography might in fact exclude some women from a diagnosis of PCOS who could benefit from preventive management.

New approaches are required for the prevention and treatment of obesity and its associated pathologies. Here, Martel and colleagues review the potential anti-obesogenic and antidiabetic effects of plants, mushrooms and their derivatives, some of which have longstanding uses in traditional Chinese medicine.

Peroxisome proliferator-activated receptors (PPARs) are integrators of both inflammatory and metabolic signalling networks. In this Review, the authors provide a comprehensive overview of how PPARs contribute to the development of metabolic disorders and how pharmacologically targeting these pathways can be used to develop new therapeutics for such diseases.

In addition to undergoing adaptive thermogenesis, brown adipose tissue secretes a number of adipokines that can influence systemic metabolism. In this Review, Villarroya and colleagues discuss the current evidence for these so-called 'batokines' and how they might influence whole-body metabolic health.

Sergueï Fetissov discusses the possible involvement of gut bacteria in the host regulation of appetite and proposes an integrative homeostatic model of appetite control that includes the energy needs of both the host and its gut bacteria.

The latest report from the Childhood Cancer Survivor Study highlights the effect of cancer therapy on endocrine abnormalities over >30 years of follow up. Overall, 44% of patients had one endocrine abnormality, 16.7% had two and 6.6% had three or more. The findings highlight the need for long-term endocrine monitoring of these patients.

Silver–Russell syndrome (SRS) is an imprinting disorder that causes prenatal and postnatal growth retardation. This Consensus Statement summarizes recommendations for clinical diagnosis, investigation and management of patients with SRS, including the use of growth hormone and gonadotropin-releasing hormone analogues.

In this Review, Heiko Lickert and colleagues discuss β-cell heterogeneity, placing a particular emphasis on the role of islet architecture in defining phenotypic and functional plasticity among β cells. The potential to exploit β-cell heterogeneity and plasticity for diagnostic and therapeutic purposes in the context of regenerative therapies for diabetes mellitus is also discussed.