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A recent study by Clayton et al. shows that overall mortality is increased for patients with Cushing disease, even in remission, but that mortality is normal if long-term remission is induced by only one pituitary surgery. These findings emphasize the importance of expert pituitary surgery.
Insulin resistance and type 2 diabetes mellitus are associated with mitochondrial dysfunction, and promoting healthy mitochondrial function could benefit patients. This Review discusses novel molecular targets for therapies that enhance mitochondrial function, with an emphasis on nonpharmacological regulation of factors such as nutrition, exercise, temperature and circadian rhythm.
The human endometrium repeatedly undergoes specific cyclic changes to prepare for embryo implantation. Understanding the mechanisms involved in endometrial cycling is important for the treatment of reproductive pathologies, and can also provide insight into conditions such as wound healing and even cancer.
The incidence of thyroid cancer has increased substantially in many countries over the past few decades. In this Review, Kitahara and Sosa describe the changing incidence of the disease and suggest possible explanations for the trends, emphasizing implications for patients and ongoing strategies to combat this growing public health issue.
Oral contraceptives are the mainstay of long-term PCOS treatment, but have potential adverse cardiometabolic effects. In a randomized controlled trial comparing oral contraceptive use and structured exercise in women with PCOS and overweight on a calorie-restricted diet, androgen excess was ameliorated with oral contraceptive use and structured exercise improved markers of cardiometabolic risk.
Recently, 45 international medical and scientific organizations agreed that bariatric or metabolic surgery should be included among the therapeutic interventions for people with type 2 diabetes mellitus and obesity. The endorsement of these guidelines follows findings that several surgical procedures developed for weight loss improve glycaemia more effectively than any pharmacological or lifestyle approach.
In this Perspectives article, Paul Zimmet and colleagues outline how current estimates of the prevalence diabetes mellitus and of related mortality are imprecise. They call for international consensus on uniform standards and criteria for reporting national data on diabetes mellitus.
In this Review, Lício Velloso and colleagues describe the main components involved in the proteostasis network and consider how defects in these components might interfere with the correct function of the hypothalamus in obesity and ageing.
This Review focuses on the diagnosis, natural history and management of children with subclinical hypothyroidism, as well as the controversy regarding treatment. The latest data on health outcomes, metabolic issues and the risk of cardiovascular disease are outlined.