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Vitamin D administration lowers blood pressure in animal models, but findings from studies in humans are inconsistent. Vimaleswaran and colleagues used a Mendelian randomization approach to show that alleles associated with increased plasma levels of 25-hydroxyvitamin D3 are associated with a reduced risk of hypertension, suggesting a causal relationship in humans.
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.
Mutations in the genes that encode the thyroid hormone receptors (THRs),THRA and THRB, result in resistance to thyroid hormone disorders, RTHα and RTHβ, respectively. In this Review, the authors discuss mutations that have been identified in patients with RTH and mouse models of these disorders that have contributed to understanding the physiology and functions of THRs.
The evidence base for the efficacy of insulin pump therapy in type 2 diabetes mellitus (T2DM) has been inconsistent to date. However, a recent large-scale randomized controlled trial comparing pump treatment with multiple daily insulin injections in patients with poorly controlled T2DM has shown substantial improvement in glycaemic control with pump therapy.
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.
Gynaecomastia is a common condition that is generally benign. However, the condition can cause localised pain and might be the result of a serious underlying illness or medication. In this Review, the latest advances in the pathophysiology, evaluation and management of gynaecomastia are discussed.
Defining follicular thyroid lesions with indeterminate cytology as either benign or malignant without surgery is an important clinical challenge. Maia and colleagues integrated the Thyroid Imaging and Data Reporting System with the Bethesda System for malignancy risk classification; their report suggests that this method leads to increased diagnostic accuracy with direct clinical implications.
Patients with obesity and obstructive sleep apnoea have increased morbidity. Now, one study has reported limited beneficial effects of continuous positive airway pressure (CPAP) in patients with both these conditions. However, in another study, the reduction in blood pressure obtained with CPAP was not observed when nocturnal hypoxia was suppressed with supplemental oxygen.
Disorders of sex development (DSDs) arise when the tightly regulated process of sex determination in the developing bipotential gonads is disrupted. In this Review, the authors discuss mutations in sex determining genes that are associated with DSDs, as well as classification of the disorders and the psychosexual differentiation of individuals with DSDs.
The rate of osteoporotic fractures seems to be stabilizing, but is still associated with considerable disability, costs and an increased risk of mortality. This Review summarizes the evidence regarding osteoporosis-related fractures and their link with mortality and examines data on the effects of treating osteoporosis on mortality in patients with this condition.