Comment

Adipocytes have high levels of many components of the complement system. These components are involved in antimicrobial activities, but also have the potential to regulate the maintenance and turn-over of adipocytes under normal and pathophysiological conditions through positive and negative regulation of the membrane attack complex.

Case studies of patients with anorexia nervosa revealed psychological improvements upon treatment with recombinant human leptin, including an alleviation of the entrapment in this eating disorder. Hypoleptinaemia induced by loss of adipose tissue mass might trigger psychological changes observed in starvation. Accordingly, leptin analogues might prove beneficial for treatment of anorexia nervosa.

Artificial intelligence has already revolutionized various fields in medicine and research. Due to the complex and interconnected nature of the endocrine system, it is an ideal area to further exploit and maximize the potential benefits of artificial intelligence.

The path to becoming a clinical academic researcher is arduous and convoluted, with many hurdles. A good mentor is key to growth and development, not only as one embarks on the journey, but also as a ‘sounding board’ throughout one’s career.

The field of bioenergetics is rapidly expanding with new discoveries of mechanisms and potential therapeutic targets. The 2023 Keystone symposium on ‘Bioenergetics in Health and Disease’, which was jointly held with the symposium ‘Adipose Tissue: Energizing Good Fat’, consisted of a powerhouse line-up of researchers who shared their insights.

“Adults have really boring ideas” is what we repeatedly learn from our participatory research with young people. Nevertheless, it is common practice that adults design research, questionnaires and interventions for young people. Not surprisingly, many research initiatives, questionnaires and interventions are utterly boring and a bad fit for the intended population. Consequently, many research efforts go to waste.

Classic psychedelics are being revisited as novel drug candidates. Researchers are investigating the efficacy of psychedelics for disorders such as depression and addiction. Facets of obesity pathophysiology are neurobiologically similar to these conditions, and we propose that obesity could be the next frontier in psychedelic research.

Control loop designs are widely present in biology but can undergo errors, which can be fixed using generic strategies. Loop designs in response to organismal stress exhibit distinct features and are under ongoing investigations. Understanding control theory as an organizing principle in biology creates a broader perspective on endocrine and non-endocrine systems.

Radioactive iodine (RAI) treatment is used in patients with thyroid cancer to treat disease and to eradicate normal thyroid remnants. Routine post-operative administration of RAI is no longer indicated in patients with low risk thyroid cancer and might instead be used selectively in patients with a post-operative high serum level of thyroglobulin.

From April 2022, as part of the UK government’s new obesity strategy, it is now compulsory for all larger restaurant and cafes in the UK to include calorie labelling on their menus. Is this legislation, however, likely to be effective in reducing our caloric intake, thereby tackling obesity?

The symptoms of long COVID and chronic adrenal insufficiency have striking similarities. Therefore, we aim to raise awareness of assessing adrenal function in patients with long COVID.

It is increasingly clear that pancreatic islet replacement is needed to provide a comprehensive treatment for the growing numbers of patients with type 1 diabetes mellitus. Advances from the past year suggest that this goal might now be within reach.

A large body of indisputable evidence shows that a certain treatment, commonly advocated by all healthcare professionals for a highly prevalent chronic medical condition, is associated with detrimental effects on health and an increased risk of mortality. This ‘treatment’, which needs eradicating from healthcare settings, is weight stigma.

Remission of type 2 diabetes mellitus is highly desirable and potentially reduces risks of complications. Improving the probability of remission requires early detection and substantial weight loss during a 6-year therapeutic window when β-cells remain functional.

Exosomes include plasma-transported vesicles that are secreted by human tissues and reflect metabolic status. The profile of exosomes (particularly microRNA content) is altered in metabolic disease. In type 2 diabetes mellitus, exosomes circulating in plasma induce transcriptional changes related to tumour progression and pro-metastatic phenotypes in target cancer cells, potentially linking obesity to cancer progression and metastasis.

The maintenance and regulation of body temperature in neonates is critical for survival. However, the mechanisms by which human neonates achieve body temperature control are unclear. Current evidence has demonstrated that infrared thermography is a suitable non-invasive technique that can be safely applied to human babies to investigate brown adipose tissue thermogenesis.

Weight gain indicates a positive energy balance, with calorie intake exceeding expenditure. However, this fact of physics cannot inform causality. Potential pathways to obesity include a positive energy balance that drives weight gain or weight gain that drives the positive energy balance. Here, we propose an integrated model of obesity pathogenesis that incorporates both pathways.

Whether or not there is a form of healthy obesity remains controversial. Contemporary imaging techniques might help answer this question. It is proposed that low levels of visceral adipose tissue and ectopic adipose tissue combined with a preferential accumulation of gluteal and femoral adipose tissue might define a ‘super healthy obesity’ phenotype.

An emerging feature of type 1 diabetes mellitus and type 2 diabetes mellitus is their association with pulmonary fibrosis, which negatively affects the prognosis of patients. Here, we provide a brief update of the field and the remaining open questions.

Up to one in four women with type 1 diabetes mellitus (T1DM) also have polycystic ovary syndrome (PCOS). Under subcutaneous insulin administration, systemic hyperinsulinism might trigger PCOS in women predisposed to the condition. However, very little is known about the long-term consequences of androgen excess in women with T1DM, and management guidelines are lacking.