News & Views in 2020

It is well established that marketing of unhealthy food is highly prevalent and has a detrimental effect on children’s eating behaviours and diet. A new study highlights how a new type of social media influencer — children themselves — is contributing to this phenomenon.

U-shaped or J-shaped relationships have been demonstrated between BMI and all-cause or cardiovascular mortality. Now, a study has demonstrated the correlation of increased waist circumference, high adipose tissue mass and low adipose tissue-free mass with all-cause and cardiovascular mortality in an Asian population.

In two phase III trials, surufatinib, a novel oral tyrosine kinase inhibitor targeting immune cells and angiogenesis, was effective for treating pancreatic and extra-pancreatic neuroendocrine tumours. These findings further expand the therapeutic options for patients with gastro–entero–pancreatic, thymic and lung neuroendocrine tumours.

A large fraction of patients with diabetes mellitus require insulin treatment to control glucose metabolism; however, this treatment brings risks of hypoglycaemia and provides suboptimal metabolic control. Transplantation of stem cell-derived pancreatic islet cells could be an ideal solution, which is approaching clinical translation.

A need exists for rapid, cheap and noninvasive diagnostic tests for type 2 diabetes mellitus (T2DM). Now, a smartphone-based photoplethysmography screening test has been reported to detect T2DM based on a novel digital vascular biomarker, distinct from blood glucose, analysed with deep learning.

Typically, our mechanistic understanding about links between exercise and mortality come from epidemiological and short-period training studies. An initial transcriptomic study shows that decades-long endurance training shifts skeletal muscle gene activity to favour cellular respiration, upholding the consilience of evidence for ‘aerobic’ as a central feature of health and longevity.

Bone marrow adipose tissue secretes adipokines and is involved in glucose and lipid metabolism. The confined bone marrow cavity could partially explain the resistance of bone marrow adipose tissue to insulin-mediated glucose uptake and its role in systemic energy regulation.

Most research treats endometriosis as a single entity, potentially obscuring informative subtype-specific associations with risk factors, biomarkers and treatment responses. A 2020 study raises the hypothesis that deep endometriosis oestrogen receptor-α expression might be associated with progestin treatment and the degree of post-surgical excision pain.

For type 1 diabetes mellitus (T1DM), keeping glucose levels within the normal range of 65–150 mg/dl with administered insulin has had limited success. Now, Fussenegger and colleagues have engineered cells to release insulin in response to electrical signals, but can this advance lead to better glucose control?

Thermogenic adipose tissue is a metabolic sink for excess fuel and is a promising target for the treatment of obesity and type 2 diabetes mellitus. However, hurdles exist in activating thermogenic adipose tissue in humans. A new study developed a drug screening platform utilizing human beige adipose tissue and identified non-canonical activators.

Available interventions for adolescents with obesity are based on behavioural therapy and lifestyle modification. A new randomized, controlled trial provides evidence of efficacy of a pharmacological therapy, liraglutide, for weight control in adolescent obesity. The indications for more widespread use of this medication in clinical practice are under discussion.

Neuroendocrine liver metastases often require multiple modes of treatment to attain disease control, which can utilize various forms of radiolabelled agents either delivered systemically or preferentially towards the liver. A recent trial suggested both safety and efficacy of a novel approach of combining the two to provide a radiation ‘boost’ to hepatic deposits.

Available evidence demonstrates a crosstalk between the renin–angiotensin and the parathyroid hormone–vitamin D systems. A new study suggests that vitamin D supplementation can lower systolic blood pressure and plasma aldosterone levels in patients with primary aldosteronism.

Current recommendations for perioperative doses of hydrocortisone in patients with adrenal insufficiency undergoing major surgery with general anaesthesia have been examined in a new paper. Compared with current guidelines, lower doses of hydrocortisone, tapered quickly back to baseline levels of glucocorticoids, were found to be effective and safe.

Effective medical treatment for thyroid eye disease, a debilitating condition that can cause sight loss, has been lacking. A recent phase III trial of teprotumumab, an IGF1R antagonist, reports encouraging results and could be a game changer. Here, the trial is put in the context of current management strategies to address this question.

A new study reveals that a high-sugar diet acutely alters human sperm small RNA profiles after 1 week and that these changes are associated with changes in sperm motility. This rapid response by sperm to nutritional fluctuation raises intriguing questions regarding the underlying mechanisms and the potential effects on offspring metabolic health.

In a cross-sectional study of individuals with type 1 diabetes mellitus, those who were designated to be slow disease progressors had an increased proportion of autoreactive, islet-specific CD8⁺ T cells expressing an ‘exhausted’ phenotype. By contrast, rapid disease progressors had increased numbers of islet-specific CD8⁺ T cells with a transitional memory phenotype.

A discovery metabolomic study was performed in a large cohort of adults to identify circulating biomarkers of frailty. The study found that carnitine and vitamin E pathways were dysregulated in frail compared with non-frail participants. These findings point to dysregulated mitochondrial metabolism as a potential root of age-related frailty.