Opinion

  • Opinion |

    The incidence of adolescent obesity is increasing, which has serious long-term implications for the affected individuals and wider society. Here, Thomas Reinehr outlines the effects of adolescent obesity and discusses how the epidemic could be addressed.

    • Thomas Reinehr
  • Opinion |

    In this Opinion article, Klose and Feldt-Rasmussen posit that the true risk and disease burden of hypopituitarism after traumatic brain injury might have been overestimated in recent years. Possible reasons for this overestimation are discussed, along with current recommendations for diagnosing and treating the condition.

    • Marianne Klose
    •  & Ulla Feldt-Rasmussen
  • Opinion |

    The emerging field of omics has the potential to advance and strengthen research into endocrine-disrupting chemicals (EDCs). In this Opinion article, Andrea Baccarelli and colleagues discuss the potential of using omics technologies — both established and developing — to characterize present and past EDC exposures and predict risk of developing EDC-related diseases.

    • Carmen Messerlian
    • , Rosie M. Martinez
    • , Russ Hauser
    •  & Andrea A. Baccarelli
  • Opinion |

    Monthly or annual bolus doses of vitamin D have been reported to be harmful rather than beneficial, increasing falls and fractures. In this Perspectives, J. Christopher Gallagher proposes that the vitamin D dose recommended by the Institute of Medicine be revised downwards.

    • J. Christopher Gallagher
  • Opinion |

    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.

    • Paul Zimmet
    • , K. George Alberti
    • , Dianna J. Magliano
    •  & Peter H. Bennett
  • Opinion |

    Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cancer. In this Perspectives article, Xilin Yang and colleagues discuss risk factors (subphenotypes) for cancer in Chinese patients with T2DM, which can lead to drug-subphenotype interactions. The authors also propose plausible biological links between T2DM and cancer and underlying the drug-subphenotype interactions.

    • Xilin Yang
    • , Heung M. Lee
    •  & Juliana C. N. Chan
  • Opinion |

    Successful studies in the nonobese diabetic (NOD) mouse model often do not translate to positive outcomes in human studies. This Perspectives outlines the genetic and immunologic differences that might contribute to these differential outcomes and suggests how the NOD mouse model could be adapted to improve its utility.

    • James C. Reed
    •  & Kevan C. Herold
  • Opinion |

    Colonization of an infant with their microbiota in early life is important for normal development of host metabolism. In this Perspectives article, Cox and Blaser posit that exposure to antibiotics that disrupt either vertical transmission or colonization and maturation of the microbiota in the infant can lead to adverse consequences such as obesity in adulthood.

    • Laura M. Cox
    •  & Martin J. Blaser
  • Opinion |

    Transfer from paediatric to adult health-care services for individuals with a disorder of sex development has specific issues that can impede continuity of care. Here, Crouch and Creighton discuss these barriers, and propose that a long-term plan with psychological support at each stage of transition could ensure successful transfer for these patients.

    • Naomi S. Crouch
    •  & Sarah M. Creighton
  • Opinion |

    Hyperinsulinaemic androgen excess leads to hirsutism, acne, seborrhoea and irregular menstrual cycles in young women. In this Perspectives article, Ibáñez and colleagues hypothesize that hyperinsuliaemic androgen excess arises owing to increased lipid load in adipose tissue, outline potential diagnostic criteria, and discuss the advantages and disadvantages of different treatment options for girls with this disorder.

    • Lourdes Ibáñez
    • , Ken K. Ong
    • , Abel López-Bermejo
    • , David B. Dunger
    •  & Francis de Zegher
  • Opinion |

    The cellular mechanisms whereby stressful life experiences cause biological damage and increase disease risk remain poorly understood. Here, Picard et al. expand upon the metabolic aspects of this process. They propose that mitochondrial allostatic load could underpin the deleterious structural and functional changes that mitochondria undergo in response to elevated glucose levels and stress-related pathophysiology.

    • Martin Picard
    • , Robert-Paul Juster
    •  & Bruce S. McEwen
  • Opinion |

    Emerging data suggest a role for autoimmunity in type 2 diabetes mellitus (T2DM). In this Perspectives, the authors discuss the nature of the immune response in diabetes mellitus and the evidence for an autoimmune component in T2DM and obesity.

    • Lício A. Velloso
    • , Decio L. Eizirik
    •  & Miriam Cnop
  • Opinion |

    Fructose is increasingly being used in food supply. In this Perspectives, the authors discuss the links between fructose intake and obesity; in particular, the negative effects of fructose exposure during early development are highlighted.

    • Michael I. Goran
    • , Kelly Dumke
    • , Sebastien G. Bouret
    • , Brandon Kayser
    • , Ryan W. Walker
    •  & Bruce Blumberg
  • Opinion |

    Vitamin D is the nutrient du jour, yet scant evidence exists for various health claims related to vitamin D. This Perspectives article aims to dispel misconceptions about vitamin D, including discussion of osteoporosis, chronic disease risk, requirements in pregnancy and lactation, and vitamin D deficiency and supplementation.

    • Clifford J. Rosen
    •  & Christine L. Taylor
  • Opinion |

    For >30 years, HDL's association with protection from atherosclerosis has been unquestioned. However, in the past 5 years, powerful new human genetic data together with negative clinical trials have cast doubt on the HDL hypothesis. This Perspectives examines evidence for and against HDL's direct role in atherosclerosis and considers reasons why the HDL hypothesis seems to be 'too big to fail'.

    • Dominic S. Ng
    • , Norman C. W. Wong
    •  & Robert A. Hegele
  • Opinion |

    Early life experiences can affect cardiovascular risk and influence the development of metabolic problems later in life. In this Perspectives article, Gerthe Kerkhof and Anita Hokken-Koelega discuss how rapid weight gain in relation to length increase during the first few months of life can lead to an increased risk of obesity, diabetes mellitus and cardiovascular problems in adults.

    • Gerthe F. Kerkhof
    •  & Anita C. S. Hokken-Koelega
  • Opinion |

    Developing countries are experiencing huge rises in the incidence of type 2 diabetes mellitus (T2DM). In this Perspectives, Justin Echouffo-Tcheugui and Samuel Dagogo-Jack describe factors that underlie the rising prevalence of (T2DM), strategies to tackle the problem and discuss the difficulties that need to be overcome in order to implement solutions.

    • Justin B. Echouffo-Tcheugui
    •  & Samuel Dagogo-Jack
  • Opinion |

    Controversy on the optimal target for blood glucose control in patients admitted to the intensive care unit remains. The debate has been fierce, given the universally present risk of hypoglycaemia and its associated adverse outcomes. In this Perspectives article, the author endeavours to reconcile the currently available evidence on stress-induced diabetes mellitus.

    • Greet Van den Berghe
  • Opinion |

    This Perspectives re-evaluates the role of radioiodine treatment following surgery in low-risk patients with undetectable serum thyroglobulin levels after TSH stimulation and without evidence of disease. Moreover, the authors discuss the methods used for preparing low-risk patients for the administration of radioiodine after surgery and the activity of radioiodine that should be administered.

    • Martin Schlumberger
    • , Isabelle Borget
    • , Camila Nascimento
    • , Maryse Brassard
    •  & Sophie Leboulleux
  • Opinion |

    Microvascular complications in diabetes mellitus are driven by chronic hyperglycemia. Their correlation with HbA1c levels is considered useful; however, unlike the direct information provided by glucose, HbA1c values reflect glycemic and nonglycemic factors. The author of this Perspective delineates the prominent roles of genetic and ethnic factors in determining HbA1c variance and questions the usefulness of HbA1c levels as a diagnostic tool for diabetes mellitus and prediabetes.

    • Samuel Dagogo-Jack
  • Opinion |

    Disorders of the thyroid gland are relatively frequent in women of childbearing age and can result in poor pregnancy outcome. The authors of this Perspective are in favor of serum TSH measurement for all pregnant women and present relevant information on analytical and clinical aspects of serum TSH determination and its usefulness to detect subtle thyroid function abnormalities associated with the pregnant state, namely overt and subclinical hypothyroidism and hyperthyroidism.

    • Daniel Glinoer
    •  & Carole A. Spencer
  • Opinion |

    HbA1c is the cornerstone of diabetes management; however, measurement and interpretation of HbA1c values is complex and hampered by lack of international standardization. The implementation of a reference system developed by the International Federation for Clinical Chemistry could potentially allow reporting of true HbA1c results, standardized to an absolute value, worldwide.

    • Sally M. Marshall
  • Opinion |

    In this Perspective, De Graaf and Kok argue that two elements of contemporary eating that facilitate a high energy intake, namely a high eating rate and distraction of attention from eating, undermine the body's capacity to regulate its energy intake at healthy levels because they impair the congruent association between sensory signals during eating and the metabolic consequences after ingestion.

    • Cees de Graaf
    •  & Frans J. Kok
  • Opinion |

    The ability of human embryonic stem cells to differentiate into pancreatic islet cells has defined the developmental stages and transcription factors involved in this process. As a consequence, refinement of gene and stem cell therapies for patients with insulin-dependent diabetes mellitus has become an area of intense research. In this Perspectives article, Calne and colleagues comment on the progress of these experimental therapies, which might one day become a clinical reality.

    • Roy Y. Calne
    • , Shu Uin Gan
    •  & Kok Onn Lee
  • Opinion |

    Many foods are marketed on the basis of a claim to reduce hunger, food intake or body weight. It is clear that any claim should be substantiated by scientific evidence. This article discusses the validity of such claims and the capacity of diet foods to influence behavior in a meaningful way in the real world.

    • John Blundell
  • Opinion |

    The development of anti-obesity drugs has not been straightforward. With very few drugs on the market, and bad publicity related to adverse events, obesity remains a major challenge for the pharmaceutical industry. In light of past experience with endocannabinoid-system antagonists, such as rimonabant, the authors of this Perspectives article propose that a major paradigm shift in clinical practice might be necessary to justify the use of pharmacotherapy for obesity.

    • Vincenzo Di Marzo
    •  & Jean-Pierre Després
  • Opinion |

    Knowledge of the epidemiology, natural history, diagnosis, treatment, and rates of recurrence of nonfunctioning pituitary adenomas has greatly improved over the past few years. Wass and Karavitaki now highlight some of these advances and speculate on future avenues of research. In addition, they describe their own experience in the clinical management of patients with nonfunctioning pituitary adenomas.

    • John A. H. Wass
    •  & Niki Karavitaki