Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
2014 was a good year for developments in automated insulin delivery systems for patients with diabetes mellitus. Clinical trials shifted from research units to the outpatient setting, included both adult and adolescent individuals and were conducted over periods from overnight to 24 h, with improvements seen in time spent in the target glycaemic range and reduced risk of hypoglycaemia.
Observational studies suggest that statin treatment has a fracture-preventive effect; however, there is only limited supporting evidence from randomized controlled trials. Now, results from the JUPITER trial show that rosuvastatin treatment does not reduce the risk of fractures and, further, that levels of high sensitivity C-reactive protein are not associated with fracture risk.
In 2014, many articles focusing on pituitary tumours were published, including studies on genetics, surgery, radiotherapy and medical treatment. This commentary highlights advances in the management of patients with acromegaly, Cushing disease and TSH-secreting tumours. Together, these advances will benefit the care and management of patients with pituitary tumours.
2014 has seen advances in our understanding of benign and malignant tumours of the adrenal cortex, particularly in Cushing syndrome. Modern genetics has generated a flurry of data. The challenge is to give sense to them; however, the difficulties of collecting the clinical data must not be underestimated.
In 2014, numerous noteworthy papers focusing on adipose tissue physiology were published. Many of these articles showed the promise of adipose-tissue-targeted approaches for therapeutic intervention in obesity and type 2 diabetes mellitus. Here, we highlight advances in the development and maintenance of brown and/or beige adipocytes and the metabolic implications of inflammation in adipose tissues.
Aromatase inhibitors are the most effective agents for preventing breast cancer; however, their use is associated with bone loss and an increased risk of fractures. Sestak and colleagues show that administration of an oral bisphosphonate prevents aromatase-inhibitor-induced bone loss in postmenopausal women with osteopenia or osteoporosis who are at high risk of breast cancer.
In 2014, two phase II clinical studies reported rapid, impressive increases in BMD in women with low bone mass who were treated with sclerostin inhibitors for 1 year. The antifracture efficacy and tolerability of these new, bone-building therapies are currently being investigated in phase III clinical trials.
Studies published in 2014 have helped in our understanding of the epigenetic mechanisms by which suboptimal nutritional exposures during in utero development are transmitted to subsequent generations through the maternal and the paternal germlines. Advances include identification of common genetic loci that are vulnerable to the effects of in utero undernutrition and overnutrition, as well as those that are epigenetically modified tissue-wide.
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.