News & Comment

The first International Symposium on Phaeochromocytoma in 2005 was followed by considerable progress in the field, largely owing to the many collaborations and networks stimulated by that and subsequent meetings. The rich hereditary background of phaeochromocytomas has since provided for strong interdisciplinary links of genetics with personalized diagnostics, imaging and therapeutic interventions.

This Comment article provides a behind-the-scenes perspective and update of our 2016 Review, which discussed possible factors contributing to thyroid cancer incidence trends worldwide. We also highlight promising research directions that are improving the understanding of thyroid cancer aetiology.

In 2019, we published a Review on the relevance of gut microbial metabolites in obesity, non-alcoholic fatty liver disease and type 2 diabetes mellitus. Here, we highlight the importance of the balance between colonic proteolytic and saccharolytic metabolite production for metabolic health and the need to focus on more subgroup-based or personalized nutritional approaches.

In the past decade, the prevalence of obesity and related comorbidities has continued to increase across the globe, prompting many countries to adopt policies to improve diet quality. Here, we discuss key nutrition policies that have been implemented in the past few years and consider future priorities for global obesity prevention.

Islet inflammation (insulitis) in type 1 diabetes mellitus is triggered by a deleterious dialogue between β-cells and the immune system, inducing β-cell dysfunction and death. This concept, outlined in our 2009 Review, has been confirmed and extended. Here, we provide a brief update of the field and outline key pending questions.

In 2012, we were invited by Nature Reviews Endocrinology to write a Review titled ‘Muscles, exercise and obesity: skeletal muscle as a secretory organ’. At the time, following our findings in the 2000s, we knew the concept of skeletal muscle as an endocrine organ was important. Eight years on, the magnitude of the importance of this concept surprises us.

The sudden outbreak and global spread of COVID-19 represents one of the most profound societal and public health challenges in modern times. In this Comment, we call attention to the possibility that the societal strategies implemented to oppose COVID-19 might have long-term, negative effects on the obesity epidemic.

The COVID-19 pandemic has broad implications for the care of patients with bone fragility. A dramatic surge in fractures and related mortality is expected in the next few months. We pledge to intensify the current efforts to improve the management of bone health, and to prioritize fragility fracture care and prevention.

Preliminary data suggest that people with obesity are at increased risk of severe COVID-19. However, as data on metabolic parameters (such as BMI and levels of glucose and insulin) in patients with COVID-19 are scarce, increased reporting is needed to improve our understanding of COVID-19 and the care of affected patients.

Type 2 diabetes mellitus and hypertension are the most common comorbidities in patients with coronavirus infections. Emerging evidence demonstrates an important direct metabolic and endocrine mechanistic link to the viral disease process. Clinicians need to ensure early and thorough metabolic control for all patients affected by COVID-19.

Studies uncovering the cellular mechanisms of adaptation to varying oxygen levels were recognized with the 2019 Nobel Prize in Physiology or Medicine. Here, we focus on the remarkable parallels between the pathways regulating oxygen availability and those driving rare neuroendocrine tumours, phaeochromocytomas and paragangliomas, and discuss the translational implications of this connection.

Thyroid status and serum cholesterol levels are intimately linked. Hypothyroidism causes hypercholesterolaemia, which is thought to be resolved after treatment with levothyroxine and normalization of thyroid-stimulating hormone. However, some studies indicate that hypercholesterolaemia persists despite treatment, requiring more frequent use of statins.

In the pursuit of understanding metabolic control and energy balance, peripheral nerve communication between adipose tissues and the brain has been largely ignored. This Comment discusses the need for additional research that focuses on the role of adipose peripheral nerve function in the maintenance of energy balance.