Reviews & Analysis

Mild autonomous cortisol secretion from benign adrenocortical adenomas (usually diagnosed incidentally) is associated with cardiometabolic risk and other comorbidities, but without the signs of overt Cushing syndrome. This Review outlines the mechanisms, complications and comorbidities, diagnosis and management of mild autonomous cortisol secretion.

This article reviews advances in incretin-based pharmacotherapy, including the latest glucagon-like peptide 1 (GLP1) receptor agonists (GLP1RAs), ‘GLP1 plus’ agents, which combine the benefits of these agonists with the activity of additional hormones, and oral GLP1RAs, which promise to extend the benefits of GLP1 therapy.

Continuous glucose monitoring (CGM) is an effective tool in the management of diabetes mellitus. This Perspective discusses the potential benefits of widespread adoption of CGM in people with type 2 diabetes mellitus at different stages of disease progression and treatment intensification.

This Review summarizes cellular processes and regulation of protein tyrosine phosphatase 1B (PTP1B), discussing evidence from in vivo preclinical and human studies. PTP1B inhibitors, which are being developed for type 2 diabetes mellitus, obesity, rare diseases (such as Rett syndrome) and some cancers, are also discussed.

The acid-labile subunit (ALS) of the insulin-like growth factor (IGF) binding protein complex regulates the endocrine transport and bioavailability of IGF-1 and IGF-2 and therefore influences postnatal growth and metabolism. This Review addresses the endocrine physiology and pathology of ALS, discusses the emerging cellular roles for ALS and outlines its involvement in disease states.

The skeleton is a metabolically active organ, with bone formation and maintenance relying on highly anabolic, nutrient-consuming processes. Here, the authors describe the current understanding of fuel selection and intermediary metabolic pathways in bone cells during bone formation and discuss how metabolic dysfunction can contribute to skeletal disease.

This Review discusses the effect of antibiotic-induced perturbations of the gut microbiome on host metabolic health. The authors outline factors that might influence the response to antibiotic use and highlight prebiotic strategies that could improve microbial composition and modulate microbial recovery.

A new study by Reverte-Salisa and colleagues identifies a molecular mechanism through which the cAMP-mediating protein EPAC1 controls the size of brown and beige adipose tissue. This finding opens the door for the development of pharmacological interventions to prevent the decline of brown adipose tissue in obesity and ageing, and thereby improve metabolic health.

This Review highlights how cryo-electron microscopy has revolutionized our understanding of G protein-coupled receptor (GPCR) functions. Specific examples are outlined that provide insights into GPCR biology and drug discovery in endocrinology and metabolism.

The current increasing rates of obesity are paralleled by a rise in the prevalence of chronic kidney disease. This Review outlines the potential mechanisms by which obesity might influence kidney function, but also presents evidence for the regulation of body weight by the kidney.

COVID-19 has been linked to an increase in thyroid dysfunction among current and past patients. This Review discusses and evaluates the evidence for COVID-19 causing thyroid dysfunction, including after COVID-19 vaccination and during long COVID.

Evidence and guidance for the care of pituitary adenomas in children and adolescents is currently lacking. Part 1 of this two-part consensus guideline presents 17 general recommendations for diagnosis and management of pituitary adenomas in children and young people under 19 years of age.

This article is the second part of the first-ever comprehensive, two-part, consensus guideline to cover the care of children and young people under 19 years of age with pituitary adenoma. Part 2 details 57 recommendations for CYP with prolactinomas, Cushing disease, growth hormone excess, clinically non-functioning adenomas and TSHomas.

Sarcopenic obesity is a growing clinical problem because of ageing populations and the increasing prevalence of obesity. This Review highlights the new consensus definition and diagnostic criteria for sarcopenic obesity, and provides an overview of the pathogenesis, clinical outcomes, and management of this syndrome.

Iatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI.

Vitamin D is precursor of the steroid hormone calcitriol and has important functions throughout the body, including increasing intestinal absorption of calcium, magnesium and phosphate. Vitamin D deficiency has been linked with a range of disorders, including several bone diseases. However, large trials of vitamin D supplementation have produced mixed results. Here, experts from around the world discuss several key questions in the vitamin D research and clinical fields.

The protein complex mTORC1 is a key regulator of cellular metabolism in response to energy availability. This Review discusses the role of mTORC1 in regulating energy expenditure and the implications for the development and treatment of obesity.

Schuermans et al. report phospholipase A and acyltransferase 3 (PLAAT3) deficiency in patients with lipodystrophy and peripheral neuropathy. Their discovery adds to the growing list of genetic lipodystrophies due to deficiencies of enzymes involved in phospholipid biosynthesis, including 1-acylglycerol-3-phosphate O-acyltransferase 2 and choline phosphate cytidylyltransferase 1 A.

Organoid technologies are a potent tool for investigating human biology, modelling diseases and developing novel therapies. In this Viewpoint, experts in metabolic and endocrine research in the brain, pituitary, skeletal muscle, bone and gastrointestinal system discuss how organoids and related bioengineered systems are currently used in their field and how innovations in these technologies could transform future research.

In this Review, the emerging cellular and molecular mechanisms by which obesity impairs key aspects of immunity are discussed, including changes in the abundance of key hormones, dysregulation of adipose-tissue-derived extracellular vesicles and dysregulation of polyunsaturated fatty acid metabolism.