Reviews & Analysis

This Review focuses on challenges and advances in the management and treatment of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. New therapeutic developments are discussed, including novel glucocorticoid therapies, adjunct agents aimed at controlling excess androgens, and cell-based and gene-based therapies.

This article discusses the current understanding of the genetics of autoimmune Addison disease and outlines the autoimmune mechanisms that could underlie the effects on the adrenal cortex.

Exerkines are signalling moieties that are released in response to acute and/or chronic exercise that exert their effects through endocrine, paracrine and/or autocrine pathways. This Review summarizes the importance and current state of exerkine research, prevailing challenges and future directions.

The growth hormone (GH)–insulin-like growth factor 1 (IGF1) axis regulates bone remodelling and metabolism. This Review highlights the pathophysiological and clinical aspects of skeletal fragility associated with perturbations in the GH–IGF1 axis such as GH deficiency, anorexia nervosa, ageing and acromegaly.

Intermittent fasting diets are increasingly popular alternatives to traditional weight loss methods; however, their efficacy and safety are currently unclear. This Review evaluates the current research on intermittent fasting and discusses the benefits and challenges of these diets.

This Review discusses the role of mitochondria in metabolism and how mitochondria contribute to age-related metabolic diseases. This knowledge might guide us in designing therapies targeting metabolic disorders to extend human health span and lifespan.

Abnormal uterine bleeding affects many individuals who menstruate and can have a detrimental impact on physical and mental health. This Review discusses endometrial physiology and the causes underlying abnormal uterine bleeding (including heavy menstrual bleeding).

Evidence from cohort studies and clinical trials supports an aetiological role of sugar-sweetened beverage (SSB) intake in the development of obesity and related chronic diseases. This Review provides an up-to-date view, considering the evidence, potential mechanisms and policy actions to reduce the global intake of SSBs.

Treatment of primary hypothyroidism is improving but many patients still report a reduced quality of life compared with healthy individuals. This Review discusses the management of primary hypothyroidism and the potential reasons for patient dissatisfaction with treatment.

Thyroid hormone is important during pregnancy, as it facilitates appropriate fetal development. Furthermore, thyroid dysfunction during pregnancy can negatively affect obstetric outcomes and maternal health. This Review discusses the evaluation and management of thyroid disorders in pregnancy and in the postpartum period.

This Review outlines the burden of type 2 diabetes mellitus and its complications in sub-Saharan Africa, including the pathogenesis, standards of care for treatment and preventive strategies.

This article discusses trends in human reproductive behaviour and health that are associated with infertility. These changes have occurred over a period of only a couple of generations, so environmental factors are suggested to have a role.

This Review highlights results from large randomized clinical trials performed during the period 2017–2020 and Mendelian randomization studies on vitamin D levels. Together, findings indicate that vitamin D supplementation alone in vitamin D-replete adults does not provide health benefits; however, vitamin D deficiency should always be corrected.

Imaging modalities are now available that enable non-invasive quantitative measurements of liver fat content. This Review highlights the various modalities and their use in clinical trials, discusses the clinical importance of hepatic steatosis for progression of nonalcoholic fatty liver disease and proposes how the new modalities might be used going forward.

S-nitrosylation is a key molecular mechanism in the regulation of insulin signalling. This Review explores the role of S-nitrosylation throughout the life cycle of insulin, in both metabolic health and disease.

This Review explains core concepts in artificial intelligence (AI) and machine learning for endocrinologists. AI applications in endocrine cancer diagnostics are highlighted as well as research challenges and future directions for the field.

This Review summarizes adaptive immune cell dysregulation in obesity and type 2 diabetes mellitus (T2DM). Under-appreciated comorbidities of obesity and T2DM (oral cavity inflammation, neuroinflammation and dysbiosis) are considered, and previous clinical trials of anti-inflammatory therapies for T2DM are discussed.

There is growing evidence that fat accumulation in the pancreas can have consequences for metabolic health. This Review discusses the methods for detecting pancreatic fat and the potential causes and pathogenic consequences of pancreatic fat accumulation.

Within the pancreatic islets of Langerhans, endocrine cells are heterogeneous in terms of transcriptional profile, protein expression and the regulation of hormone release. This Review describes how endocrine cell heterogeneity, particularly of β-cells, affects the regulation of hormone secretion within pancreatic islets.

This Review highlights the ontogeny of thermogenic adipocytes, regulation of the adipose tissue microenvironment and inter-organ communication between adipose and other tissues. In addition, activation of thermogenic adipose tissue in humans and animal models is discussed, as well as the therapeutic potential of thermogenic adipose tissue.