Reviews & Analysis

Understanding of intermuscular adipose tissue has expanded over the past few years. This Review discusses the specific role of intermuscular adipose tissue in metabolic diseases in humans and in animal models, with a particular emphasis on the quantity and biological properties of this unique adipose tissue.

This Review highlights the extrapancreatic actions of the incretin hormones gastric inhibitory polypeptide and glucagon-like peptide 1. These peptides are active on tissues with cardiometabolic relevance, such as liver, adipose tissue, muscle, the immune, kidney, heart, blood vessels and the central nervous system.

There is growing awareness of differences in susceptibility to SARS-CoV-2 infection and COVID-19 severity between men and women. This Review assesses the evidence for this disparity and its potential causes, with a focus on the role of sex hormones.

This Review presents evidence that points to a critical role for metabolic pathways in influencing processes that support the early stages of tumour development, provides examples of the role of metabolic networks intrinsic to cancer cells in tumour progression and outlines how environmental factors can affect tumour incidence.

Cardiorenal diseases are common in patients with type 2 diabetes mellitus (T2DM), with substantial morbidity and premature mortality. This Review discusses how atherosclerotic cardiovascular disease and cardiorenal diseases can be prevented in T2DM, considering evidence from clinical trials and its implementation in clinical practice.

Exercise has many beneficial effects; however, glycaemia needs to be carefully managed in patients with type 1 diabetes mellitus undertaking exercise. This Review characterizes the exercise response in people with type 1 diabetes mellitus and provides clinical management strategies to address glucose control around exercise.

Hypoglycaemia is a common occurrence in people with type 1 diabetes mellitus, and can have serious consequences. This Review defines hypoglycaemia in type 1 diabetes mellitus, and also outlines its frequency, risk factors and adverse outcomes. Ways to prevent and treat this complication of insulin therapy are also discussed.

Bariatric surgery induces weight loss and can trigger remission of type 2 diabetes mellitus (T2DM) but may also lead to post-bariatric hypoglycaemia. This Review examines surgery-induced changes in glucose regulation and the potential mechanisms responsible for the resolution of T2DM and induction of hypoglycaemia.

Insufficient sleep and circadian misalignment contribute to obesity risk. This Review discusses how modern society disrupts sleep, it considers evidence from human studies on how sleep disruption affects energy expenditure, appetite hormones and food intake, and discusses some potential strategies to reduce the adverse effects of sleep disruption.

Life stress is known to affect the development and progression of metabolic diseases. This Review discusses the pathophysiological mechanisms underlying the association between stress and metabolic disease, and evaluates the epidemiological evidence for the influence of stress on metabolic disease.

This Review discusses the ATP-binding cassette (ABC) proteins ABCB1 and ABCC1 and their preferential cellular export of cortisol and corticosterone, respectively. The article also explores the potential to select therapeutic glucocorticoids on the basis of their different tendencies for export to avoid harmful adverse effects.

Membrane trafficking is essential for the sorting and distribution of several different types of cargo between different intracellular compartments and the plasma membrane. In this Review, advances in understanding the contribution of the endosomal system to metabolic physiology and pathology are outlined.

The mammary gland is responsible for lactation and is regulated by the coordinated actions of reproductive and metabolic hormones. This Review discusses the hormonal regulation of lactation, hormonal functions of the mammary gland, the hormone composition of human milk, and endocrine and metabolic diseases that cause lactation insufficiency.

Two maternal cardiometabolic disorders, hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM), affect many pregnant individuals worldwide. This Review discusses the global disease burden and risk factors for HDP and GDM and discusses public health interventions that might help reduce the associated mortality and morbidity.

Organoids are a promising tool for modelling diseases in vitro. This Review discusses the progress in developing liver and adipose tissue organoids to study metabolic diseases such as obesity and non-alcoholic fatty liver disease and assesses the strengths and limitations of these systems.

Endometrial diseases affect many women yet often have unclear pathogenesis and no definitive treatment. This Review assesses the current systems for modelling endometrial diseases in vitro and outlines future directions for these model systems.

This Review discusses how redefining the primary aldosteronism syndrome as a multidimensional spectrum will affect the approach to the diagnosis and subtyping of primary aldosteronism.

Patients with obesity-associated metabolic dysfunction exhibit dysregulation in iron homeostasis and alterations in gut microbiota composition and functionality. This Review discusses the bidirectional relationships between the host and the microbiota in the acquisition of elemental iron and the implications for glucose metabolism.

Primary bilateral macronodular adrenocortical hyperplasia (PBMAH) is an adrenal cause of Cushing syndrome. This Review outlines recent progress in understanding the genetics of PBMAH.

Rare monogenic obesity is caused by pathogenic variants in single genes, while common obesity mostly has a polygenic basis. This Review discusses genetic obesity traits, the emergence of novel pharmacological treatment options that target the central melanocortin pathway and future innovative therapies.