Reviews & Analysis

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.

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.

Health equity is when every person can achieve their full potential for health and wellbeing. In this Viewpoint, global experts discuss the root causes and contributing factors to health inequity in endocrinology. Potential action points and research directions to help reduce health disparities are also discussed.

In May 2022, the WHO released global targets for diabetes mellitus. In this Viewpoint, experts from around the world discuss the challenges and opportunities in applying these targets.

In this Viewpoint, experts in the fields of medical therapy, adipocyte biology, exercise and muscle, bariatric surgery, genetics, and public health give their perspectives on current and future progress in addressing the rising prevalence of obesity.

Diabetes mellitus is a global health issue, yet huge regional disparities exist in its care, including in access to basic necessities such as insulin. In this Viewpoint, six experts from different regions discuss differences in access to insulin and other diabetes mellitus therapies as well as the key barriers in diabetes mellitus care accessibility and potential solutions.

Here, five of our Advisory Board Members look back at the past decade of endocrinology research, highlighting key advances and identifying roadblocks. They also discuss where effort and money should be invested now and speculate on where progress might be made in the coming decade.

In this Viewpoint, six members of our Advisory Board comment on advances in the past 10 years that have revealed new hormones, new functions for known hormones and endocrine organs and new endocrine roles for well-known organs. The authors discuss how bone was recognized as an endocrine organ, the emerging understanding of the importance of gut hormones, targeting ectopic adipose tissue and the pathogenesis and treatment of type 2 diabetes mellitus.

Nature Reviews Endocrinologypresents a new form of article, a Viewpoint, which provides a forum for a number of researchers to discuss important ongoing issues in endocrinology. In this Viewpoint article, experts from the field of thyroid cancer discuss and offer insight into the controversy surrounding the changing trends in thyroid cancer incidence.

Idiopathic short stature (ISS) describes a group of conditions associated with subnormal growth in the absence of an obvious cause. ISS represents an important problem in pediatric endocrinology; however, its heterogeneous nature can make clinical management difficult. Here, the possible merits of growth-hormone therapy for children with ISS are discussed.

Oral and transdermal estrogen therapies are both routinely used to treat menopausal symptoms, but there are multiple differences between their physiological effects. The author of this Viewpoint compares the pharmacodynamics of oral and nonoral estradiol therapies, and discusses the most important risk factors to consider when using either administration route.

Increasing demand for fertility treatment seems to correlate with declining semen quality among young men. The factors that cause impaired male reproductive capacity remain to be elucidated. Here, Nordström Joensen et al. suggest that early environmental exposure to endocrine disruptors could promote development of conditions such as testicular dysgenesis syndrome.

Subclinical hypothyroidism is characterized by an elevated TSH level in the presence of thyroid hormone levels within the population-based normal range. Debate continues as to whether individuals with subclinical hyperthyroidism require treatment with levothyroxine. The author of this Viewpoint argues in favor of such therapy, particularly for women of reproductive age.

Continuous glucose monitoring systems provide dynamic measurements of interstitial glucose levels, enabling patients with diabetes mellitus to act preemptively to reduce glycemic variability. The authors of this Viewpoint discuss the advantages of continuous glucose-monitoring systems over self-monitoring of blood glucose, as well factors that limit its availability and success.

Fine-needle aspiration cytology (FNAC) is a widely useed method for identifying malignant thyroid nodules. The main limitation of FNAC is the relatively high number of non-diagnostic specimens. The author of this Viewpoint suggests that the use of a stylet needle remarkably improves the diagnostic performance of FNAC and reduces health care costs.

FDA approval of inhaled insulin offered the possibility of a new direction in diabetes care. Nonetheless, within a year of coming to market, the first inhaled insulin product was withdrawn by the manufacturer. Here, Mitri and Pittas examine the factors behind the failure of inhaled insulin to be adopted by patients and clinicians.

Use of the second-generation (atypical) antipsychotic agents has led to concerns about possible adverse metabolic effects, including an increased risk of diabetes mellitus. The potential mechanisms underlying treatment-emergent diabetes mellitus, and strategies for effective management of affected individuals, are explored by the author of this Viewpoint.

Cystic lesions of the pituitary region are quite common but present a challenge for diagnosis and treatment. Several types of cystic lesion are recognized, including cystic pituitary adenomas, Rathke cleft cysts, arachnoid cysts, and craniopharyngiomas. The clinical symptoms and diagnosis of these lesions, and the use of endoscopy for surgical intervention, are discussed in this Viewpoint.

Current approaches to treat type 1 diabetes mellitus can be divided into three categories: insulin therapy, cell-based therapy and modification of the autoimmune process associated with type 1 diabetes mellitus. Comparing the benefits, risk and challenges of insulin therapy and cell-based therapy, the author of this Viewpoint discusses the prospects for these two therapeutic approaches.

Treatment of thyroid cancer has not changed substantially for many years; however, few effective therapies are available for tumors that are metastatic or unable to take up radioiodine. The author of this Viewpoint, therefore, argues for the need to increase individual treatment efficacy through the introduction of novel targeted therapies.