Volume 10 Issue 3, March 2014

Limited options for clinical management of patients with juvenile-onset diabetes mellitus call for a novel therapeutic paradigm. Two innovative studies support endoplasmic reticulum as an emerging target for combating both autoimmune and heritable forms of this disease.

An Endocrine Society-appointed task force has developed an evidence-based clinical practice guideline for the diagnosis and treatment of polycystic ovary syndrome. The guidelines provide suggestions for the management of patients with polycystic ovary syndrome and highlight many areas of uncertainty requiring further scientific efforts.

New US guidelines for the management of overweight and obesity have disregarded robust evidence from intervention trials demonstrating the importance of dietary factors for weight control and disease prevention. This omission implies that diet composition does not matter, a stance that is potentially counterproductive for prevention and treatment strategies.

Iodine from the diet is fundamental for brain development. Via milk, infants receive 40–45% of the iodine in their mother's diet during breastfeeding; however, it is unclear to what extent depot iodine supplements (that is, iodized oil) given to iodine-deficient breastfeeding mothers compares with direct supplementation of the infants.

The recommended daily iodine intake is 150 µg in adults who are not pregnant or lactating. Most people can tolerate levels above this threshold, but excess iodine exposure or ingestion can result in thyroid dysfunction in certain susceptible individuals. This article discusses the consequences of excess iodine.

This Review discusses the molecular mechanisms through which metformin acts on metabolism, mainly focussing on liver gluconeogenesis, and on tumourigenesis. In addition, the authors review the potential implications of new discoveries about the molecular targets of metformin for the development of antidiabetic and anticancer therapies.

This Review focuses on the roles of the natriuretic peptides and the sympathetic nervous system in regulating adipocyte metabolism. The potential for manipulating the natriuretic peptide pathway to increase energy expenditure in patients with obesity and to manage the complications of cardiometabolic disease is also discussed.

This Review discusses paradigm shifts in the treatment of hypothyroidism and their influence on clinical practice—a far from trivial issue, given the number of affected patients. Although levothyroxine monotherapy remains the standard treatment for hypothyroidism, the latest guidelines indicate that levothyroxine plus liothyronine combination therapy might be considered in specific circumstances.

Vitamin D receptor and enzymes that metabolize vitamin D are expressed in male reproductive organs. This Review highlights the role of vitamin D in male reproduction. Effects of vitamin D signalling on semen quality, estrogen responsiveness and the development of testicular germ cell tumours are discussed.