Current Opinion in Endocrinology & Diabetes and Obesity最新文献

Microbiome-derived signaling molecules and the brain-gut axis: emerging mechanisms and clinical implications. 微生物衍生的信号分子和脑肠轴：新出现的机制和临床意义。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-06-01 Epub Date: 2026-03-24 DOI: 10.1097/MED.0000000000000959

Marya Pulaski, H Christian Weber

{"title":"Microbiome-derived signaling molecules and the brain-gut axis: emerging mechanisms and clinical implications.","authors":"Marya Pulaski, H Christian Weber","doi":"10.1097/MED.0000000000000959","DOIUrl":"10.1097/MED.0000000000000959","url":null,"abstract":"Purpose of review: Recent advances in metabolomics, multi-omics integration, and neurogastroenterology have fundamentally reshaped understanding of the human gut microbiome. Rather than microbial composition alone, emerging evidence highlights microbial secretory and signaling activity as a central regulator of brain-gut communication. Understanding how microbiome-derived molecules interact with epithelial, immune, endocrine, and neural pathways is essential for advancing mechanistic insight and precision interventions in disorders of gut-brain interaction (DGBI).Recent findings: Recent studies demonstrate that the gut microbiome functions as a metabolic and endocrine signaling system, producing compounds such as short-chain fatty acids, bile acids, tryptophan-derived metabolites, polyamines, and lipid mediators that act on enteroendocrine cells, immune circuits, mechanosensory pathways, and vagal afferents. These signals are integrated centrally through brainstem and cortical networks, shaping gastrointestinal motility, visceral sensitivity, stress responsiveness, and affective processing. Functional dysbiosis and altered microbial signaling - rather than consistent taxonomic changes - appear to be primary modulators of brain-gut axis dysregulation.Summary: Emerging data calls for a reframing of gut-brain disorders as conditions of disrupted microbial signaling. Clinically, they support mechanism-based stratification and targeted dietary, microbiome-directed, and neuromodulatory therapies. The findings identify a need for functional biomarkers and targeted molecular approaches to advance precision medicine in DGBIs.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"101-107"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introduction. 编辑介绍。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-06-01 Epub Date: 2026-04-29 DOI: 10.1097/MED.0000000000000958

引用次数: 0

Beyond weight loss: tirzepatide as a dual GIP/GLP-1 receptor agonist for obstructive sleep apnea. 除减肥外：替西肽作为阻塞性睡眠呼吸暂停的双GIP/GLP-1受体激动剂。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-06-01 Epub Date: 2025-12-17 DOI: 10.1097/MED.0000000000000949

Jairo A Noreña, Tugce Akcan, Dimpi Desai

{"title":"Beyond weight loss: tirzepatide as a dual GIP/GLP-1 receptor agonist for obstructive sleep apnea.","authors":"Jairo A Noreña, Tugce Akcan, Dimpi Desai","doi":"10.1097/MED.0000000000000949","DOIUrl":"10.1097/MED.0000000000000949","url":null,"abstract":"Purpose of review: This review summarizes emerging evidence on the use of the dual glucose-dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist (RA) tirzepatide in improving obstructive sleep apnea (OSA) outcomes in individuals with obesity.Recent findings: Tirzepatide has demonstrated significant reductions in apnea-hypopnea index (AHI) among patients with OSA and coexisting obesity. It has recently become the first medication approved by the U.S. Food and Drug Administration (FDA) specifically for moderate-to-severe OSA in adults with obesity. In addition to weight loss, tirzepatide has been associated with reduced cardiovascular, hepatic, and renal events, suggesting broader systemic benefits.Summary: As a dual GIP/GLP-1 RA, tirzepatide represents a promising therapy for OSA in individuals with obesity, offering benefits of both weight reduction and symptom improvement. Given the high burden and underdiagnosis of OSA, particularly in populations with obesity, it should be considered earlier in the treatment algorithm, either in combination with or as an alternative to traditional therapies.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"108-114"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metabolic dysfunction and the use of adjunct medications in type 1 diabetes. 1型糖尿病的代谢功能障碍和辅助药物的使用。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-06-01 Epub Date: 2026-03-26 DOI: 10.1097/MED.0000000000000956

Andrew Luk, Yee Seun Cheah, Shivani Misra, Victoria Salem

{"title":"Metabolic dysfunction and the use of adjunct medications in type 1 diabetes.","authors":"Andrew Luk, Yee Seun Cheah, Shivani Misra, Victoria Salem","doi":"10.1097/MED.0000000000000956","DOIUrl":"10.1097/MED.0000000000000956","url":null,"abstract":"Purpose of review: Type 1 diabetes is increasingly complicated by obesity and broader metabolic dysfunction, yet there are barriers to the use of adjunctive pharmacotherapies in this population. This review evaluates the evidence for metformin, glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) in type 1 diabetes, with a focus on weight loss, glycaemic control, insulin dose requirements and safety.Recent findings: Despite advances, metformin remains the only adjunct widely endorsed in national guidelines for adults with type 1 diabetes. In clinical trials, GLP-1RAs used alongside automated insulin delivery systems demonstrate significant improvements in weight, glucose sensor time-in-range, and total daily insulin dose, without increased risk of diabetic ketoacidosis (DKA). SGLT2i produce more modest weight and HbA1c improvements, and may be associated with an increased risk of DKA, although they have a clear evidence base for independent cardiovascular benefits.Summary: There is an increasing demand by patients and desire by physicians to utilize adjunctive medications in type 1 diabetes. Many patients with type 1 diabetes who are highly likely to benefit from the weight loss and cardiorenal risk reduction effects of these drugs are denied access to them because of putative safety concerns and a dearth of clinical trial evidence in type 1 diabetes. Identifying patients with type 1 diabetes most likely to tolerate and benefit from these agents is a research priority. Real world datasets accounting for the increased off license use of these drugs offers an opportunity to rapidly develop evidence-based guidance.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"115-124"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revisiting the relationship between weight loss and bone health in people living with obesity: insights from the latest evidence. 重新审视肥胖人群减肥与骨骼健康之间的关系：来自最新证据的见解。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-05-05 DOI: 10.1097/MED.0000000000000962

Julien Paccou

{"title":"Revisiting the relationship between weight loss and bone health in people living with obesity: insights from the latest evidence.","authors":"Julien Paccou","doi":"10.1097/MED.0000000000000962","DOIUrl":"https://doi.org/10.1097/MED.0000000000000962","url":null,"abstract":"Purpose of review: This review summarizes recent advances in understanding bone outcomes associated with lifestyle, surgical, and pharmacological weight-loss strategies.Recent findings: Lifestyle-induced weight loss achieved through calorie restriction is consistently associated with reductions in hip areal bone mineral density (aBMD) when weight loss is clinically meaningful. However, recent randomized controlled trials show that structured lifestyle interventions incorporating resistance exercise and adequate nutritional support can mitigate bone loss and preserve bone strength. These studies also emphasize the added value of advanced imaging techniques for evaluating bone quality beyond aBMD alone. In the surgical setting, accumulating evidence clarifies the detrimental skeletal effects of sleeve gastrectomy and other bariatric procedures, with postmenopausal women and adults over 60 years at particularly high risk. Preventive approaches, including targeted physical activity and antiresorptive therapies, are under active investigation. In parallel, emerging data on antiobesity medications are beginning to elucidate their skeletal effects, including changes in bone microarchitecture and fracture risk.Summary: Lifestyle interventions can attenuate skeletal impairment and preserve bone quality during calorie-restriction-induced weight loss. In contrast, bariatric surgery, particularly sleeve gastrectomy, adversely affects bone health, especially in postmenopausal women. The skeletal impact of antiobesity medications remains incompletely defined and warrants further study.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Secondary hyperparathyroidism in chronic kidney disease: update on pathophysiology and new treatment targets. 慢性肾脏疾病继发性甲状旁腺功能亢进：病理生理学的最新进展和新的治疗靶点。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-05-05 DOI: 10.1097/MED.0000000000000961

Amal Derai, Ditte Hansen, Hanne Skou Jørgensen

{"title":"Secondary hyperparathyroidism in chronic kidney disease: update on pathophysiology and new treatment targets.","authors":"Amal Derai, Ditte Hansen, Hanne Skou Jørgensen","doi":"10.1097/MED.0000000000000961","DOIUrl":"https://doi.org/10.1097/MED.0000000000000961","url":null,"abstract":"Purpose of review: Secondary hyperparathyroidism remains a universal complication of chronic kidney disease (CKD), yet evidence-based treatment targets for parathyroid hormone (PTH) are lacking. This review revisits the pathophysiology of secondary hyperparathyroidism with emphasis on PTH as a master regulator of both calcium and phosphate homeostasis and discusses emerging treatment targets beyond PTH.Recent findings: Recent data reinforce the role of phosphate burden as a central driver of hyperparathyroidism in CKD. At the same time, publications from recent years highlight substantial heterogeneity in skeletal responsiveness to PTH with discordance between PTH levels and bone turnover. Observational data continue to demonstrate nonlinear associations between PTH levels and patient-relevant outcomes, while interventional trials defining optimal PTH targets remain scarce. Recent consensus statements propose the use of nonkidney-cleared bone turnover markers as a supplemental noninvasive tool to better assess skeletal remodeling activity and guide treatment decisions.Summary: PTH levels do not adequately reflect skeletal remodeling in CKD. A broader approach that considers biochemical bone turnover markers alongside PTH may allow a more individualized management strategy. Future studies should focus on defining optimal treatment targets and should include clinically important and patient-relevant, rather than biochemical, outcomes.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parathyroid hormone assays in 2026: second versus third generation, standardization, and clinical interpretation. 2026年甲状旁腺激素检测：第二代与第三代、标准化和临床解释。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-04-10 DOI: 10.1097/MED.0000000000000960

Niklas Rye Jørgensen, Etienne Cavalier, Samuel D Vasikaran

{"title":"Parathyroid hormone assays in 2026: second versus third generation, standardization, and clinical interpretation.","authors":"Niklas Rye Jørgensen, Etienne Cavalier, Samuel D Vasikaran","doi":"10.1097/MED.0000000000000960","DOIUrl":"10.1097/MED.0000000000000960","url":null,"abstract":"Purpose of review: Accurate measurement of parathyroid hormone (PTH) remains essential for the diagnosis and management of disorders of mineral metabolism, particularly in parathyroid disorders including in chronic kidney disease-mineral and bone disorder. Persistent inter-assay variability limits the comparability of clinical results across platforms and impedes guideline harmonization. This review focuses on recent advances in methodology, highlighting recent developments that move the field toward harmonization or even standardization of PTH assays.Recent findings: Recent landmark studies have applied liquid chromatography-tandem mass spectrometry (LC-MS/MS) as a candidate reference measurement procedure, enabling direct quantification of intact 1-84PTH with improved specificity. Novel immunocapture LC-MS/MS workflows demonstrate enhanced analytical precision and reveal substantive biases among commercial immunoassays. Recent progress in feasibility of harmonizing calibration was shown in a multicenter study where immunoassays were calibrated against LC-MS/MS reference methods, yielding reduced inter-assay bias, facilitating shared reference intervals. High-accuracy isotope-dilution mass spectrometry has been deployed to characterize reference materials, supporting future standard formulation.Summary: Emerging LC-MS/MS methods and harmonization strategies represent significant progress toward future standardization of assays for PTH. While technical complexity and cost still remain barriers, recent developments point towards improved analytical comparability and enhanced clinical interpretation.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The future of triglyceride-regulating therapies and registries. 甘油三酯调节疗法和登记的未来。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-04-01 Epub Date: 2026-02-26 DOI: 10.1097/MED.0000000000000951

Gerald F Watts, Dick C Chan

引用次数: 0

Familial hypercholesterolemia in pregnancy. 妊娠期家族性高胆固醇血症。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1097/MED.0000000000000954

Jayanthi Ramanathan, David Sullivan, Gerald Watts, Kirsten Holven, Yee Sian Tiong

{"title":"Familial hypercholesterolemia in pregnancy.","authors":"Jayanthi Ramanathan, David Sullivan, Gerald Watts, Kirsten Holven, Yee Sian Tiong","doi":"10.1097/MED.0000000000000954","DOIUrl":"10.1097/MED.0000000000000954","url":null,"abstract":"Purpose of review: Familial hypercholesterolemia (FH) in pregnancy poses several challenges, requiring a delicate balance between maternal atherosclerotic cardiovascular disease (ASCVD) risk and foetal safety. The review synthesizes current evidence, research gaps, evaluates emerging data on existing lipid-lowering strategies and highlights evolving guideline recommendations.Recent findings: Pregnancy in women with FH has unique considerations for both the mother and the foetus. Data from registries and observational studies indicate that heterozygous FH (HeFH) does not significantly increase foetal adverse outcomes such as congenital malformation, prematurity, low birth weight although there may be a predisposition to early atherogenesis. Maternal risks include preeclampsia, endothelial dysfunction and prothrombotic tendency. Pregnant women with homozygous FH (HoFH) carry a substantially higher morbidity. Management strategies emphasize the need for timely, multidisciplinary care, dietary optimization, selective use of low-dose statins in high-risk HoFH and LDL apheresis for severe cases. Despite emerging evidence of lack of a major teratogenic risk, statins remain contraindicated in most guidelines, during pregnancy and lactation. Time off statins represent a critical gap in ASCVD prevention.Summary: Pregnancy in FH requires a nuanced, stage-specific, individualized approach. Expansion of FH pregnancy registries and prospective studies is essential to guide evidence based care and refine recommendations for the future.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"84-89"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lessons from recent clinical trials for the prevention of acute pancreatitis in chylomicronemia syndromes. 近期临床试验预防乳糜微粒血症综合征急性胰腺炎的经验教训。

IF 2.7 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-04-01 Epub Date: 2025-11-05 DOI: 10.1097/MED.0000000000000941

Laura D'Erasmo, Daniele Tramontano, Marcello Arca

{"title":"Lessons from recent clinical trials for the prevention of acute pancreatitis in chylomicronemia syndromes.","authors":"Laura D'Erasmo, Daniele Tramontano, Marcello Arca","doi":"10.1097/MED.0000000000000941","DOIUrl":"10.1097/MED.0000000000000941","url":null,"abstract":"Purpose of review: Familial chylomicronemia (FCS) and multifactorial or persistent chylomicronemia syndromes (MCS, pCS) are rare, severe disorders characterized by extreme hypertriglyceridemia and a high risk of recurrent, potentially life-threatening acute pancreatitis. Most patients do not achieve adequate triglyceride control with lifestyle interventions or conventional lipid-lowering therapies, leaving them exposed to persistent complications. This review critically examines emerging therapeutic strategies aimed at improving triglyceride control and reducing acute pancreatitis risk.Recent findings: Advances targeting key molecular regulators of triglyceride metabolism have shown substantial promise. APOC3 inhibitors, including volanesorsen, olezarsen, and plozasiran, achieve up to 80% reductions in triglycerides and markedly lower AP incidence, with favorable safety profiles. ANGPTL3 inhibition via evinacumab may benefit patients with residual lipoprotein lipase activity, including polygenic or mixed chylomicronemia, and could be used during acute sHTG episodes. Lomitapide, acting independently of LPL, is effective in selected FCS patients but requires careful hepatic monitoring. FGF21 analogs, such as pegozafermin, are in early development and show potential for metabolic dysfunction-associated steatotic liver disease, though their impact on acute pancreatitis prevention remains to be established.Summary: These emerging mechanism-based therapies are reshaping the management of severe hypertriglyceridemia, offering targeted approaches to reduce triglycerides and acute pancreatitis risk. Ongoing studies will clarify long-term safety, durability of response, and optimal patient selection, providing a framework for improved clinical outcomes.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"90-100"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0