Current Opinion in Endocrinology & Diabetes and Obesity最新文献_第2页

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 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-01 Epub Date: 2026-05-04 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":"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":"151-159"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","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

Normocalcemic primary hyperparathyroidism: an update on diagnostic and management challenges. 正常钙血症原发性甲状旁腺功能亢进：诊断和管理挑战的最新进展。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-01 Epub Date: 2026-05-25 DOI: 10.1097/MED.0000000000000965

Krupa B Doshi, Manju Chandran

{"title":"Normocalcemic primary hyperparathyroidism: an update on diagnostic and management challenges.","authors":"Krupa B Doshi, Manju Chandran","doi":"10.1097/MED.0000000000000965","DOIUrl":"10.1097/MED.0000000000000965","url":null,"abstract":"Purpose of review: Normocalcemic primary hyperparathyroidism (NPHPT) is defined by persistently elevated parathyroid hormone (PTH) levels in the presence of normal total and ionized serum calcium after excluding secondary causes of PTH elevation. Increasing use of biochemical screening has led to growing recognition of this phenotype, yet uncertainties remain regarding its natural history, diagnostic criteria, and optimal management.Recent findings: NPHPT shares several clinical features with hypercalcemic primary hyperparathyroidism (HPHPT). Substantial rates of osteoporosis, fragility fractures, and nephrolithiasis are reported. Diagnosis requires repeated biochemical measurements, confirmation of normal ionized calcium, and rigorous exclusion of secondary causes such as vitamin D insufficiency, chronic kidney disease, malabsorption, and medication effects. Preoperative localization may also be more difficult than in HPHPT due to smaller adenomas and higher prevalence of multigland disease.Summary: Parathyroidectomy appears safe and effective in selected individuals. However, NPHPT may carry a greater risk of recurrence than HPHPT. Improvements in bone mineral density (BMD) and quality of life (QOL) have been reported after surgery, although renal outcomes remain less certain.This review summarizes current evidence on the epidemiology, diagnosis, clinical manifestations, and management of NPHPT and highlights key areas requiring further study.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"131-136"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027979","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 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-01 Epub Date: 2026-05-04 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":"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":"137-145"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","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

EDITORIAL INTRODUCTION. 编辑介绍。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-01 Epub Date: 2026-06-25 DOI: 10.1097/MED.0000000000000967

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 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-01 Epub 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":"125-130"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","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

Exploring the role of parathyroid hormone in sarcopenia: A review. 探讨甲状旁腺激素在肌肉减少症中的作用：综述。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-01 Epub Date: 2026-05-25 DOI: 10.1097/MED.0000000000000963

Ana Carolina Vieira Selva, Pushpa Suriyaarachchi, Gustavo Duque

{"title":"Exploring the role of parathyroid hormone in sarcopenia: A review.","authors":"Ana Carolina Vieira Selva, Pushpa Suriyaarachchi, Gustavo Duque","doi":"10.1097/MED.0000000000000963","DOIUrl":"10.1097/MED.0000000000000963","url":null,"abstract":"Purpose of review: Sarcopenia is a progressive, multifactorial geriatric syndrome linked to increased risk of falls, fractures, disability, frailty, and all-cause mortality. The pathophysiology of this complex syndrome remains unclear. Emerging evidence suggests that chronically elevated parathyroid hormone (PTH) concentration may contribute to muscle decline, increasing the risk of sarcopenia. This review evaluates the most recent evidence on the role of PTH in sarcopenia.Recent findings: A recent meta-analysis of eleven observational studies involving 4759 participants supports an association between elevated PTH and a higher risk of sarcopenia. Proposed mechanisms include PTH-mediated alterations in serum calcium levels and modulation of muscle protein metabolism by PTH and its N-terminal fragment. The metabolic effects of elevated PTH may also indirectly affect muscle mass by altering skeletal muscle energy metabolism.Summary: Elevated PTH concentration is increasingly linked to a higher risk of sarcopenia in older adults, although the biological mechanisms behind this remain only partially understood. Most current evidence comes from observational studies and cannot establish causation. Future research should focus on mechanistic studies in humans and interventional trials to determine whether higher PTH concentrations directly cause muscle decline and whether correcting PTH concentrations can lead to significant improvements in muscle mass and function.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"146-150"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027947","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

Functioning pituitary adenomas in pregnancy: updates and controversies. 妊娠期功能性垂体腺瘤：最新进展和争议。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-07-28 DOI: 10.1097/MED.0000000000000968

Elena V Varlamov, Monica L Gheorghiu, Maria Fleseriu

{"title":"Functioning pituitary adenomas in pregnancy: updates and controversies.","authors":"Elena V Varlamov, Monica L Gheorghiu, Maria Fleseriu","doi":"10.1097/MED.0000000000000968","DOIUrl":"https://doi.org/10.1097/MED.0000000000000968","url":null,"abstract":"Purpose of review: Fertility and pregnancy in women with functioning pituitary adenomas are often compromised. Advances in surgical, medical and multidisciplinary care have improved outcomes, although important uncertainties remain regarding management before, during, and after pregnancy.Recent findings: Recent systematic reviews and meta-analyses have provided updated evidence on pregnancy outcomes in women with prolactinomas, acromegaly, and Cushing's disease. Although medical therapy is used selectively during pregnancy, studies of cabergoline and bromocriptine have consistently demonstrated overall maternal and fetal safety. Favorable surgical prolactinoma outcomes in specialized centers have led to evolving recommendations, with surgery increasingly considered an alternative to traditional dopamine agonist therapy for selected patients.Summary: Owing to the relative rarity of functioning pituitary adenomas in pregnancy, current clinical practice and guidelines rely largely on limited retrospective evidence regarding the disease course and outcomes. Although new medical therapies for acromegaly and Cushing's disease are now available, data to support their use in pregnancy are lacking. Management therefore remains individualized and emphasizes shared decision-making.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590698","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

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 3.5 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":3.5,"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

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

Editorial introduction. 编辑介绍。

IF 3.5 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