Nature Reviews Endocrinology最新文献

Highlights from SfE BES 2026. SfE BES 2026的亮点。

IF 4 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-27 DOI: 10.1038/s41574-026-01256-7

Olivia Tysoe

引用次数: 0

Clinical obesity in Asian people: bridging the gap between adiposity and disease. 亚洲人的临床肥胖：弥合肥胖与疾病之间的差距。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-27 DOI: 10.1038/s41574-026-01239-8

Soo Lim,Linong Ji,Kwang Wei Tham,Anoop Misra,Takashi Kadowaki

{"title":"Clinical obesity in Asian people: bridging the gap between adiposity and disease.","authors":"Soo Lim,Linong Ji,Kwang Wei Tham,Anoop Misra,Takashi Kadowaki","doi":"10.1038/s41574-026-01239-8","DOIUrl":"https://doi.org/10.1038/s41574-026-01239-8","url":null,"abstract":"This Perspective argues for a reconceptualization of clinical obesity in Asian populations, moving beyond BMI-centric definitions towards an adiposity-based and function-based framework. Asian populations exhibit a distinctive obesity phenotype, characterized by excess visceral and ectopic adipose tissue accumulation, reduced β-cell reserve, sarcopenic obesity and heightened cardiometabolic risk at lower BMI thresholds than for white European and North American populations, leading to systematic under-recognition of obesity-related disease when conventional criteria are applied. Building on the Lancet Commission's framework for defining and diagnosing clinical obesity, we propose an integrated approach that combines anthropometric measures, body composition assessment, metabolic and organ-specific markers and emerging biomarkers to distinguish preclinical obesity from clinical obesity on the basis of organ dysfunction and functional impairment. This approach improves risk stratification, supports earlier and more precise diagnosis and informs stage-specific management, including lifestyle intervention, pharmacotherapy and metabolic surgery, particularly in Asian populations. We discuss implications for clinical practice, prevention strategies and public health policy, emphasizing the need to align clinical guidelines, reimbursement systems and education with a function-based definition of obesity. Finally, we highlight key research priorities, including validation of biomarker-driven classifications, assessment of long-term clinical and economic outcomes and development of scalable diagnostic tools, to advance precision care and metabolic health equity across diverse Asian populations.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"26 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Pathophysiology, diagnosis and management of secondary osteoporosis. 继发性骨质疏松的病理生理、诊断和治疗。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-20 DOI: 10.1038/s41574-026-01252-x

Julien Paccou,Elena Tsourdi,Athanasios D Anastasilakis,Willem F Lems,Juliet Compston

{"title":"Pathophysiology, diagnosis and management of secondary osteoporosis.","authors":"Julien Paccou,Elena Tsourdi,Athanasios D Anastasilakis,Willem F Lems,Juliet Compston","doi":"10.1038/s41574-026-01252-x","DOIUrl":"https://doi.org/10.1038/s41574-026-01252-x","url":null,"abstract":"Age-related decline in sex hormones is the most frequent cause of primary osteoporosis; however, secondary causes contribute to osteoporosis in a substantial proportion of cases. These causes are diverse and often overlooked, ranging from endocrine diseases to chronic inflammatory conditions and medication use. The identification and exclusion of secondary causes of osteoporosis is crucial, because treatment typically begins by addressing the underlying condition. Investigation to exclude common secondary causes is recommended for everyone presenting with fractures indicative of osteoporosis. Advanced investigations are reserved for premenopausal individuals and those aged <50 years, and for older people in whom common risk factors, comorbidities or drugs predisposing to osteoporosis are absent. The risk of fracture can be underestimated by bone mineral density in some chronic diseases and overestimated in others. Specific adjustments can be made to the criteria in the online fracture risk FRAX calculator to provide a more accurate estimation of fracture risk in people with some forms of secondary osteoporosis. The response to conventional anti-osteoporosis treatments can be suboptimal if the underlying condition remains unrecognized and untreated. In most conditions, the evidence for antiresorptive or anabolic therapy is based on changes in bone mineral density rather than fracture. This Review covers the aetiology, pathogenesis, diagnosis and management of secondary osteoporosis, together with key areas for future research.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"54 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Precision medicine in low-income settings and small island developing states. 低收入环境和小岛屿发展中国家的精准医疗。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-16 DOI: 10.1038/s41574-026-01250-z

Sushant Saluja,Fahmida Mannan,Guillaume Pare,Sonia S Anand,Neil A Hanchard,Claudia Langenberg,Simon G Anderson

{"title":"Precision medicine in low-income settings and small island developing states.","authors":"Sushant Saluja,Fahmida Mannan,Guillaume Pare,Sonia S Anand,Neil A Hanchard,Claudia Langenberg,Simon G Anderson","doi":"10.1038/s41574-026-01250-z","DOIUrl":"https://doi.org/10.1038/s41574-026-01250-z","url":null,"abstract":"Precision medicine tailors prevention, diagnosis and treatment of cardiometabolic diseases to individual genetic, environmental and lifestyle determinants, with the potential to fundamentally change healthcare. However, low-income and middle-income countries (LMICs) and small island developing states (SIDS) experience severe implementation barriers: inadequate healthcare infrastructure, prohibitive costs, under-representation in genomic datasets and additional SIDS-specific constraints. This Perspective advances three specific contributions beyond generic equity calls. First, it delineates distinct precision medicine pathways for larger LMICs versus SIDS, highlighting SIDS opportunities for regional consortia, shared sequencing and/or biobanking hubs and technological leapfrogging via mobile health platforms and digital phenotyping. Second, it emphasizes practical and high-impact entry points that are financially sustainable. Additionally, it advocates for integrating polygenic risk-based stratification into existing non-communicable disease care pathways rather than establishing separate specialist services. Third, it delineates a staged implementation framework that prioritizes ethical oversight and robust data governance, underscoring the importance of privacy safeguards, data sovereignty, equitable benefit sharing, community consent mechanisms and alignment with the Sustainable Development Goals to minimize associated risks of exploitation. Equitable partnerships between LMICs and high-income countries, expansion of diverse genomic data and community-driven innovation will ensure that precision tools effectively target metabolic phenotypes in LMICs and SIDS while advancing global health equity.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"26 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 effect of hypoglycaemia on neurodevelopment: insights from congenital hyperinsulinism. 低血糖对神经发育的影响：来自先天性高胰岛素血症的见解。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-16 DOI: 10.1038/s41574-026-01253-w

Pamela Bowman,Jonna M E Männistö,Sarah E Flanagan

引用次数: 0

Neurokinin receptor antagonists for vasomotor symptoms: from KNDy neurons to clinical translation. 血管舒缩症状的神经激肽受体拮抗剂：从KNDy神经元到临床转化。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-14 DOI: 10.1038/s41574-026-01247-8

Encarnación Torres,Ellen G Wall,Víctor M Navarro

{"title":"Neurokinin receptor antagonists for vasomotor symptoms: from KNDy neurons to clinical translation.","authors":"Encarnación Torres,Ellen G Wall,Víctor M Navarro","doi":"10.1038/s41574-026-01247-8","DOIUrl":"https://doi.org/10.1038/s41574-026-01247-8","url":null,"abstract":"Vasomotor symptoms (VMS), including hot flushes and night sweats, affect approximately 70% of people experiencing menopause and have a notable effect on quality of life. Until the past few years, the underlying neuroendocrine mechanisms remained poorly understood, limiting therapeutic options beyond menopausal hormone therapy. The discovery that neurons expressing kisspeptin, neurokinin B and dynorphin (KNDy neurons) in the hypothalamic arcuate nucleus trigger VMS through modulation of neurons expressing neurokinin 3 receptor (NK3R) in the median preoptic area has revolutionized our understanding of VMS pathophysiology. During oestrogen withdrawal, hyperactivated KNDy neurons release excessive levels of neurokinin B, inappropriately triggering heat dissipation responses that are characteristic of hot flushes. This mechanistic insight has enabled the development of NK3R antagonists as the first non-hormonal therapeutic specifically targeting VMS neurobiology. These new treatments offer promise for populations in which hormone therapy is contraindicated. This Review synthesizes the current understanding of VMS neurobiological pathways, examines translational approaches from preclinical animal models to clinical studies, and discusses the evolution of treatments and mechanism-based interventions that might fundamentally transform the management of menopausal symptoms.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"433 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

NKX6.1 expression is linked to successful pancreatic islet transplantation. NKX6.1的表达与成功的胰岛移植有关。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-14 DOI: 10.1038/s41574-026-01255-8

Senegal Carty

引用次数: 0

Causes of sarcopenia and frailty in people taking GLP1RAs. 服用GLP1RAs的人肌肉减少症和虚弱的原因。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-14 DOI: 10.1038/s41574-026-01254-9

Henning T Langer,Aniket S Joshi,Ursula Müller-Werdan,Kristina Norman

引用次数: 0

Human thyroid organoids: tools for understanding thyroid diseases and development. 人类甲状腺类器官：了解甲状腺疾病和发展的工具。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-13 DOI: 10.1038/s41574-026-01249-6

Mírian Romitti,Sabine Costagliola

{"title":"Human thyroid organoids: tools for understanding thyroid diseases and development.","authors":"Mírian Romitti,Sabine Costagliola","doi":"10.1038/s41574-026-01249-6","DOIUrl":"https://doi.org/10.1038/s41574-026-01249-6","url":null,"abstract":"The thyroid gland develops in five main stages, each characterized by specific molecular and cellular processes that are highly conserved across invertebrates and vertebrate species. In vivo studies have elucidated the key molecular players orchestrating each stage of thyroid organogenesis and thyroid hormone biosynthesis, laying the groundwork for developing thyroid organoids in vitro. Thyroid organoids have been successfully derived from mouse and human pluripotent stem cells, including embryonic stem cells and induced pluripotent stem cells, as well as from fetal and adult thyroid tissues. Protocols using directed differentiation through chemical signalling modulators and/or by overexpression of pivotal thyroid transcription factors have yielded thyroid progenitors with varying levels of maturation, differing in timeline, purity and functional outcomes. However, only a few protocols have succeeded in producing thyroid organoids capable of recapitulating thyroid functionality both in vitro and in vivo. This Review explores the various thyroid organoid models currently available, their contributions to understanding thyroid developmental biology and their application in modelling thyroid diseases. We also discuss the current challenges to translating thyroid organoid technology from experimental frameworks into clinical applications, framing the question: could thyroid organoids offer a therapeutic avenue for hypothyroidism, particularly in cases of congenital, post-surgical and treatment-refractory conditions?","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"2 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147666634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Data-driven diabetes mellitus subtypes and precision care. 数据驱动型糖尿病亚型与精准护理。

IF 40.5 1区医学

Nature Reviews Endocrinology Pub Date : 2026-04-07 DOI: 10.1038/s41574-026-01251-y

Dang Nguyen,Anthony Zhong

引用次数: 0