Nature Reviews Endocrinology最新文献

{"title":"Publisher Correction: Neuro–immuno–endocrinology of the skin: how environment regulates body homeostasis","authors":"Radomir M. Slominski, Chander Raman, Anton M. Jetten, Andrzej T. Slominski","doi":"10.1038/s41574-025-01126-8","DOIUrl":"https://doi.org/10.1038/s41574-025-01126-8","url":null,"abstract":"<p>Correction to: <i>Nature Reviews Endocrinology</i> https://doi.org/10.1038/s41574-025-01107-x, published online 22 April 2025.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"44 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901786","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}

{"title":"Reply to ‘Ensuring diverse representation and minimizing conflicts of interest in clinical practice guidelines’","authors":"Ravi Savarirayan, Svein Otto Fredwall","doi":"10.1038/s41574-025-01123-x","DOIUrl":"https://doi.org/10.1038/s41574-025-01123-x","url":null,"abstract":"<p>Thank you for your thoughtful letter (Schelhaas, A. et al. Ensuring diverse representation and minimizing conflicts of interest in clinical practice guidelines. <i>Nat. Rev. Endocrinol</i>. https://doi.org/10.1038/s41574-025-01122-y (2025))¹ concerning the recent guidelines regarding the implementation and monitoring of vosoritide therapy in individuals with achondroplasia (Savarirayan, R. et al. International consensus guidelines on the implementation and monitoring of vosoritide therapy in individuals with achondroplasia. <i>Nat. Rev. Endocrinol</i>. https://doi.org/10.1038/s41574-024-01074-9 (2025))². Vosoritide is now available for the treatment of children with achondroplasia in more than 50 countries. The core purpose of these guidelines was to provide evidence-based and experience-based recommendations for physicians to assist with the informed initiation, responsible monitoring and appropriate cessation of vosoritide therapy when it has been deemed appropriate and requested by families and/or children with achondroplasia. These guidelines are not intended to promote the use of this medication and recommendation R10 states that “it should be recognized and fully supported that not all patients and their caregivers will decide to pursue therapy (strong recommendation, Delphi 100%)”. Many members of this consensus group were also members of the panel that published international guidelines³ concerning the diagnosis, multidisciplinary management and lifelong care of individuals with achondroplasia, which aimed to promote multidisciplinary, holistic and evidence-based care of these individuals.</p><p>As explicitly stated in the Acknowledgements, “BioMarin was not involved in the selection of the guideline development group, defining the guideline scope, the voting process, analysis of the results or preparation of the submitted manuscript.” Many of the consensus group have been key figures in evaluating the safety and efficacy of vosoritide in clinical trials and this was fully disclosed, as per journal policy, prior to the Consensus Statement being commissioned. The selection of all expert panels can be inherently biased with conflicts; we sought to minimize this bias by using an independent mapping tool⁴ to inform selection of the expert panel, in addition to our combined experience (290 collective years) in treating and managing the care of patients with achondroplasia.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"8 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893194","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}

{"title":"Ensuring diverse representation and minimizing conflicts of interest in clinical practice guidelines","authors":"Andrea Schelhaas, Kara Ayers, Stephanie Meredith, Leah Smith, Katie Stoll","doi":"10.1038/s41574-025-01122-y","DOIUrl":"https://doi.org/10.1038/s41574-025-01122-y","url":null,"abstract":"<p>During their Q3 2024 investor call, BioMarin, a manufacturer of vosoritide, estimated that 24,000 individuals worldwide could use vosoritide and stated that “new global guidelines” would recommend that “children with achondroplasia be referred as soon as diagnosis is suspected to enable early initiation of treatment”¹. In January 2025, a Consensus Statement on the use of vosoritide in achondroplasia was published (Savarirayan, R. et al. International consensus guidelines on the implementation and monitoring of vosoritide therapy in individuals with achondroplasia. <i>Nat. Rev. Endocrinol</i>. https://doi.org/10.1038/s41574-024-01074-9 (2025))²; these guidelines received financial support from BioMarin and a majority (75%) of the guideline development group (GDG) members disclosed financial ties with the company². These relationships between BioMarin and the GDG members raise questions about the independence and objectivity of the guidelines, particularly as clinical experts and prominent advocates with opposing viewpoints were not involved in the guideline development process. The dominance of BioMarin-affiliated experts in developing these guidelines could undermine the credibility of the recommendations.</p><p>The GDG included two patient-advocacy representatives in their development process². However, the selection process also raises concerns about representation. Instead of collaborating with individuals from well-established patient advocacy organizations, one of the representatives was from an organization founded in February 2024, after the Delphi meeting. Little People of America (LPA), for example, was not included in the process despite originating in 1957 and serving as the largest advocacy organization that supports individuals with dwarfism and their families in the USA. In May 2022, LPA published a position statement expressing concern about the pharmaceutical focus on height rather than on their primary concerns: social attitudes, lack of accessibility and medical comorbidities³. The position statement further emphasized that many people with achondroplasia believe that height is not a medical problem and that diversity in all forms (including stature) is an essential component of one’s identity.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"10 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893196","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}

{"title":"Replacing body mass index with relative fat mass to accurately estimate adiposity","authors":"Navin Suthahar, Richard N. Bergman, Rudolf A. de Boer","doi":"10.1038/s41574-025-01120-0","DOIUrl":"https://doi.org/10.1038/s41574-025-01120-0","url":null,"abstract":"Body mass index (BMI), as its name indicates, is a marker of total body mass and not a specific marker of adipose tissue mass. Here, we position relative fat mass (RFM) as an ideal alternative to BMI by highlighting the superior performance of RFM in assessing cardiometabolic risk.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893195","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}

{"title":"Neuro–immuno–endocrinology of the skin: how environment regulates body homeostasis","authors":"Radomir M. Slominski, Raman Chander, Anton M. Jetten, Andrzej T. Slominski","doi":"10.1038/s41574-025-01107-x","DOIUrl":"https://doi.org/10.1038/s41574-025-01107-x","url":null,"abstract":"<p>The skin, including the hypodermis, is the largest organ of the body. The epidermis, the uppermost layer, is in direct contact with the environment and is exposed to environmental stressors, including solar radiation and biological, chemical and physical factors. These environmental factors trigger local responses within the skin that modulate homeostasis on both the cutaneous and systemic levels. Using mediators in common with brain pathways, immune and neuroendocrine systems within the skin regulate these responses to activate various signal transduction pathways and influence the systemic endocrine and immune systems in a context-dependent manner. This skin neuro–immuno–endocrine system is compartmentalized through the formation of epidermal, dermal, hypodermal and adnexal regulatory units. These units can act separately or in concert to preserve skin integrity, allow for adaptation to a changing environment and prevent the development of pathological processes. Through activation of peripheral nerve endings, the release of neurotransmitters, hormones, neuropeptides, and cytokines and/or chemokines into the circulation, or by priming circulating and resident immune cells, this system affects central coordinating centres and global homeostasis, thus adjusting the body’s homeostasis and allostasis to optimally respond to the changing environment.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"63 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857822","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}

{"title":"A modified liver enzyme with enhanced stability helps to control glycaemia","authors":"Senegal Carty","doi":"10.1038/s41574-025-01119-7","DOIUrl":"https://doi.org/10.1038/s41574-025-01119-7","url":null,"abstract":"<p>Reducing insulin resistance in skeletal muscle is a promising potential strategy for controlling blood levels of glucose in people with type 2 diabetes mellitus (T2DM). A study published in <i>Diabetologia</i> now shows that treatment with HEXA–Fc (a protein created by fusing the liver enzyme hexosaminidase A (HEXA) with the fragment crystallizable (Fc) region of immunoglobulin G1) can promote glucose uptake by skeletal muscle in mice with obesity and T2DM.</p><p>Next, the researchers investigated which tissue HEXA–Fc localizes to after administration and tested the effects of HEXA–Fc on glycaemic control. They administered HEXA–Fc to wild-type mice that had been fed a high-fat diet to induce obesity, and then collected several types of tissue from the mice, including skeletal muscle, adipose tissue, hypothalamus and liver. They performed immunoblot analysis on these tissues and saw that there was more HEXA–Fc in the skeletal muscle than in any of the other tissues that were analysed. They also saw that although insulin tolerance did not change in obese mice treated with HEXA–Fc, these mice displayed a notable increase in glucose tolerance and decreased glucose-stimulated insulin secretion.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"3 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857821","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}

{"title":"Potential downsides of calorie restriction","authors":"Anyongqi Wang, John Roger Speakman","doi":"10.1038/s41574-025-01111-1","DOIUrl":"https://doi.org/10.1038/s41574-025-01111-1","url":null,"abstract":"<p>Although the potential benefits of calorie restriction on human lifespan remain uncertain, it is currently one of the most extensively researched non-genetic approaches to extending both lifespan and healthspan in animals. Calorie restriction offers numerous health benefits, including a reduced incidence of age-related diseases. However, calorie restriction also produces a range of negative effects, which are not fully documented and require further investigation, particularly in humans. As the viability of calorie restriction in humans will depend on the balance of benefits and detrimental effects, it is crucial to understand the nature of these negative effects and what drives them. In this Review, we summarize the effects of calorie restriction on wound healing, hunger, cold sensitivity, bone health, brain size, cognition, reproductive performance and infection, primarily based on studies of rodents with some data from other species and from humans. Overall, the detrimental effects of calorie restriction seem to stem directly from prioritization of vital functions and downregulation or suppression of energy-demanding processes, which helps preserve survival but can also lead to impaired physiological performance and increased vulnerability to stressors. The exact mechanisms underlying these effects remain unclear. Whether it might be possible to engage in calorie restriction but avoid these negative effects remains uncertain.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"28 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846498","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}

{"title":"Insulin resistance in type 2 diabetes mellitus","authors":"Domenico Accili, Zhaobing Deng, Qingli Liu","doi":"10.1038/s41574-025-01114-y","DOIUrl":"https://doi.org/10.1038/s41574-025-01114-y","url":null,"abstract":"<p>Insulin resistance is an integral pathophysiological feature of type 2 diabetes mellitus. Here, we review established and emerging cellular mechanisms of insulin resistance, their complex integrative features and their relevance to disease progression. While recognizing the heterogeneity of the elusive fundamental disruptions that cause insulin resistance, we endorse the view that effector mechanisms impinge on insulin receptor signalling and its relationship with plasma levels of insulin. We focus on hyperinsulinaemia and its consequences: acutely impaired but persistent insulin action, with reduced ability to lower glucose levels but preserved lipid synthesis and lipoprotein secretion. We emphasize the role of insulin sensitization as a therapeutic goal in type 2 diabetes mellitus.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"90 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841263","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}

{"title":"Older people with type 1 diabetes mellitus: a call for a new management approach","authors":"Giuseppe Maltese, Alan J. Sinclair","doi":"10.1038/s41574-025-01118-8","DOIUrl":"https://doi.org/10.1038/s41574-025-01118-8","url":null,"abstract":"The growing population of older adults with type&nbsp;1 diabetes mellitus presents unique challenges, including frailty, comorbidities and polypharmacy. A holistic multidisciplinary approach is crucial to address this population’s complex needs, improve care delivery, and ensure their independence and quality of life amid the realities of ageing with this lifelong condition.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"75 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827189","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}

{"title":"Author Correction: Adrenocortical stem cells in health and disease","authors":"Yulan Chu, Jordan Setayesh, Typhanie Dumontet, Lauren Krumeich, Johanna Werner, Isabele F. Moretti, Kelly De Sousa, Christopher Kennedy, Christopher La Pensee, Antonio M. Lerario, Gary D. Hammer","doi":"10.1038/s41574-025-01108-w","DOIUrl":"https://doi.org/10.1038/s41574-025-01108-w","url":null,"abstract":"<p>Correction to: <i>Nature Reviews Endocrinology</i> https://doi.org/10.1038/s41574-025-01091-2, published online 10 March 2025.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"25 1","pages":""},"PeriodicalIF":40.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822630","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}