Nature Reviews Endocrinology最新文献

{"title":"Menopause in the spotlight: important research and clinical advances","authors":"","doi":"10.1038/s41574-026-01262-9","DOIUrl":"10.1038/s41574-026-01262-9","url":null,"abstract":"Despite directly affecting around half of the global population during their lifetime, menopause research has been chronically underfunded, with clinical care lagging behind other fields. Over the past few years, this picture has started to shift.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 7","pages":"381-382"},"PeriodicalIF":39.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41574-026-01262-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose tissue as a humoral–neuronal hub in metabolic regulation","authors":"Tadataka Tsuji, Yu-Hua Tseng","doi":"10.1038/s41574-026-01265-6","DOIUrl":"10.1038/s41574-026-01265-6","url":null,"abstract":"Adipose tissue has emerged as a dynamic endocrine organ that coordinates systemic energy balance and cardiometabolic health. This Review highlights the dual humoral and neuronal pathways through which adipose tissue regulates systemic metabolism. Humoral signals include peptide hormones, lipid mediators, metabolites, chemokines and exosomal microRNAs secreted by adipose depots. Neuronal circuits control adipose function rapidly and precisely: sympathetic efferents trigger lipolysis in white adipose tissue and thermogenesis in brown adipose tissue, whereas sensory afferents detect chemical, thermal and mechanical signals to adjust sympathetic activity. Nutritional and environmental stimuli (for example, diet, cold exposure and exercise), along with pathological states (for example, obesity, type 2 diabetes mellitus, lipodystrophy and ageing-associated disorders), dynamically modulate these endocrine and neural outputs. Methodological innovations, such as omics based on mass spectrometry or liquid chromatography–mass spectrometry, secretome labelling, adipose tissue organoid models and click chemistry, enable high-resolution characterization of adipose-derived signals and their targets. Finally, we discuss translational opportunities, including synthetic analogues of lipophilic hormones, and future therapeutic strategies that harness adipose communication networks. This Review highlights adipose humoral and neuronal pathways that operate through inter-organ communication to regulate systemic metabolism, examines how physiological and pathological contexts shape these signals, and explores emerging technologies and translational opportunities for targeting adipose networks in metabolic disease.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 10","pages":"574-586"},"PeriodicalIF":39.1,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239707","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":"Polyendocrine metabolic ovarian syndrome in pregnancy: pathophysiology and outcomes","authors":"Helena J. Teede, Eszter Vanky, Terhi T. Piltonen, Elisabet Stener-Victorin, Lisa J. Moran, Mahnaz Bahri Khomami","doi":"10.1038/s41574-026-01261-w","DOIUrl":"10.1038/s41574-026-01261-w","url":null,"abstract":"Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome, is a chronic condition driven by genetic, epigenetic and lifestyle factors. The resulting endocrine changes, including hyperinsulinaemia and hyperandrogenism, underpin the clinical manifestations of PMOS and are amplified by overweight and obesity. Reproductive features of PMOS, including ovulatory disturbance, endometrial abnormalities, subfertility and an increased rate of pregnancy and birth complications, have long been documented in these patients, but awareness in clinical practice has only increased in the past decade. The pathophysiology of PMOS interacts with physiological changes in pregnancy, leading to pregnancy and birth complications, exacerbated by the high prevalence of pre-pregnancy overweight, obesity and increased gestational weight gain in PMOS. However, the condition is poorly recognized as an independent risk factor for pregnancy and birth complications in antenatal guidelines and clinical practice. The 2023 international evidence-based guidelines, supported by extensive meta-analyses, have advanced knowledge on PMOS and pregnancy and birth outcomes. They recommend recognition of ‘higher-risk’ status for individuals with PMOS in pregnancy and aim to improve antenatal prevention, awareness, screening and treatment. Here, we explore the pathophysiology of PMOS and PMOS during pregnancy as well as related pregnancy and birth complications. We also outline current guideline recommendations, implementation strategies and research priorities related to PMOS in pregnancy. Clinical awareness of the effects of polyendocrine metabolic ovarian syndrome (PMOS; formerly known as polycystic ovary syndrome) on fertility, pregnancy and birth complications has increased over the past decade. In this Review, Teede et al. explore the pathophysiology of PMOS and how this condition affects the physiological changes of pregnancy. They also outline current guideline recommendations for PMOS, and research priorities to address knowledge gaps and inform implementation strategies.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 9","pages":"516-529"},"PeriodicalIF":39.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176361","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":"Intestinal mitochondrial complex I inhibition essential for clinical benefits of metformin","authors":"Olivia Tysoe","doi":"10.1038/s41574-026-01269-2","DOIUrl":"10.1038/s41574-026-01269-2","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 8","pages":"449-449"},"PeriodicalIF":39.1,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157277","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":"Elucidating the structure of TRH: a defining moment for modern neuroendocrinology","authors":"Mirela-Diana Ilie","doi":"10.1038/s41574-026-01267-4","DOIUrl":"10.1038/s41574-026-01267-4","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 8","pages":"451-451"},"PeriodicalIF":39.1,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150606","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":"Cancer prevention through metabolic remission","authors":"Andreas L. Birkenfeld, Mathias Heikenwälder","doi":"10.1038/s41574-026-01268-3","DOIUrl":"10.1038/s41574-026-01268-3","url":null,"abstract":"Updated global estimates confirm that a substantial fraction of cancers remains attributable to modifiable or preventable exposures. Yet many risk factors converge on shared physiological states (namely, dysglycaemia, hyperinsulinaemia, chronic inflammation and altered substrate flux) that might shape tumour initiation and progression.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 8","pages":"445-446"},"PeriodicalIF":39.1,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150641","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":"Endocrinologists gather at ECE 2026","authors":"Claire Greenhill","doi":"10.1038/s41574-026-01264-7","DOIUrl":"10.1038/s41574-026-01264-7","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 7","pages":"386-386"},"PeriodicalIF":39.1,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043020","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":"T cell activity is boosted after meals","authors":"Senegal Carty","doi":"10.1038/s41574-026-01263-8","DOIUrl":"10.1038/s41574-026-01263-8","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 7","pages":"385-385"},"PeriodicalIF":39.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148033047","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":"Aldosterone synthase inhibitors for the treatment of cardiovascular disease","authors":"Gian Paolo Rossi, Federico Bernardo Rossi, Andrea Cignarella, Teresa Maria Seccia","doi":"10.1038/s41574-026-01259-4","DOIUrl":"10.1038/s41574-026-01259-4","url":null,"abstract":"Aldosterone is essential for maintaining blood pressure during hypovolaemia and/or dehydration through genomic actions mediated by the mineralocorticoid receptor and rapid signalling pathways involving the G-protein-coupled oestrogen receptor. Inappropriate aldosterone secretion contributes to cardiovascular and renal injury in several common disorders, including resistant hypertension, primary aldosteronism and heart failure. Pharmacological blockade of the mineralocorticoid receptor has therefore become a cornerstone in the therapy of cardiovascular disease. Nevertheless, mineralocorticoid receptor antagonism does not address the pathophysiological effects that are mediated by aldosterone, and residual cardiovascular risk remains substantial in many patients. Aldosterone synthase inhibitors are a novel therapeutic strategy that have effectively lowered aldosterone concentrations and reduced blood pressure in randomized clinical trials in patients with resistant or uncontrolled hypertension and patients with chronic kidney disease. Although these findings highlight the potential therapeutic value of aldosterone synthase inhibition, data on long-term safety, effectiveness compared with mineralocorticoid receptor antagonists and effects on cardiovascular outcomes are still lacking. Increased levels of aldosterone seem to have a role in treatment-resistant arterial hypertension, hypertension associated with primary aldosteronism and heart failure. This Review examines the evidence regarding this connection and discusses the efficacy and safety of treatment with mineralocorticoid receptor antagonists and with aldosterone synthase inhibitors.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 9","pages":"543-553"},"PeriodicalIF":39.1,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006144","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":"Causes and consequences of discontinuation of GLP1RAs or tirzepatide","authors":"Antonio Ceriello, Francesco Prattichizzo, Abdul Raouf Mastan Sheik Abdullah, Rosalba La Grotta, Cesare Celeste Berra, Barbara McGowan, Alicia Jenkins, Neale Cohen, Michael Albrecht Nauck, Giuseppina Tiziana Russo","doi":"10.1038/s41574-026-01258-5","DOIUrl":"10.1038/s41574-026-01258-5","url":null,"abstract":"Glucagon-like peptide 1 (GLP1) receptor (GLP1R) agonists and tirzepatide, a dual GLP1R and glucose-dependent insulinotropic polypeptide receptor agonist, have become fundamental in managing type 2 diabetes mellitus (T2DM) and obesity due to their potent glycaemia-lowering and weight-lowering effects as well as their cardiovascular and renal benefits. However, data from the past 2 years suggest that real-world persistence on these drug classes is often suboptimal, with many people discontinuing these medications, even within their first year of therapy. Reasons for treatment discontinuation include, but are not limited to, gastrointestinal adverse effects, less-than-desired efficacy, high cost, and fear about uncommon or rare adverse effects. When treatment is discontinued, weight regain and the deterioration of multiple cardiometabolic risk factors are common. Repeated cycles of initiation, interruption and re-initiation of these drugs might induce body weight and HbA1c fluctuations — two risk factors for cardiovascular and microvascular events. These phenomena, coupled with the re-development of overweight or obesity and poor glycaemic control when not on therapy, might increase the long-term risk of complications. The lack of anti-atherosclerotic and plaque-stabilizing effects of incretin-based medications might contribute to elevated cardiovascular risk, especially acutely following their discontinuation. However, at present, few data are available regarding the incidence of hard outcomes in people discontinuing such drugs. In this Review, we discuss common reasons for GLP1R agonist and tirzepatide discontinuation and examine available evidence related to potential cardiometabolic consequences. We also discuss long-term implications for T2DM care, weight management and, ultimately, cardiorenal disease prevention in patients with T2DM and/or overweight or obesity. As glucagon-like peptide 1 receptor agonists and tirzepatide have gained popularity, the number of people who started taking these drugs, then stopped, has increased. This Review discusses why patients discontinue these medications, the metabolic and cardiovascular effects of this discontinuation, and the need for additional research on how to manage the cessation of these drugs.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 9","pages":"530-542"},"PeriodicalIF":39.1,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988411","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}