Nature Reviews Endocrinology最新文献

{"title":"Thyroid nodules: diagnosis and management","authors":"Giorgio Grani, Marialuisa Sponziello, Sebastiano Filetti, Cosimo Durante","doi":"10.1038/s41574-024-01025-4","DOIUrl":"10.1038/s41574-024-01025-4","url":null,"abstract":"Thyroid nodules, with a prevalence of almost 25% in the general population, are a common occurrence. Their prevalence varies considerably depending on demographics such as age and sex as well as the presence of risk factors. This article provides a comprehensive overview of the prevalence, risk stratification and current management strategies for thyroid nodules, with a particular focus on changes in diagnostic and therapeutic protocols that have occurred over the past 10 years. Several sonography-based stratification systems (such as Thyroid Imaging Reporting and Data Systems (TIRADS)) might help to predict the malignancy risk of nodules, potentially eliminating the need for biopsy in many instances. However, large or suspicious nodules necessitate cytological evaluation following fine-needle aspiration biopsy for accurate classification. In the case of cytology yielding indeterminate results, additional tools, such as molecular testing, can assist in guiding the management plan. Surgery is no longer the only treatment for symptomatic or malignant nodules: active surveillance or local ablative treatments might be beneficial for appropriately selected patients. To enhance clinician–patient interactions and discussions about diagnostic options, shared decision-making tools have been developed. A personalized, risk-based protocol promotes high-quality care while minimizing costs and unnecessary testing. Thyroid nodules are common; the majority are benign and asymptomatic, and therefore the main aim of the diagnostic process is to determine their clinical significance without leading to overdiagnosis and, consequently, overtreatment, as outlined in this article.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 12","pages":"715-728"},"PeriodicalIF":31.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991991","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":"International consensus statement on the diagnosis and management of phaeochromocytoma and paraganglioma in children and adolescents","authors":"Ruth T. Casey, Emile Hendriks, Cheri Deal, Steven G. Waguespack, Verena Wiegering, Antje Redlich, Scott Akker, Rathi Prasad, Martin Fassnacht, Roderick Clifton-Bligh, Laurence Amar, Stefan Bornstein, Letizia Canu, Evangelia Charmandari, Alexandra Chrisoulidou, Maria Currás Freixes, Ronald de Krijger, Luisa de Sanctis, Antonio Fojo, Amol J. Ghia, Angela Huebner, Vasilis Kosmoliaptsis, Michaela Kuhlen, Marco Raffaelli, Charlotte Lussey-Lepoutre, Stephen D. Marks, Naris Nilubol, Mirko Parasiliti-Caprino, Henri H.J.L.M. Timmers, Anna Lena Zietlow, Mercedes Robledo, Anne-Paule Gimenez-Roqueplo, Ashley B. Grossman, David Taïeb, Eamonn R. Maher, Jacques W. M. Lenders, Graeme Eisenhofer, Camilo Jimenez, Karel Pacak, Christina Pamporaki","doi":"10.1038/s41574-024-01024-5","DOIUrl":"10.1038/s41574-024-01024-5","url":null,"abstract":"Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours that arise not only in adulthood but also in childhood and adolescence. Up to 70–80% of childhood PPGL are hereditary, accounting for a higher incidence of metastatic and/or multifocal PPGL in paediatric patients than in adult patients. Key differences in the tumour biology and management, together with rare disease incidence and therapeutic challenges in paediatric compared with adult patients, mandate close expert cross-disciplinary teamwork. Teams should ideally include adult and paediatric endocrinologists, oncologists, cardiologists, surgeons, geneticists, pathologists, radiologists, clinical psychologists and nuclear medicine physicians. Provision of an international Consensus Statement should improve care and outcomes for children and adolescents with these tumours. Phaeochromocytomas and paragangliomas (PPGL) are rare endocrine tumours that can affect paediatric patients as well as adults. In this first international Consensus Statement on PPGL in paediatric patients, the authors discuss the diagnosis, management and long-term surveillance of these tumours in children and adolescents.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 12","pages":"729-748"},"PeriodicalIF":31.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41574-024-01024-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141986287","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":"Medically not yet explained symptoms in hypothyroidism","authors":"Laszlo Hegedüs, Christina M. Van Der Feltz-Cornelis, Enrico Papini, Endre V. Nagy, Anthony P. Weetman, Petros Perros","doi":"10.1038/s41574-024-01022-7","DOIUrl":"10.1038/s41574-024-01022-7","url":null,"abstract":"Persistent symptoms are common in the general population and even more so in people with hypothyroidism. When symptoms are unexplained and brought to medical attention, they can be referred to as medically not yet explained symptoms (MNYES), a term preferred to other descriptors by patients, care-givers and experts. MNYES might be neglected by endocrinologists or misattributed to hypothyroidism. Awareness of MNYES could open up more effective and less harmful interventions for patients who present to endocrinologists with unexplained symptoms than costly over-investigations and over-treatment with thyroid hormones (such as levothyroxine and liothyronine). The role of the endocrinologist is to recognize and acknowledge that MNYES could be underlying a patient’s presentation, to communicate effectively with the patient and others involved in the patient’s care, to apply a ‘two-track approach’ in management by paying equal attention to physical and psychosocial contributors, and to collaborate with other relevant health professionals. Categorization of patients into levels of risk for symptom deterioration helps in selecting suitable therapies. Effective management of MNYES demands time, training, expertise and resources. Medically not yet explained symptoms (MNYES) are an important consideration in patients treated for hypothyroidism who experience persistent symptoms. This Perspective brings attention to the issue of MNYES in hypothyroidism and considers effective management.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 11","pages":"685-693"},"PeriodicalIF":31.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141973885","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":"Microbial hydrogen sulfide hampers L-cell GLP-1 production","authors":"Senegal Carty","doi":"10.1038/s41574-024-01028-1","DOIUrl":"10.1038/s41574-024-01028-1","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 10","pages":"570-570"},"PeriodicalIF":31.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141973878","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":"Combination therapy increases human β-cell mass in vivo","authors":"Olivia Tysoe","doi":"10.1038/s41574-024-01026-3","DOIUrl":"10.1038/s41574-024-01026-3","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 10","pages":"570-570"},"PeriodicalIF":31.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877448","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":"Endocrine effects of heat exposure and relevance to climate change","authors":"Fadil M. Hannan, Melvin K. S. Leow, Jason K. W. Lee, Sari Kovats, Taha Elajnaf, Stephen H. Kennedy, Rajesh V. Thakker","doi":"10.1038/s41574-024-01017-4","DOIUrl":"10.1038/s41574-024-01017-4","url":null,"abstract":"Climate change is increasing both seasonal temperatures and the frequency and severity of heat extremes. As the endocrine system facilitates physiological adaptations to temperature changes, diseases with an endocrinological basis have the potential to affect thermoregulation and increase the risk of heat injury. The effect of climate change and associated high temperature exposure on endocrine axis development and function, and on the prevalence and severity of diseases associated with hormone deficiency or excess, is unclear. This Perspective summarizes current knowledge relating to the hormonal effects of heat exposure in species ranging from rodents to humans. We also describe the potential effect of high temperature exposures on patients with endocrine diseases. Finally, we highlight the need for more basic science, clinical and epidemiological research into the effects of heat on endocrine function and health; this research could enable the development of interventions for people most at risk, in the context of rising environmental temperatures. Climate change is causing human populations to be exposed to increasingly higher ambient temperatures and more frequent and extreme heatwaves than previously observed. This Perspective considers the available evidence on the endocrine effects of heat exposure, and maps out a path for future research into this field.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 11","pages":"673-684"},"PeriodicalIF":31.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794657","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":"The interactions between energy homeostasis and neurovascular plasticity","authors":"Bandy Chen, Elisa de Launoit, David Meseguer, Cristina Garcia Caceres, Anne Eichmann, Nicolas Renier, Marc Schneeberger","doi":"10.1038/s41574-024-01021-8","DOIUrl":"10.1038/s41574-024-01021-8","url":null,"abstract":"Food intake and energy expenditure are sensed and processed by multiple brain centres to uphold energy homeostasis. Evidence from the past decade points to the brain vasculature as a new critical player in regulating energy balance that functions in close association with the local neuronal networks. Nutritional imbalances alter many properties of the neurovascular system (such as neurovascular coupling and blood–brain barrier permeability), thus suggesting a bidirectional link between the nutritional milieu and neurovascular health. Increasing numbers of people are consuming a Western diet (comprising ultra-processed food with high-fat and high-sugar content) and have a sedentary lifestyle, with these factors contributing to the current obesity epidemic. Emerging pharmacological interventions (for example, glucagon-like peptide 1 receptor agonists) successfully trigger weight loss. However, whether these approaches can reverse the detrimental effects of long-term exposure to the Western diet (such as neurovascular uncoupling, neuroinflammation and blood–brain barrier disruption) and maintain stable body weight in the long-term needs to be clarified in addition to possible adverse effects. Lifestyle interventions revert the nutritional trigger for obesity and positively affect our overall health, including the cardiovascular system. This Perspective examines how lifestyle interventions affect the neurovascular system and neuronal networks. Nutritional imbalances (such as overnutrition in obesity) alter many properties of the neurovascular system, including neurovascular coupling and blood–brain barrier permeability. This Perspective examines how lifestyle interventions targeting weight loss, including intermittent fasting, caloric restriction and physical activity, affect the neurovascular system and neuronal networks.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 12","pages":"749-759"},"PeriodicalIF":31.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759850","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":"CCN3 maintains bone density during lactation","authors":"Claire Greenhill","doi":"10.1038/s41574-024-01023-6","DOIUrl":"10.1038/s41574-024-01023-6","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 9","pages":"507-507"},"PeriodicalIF":31.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752154","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":"The genetics behind age at menarche","authors":"Senegal Carty","doi":"10.1038/s41574-024-01020-9","DOIUrl":"10.1038/s41574-024-01020-9","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 9","pages":"508-508"},"PeriodicalIF":31.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736912","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":"Graves disease: latest understanding of pathogenesis and treatment options","authors":"Giulia Lanzolla, Michele Marinò, Francesca Menconi","doi":"10.1038/s41574-024-01016-5","DOIUrl":"10.1038/s41574-024-01016-5","url":null,"abstract":"Graves disease is the most common cause of hyperthyroidism in iodine-sufficient areas. The main responsible mechanism is related to autoantibodies that bind and activate the thyrotropin receptor (TSHR). Although Graves hyperthyroidism is relatively common, no causal treatment options are available. Established treatment modalities are antithyroid drugs, which reduce thyroid hormone synthesis, radioactive iodine and surgery. However, emerging drugs that target the main autoantigen (monoclonal antibodies, small molecules, peptides) or block the immune pathway have been recently tested in clinical trials. Graves disease can involve the thyroid exclusively or it can be associated with extrathyroidal manifestations, among which Graves orbitopathy is the most common. The presence of Graves orbitopathy can change the management of the disease. An established treatment for moderate-to-severe Graves orbitopathy is intravenous glucocorticoids. However, recent advances in understanding the pathogenesis of Graves orbitopathy have allowed the development of new target-based therapies by blocking pro-inflammatory cytokine receptors, lymphocytic infiltration or the insulin-like growth factor 1 receptor (IGF1R), with several clinical trials providing promising results. This article reviews the new discoveries in the pathogenesis of Graves hyperthyroidism and Graves orbitopathy that offer several important tools in disease management. Graves disease, an autoimmune disease characterized by an enlarged and overactive thyroid gland, is the most common cause of hyperthyroidism in iodine-sufficient areas. In this Review, the authors describe the epidemiology, pathogenesis, and conventional treatment of Graves hyperthyroidism and Graves orbitopathy and discuss advances that have enabled development of novel treatment modalities.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"20 11","pages":"647-660"},"PeriodicalIF":31.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736962","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}