Reviews in Endocrine & Metabolic Disorders最新文献

{"title":"Levothyroxine monotherapy has limited effects on body composition in clinical and subclinical hypothyroidism: a systematic review and meta-analysis.","authors":"Derrick Kretli-Souza, Gabriel Meireles-Oliveira, Raiane Aparecida Asevedo, Nathalia Elizabete Paulino, Yuri Alves-Silva, Ingrid Rodrigues Hortêncio-Medeiros, Dayani Silvina de Jesus, Sara Cristina Leonel Lemos, Candido Celso Coimbra, Lucas Rios Drummond, Helton Oliveira Campos, Rodrigo Antonio Peliciari-Garcia, Paula Bargi-Souza","doi":"10.1007/s11154-026-10093-y","DOIUrl":"https://doi.org/10.1007/s11154-026-10093-y","url":null,"abstract":"<p><p>Clinical (CH) and subclinical (SCH) hypothyroidism reduces the metabolic rate and alter body composition. The current treatment with levothyroxine (LT4) restores the thyroid axis hormonal levels; however, its efficacy in reversing the anthropometric alterations remains unclear. This review was prospectively registered on PROSPERO (CRD42024589156), followed PRISMA guidelines, and aimed to include studies involving CH and/or SCH treated with LT4 monotherapy until achieving physiological hormonal levels. Eligible studies reported pre- and post-LT4 treatment data of BMI, BW, fat mass (FM), and lean mass/fat-free mass (LM/FFM). Each variable was analyzed according to treatment duration, sex distribution, initial and final TSH levels. 35 studies were included, comprising 1,116 individuals with hypothyroidism (672 CH; 444 SCH). In CH, LT4 led to negligible changes in BMI in the general analysis (Standardized mean difference [SMD] -0.18; 95% confidence interval [CI] -0.26, -0.10; mean difference [MD] -0.68 kg/m²), while moderate BMI reductions were observed after 12 months of treatment (SMD - 0.56; CI -0.87, -0.24; MD -2.29 kg/m²). LT4 reduced BW in CH (SMD - 0.24; CI -0.34, -0.15; MD -2.15 kg), primarily in the first 3 months of treatment; it did not change FM and led to a small reduction in LM/FFM (SMD - 0.21; CI -0.37, -0.05). However, LT4 showed no significant effects on BMI, BW, FM, or LM/FFM in SCH, regardless of the analysis. Despite restoring thyroid hormonal homeostasis, LT4 showed limited efficacy in reversing the anthropometric alterations associated with CH and mainly SCH, suggesting that therapies beyond hormonal normalization may be required. Moreover, our data reinforces that LT4 monotherapy must not be prescribed for weight loss.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effects of ketogenic diets and mediterranean diets on obesity and metabolic outcomes: a systematic review and meta-analysis.","authors":"Xu Kun, Ayda Roostaee, Zeinab Safarpour Lima, Pejman Rohani","doi":"10.1007/s11154-026-10086-x","DOIUrl":"https://doi.org/10.1007/s11154-026-10086-x","url":null,"abstract":"<p><p>Ketogenic diets (KD) and Mediterranean diets (MD) are among the most widely studied dietary approaches for obesity and metabolic disorders; however, their comparative efficacy remains controversial. This systematic review and meta-analysis aimed to compare the effects of KD and MD on anthropometric and metabolic outcomes in adults. A comprehensive search of original databases was conducted from inception until March 2026. Randomized controlled trials comparing KD with MD in adults were included. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using random-effects models. KD significantly reduced body weight (WMD: -3.56 kg; 95% CI: -5.62, - 1.49), body mass index (BMI) (WMD: -1.86 kg/m²; 95% CI: -2.73, - 0.98), waist circumference (WC) (WMD: -4.25 cm; 95% CI: -7.46, - 1.04), total body fat (TBF) percentage (WMD: -2.09%; 95% CI: -3.98, - 0.20), and insulin levels (WMD: -3.15 µU/ml; 95% CI: -5.02 to - 1.28) compared with MD. In contrast, no significant differences were observed between KD and MD regarding fasting blood sugar, HbA1c, LDL-C, HDL-C, triglycerides, systolic blood pressure, diastolic blood pressure, or C-reactive protein levels. However, KD significantly reduced total cholesterol (TC) compared with MD (WMD: -9.71 mg/dl; 95% CI: -17.79, - 1.62). Publication bias was detected for triglycerides and LDL-C outcomes. KD demonstrated superior effects on anthropometric outcomes compared with MD, particularly for weight loss and body composition improvement. However, both dietary approaches showed largely comparable effects on glycemic control, lipid profile, blood pressure, and inflammatory biomarkers. While KD may provide greater short-term weight reduction, MD may remain a sustainable dietary strategy for long-term cardiometabolic health.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of sex and gender in autoimmune thyroid diseases: mechanisms and knowledge gaps.","authors":"Rosaria Maddalena Ruggeri, Rosina Scala, Serena Scalise, Francesco Trimarchi, Salvatore Cannavò","doi":"10.1007/s11154-026-10087-w","DOIUrl":"https://doi.org/10.1007/s11154-026-10087-w","url":null,"abstract":"<p><p>Autoimmune thyroid diseases (AITDs), mainly Hashimoto's thyroiditis and Graves' disease, are the most common organ-specific autoimmune disorders and display one of the strongest sex biases in autoimmunity, with a marked female predominance. This review examines how biological sex and gender-related determinants shape AITD susceptibility, expression, and clinical heterogeneity, and their relevance to personalized care. PubMed/MEDLINE and Scopus were searched from inception to June 2026, with Web of Science used for forward citation tracking. Human studies, reviews and meta-analyses, and selected experimental studies addressing sex- and gender-related mechanisms relevant to thyroid autoimmunity were considered. Sexual dimorphism in immune function provides the biological background for the higher autoimmune susceptibility of women, who generally mount stronger innate and adaptive immune responses. Sex hormones modulate immune tolerance and inflammation, while X-chromosome dosage, incomplete or skewed X-chromosome inactivation, X-linked immune genes, and emerging Y-chromosome-related mechanisms further contribute to immune regulation. Epigenetic mechanisms may amplify sex-dependent immune responses. Pregnancy, postpartum immune rebound, reproductive history, and fetal microchimerism highlight the interaction between reproductive biology and thyroid autoimmunity. Environmental exposures, smoking, psychosocial stress, occupational patterns, and healthcare-related determinants add a gender-related dimension, while sex-specific gut microbiota differences may also contribute. However, major knowledge gaps remain. Sex-stratified analyses are often lacking, and AITD-specific evidence on epigenetic profiles, microbiota, and gender-related determinants remains limited. Integrating sex and gender into AITD research and clinical practice may improve risk stratification, diagnosis, prevention, and individualized management, supporting a precision-medicine approach to thyroid autoimmunity.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal stem and progenitor cell niche organization, regulation and repair.","authors":"Kun Chen, Thomas H Ambrosi","doi":"10.1007/s11154-026-10080-3","DOIUrl":"10.1007/s11154-026-10080-3","url":null,"abstract":"<p><p>Bone has traditionally been viewed through the lens of structural support and mineral homeostasis, but it is increasingly recognized as a dynamic endocrine organ. Similarly, the concept of skeletal maintenance and repair has historically been considered through tightly coordinated regulation of specialized mature cell types. Recently, a refined understanding of skeletal stem cells (SSCs) and skeletal stem/progenitor cells (SSPCs) as key cellular drivers of skeletal development, homeostasis and regeneration has underscored their importance and broadened that framework. In this review, we examine skeletal endocrine biology through the high-resolution mapping of SSCs and SSPCs and their crosstalk with immune and matrix-associated niche components. We discuss how bone-derived endocrine factors, systemic hormones and neuroendocrine cues may act as local and systemic niche modulators that shape SSC and SSPC behavior during skeletal maintenance, physiological adaptation and repair. We further highlight how timed immune activation as well as inflammatory resolution shape successful skeletal repair, whereas aging, osteoporosis and chronic inflammation disrupt SSC competence, progenitor lineage progression and niche coordination. Together, these insights define stem cell-based skeletal actions as a niche-regulated process in which endocrine and immune cell programs are temporally and spatially coordinated. Understanding the interactive endocrine-SSPC niche may open new therapeutic avenues for restoring regenerative capacity of the aging and diseased skeleton.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-efficient exercise strategies to reduce visceral adipose tissue in children and adolescents with overweight or obesity: evidence from a pairwise and network meta-analysis.","authors":"Chaofan Chen, Xiaoke Chen, Isaac A Chávez-Guevara, Francisco J Amaro-Gahete, Yanwei You, Qing Yi, Zhiyuan Tan, Yang Jiang, Mengmeng Ji, Carlo Castagna, Susana Póvoas, Danijela Gasevic, Jianxiu Liu, Xindong Ma","doi":"10.1007/s11154-026-10082-1","DOIUrl":"https://doi.org/10.1007/s11154-026-10082-1","url":null,"abstract":"<p><p>High-quality meta-analyses focusing specifically on exercise-induced changes in visceral adipose tissue (VAT) in children and adolescents with overweight or obesity (CAO) remain limited. This study compared the relative effects of four common exercise modalities and identified potentially promising strategies for reducing VAT in CAO. Seven databases were searched from inception to September 2025 for studies comparing exercise interventions with controls on VAT in CAO. A multi-level and network meta-analysis were performed to estimate effect sizes and rank exercise modalities. Subgroup and meta-regression analyses explored the influence of various moderators. Risk of bias, publication bias, sensitivity, and certainty of evidence were also assessed. A two-dimensional analysis was conducted to compare efficacy, acceptability, and time efficiency across different exercise modalities. A total of 34 studies and 2060 participants were included. High-intensity interval training (HIIT) showed the most pronounced effect (g = -0.78 [-1.24 to -0.32]) on reducing VAT, followed by aerobic combined resistance training (g = -0.65 [-1.01 to -0.29]) and aerobic exercise (g = -0.42 [-0.63 to -0.21]), while resistance training showed no significant benefit. Exploratory subgroup analyses suggested greater VAT reductions in interventions conducted at least three times per week and lasting 12 weeks or longer. Meta-regression identified study-level associations of VAT reduction with baseline BMI, changes in cardiorespiratory fitness, and sex distribution. Network and two-dimensional analyses suggested that HIIT had the highest ranking probability for VAT reduction and was associated with the shortest weekly intervention time and the lowest dropout rate, although the certainty of evidence was low to very low. The effects of different exercise modalities on VAT vary, with intervention efficacy influenced by duration and individual characteristics. HIIT may be a promising and time-efficient exercise option for reducing VAT in CAO; however, this finding should be interpreted cautiously given the low to very low certainty of evidence.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the socio-economic and health burden of obesity: a 10-year retrospective analysis of population-wide administrative healthcare data.","authors":"Roser Cantenys-Sabà, Lucía Camacho-Barcia, Lucero Munguía, Nadia Micali, Elena Jansen, Isabel Baenas, Anders Juul, Stine A Holmboe, Maria B Damholt, Trine K Hueg, Isabelle Mack, Stephan Zipfel, Katrin Elisabeth Giel, Dorota Drozdz, Małgorzata Wójcik, Manuel Tena-Sempere, Emili Vela, Jordi Piera-Jiménez, Susana Jimenez-Murcia, Gerard Carot-Sans, Fernando Fernández-Aranda","doi":"10.1007/s11154-026-10083-0","DOIUrl":"https://doi.org/10.1007/s11154-026-10083-0","url":null,"abstract":"<p><p>Obesity is a major contributor to chronic disease and multimorbidity, leading to progressively increasing clinical complexity across the life course. However, the relationship between obesity and overall clinical complexity remains insufficiently characterized, particularly at the population level, where territorial and socioeconomic inequalities should also be considered. In this review, we summarize the current evidence and complement it with an in-depth characterization of the demographic, socioeconomic, clinical, and healthcare utilization burden associated with obesity in a population of 8 million people in Catalonia, Spain. Beyond individual comorbidities, we examine multimorbidity using a comprehensive risk stratification measure and evaluate the impact of obesity on healthcare resource utilization and expenditure. Obesity was more prevalent among women and socioeconomically disadvantaged populations and followed a marked geographic deprivation gradient. Compared with a reference population standardized by age, sex, and socioeconomic status, individuals with obesity had a substantially greater multimorbidity burden, with 13% classified as high risk according to the AMG index versus 5% of the reference population. They also had greater healthcare utilization, including 4.5 additional primary care visits and 2.4 more prescribed medications per person annually. Mean annual healthcare expenditure reached €2,633 per person, representing a 108% increase compared with the reference population, while the total healthcare expenditure attributable to obesity was estimated at €2.1 billion in 2023. These findings underscore the substantial impact of obesity on multimorbidity, healthcare utilization, and healthcare expenditure, reinforcing the need for policies that address both obesity and its underlying socioeconomic determinants.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics and artificial intelligence in pituitary adenomas (PitNETs): from imaging biomarkers to clinical translation.","authors":"Sabina Ruiz, Anna Oliva, Roger Mateu, Ariadna Izquierdo, Joshua Bernal, Gemma Monté-Rubio, Elena Valassi, Maria de la Iglesia-Vayá, Jesús A Alzate, Paloma Puyalto, Manel Puig-Domingo","doi":"10.1007/s11154-026-10078-x","DOIUrl":"https://doi.org/10.1007/s11154-026-10078-x","url":null,"abstract":"<p><p>Pituitary neuroendocrine tumors (PitNETs) are common intracranial neoplasms with heterogeneous hormonal activity, invasiveness, and treatment response. Conventional MRI is central to diagnosis, but is limited in quantifying tumor heterogeneity and predicting clinically relevant features such as consistency, molecular subtype, proliferation, and clinical outcomes. To review current evidence on MRI-based radiomics and artificial intelligence (AI) in PitNETs, focusing on clinical applications, methodological quality, and future integration into precision medicine. Narrative review of studies published between 2019 and 2025 evaluating radiomics, machine learning, and deep learning applied to PitNETs, highlighting tumor consistency, molecular and histological subtypes, proliferation, invasiveness, treatment response, recurrence, visual outcomes, and differential diagnosis of sellar lesions. Radiomics has been applied across the PitNET clinical trajectory. Texture- and shape-based features from T2-weighted and multiparametric MRI predict intraoperative tumor consistency with AUCs often > 0.80, outperforming conventional radiology. Radiomic signatures allow non-invasive differentiation of functional vs. non-functional adenomas, somatotroph granulation patterns, silent corticotroph adenomas, prolactinomas, and prediction of Ki-67 and PIT-1 expression. Models also predict cavernous sinus invasion, postoperative regrowth, recurrence, visual outcomes, and treatment response, including dopamine-agonist therapy. Differential diagnosis of hypophysitis and Rathke's cleft cyst has also been explored. Methodological quality remains heterogeneous, with frequent single-center, retrospective designs, limited external validation, and suboptimal adherence to reporting guidelines. Radiomics and AI show promise for risk stratification and personalized therapy in PitNETs, particularly for predicting tumor consistency, molecular subtypes, and recurrence. Clinical implementation requires standardized imaging protocols, multicenter datasets, reproducible segmentation, interpretable models, and prospective validation.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The central role of the β-cell in diabetes: from monogenic forms to type 1, type 2, and gestational diabetes.","authors":"Zhaoying Chen, Haipeng Pang","doi":"10.1007/s11154-026-10084-z","DOIUrl":"https://doi.org/10.1007/s11154-026-10084-z","url":null,"abstract":"<p><p>Diabetes encompasses a heterogeneous group of metabolic disorders characterized by hyperglycemia resulting from inadequate insulin secretion and/or impaired insulin action. A central, common feature across all major forms of diabetes is the loss of functional pancreatic β-cell mass. Recent advancements have significantly highlighted the critical role of pancreatic β-cell in diabetes, primarily driven by advances in genome-wide and multi-omics approaches, the availability of isolated human islets, and the data from large clinical trials. This review synthesizes current evidence on the pathogenesis of different diabetes types including monogenic diabetes (MD), type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes (GD), from the perspective of the pancreatic β-cell, emphasizing its contribution to disease heterogeneity and progression. In MD, single-gene defects directly impair β-cell function, highlighting the genetic basis of insulin secretion and offering insights into personalized treatment. In T1D, β-cells are not merely passive targets of autoimmunity but may actively participate in initiating immune responses through stress-induced changes. T2D is characterized by β-cell failure in the context of insulin resistance (IR), with genetic and functional studies underscoring the key role of β-cell decline in disease development. GD results from an inadequate β-cell compensatory response to pregnancy-related IR, revealing the intrinsic metabolic defect. Overall, a β-cell-centered framework helps elucidate the diverse mechanisms underlying different types of diabetes, provides a mechanistic foundation for improved disease subclassification.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FGF23　- A hormone produced by bone and has many faces.","authors":"Seiji Fukumoto","doi":"10.1007/s11154-026-10079-w","DOIUrl":"https://doi.org/10.1007/s11154-026-10079-w","url":null,"abstract":"<p><p>Fibroblast growth factor 23 (FGF23) was identified as an etiological factor for hypophosphatemic rickets/osteomalacia approximately a quarter-century ago. Since then, FGF23 has been shown to be a bone-derived hormone that regulates phosphate and vitamin D metabolism by binding to the α-KLOTHO-FGF receptor complex. Dysregulation of FGF23 activity results in hypophosphatemic and hyperphosphatemic disorders. Medical therapy targeting FGF23 is now available for hypophosphatemic diseases caused by FGF23 excess. Furthermore, elevated FGF23 levels have been associated with various adverse clinical outcomes, including left ventricular hypertrophy, cardiovascular events, vascular calcification, and increased mortality. Beyond its role in mineral metabolism, FGF23 has been reported to exert direct effects on other organs, contributing to conditions such as left ventricular hypertrophy, anemia, and cardiac and renal fibrosis. However, the exact mechanisms underlying these pleiotropic actions have not yet been fully elucidated. This review summarizes recent findings regarding FGF23, focusing on its classical role as a hormone and its broader effects as a humoral factor on other organs.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothalamic neurovascular and extracellular matrix remodeling: Cellular niche orchestration of immune-metabolic adaptation to nutritional stress.","authors":"Natalia Ferreira Mendes","doi":"10.1007/s11154-026-10081-2","DOIUrl":"https://doi.org/10.1007/s11154-026-10081-2","url":null,"abstract":"<p><p>Under normal physiological conditions, hypothalamic resident immune cells interact with neurons and other non-neuronal cells to maintain tissue homeostasis. Accumulated evidence from studies with rodents shows that excessive intake of saturated fatty acids triggers hypothalamic neuroinflammation, innate and adaptive immune activation, and chemotaxis of peripheral immune cells toward the hypothalamus. The functional consequences of this immune activation are not uniformly detrimental, as specific immune subsets can instead support metabolic resilience. Beyond this functional heterogeneity, the structural mechanisms underlying immune cell recruitment within the arcuate nucleus (ARC) and median eminence (ME), particularly extracellular matrix (ECM) and neurovascular remodeling, remain poorly defined. To address this gap, this review integrates established mechanisms from other central nervous system compartments with recent hypothalamic findings, proposing a framework for how structural changes, including microgliosis, tanycyte barrier breakdown, and ECM and neurovascular remodeling, orchestrate immune-metabolic adaptations within the ARC and ME under nutritional stress. We further provide an overview of the hypothalamic immune landscape and describe how microglia, perivascular macrophages, and tanycytes, are involved with this hypothalamic niche remodeling.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}