The Lancet Diabetes & Endocrinology最新文献

{"title":"Policies on ultra-processed diets: feasible and urgent","authors":"Phillip Baker, Carlos Monteiro","doi":"10.1016/s2213-8587(25)00194-9","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00194-9","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"10 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640348","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 unique signature of tyrosine kinase inhibitor-induced hypothyroidism","authors":"Tommaso Porcelli, Maria Angela De Stefano, Cristina Luongo, Martin Schlumberger, Domenico Salvatore","doi":"10.1016/s2213-8587(25)00193-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00193-7","url":null,"abstract":"Tyrosine kinase inhibitors (TKIs) are anti-cancer agents that inhibit the activity of oncogenic protein kinases. Thyroid hormone abnormalities are common during treatment with TKIs, typically manifesting as increased serum thyroid stimulating hormone concentrations and reduced tri-iodothyronine (T₃) to thyroxine (T₄) ratio, both in patients with an intact thyroid gland and those with hypothyroidism receiving thyroid hormone treatment. Studies have highlighted the effect of TKIs on peripheral thyroid hormone metabolism, particularly through interference with the activity of deiodinases in healthy tissues. These enzymes are targets of TKIs, and their altered function might contribute considerably to the changes in circulating thyroid hormone concentrations. Although such alterations can affect the tolerability to TKI treatment, TKI-induced hypothyroidism has been associated with improved survival outcomes. Several advanced malignancies show overexpression of type 2 deiodinase, suggesting that inhibition of this enzyme in tumour tissue might contribute to the anti-tumour effects of TKIs. This Review summarises advances in the understanding of TKI-induced disruption of thyroid hormone homoeostasis, and discusses clinical strategies for managing hypothyroidism in this setting.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"23 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629894","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":"Healthy weight for the next generation's health in China","authors":"Xiong-Fei Pan, Zhong-Ze Fang","doi":"10.1016/s2213-8587(25)00170-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00170-6","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"1 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594605","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":"Parental preconception BMI and risk of adverse birth outcomes in 8 million parent–child triads: a nationwide population-based cohort study in China","authors":"Buyun Liu, Chuanyu Zhao, Ying Yang, Jiaxin Li, Yuxiao Wu, Conghui Liu, Yue Cheng, Huaqun Chen, Guifeng Xu, Xinyi Lyu, Hanbin Wu, Jueming Lei, Yiyao Jin, Tsomo Tenzin, Jihong Xu, Yuan He, Yuanyuan Wang, Zuoqi Peng, Ya Zhang, Hongguang Zhang, Xu Ma","doi":"10.1016/s2213-8587(25)00127-5","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00127-5","url":null,"abstract":"<h3>Background</h3>Maternal obesity has been identified as a risk factor for adverse birth outcomes, but the role of paternal obesity (separately and in combination with maternal obesity) on perinatal outcomes remains to be determined. Therefore, this study aims to investigate the independent and joint associations of paternal and maternal BMI with adverse birth outcomes in the general population in China.<h3>Methods</h3>This population-based cohort study used data from the National Free Preconception Checkups Project between 2010 and 2020. Parent–child triads with available data on parental preconception BMI and birth outcomes were included. The outcomes included spontaneous abortion, medically induced abortion, preterm birth, small for gestational age (SGA), large for gestational age (LGA), birth defects, and perinatal death. Restricted cubic spline analyses were performed to assess the dose–response relationship and robust Poisson regression models were applied to quantify the risk ratios (RRs) and 95% CIs.<h3>Findings</h3>We included 8 787 096 parent–child triads, with an average age of 26·18 (SD 4·33) years for mothers and 27·83 (4·73) years for fathers. Restricted cubic spline analyses showed robust monotonic associations for both maternal and paternal BMI with risk of LGA (positive association) and SGA (inverse association). Both maternal and paternal BMI showed J-shaped associations with all other adverse birth outcomes examined. Compared with a healthy BMI in both parents, we found that preconception BMI categories of underweight, overweight, or obesity in either or both parents were associated with a higher risk of spontaneous abortion, medically induced abortion, perinatal death, preterm birth, birth defects, and composite adverse birth outcome. For instance, the RR of perinatal death was 1·17 (95% CI 1·03–1·33) when both parents had obesity and 1·12 (1·01–1·23) when both parents had underweight. The RR of LGA was 1·70 (1·65–1·74) when both parents had obesity and 0·67 (0·66–0·69) when both parents had underweight. The RR of SGA was 0·73 (0·69–0·76) when both parents had obesity and 1·57 (1·53–1·60) when both parents had underweight. However, regarding all these outcomes as a composite, the risk increased by 10% (RR 1·10 [1·08–1·11]) when the mother had obesity and the father had a healthy BMI, by 4% (1·04 [1·04–1·05]) when the mother had a healthy BMI and the father had obesity, and by 16% (1·16 [1·14–1·18]) when both parents had obesity; the RR when both parents had underweight was 1·08 (1·06–1·09).<h3>Interpretation</h3>In this large, nationwide population-based cohort study, a preconception BMI in the category of underweight, overweight, or obesity in either or both parents was associated with a higher risk of various adverse birth outcomes, including perinatal death and birth defects. Therefore, maintaining a healthy weight for both parents before pregnancy is key to perinatal wellbeing.<h3>Funding</h3>National Key Research and De","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"47 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594611","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":"Incretins and the cardiovascular system: bridging digestion with metabolism","authors":"Angelo Avogaro, Gian Paolo Fadini","doi":"10.1016/s2213-8587(25)00166-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00166-4","url":null,"abstract":"The mechanisms driving the cardiovascular and renal benefits of therapies targeting intestinal hormones in type 2 diabetes are still not fully understood. We propose that incretin hormones—glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP)—act as a critical link connecting digestion, metabolism, and cardiovascular function, supporting physiological adaptations to nutrient intake. Incretin hormones help regulate blood flow and cardiac activity, enhancing nutrient absorption while protecting the heart and vessels. After meals, incretin hormones promote vasodilation—especially in the splanchnic and peripheral circulations—via nitric oxide, improving endothelial function, vascular flexibility, and blood pressure control, which supports tissue perfusion and meets the body's increased metabolic demands. GLP-1 also has mild inotropic effects, promoting efficient circulation without straining the heart. At the same time, vasodilation boosts glucose and lipid uptake, linking digestion directly to energy metabolism. These mechanisms lower vascular resistance, reduce cardiac workload, and improve myocardial glucose use, which becomes especially valuable during ischaemic events. Incretins also have anti-inflammatory and antioxidant effects, which help prevent endothelial dysfunction and arterial stiffening, reducing the risk of atherosclerosis. Clinically, GLP-1 receptor agonists and dual GLP-1 and GIP receptor agonists leverage these effects to improve cardiovascular and possibly renal outcomes in people with type 2 diabetes or obesity. By linking digestion, metabolism, and cardiovascular health, incretin-based therapies do more than just regulate blood sugar; they help reduce morbidity and mortality and are becoming a core component of modern diabetes care.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"109 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578260","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":"Reassessing driving safety in diabetes","authors":"","doi":"10.1016/s2213-8587(25)00199-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00199-8","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"655 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565726","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":"Body composition during major incretin-based weight loss","authors":"Carsten Dirksen, Sten Madsbad","doi":"10.1016/s2213-8587(25)00122-6","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00122-6","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"8 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520957","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":"Association of gestational thyroid function and thyroid autoimmunity with gestational diabetes: a systematic review and individual participant meta-analysis","authors":"Joris A J Osinga, Arash Derakhshan, Marianna Karachaliou, Kris G Poppe, Leonie Warringa, Koen Verdonk, Bijay Vaidya, Tuija Männistö, Abel López-Bermejo, Judit Bassols, Maarten A C Broeren, Suzanne J Brown, Richard Christian Jensen, Polina V Popova, Victor J M Pop, Ulla Feldt-Rasmussen, Ashraf Aminorroaya, Sofie Bliddal, Lorena Mosso, Lida Chatzi, Tim I M Korevaar","doi":"10.1016/s2213-8587(25)00068-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00068-3","url":null,"abstract":"<h3>Background</h3>Pregnancy is a state of increased metabolic demand that necessitates major changes in endocrine physiology. Gestational thyroid dysfunction and gestational diabetes are common endocrine conditions of pregnancy that frequently coincide. Although the effects of thyroid hormones on glucose metabolism are well documented, important knowledge gaps remain in terms of the extent and clinical relevance of these effects during pregnancy. The aim of this meta-analysis is to assess the association of thyroid function test results with gestational diabetes and markers of glucose metabolism.<h3>Methods</h3>In this systematic review and individual participant data meta-analysis, we searched Ovid MEDLINE, EMBASE, and Web of Science from database inception to Dec 12, 2024, for prospective population-based cohort studies with individual patient data on thyroid function, gestational diabetes, and measures of glucose homoeostasis during pregnancy. Furthermore, open invitations to join the Consortium on Thyroid and Pregnancy were issued to identify unpublished datasets. We excluded participants with multiple pregnancies; pre-existing thyroid disease or diabetes; current use of medications that could affect thyroid or glucose levels; or a history of infertility treatment, miscarriage, or stillbirth. Exposures were maternal gestational concentrations of thyroid-stimulating hormone (TSH), free T<sub>4</sub> (FT<sub>4</sub>), free T<sub>3</sub> (FT<sub>3</sub>), and total T<sub>3</sub>; thyroperoxidase antibody positivity; thyroglobulin antibody positivity; and thyroid disease entities (ie, subclinical hypothyroidism, overt and subclinical hyperthyroidism, and isolated hypothyroxinaemia), which were defined according to current guidelines. The primary outcome was presence of gestational diabetes as defined in individual cohorts. Individual participant data were analysed using generalised linear mixed-effects regression models adjusting for maternal age, BMI, smoking status, parity, ethnicity, fetal sex, and gestational age at blood sampling. We preregistered our study protocol with PROSPERO (CRD42022371927).<h3>Findings</h3>We identified 638 published studies with our systematic search, of which 21 studies based on 17 cohorts met inclusion criteria; 11 of these prospective cohort studies provided individual participant data, and data from an additional 14 cohorts were added via personal contacts and open invitations, resulting in a study population of 63 548 participants from 25 cohorts after exclusions. Of the 52 632 participants in 17 cohorts with TPOAb measurements available to define thyroid disease entities, 1687 (3·2%) of these participants had subclinical hypothyroidism, 1153 (2·2%) had isolated hypothyroxinaemia, and 2958 (4·7%) had gestational diabetes. Compared with euthyroidism, isolated hypothyroxinaemia was associated with a higher risk of gestational diabetes (absolute risk 6·5% [72 of 1113] for isolated hypothyroxinaemia <em>vs</em> 3·5","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"633 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521016","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":"Maternal thyroid hypofunction and gestational diabetes risk","authors":"Sun Y Lee","doi":"10.1016/s2213-8587(25)00126-3","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00126-3","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"184 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521192","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":"Effects of retatrutide on body composition in people with type 2 diabetes: a substudy of a phase 2, double-blind, parallel-group, placebo-controlled, randomised trial","authors":"Tamer Coskun, Qiwei Wu, Nanette C Schloot, Axel Haupt, Zvonko Milicevic, Courtney Khouli, Charles Harris","doi":"10.1016/s2213-8587(25)00092-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00092-0","url":null,"abstract":"<h3>Background</h3>Retatrutide, a glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1, and glucagon receptor agonist, has demonstrated robust glucose and bodyweight reductions in participants with type 2 diabetes. This substudy assessed percent change from baseline to week 36 in total body fat mass versus placebo and dulaglutide.<h3>Methods</h3>This phase 2, double-blind, parallel-group, placebo-controlled, randomised controlled trial was done in 42 medical centres in the USA. Eligible participants were adults aged 18–75 years with type 2 diabetes, HbA<sub>1<em>c</em></sub> of 7·0–10·5%, stable bodyweight, and BMI of 25–50 kg/m<sup>2</sup>. Eligible participants were randomly assigned in a 2:2:2:1:1:1:1:2 ratio to once-weekly subcutaneous placebo, dulaglutide 1·5 mg, or retatrutide 0·5 mg, 4 mg (2 mg initial dose), 4 mg (4 mg initial dose), 8 mg (2 mg initial dose), 8 mg (4 mg initial dose), or 12 mg. The prespecified primary substudy endpoint was percent change from baseline to week 36 in total fat mass, as measured by dual-energy X-ray absorptiometry (DXA). Regression methods with on-treatment data before study drug discontinuation from all randomly assigned participants with non-missing DXA scans were included in efficacy analysis. All participants who received at least one dose of study drug were included in the safety analysis population. The completed trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT04867785</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>.<h3>Findings</h3>Between May 13, 2021 and June 13, 2022, 534 participants were screened for inclusion into the main study. 253 were excluded and 281 participants were enrolled and randomly assigned to the main study. Of the main study participants, 189 participants were enrolled to the body composition substudy (29 in the placebo group, 32 in the retatrutide 0·5 mg group, 31 in the retatrutide 4 mg groups [pooled], 33 in the retatrutide 8 mg group [pooled], 30 in the retatrutide 12 mg group, and 34 in the dulaglutide 1·5 mg group). Of these, 155 had a baseline DXA scan and 103 completed treatment and both baseline and week 36 DXA scans. 105 (56%) of 189 participants were female and 84 (44%) were male. 160 (85%) of 189 participants were White, 24 (13%) were Black, and five (3%) were Asian. Percent reduction from baseline in total fat mass was 4·9% (SE 1·4%) with retatrutide 0·5 mg, 15·2% (3·2%) with retatrutide 4 mg (pooled), 26·1% (2·5%) with retatrutide 8 mg (pooled), 23·2% (3·0%) with retatrutide 12 mg, 2·6% (1·6%) with dulaglutide, and 4·5% (1·2%) with placebo. Least squares me","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"19 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520951","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}