The Lancet Diabetes & Endocrinology最新文献

{"title":"Natural history of thyroid function in ageing: an individual participant data analysis of 137 488 participants from 31 prospective cohort studies.","authors":"Yanning Xu, Ola Hysaj, Xiaoyi Qi, Martin Feller, Alessandro Pingitore, Suzanne J Brown, Till Ittermann, Massimo Iacoviello, Stella Trompet, Ji Won Han, Börge Schmidt, José A Sgarbi, Sergio Valdés, Axel Muendlein, Johannes Riis, Stig Andersen, Heinz Drexel, Alexander Teumer, Marcus Dörr, Mark P J Vanderpump, Nick Wareham, Bert Vaes, W Edward Visser, J Wouter Jukema, Misa Imaizumi, Robin P F Dullaart, Marco Medici, Howard A Fink, Graziano Ceresini, Luigi Ferrucci, M Arfan Ikram, Graeme J Hankey, Giorgio Iervasi, Richard Eastell, Douglas C Bauer, Graham R Williams, Kristien Boelaert, Bruce M Psaty, Dagmar Führer-Sakel, Stephan J L Bakker, Lambertus A L M Kiemeney, Niels P Riksen, Ki Woong Kim, Fereidoun Azizi, Henry Völzke, Bu B Yeap, Salman Razvi, Jacobijn Gussekloo, John P Walsh, Isabela M Bensenor, Jennifer Mammen, Nicolas Rodondi, Anne R Cappola, Robin P Peeters, Layal Chaker","doi":"10.1016/S2213-8587(26)00009-4","DOIUrl":"10.1016/S2213-8587(26)00009-4","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding thyroid function changes with ageing remains inconsistent and the implications of potential changes are unclear. We aimed to investigate ageing-related thyroid function changes and their associations with mortality.</p><p><strong>Methods: </strong>In this individual participant data (IPD) analysis, prospective population-based cohorts were eligible for inclusion when data on thyroid function measurements and mortality were available in individuals aged 18 years and older. Eligible datasets were identified through a systematic search of PubMed. We excluded cohorts of participants with only thyroid disease or thyroid-altering medications, or pregnant individuals. We requested data from all eligible cohorts that agreed to participate in the study. Linear mixed models were used to investigate associations between age and thyroid function, stratified for sex and regional iodine status. Annual changes in thyroid-stimulating hormone (TSH) and free thyroxine (FT<sub>4</sub>) were estimated per individual and categorised into quintiles, with the highest and lowest quintiles defined as increasing and decreasing, respectively, and the rest as stable. Patterns of thyroid function change were identified based on combined TSH and FT<sub>4</sub> evolution. We used cohort-stratified Cox models to assess associations between changing patterns and all-cause mortality. This study is registered with PROSPERO, CRD42023408086.</p><p><strong>Findings: </strong>In this IPD analysis, we analysed data collected between Jan 1, 2011, and Oct 13, 2022, from 31 cohorts across Europe (n=19), the USA (n=5), Asia (n=3), Brazil (n=2), and Australia (n=2; 137 488 participants; 68 322 [49·7%] were female and 69 166 [50·3%] were male; median age 60 years [range 18-106]). Cross-sectionally, older age was associated with higher TSH in iodine-sufficient regions and with lower TSH in iodine-insufficient regions. Longitudinal analyses showed that TSH increased with increasing age regardless of iodine status. The overall increase in TSH from age 18 years to 100 years was 0·61 mIU/L (0·52 SD) for female participants and 0·99 mIU/L (0·76) for male participants from iodine-sufficient regions. Greater variability in population distribution and longitudinal TSH changes was observed in adults aged 65 years or older. Higher FT<sub>4</sub> with older age was suggested cross-sectionally, but longitudinally FT<sub>4</sub> increased in iodine-sufficient regions and decreased in iodine-insufficient regions. Compared with stable thyroid function, all changing patterns were associated with increased all-cause mortality: hazard ratios of 1·80 (95% CI 1·57-2·06) for increasing TSH with stable or decreasing FT<sub>4</sub>; 2·45 (2·01-2·97) for increasing TSH and increasing FT<sub>4</sub>; 2·45 (1·99-3·01) for decreasing TSH with decreasing FT<sub>4</sub>; and 1·94 (1·68-2·24) for decreasing TSH with stable or increasing FT<sub>4</sub>.</p><p><strong>Inter","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"485-497"},"PeriodicalIF":36.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822549","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":"Safety, tolerability, pharmacokinetics, and efficacy of burosumab in infants with X-linked hypophosphataemia: an open-label, multicentre, non-randomised study.","authors":"Agnès Linglart, Francesco Emma, Justine Bacchetta, Francisco de la Cerda, Wesley Hayes, Moira Cheung, Alessandra Cocca, Wolfgang Högler, Raja Padidela, Lucy Henderson, Alina Tudor, Hiroki Okada, Wei Sun, Emilia Quattrocchi","doi":"10.1016/S2213-8587(26)00013-6","DOIUrl":"10.1016/S2213-8587(26)00013-6","url":null,"abstract":"<p><strong>Background: </strong>Burosumab, a human anti-fibroblast growth factor 23 monoclonal antibody, is approved in Europe for treating X-linked hypophosphataemia (XLH) in patients aged at least 1 year. Early initiation might further improve clinical outcomes. This study investigated the safety and efficacy of administering burosumab to patients younger than 12 months.</p><p><strong>Methods: </strong>This open-label, non-randomised, phase 1/2 study included infants from clinical sites in Austria, France, Italy, Spain and the UK. Key eligibility criteria were age less than 12 months, presence of a pathogenic or likely pathogenic variant, or variant of uncertain importance in the PHEX gene in either the participant or a directly related family member with appropriate X-linked inheritance, and hypophosphataemia. Participants received burosumab every 2 weeks for up to 48 weeks: cohorts 1 and 2 (infants aged from 6 to less than 12 months with starting doses 0·4 or 0·8 mg/kg) and cohort 3 (infants younger than 6 months with starting dose 0·4 mg/kg). The primary endpoint was safety and tolerability assessed in the full-analysis set of all participants who received at least one dose of burosumab and had at least one serum phosphate measurement after treatment, was safety, with a focus on treatment-emergent adverse events (TEAEs). The study is registered with ClinicalTrials.gov (NCT04188964) and is completed.</p><p><strong>Findings: </strong>Study recruitment was initiated on Feb 26, 2020, and the study was completed on March 6, 2024. Of 17 participants assessed for eligibility, 16 were enrolled and assigned to cohorts 1, 2, and 3, which included three, nine, and four participants, respectively (n=16); seven of 16 were female, 15 of 16 completed the study, one discontinued and transitioned to receive burosumab in a local hospital. All participants had TEAEs with no differences in incidence across cohorts; four had at least one treatment-related TEAE, one developed antidrug antibodies. No TEAEs led to treatment discontinuation or death. The most common TEAE was pyrexia, reported in 12 (75%) of 16 (95% CI 47·6-92·7) participants. The most common treatment-related TEAE was blood parathyroid hormone increase, reported in three (19%) of 16 (4·0-45·6) participants.</p><p><strong>Interpretation: </strong>This study confirms the safety and tolerability of burosumab in patients with XLH initiating treatment aged less than 12 months and is consistent with previous reports with no new safety concerns.</p><p><strong>Funding: </strong>Kyowa Kirin Pharmaceutical Development.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"475-484"},"PeriodicalIF":36.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786482","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":"Diabetes-related complications: an evolving spectrum.","authors":"The Lancet Diabetes Endocrinology","doi":"10.1016/S2213-8587(26)00103-8","DOIUrl":"10.1016/S2213-8587(26)00103-8","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"437"},"PeriodicalIF":41.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822586","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":"Analogue insulin, GLP-1, and the WHO Model Essential Medicines List - Authors reply.","authors":"David Beran, Amanda Adler, Naomi Levitt, Janeth Tenorio-Mucha, Stephen Colagiuri","doi":"10.1016/S2213-8587(26)00066-5","DOIUrl":"10.1016/S2213-8587(26)00066-5","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"377-378"},"PeriodicalIF":41.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576054","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":"Analogue insulin, GLP-1, and the WHO Model Essential Medicines List.","authors":"Jennifer Manne-Goehler, Giulia Segafredo, Jing Luo, Nomathemba Chandiwana, Willem D F Venter","doi":"10.1016/S2213-8587(26)00068-9","DOIUrl":"10.1016/S2213-8587(26)00068-9","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"377"},"PeriodicalIF":41.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576048","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":"Artificial intelligence for interpreting diabetes data using clinician-curated benchmarks.","authors":"David C Klonoff, Elizabeth Healey, Kenneth D Mandl, David Kerr","doi":"10.1016/S2213-8587(26)00044-6","DOIUrl":"10.1016/S2213-8587(26)00044-6","url":null,"abstract":"","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":" ","pages":"375"},"PeriodicalIF":41.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582608","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":"Burosumab treatment for children younger than 12 months with X-linked hypophosphataemia","authors":"Salvatore Minisola, Jessica Pepe, Cristiana Cipriani","doi":"10.1016/s2213-8587(26)00073-2","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00073-2","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"28 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147744076","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":"Strengthening diabetes care in sub-Saharan Africa: health systems, digital innovations, lifestyle interventions, and socioeconomic dimensions","authors":"Shabana Cassambai, Pamela Godia, Silver Bahendeka, Damilola Omodara, Deborah Ikhile, Samuel Seidu, Kamlesh Khunti","doi":"10.1016/s2213-8587(26)00035-5","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00035-5","url":null,"abstract":"The prevalence of diabetes, particularly type 2, in sub-Saharan Africa is rising at an alarming rate. This surge has exposed deep structural challenges, including an over-reliance on hospital-based services and strong cultural and faith-based influences that shape health-seeking behaviours. These factors, combined with socioeconomic inequalities and urbanisation, contribute to poor glycaemic control. Several strategies have been proposed to tackle this problem, including task shifting, integrated models that make use of HIV care infrastructure, digital health tools such as SMS reminders, culturally adapted lifestyle and nutrition programmes, community-based and faith-based interventions, and public–private partnerships. Despite these promising approaches, evidence of long-term sustainability, scalability, cost-effectiveness, and the impact of these interventions remains scarce. Additionally, stigma, gender-related barriers, and patient-reported outcomes are insufficiently studied in sub-Saharan Africa. Large-scale, longitudinal research is urgently needed to assess health system strengthening and culturally grounded models. Achieving effective diabetes care will require resilient, inclusive systems that integrate clinical, community, and digital innovations within the sociocultural and economic realities of the region.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"22 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751558","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":"Diabetes-related complications and multiple long-term conditions in sub-Saharan Africa: determinants and management strategies","authors":"Deborah Ikhile, Samuel Seidu, Damilola Omodara, Jean Claude Katte, Kaushik Ramaiya, Kamlesh Khunti","doi":"10.1016/s2213-8587(26)00036-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00036-7","url":null,"abstract":"Saharan Africa is experiencing a rapid increase in the burden of diabetes, accompanied by increasing rates of microvascular, macrovascular, and pregnancy-related complications. This Series paper synthesises current evidence on diabetes-related complications in sub-Saharan Africa and examines shared cardiometabolic risks, mental health comorbidities, and interactions with communicable diseases through a multiple long-term conditions lens. Widespread late diagnosis and inadequate control of key cardiometabolic risk factors (eg, hypertension, dyslipidaemia, obesity, and hyperglycaemia) drive high complication rates—whereas mental health disorders and infectious disease comorbidities further exacerbate susceptibility. Although risk factor reduction is central to preventing diabetes complications in sub-Saharan Africa, progress is impeded by multilevel barriers spanning individual, interpersonal, health system, societal, and policy domains. To address this growing complexity, we identify priorities for research and implementation, including the development of context-specific guidelines, scalable integrated care models, strengthened surveillance systems, and long-term cohorts co-designed with communities, health-care providers, and policy makers.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"11 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751559","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 conceptual framework for modernising and right-sizing global diabetes care","authors":"Mohammed K Ali, Rodrigo M Carillo-Larco, Troels Krarup Hansen, Nikhil Tandon, Martin Ridderstråle","doi":"10.1016/s2213-8587(26)00070-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(26)00070-7","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"9 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725921","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}