Pub Date : 2025-09-04DOI: 10.1038/s41574-025-01179-9
Patricia Ducy
Aside from a few days around Halloween, the skeleton tends not to have a positive image. However, at least in the biomedical field, this view is changing as bone is now identified as an endocrine organ that positively regulates a broad range of key functions, including several aspects of energy metabolism.
{"title":"Two decades into the crosstalk between bone and energy metabolism","authors":"Patricia Ducy","doi":"10.1038/s41574-025-01179-9","DOIUrl":"10.1038/s41574-025-01179-9","url":null,"abstract":"Aside from a few days around Halloween, the skeleton tends not to have a positive image. However, at least in the biomedical field, this view is changing as bone is now identified as an endocrine organ that positively regulates a broad range of key functions, including several aspects of energy metabolism.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 11","pages":"660-661"},"PeriodicalIF":40.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983289","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}
Pub Date : 2025-09-03DOI: 10.1038/s41574-025-01168-y
Debbie W. Chen, Megan R. Haymart
The global incidence of thyroid cancer has risen sharply since the 1980s, whereas thyroid cancer mortality rates have remained relatively stable. Much of the increase in incidence can be attributed to overdiagnosis of small and indolent papillary thyroid cancers, which has largely been driven by widespread (and sometimes inappropriate) use of imaging studies, especially thyroid and neck ultrasonography. To a lesser extent, increases in the incidence rate of advanced-stage thyroid cancer over the past four decades have also contributed to the observed trends. This Review describes changes in the incidence of thyroid cancer over the past 40 years, outlines well-known and potential risk factors, including obesity and environmental exposures, and explores strategies to address the public-health issues of overdiagnosis and the consequent overtreatment of thyroid cancer. The global incidence of thyroid cancer rose sharply after the 1980s despite stable mortality rates. Chen and Haymart outline known and emerging risk factors for thyroid cancer and discuss strategies to address the public-health issues of thyroid cancer overdiagnosis and overtreatment.
{"title":"Unravelling the rise in thyroid cancer incidence and addressing overdiagnosis","authors":"Debbie W. Chen, Megan R. Haymart","doi":"10.1038/s41574-025-01168-y","DOIUrl":"10.1038/s41574-025-01168-y","url":null,"abstract":"The global incidence of thyroid cancer has risen sharply since the 1980s, whereas thyroid cancer mortality rates have remained relatively stable. Much of the increase in incidence can be attributed to overdiagnosis of small and indolent papillary thyroid cancers, which has largely been driven by widespread (and sometimes inappropriate) use of imaging studies, especially thyroid and neck ultrasonography. To a lesser extent, increases in the incidence rate of advanced-stage thyroid cancer over the past four decades have also contributed to the observed trends. This Review describes changes in the incidence of thyroid cancer over the past 40 years, outlines well-known and potential risk factors, including obesity and environmental exposures, and explores strategies to address the public-health issues of overdiagnosis and the consequent overtreatment of thyroid cancer. The global incidence of thyroid cancer rose sharply after the 1980s despite stable mortality rates. Chen and Haymart outline known and emerging risk factors for thyroid cancer and discuss strategies to address the public-health issues of thyroid cancer overdiagnosis and overtreatment.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"22 1","pages":"10-20"},"PeriodicalIF":40.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930693","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}
Pub Date : 2025-09-03DOI: 10.1038/s41574-025-01178-w
Sophia Metz
{"title":"New maps and new challenges in the post-genomic era","authors":"Sophia Metz","doi":"10.1038/s41574-025-01178-w","DOIUrl":"10.1038/s41574-025-01178-w","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 12","pages":"742-742"},"PeriodicalIF":40.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930670","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}
Pub Date : 2025-08-26DOI: 10.1038/s41574-025-01174-0
Bulent O. Yildiz
Over the past two decades, polycystic ovary syndrome (PCOS) has been redefined from a symptom-based condition to a biologically complex disorder with distinct genetic, developmental and phenotypic features. Translating these advances into precision diagnostics, early interventions and equitable care is essential to improve outcomes.
{"title":"PCOS research from the past to the future","authors":"Bulent O. Yildiz","doi":"10.1038/s41574-025-01174-0","DOIUrl":"10.1038/s41574-025-01174-0","url":null,"abstract":"Over the past two decades, polycystic ovary syndrome (PCOS) has been redefined from a symptom-based condition to a biologically complex disorder with distinct genetic, developmental and phenotypic features. Translating these advances into precision diagnostics, early interventions and equitable care is essential to improve outcomes.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 11","pages":"668-670"},"PeriodicalIF":40.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898016","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}
Pub Date : 2025-08-26DOI: 10.1038/s41574-025-01173-1
Laura Sterian Ward, Lucas Leite Cunha
Thyroid cancer management has evolved from a uniform, surgery-centric approach to a paradigm of precise diagnosis and personalized therapy. Transformative advances have occurred in the past two decades; however, global inequities in accessing these innovations are a key challenge.
{"title":"Redefining thyroid cancer management","authors":"Laura Sterian Ward, Lucas Leite Cunha","doi":"10.1038/s41574-025-01173-1","DOIUrl":"10.1038/s41574-025-01173-1","url":null,"abstract":"Thyroid cancer management has evolved from a uniform, surgery-centric approach to a paradigm of precise diagnosis and personalized therapy. Transformative advances have occurred in the past two decades; however, global inequities in accessing these innovations are a key challenge.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 11","pages":"664-665"},"PeriodicalIF":40.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898027","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}
Pub Date : 2025-08-26DOI: 10.1038/s41574-025-01172-2
Matthias Blüher
Over the past 20 years, obesity research has resulted in a better understanding of the complex disease mechanisms underlying the condition, including biological, behavioural, societal and environmental factors. Although obesity research in the past 10 years has resulted in very effective and safe obesity treatments, more research is needed to improve the lives of people with obesity.
{"title":"The past and future of obesity research","authors":"Matthias Blüher","doi":"10.1038/s41574-025-01172-2","DOIUrl":"10.1038/s41574-025-01172-2","url":null,"abstract":"Over the past 20 years, obesity research has resulted in a better understanding of the complex disease mechanisms underlying the condition, including biological, behavioural, societal and environmental factors. Although obesity research in the past 10 years has resulted in very effective and safe obesity treatments, more research is needed to improve the lives of people with obesity.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 11","pages":"666-667"},"PeriodicalIF":40.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898028","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}
Pub Date : 2025-08-22DOI: 10.1038/s41574-025-01162-4
Beata Lecka-Czernik, Clifford J. Rosen, Nicola Napoli
The skeleton is one of the largest organs in the body and is integrated with systemic energy metabolism. This integration is mediated in part through the process of skeletal remodelling, which is fundamental for maintenance of bone mass and quality. Remodelling is an energetically expensive process that contributes to energy balance owing to constant substrate flow to the skeleton in the form of glucose, lipids and amino acids, as well as output of hormonal factors regulating peripheral metabolism. Bone remodelling is orchestrated by osteocytes, the most abundant cells in bone. Hence, it stands to reason that osteocytes must also regulate substrate availability and utilization not only for their own function but also for those of other skeletal cells (namely, osteoblasts and osteoclasts). Osteocytes also secrete factors (such as osteokines) that are engaged in complex molecular signalling networks that influence glucose metabolism, insulin sensitivity and energy homeostasis. Importantly, whole-body metabolism and bone homeostasis share similar regulatory mechanisms, including the RANKL and parathyroid hormone signalling pathways. This Review summarizes our current understanding of how the skeleton regulates whole-body energy metabolism and leads to the conclusion that bone might not be the core regulator of systemic energy metabolism but rather acts as an organ that instead regulates these complex processes. This Review summarizes our current understanding of how the skeleton regulates whole-body energy metabolism; rather than viewing bone as the core regulator of systemic energy metabolism, the authors suggest that bone contributes to the regulation of the complex processes underlying whole-body energy metabolism.
{"title":"The role of bone in whole-body energy metabolism","authors":"Beata Lecka-Czernik, Clifford J. Rosen, Nicola Napoli","doi":"10.1038/s41574-025-01162-4","DOIUrl":"10.1038/s41574-025-01162-4","url":null,"abstract":"The skeleton is one of the largest organs in the body and is integrated with systemic energy metabolism. This integration is mediated in part through the process of skeletal remodelling, which is fundamental for maintenance of bone mass and quality. Remodelling is an energetically expensive process that contributes to energy balance owing to constant substrate flow to the skeleton in the form of glucose, lipids and amino acids, as well as output of hormonal factors regulating peripheral metabolism. Bone remodelling is orchestrated by osteocytes, the most abundant cells in bone. Hence, it stands to reason that osteocytes must also regulate substrate availability and utilization not only for their own function but also for those of other skeletal cells (namely, osteoblasts and osteoclasts). Osteocytes also secrete factors (such as osteokines) that are engaged in complex molecular signalling networks that influence glucose metabolism, insulin sensitivity and energy homeostasis. Importantly, whole-body metabolism and bone homeostasis share similar regulatory mechanisms, including the RANKL and parathyroid hormone signalling pathways. This Review summarizes our current understanding of how the skeleton regulates whole-body energy metabolism and leads to the conclusion that bone might not be the core regulator of systemic energy metabolism but rather acts as an organ that instead regulates these complex processes. This Review summarizes our current understanding of how the skeleton regulates whole-body energy metabolism; rather than viewing bone as the core regulator of systemic energy metabolism, the authors suggest that bone contributes to the regulation of the complex processes underlying whole-body energy metabolism.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 12","pages":"743-756"},"PeriodicalIF":40.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898104","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}
Pub Date : 2025-08-21DOI: 10.1038/s41574-025-01164-2
Clipper F. Young, Diana Isaacs
Immediate attention is paramount for addressing the escalating prevalence of severe insulin resistance during pregnancy. A collaborative and multidisciplinary approach involving clinical care, public health initiatives and advanced technologies is essential for enhancing care, improving maternal and fetal outcomes, and mitigating long-term metabolic risks.
{"title":"A call for a multidisciplinary intervention to address severe insulin resistance during pregnancy","authors":"Clipper F. Young, Diana Isaacs","doi":"10.1038/s41574-025-01164-2","DOIUrl":"10.1038/s41574-025-01164-2","url":null,"abstract":"Immediate attention is paramount for addressing the escalating prevalence of severe insulin resistance during pregnancy. A collaborative and multidisciplinary approach involving clinical care, public health initiatives and advanced technologies is essential for enhancing care, improving maternal and fetal outcomes, and mitigating long-term metabolic risks.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 10","pages":"586-587"},"PeriodicalIF":40.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898113","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}
Pub Date : 2025-08-15DOI: 10.1038/s41574-025-01161-5
Luigi Barrea, Ludovica Verde, Annamaria Colao, Lawrence J. Mandarino, Giovanna Muscogiuri
Type 2 diabetes mellitus (T2DM) is a major global health concern. Medical nutrition therapy has a key role in T2DM management, with dietary interventions being central to improving glycaemic control and overall metabolic health. Growing evidence suggests that certain dietary strategies can exert direct metabolic benefits independent of weight reduction. The Mediterranean diet has consistently demonstrated metabolic and cardiovascular benefits, along with improved glycaemic control, even in the absence of substantial weight reduction. Low-energy and very-low-energy diets, characterized by moderate to severe caloric restriction, respectively, have also been associated with improvements in cardiometabolic markers and glycaemic regulation. Ketogenic diets promote nutritional ketosis and have shown benefits on glycaemic control, insulin sensitivity and other metabolic outcomes, often preceding substantial weight loss. Intermittent fasting strategies, such as alternate-day fasting or the 5:2 model, and time-restricted eating, have likewise been linked to enhanced glycaemic control and favourable metabolic and cardiovascular effects, although their long-term efficacy and safety require further investigation. This Review aims to provide an evidence-based synthesis of the main nutritional strategies used in the treatment of T2DM, with a focus on their underlying mechanisms, clinical efficacy and potential for sustainable long-term implementation. Medical nutrition therapy (MNT) is a key component of the management of type 2 diabetes mellitus (T2DM), and there is increasing evidence that specific dietary interventions can improve metabolic health in T2DM independently of weight loss. This Review assesses several key MNT strategies for their efficacy in T2DM management.
{"title":"Medical nutrition therapy for the management of type 2 diabetes mellitus","authors":"Luigi Barrea, Ludovica Verde, Annamaria Colao, Lawrence J. Mandarino, Giovanna Muscogiuri","doi":"10.1038/s41574-025-01161-5","DOIUrl":"10.1038/s41574-025-01161-5","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is a major global health concern. Medical nutrition therapy has a key role in T2DM management, with dietary interventions being central to improving glycaemic control and overall metabolic health. Growing evidence suggests that certain dietary strategies can exert direct metabolic benefits independent of weight reduction. The Mediterranean diet has consistently demonstrated metabolic and cardiovascular benefits, along with improved glycaemic control, even in the absence of substantial weight reduction. Low-energy and very-low-energy diets, characterized by moderate to severe caloric restriction, respectively, have also been associated with improvements in cardiometabolic markers and glycaemic regulation. Ketogenic diets promote nutritional ketosis and have shown benefits on glycaemic control, insulin sensitivity and other metabolic outcomes, often preceding substantial weight loss. Intermittent fasting strategies, such as alternate-day fasting or the 5:2 model, and time-restricted eating, have likewise been linked to enhanced glycaemic control and favourable metabolic and cardiovascular effects, although their long-term efficacy and safety require further investigation. This Review aims to provide an evidence-based synthesis of the main nutritional strategies used in the treatment of T2DM, with a focus on their underlying mechanisms, clinical efficacy and potential for sustainable long-term implementation. Medical nutrition therapy (MNT) is a key component of the management of type 2 diabetes mellitus (T2DM), and there is increasing evidence that specific dietary interventions can improve metabolic health in T2DM independently of weight loss. This Review assesses several key MNT strategies for their efficacy in T2DM management.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 12","pages":"769-782"},"PeriodicalIF":40.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851324","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}
Pub Date : 2025-08-13DOI: 10.1038/s41574-025-01167-z
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
{"title":"Author Correction: 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/s41574-025-01167-z","DOIUrl":"10.1038/s41574-025-01167-z","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"21 10","pages":"656-656"},"PeriodicalIF":40.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41574-025-01167-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825459","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}
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