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Obesity is associated with changes in levels of many blood-based factors, such as cytokines and adipokines. This Review explores the utility of such factors as biomarkers for quantifying and predicting obesity-associated disease risk, including the identification of causal relationships.

During fasting, the liver produces fuel under the control of several hormonal and metabolic cues. In this Review, the authors outline the effects of the cues (glucagon, glucocorticoids, growth hormone, adrenaline, free fatty acids, asprosin and GP73) that are known to directly signal to hepatocytes under fasting conditions.

This Review explores the link between diabetes mellitus and thyroid disease from an epidemiological and mechanistic perspective, and discusses the public health implications of this link and provides recommendations for clinical management and public health policy.

This Review outlines the inequities that exist in the diagnosis, management and outcomes for minoritized people with diabetes mellitus. The authors also discuss how these inequities can be addressed to improve the care of people with diabetes mellitus globally.

Many different models are used in research into diabetes mellitus, and each has strengths and limitations. In this Review, the authors explain several in vivo and in vitro models of hyperglycaemia and discuss how future models might be improved to better replicate physiological conditions in people with diabetes mellitus.

Chronic disturbances in autonomic regulation are increasingly recognized as contributors to metabolic diseases such as obesity and type 2 diabetes mellitus. In this Review, Wangler and colleagues discuss bidirectional communication between the autonomic nervous system and peripheral tissues in the coordination of glucose and lipid metabolism as well as emerging therapies targeting autonomic pathways that could improve metabolic health.

Brown adipose tissue is a heat-generating organ and promising therapeutic target for treating obesity and metabolic diseases. Its presence in adults supports metabolic health, whereas its decline with age and weight gain might promote chronic disease. Efforts to understand its fascinating biology and translational potential continue to gain momentum.

The efficacy of anti-obesity drugs that use glucagon-like peptide 1 receptor agonism and glucose-dependent insulinotropic polypeptide agonism raises critical questions about how next-generation drugs might offer increased metabolic benefits. In 2025, new research into incretin-based treatments has brought us closer to answering these questions.

The quest to understand the adverse health outcomes linked to endocrine-disrupting chemicals continued in 2025. Insights have been gained regarding their effects on metabolic health, their key characteristics, the mechanisms underlying their effects and the burden of disorders associated with exposure to these chemicals in terms of mortality and life-years lost.

Growing evidence has linked ultra-processed food consumption to chronic disease risk. In 2025, this field reached a turning point, with experimental, clinical and epidemiological studies converging to elucidate the underlying mechanisms at play.

Oestrogen levels change after menopause and with weight gain above the normal BMI category, both of which can affect breast cancer risk and outcomes. This Review explores the current understanding of these associations.

Physiological changes in female individuals during the menopause transition influence cardiometabolic health and type 2 diabetes mellitus (T2DM) incidence. T2DM prevention programmes during midlife among individuals who are at high risk are cost effective but, we suggest, could be enhanced by consideration of the menopause transition and other sex-specific differences in T2DM prevention strategies.

Whole-exome sequencing and single-cell technologies are providing unprecedented insights into adenomyosis, uncovering a complex phylogenetic relationship between eutopic and ectopic endometria and identifying prolactin signalling as a possible pathogenic factor. However, these advances contrast with the failure of a clinical trial for a DRD2 agonist, which underscores the formidable translational challenges.

In addition to having health benefits for those who perform it, exercise might alter parental physiology in ways that support metabolic function in offspring. In this Review, the authors discuss animal studies and data from human study participants that show how exercise affects the placenta, breast milk and sperm in ways that improve offspring health.