2287. Establishing equitable partnerships between the Global North and Global South.
作者: Hasan Mahmud Reza.;Salinah Rono.;Emily Chemoiwa.;Emmanuel Ayua.;Sheila Chebichii.;Hermine Mkrtchyan.;Mahmoud Eltholth.;Widaad Zemanay.;Andrew Farlow.;Jennifer Cole.
来源: Lancet. 2024年404卷10454期746-747页 2293. X-linked hypophosphataemia.
作者: Peter Kamenický.;Karine Briot.;Craig F Munns.;Agnès Linglart.
来源: Lancet. 2024年404卷10455期887-901页
X-linked hypophosphataemia is a genetic disease caused by defects in the phosphate regulating endopeptidase homolog X-linked (PHEX) gene and is characterised by X-linked dominant inheritance. The main consequence of PHEX deficiency is increased production of the phosphaturic hormone fibroblast growth factor 23 (FGF23) in osteoblasts and osteocytes. Chronic exposure to circulating FGF23 is responsible for renal phosphate wasting and decreased synthesis of calcitriol, which decreases intestinal phosphate absorption. These mechanisms result in lifelong hypophosphataemia, impaired growth plate and bone matrix mineralisation, and diverse manifestations in affected children and adults, including some debilitating morbidities and possibly increased mortality. Important progress has been made in disease knowledge and management over the past decade; in particular, targeting FGF23 is a therapeutic approach that has substantially improved outcomes. However, patients affected by this complex disease need lifelong care and innovative treatment strategies, such as gene repair of PHEX, are necessary to further limit the disease burden.
2296. Obesity in adults.
作者: Ildiko Lingvay.;Ricardo V Cohen.;Carel W le Roux.;Priya Sumithran.
来源: Lancet. 2024年404卷10456期972-987页
Obesity has increased in prevalence worldwide and WHO has declared it a global epidemic. Population-level preventive interventions have been insufficient to slow down this trajectory. Obesity is a complex, heterogeneous, chronic, and progressive disease, which substantially affects health, quality of life, and mortality. Lifestyle and behavioural interventions are key components of obesity management; however, when used alone, they provide substantial and durable response in a minority of people. Bariatric (metabolic) surgery remains the most effective and durable treatment, with proven benefits beyond weight loss, including for cardiovascular and renal health, and decreased rates of obesity-related cancers and mortality. Considerable progress has been made in the development of pharmacological agents that approach the weight loss efficacy of metabolic surgery, and relevant outcome data related to these agents' use are accumulating. However, all treatment approaches to obesity have been vastly underutilised.
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