Hepatic metabolic functions are altered in metabolic diseases. This Review provides a comprehensive overview of glucose metabolism in steatotic liver disease (SLD) and obesity, describes new techniques for hepatic glucose flux assessment and discusses how SLD treatments affect glucose metabolism.

Coeliac disease is an autoinflammatory disease, with the only available treatment being a lifelong gluten-free diet. Alternative therapeutic approaches are needed. This Review explores the concept of tolerance-inducing therapies for coeliac disease, highlighting the underlying mechanisms, progress, challenges and future directions.

This Review discusses the role of the gut microbiome in the conversion of primary to secondary bile acids and critically evaluates biochemical pathways that are less well understood. Insights into how secondary bile acid derivatives influence host immune function are also described.

Transgender and gender-diverse patients in the United States can have difficulty finding providers who are knowledgeable about their unique health-care needs. In many states, legislation limits the ability of physicians to provide gender-affirming and supportive care. Further awareness, advocacy and research is needed to help mitigate the discrimination and stigma endured by the transgender community.

The lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) community navigates a complex social landscape marked by strides in acceptance alongside enduring discrimination. Allies — individuals outside of the LGBTQIA+ spectrum who support and advocate for this community — are paramount, with allyship playing a critical part in influencing the health and well-being of LGBTQIA+ individuals.

Magnetic resonance imaging following injection of hepatobiliary contrast agents improves the detection of hepatocellular carcinomas when contrast agent accumulations in tumours and the surrounding pathological liver differ. However, tissue accumulation is poorly investigated, and this Clinical Outlook article highlights experimental data to understand better contrast agent accumulation in human pathological livers.

Cultural safety seeks to remediate health inequities through empowering marginalized and minoritized patient populations, minimizing implicit bias and incorporating social determinants of health into practice. Here, we propose a cultural safety framework to guide communication with patients from sexual and gender minorities.