Objective Differences in discriminative and predictive ability for all‐cause mortality of two clinical staging systems, the Edmonton Obesity Staging System (EOSS) and Cardiometabolic Disease Staging (CMDS), were estimated. Methods Data for nonpregnant persons aged 40 to 75 years were extracted from the National Health and Nutrition Examination Survey. Predictive and discriminative ability was assessed using pseudo‐R2 and C‐statistics. Median years of life lost were also computed for each score. Results Differences in out‐of‐sample estimates of pseudo‐R2 and C‐statistics (EOSS model as reference) were 0.02 (95% CI: 0.01‐0.04) (Kent pseudo‐R2), 0.03 (0.01‐0.04) (Royston pseudo‐R2), and 0.02 (0.01‐0.02) (C‐statistics). The median years of life lost for EOSS scores 2 and 3 (low to high risk) for a reference person were 1.19 and 6.76 years. Those for CMDS scores 1, 2, 3, and 4 (low to high risk) were 1.53, 2.90, 3.91, and 8.51 years. Consistent results from the in‐sample estimates were observed. Conclusions CMDS had statistically significantly greater predictive and discriminative ability than EOSS for persons aged 40 to 75. While the clinical relevance of these differences is unknown, CMDS may have greater clinical utility given that it uses fewer items to risk stratify. The clinical relevance and utility need to be studied further.

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International sports governing bodies such as the International Association for Athletics Federation and the International Olympic Committee have recently revised their policies for inclusion of athletes competing in women's international sports competitions. Previously, the focus was on verification of gender or femininity. The mishandling of Caster Semanya's case brought the complex issues of fairness with regard to athletes with disorders of sexual development or hyperandrogenism into both public and private debates. The new International Association for Athletics Federation and International Olympic Committee policies for inclusion in women's sporting events rest largely on the serum testosterone level, mandating that it be less than the lower limit of normal for men as the defining criteria. This report provides an overview of past problems and an update of the newly adopted policies for eligibility for competition in women's events. Endocrinologists will play a key role in the evaluation and treatment of women athletes who have elevated androgen levels, regardless of the underlying cause.

Obesity is defined as a BMI greater than 25 kg/m 2. Once thought to simply be a nutritional disorder, obesity has become a major health concern characterized by a state of constant low-grade inflammation caused by chronic adiposity. This state of inflammation is characterized by circulating inflammatory mediators, such as IL-6, leptin, and TNF-α, as well as varying levels of glucose-regulating hormones produced by obese adipose tissue. When left untreated, obesity can lead to a number of diseases including, but not limited to, cardiovascular disease, metabolic syndrome, neurodegeneration, type II diabetes mellitus, chronic kidney disease, and infertility. The distribution of adiposity differs in men and women, and these differences, along with the differences in sex hormones and sex hormone levels, can exacerbate or attenuate the course of disease pathology. Obesity can also be exacerbated by stress, which can worsen disease pathogenesis. In this review, we will explore how obesity affects inflammation and disease and how sex can affect the course of these diseases.

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