Endocrinology, Diabetes, and Metabolism Commons^™

Hemoglobin A1c Increase In Youth At Risk For Developing Type 2 Diabetes Mellitus During The Covid-19 Pandemic, Erica Wee, Ashley Sherman, Mark A. Clements, Kelsee Halpin, Yun Yan

Posters

No abstract provided.

Host And Gut Microbial Tryptophan Metabolism And Type 2 Diabetes: An Integrative Analysis Of Host Genetics, Diet, Gut Microbiome And Circulating Metabolites In Cohort Studies, Qibin Qi, Jun Li, Bing Yu, Jee-Young Moon, Jin C Chai, Jordi Merino, Jie Hu, Miguel Ruiz-Canela, Casey Rebholz, Zheng Wang, Mykhaylo Usyk, Guo-Chong Chen, Bianca C Porneala, Wenshuang Wang, Ngoc Quynh Nguyen, Elena V Feofanova, Megan L Grove, Thomas J Wang, Robert E Gerszten, Josée Dupuis, Jordi Salas-Salvadó, Wei Bao, David L Perkins, Martha L Daviglus, Bharat Thyagarajan, Jianwen Cai, Tao Wang, Joann E Manson, Miguel A Martínez-González, Elizabeth Selvin, Kathryn M Rexrode, Clary B Clish, Frank B Hu, James B Meigs, Rob Knight, Robert D Burk, Eric Boerwinkle, Robert C Kaplan

Faculty, Staff and Student Publications

OBJECTIVE: Tryptophan can be catabolised to various metabolites through host kynurenine and microbial indole pathways. We aimed to examine relationships of host and microbial tryptophan metabolites with incident type 2 diabetes (T2D), host genetics, diet and gut microbiota.

METHOD: We analysed associations between circulating levels of 11 tryptophan metabolites and incident T2D in 9180 participants of diverse racial/ethnic backgrounds from five cohorts. We examined host genome-wide variants, dietary intake and gut microbiome associated with these metabolites.

RESULTS: Tryptophan, four kynurenine-pathway metabolites (kynurenine, kynurenate, xanthurenate and quinolinate) and indolelactate were positively associated with T2D risk, while indolepropionate was inversely associated with …

Circadian Disruption Of Hippocampus In An Early Senescence Male Mouse Model, Jennifer A Davis, Jodi R Paul, Mugdha V Mokashi, Stefani A Yates, Daniel J Mount, Hira A Munir, Lacy K Goode, Martin E Young, David B Allison, Karen L Gamble

Children’s Nutrition Research Center Staff Publications

Age-related cognitive decline and disruptions in circadian rhythms are growing problems as the average human life span increases. Multiple strains of the senescence-accelerated mouse (SAM) show reduced life span, and the SAMP8 strain in particular has been well documented to show cognitive deficits in behavior as well as a bimodal pattern of circadian locomotor activity. However, little is known about circadian regulation within the hippocampus of these strains of mice. Here we test the hypothesis that in this early senescence model, disruption of the molecular circadian clock in SAMP8 animals drives disrupted behavior and physiology. We found normal rhythms in …

Parent-Perceived Neighbourhood Environment, Parenting Practices And Preschool-Aged Children Physical Activity And Screen Time: A Cross-Sectional Study Of Two Culturally And Geographically Diverse Cities, Ester Cerin, Anthony Barnett, Tom Baranowski, Rebecca E Lee, Robin R Mellecker, Yi Nam Suen, Jason A Mendoza, Deborah I Thompson, Teresia M O'Connor

Children’s Nutrition Research Center Staff Publications

BACKGROUND: Preschool-aged children's physical activity (PA) and screen time (ST) are important health-related behaviours likely influenced by PA opportunities, parental perceptions of neighbourhood safety and parenting practices pertaining to PA and ST. How these factors interact to impact on young children's PA and ST, and whether their effects are generalisable across cultures and geographical location is not known. This study addressed these knowledge gaps by conducting pooled analyses of comparable data from two culturally and geographically diverse samples - Chinese parent-child dyads from an ultra-dense city (Hong Kong, China) and Latino parent-child dyads from a low-density city (Houston, USA).

METHODS: …

The Ventromedial Hypothalamic Nucleus: Watchdog Of Whole-Body Glucose Homeostasis, Longlong Tu, Makoto Fukuda, Qingchun Tong, Yong Xu

Children’s Nutrition Research Center Staff Publications

The brain, particularly the ventromedial hypothalamic nucleus (VMH), has been long known for its involvement in glucose sensing and whole-body glucose homeostasis. However, it is still not fully understood how the brain detects and responds to the changes in the circulating glucose levels, as well as brain-body coordinated control of glucose homeostasis. In this review, we address the growing evidence implicating the brain in glucose homeostasis, especially in the contexts of hypoglycemia and diabetes. In addition to neurons, we emphasize the potential roles played by non-neuronal cells, as well as extracellular matrix in the hypothalamus in whole-body glucose homeostasis. Further, …

Evaluation Of A Circadian Rhythm And Sleep-Focused Mobile Health Intervention For The Prevention Of Accelerated Summer Weight Gain Among Elementary School-Age Children: Protocol For A Randomized Controlled Feasibility Study, Jennette P Moreno, Hafza Dadabhoy, Salma Musaad, Tom Baranowski, Debbe Thompson, Candice A Alfano, Stephanie J Crowley

Children’s Nutrition Research Center Staff Publications

Background: The i♥rhythm project is a mobile health adaptation of interpersonal and social rhythm therapy designed to promote healthy sleep and behavioral rhythms among 5-8-year olds during summer for the prevention of accelerated summer weight gain.

Objective: This pilot study will examine the feasibility, acceptability, and preliminary efficacy of the i♥rhythm intervention. This will ensure that the research protocol and procedures work as desired and are acceptable to families in preparation for the fully powered randomized controlled trial. The proposed study will examine the willingness of participants to participate in the intervention and determine whether modifications to the intervention, procedures, …

Functional (Psychogenic) Seizures Are Associated With Thyroid Disorders, Ali A. Asadi-Pooya, Mohsen Farazdaghi

Department of Neurology Faculty Papers

Objective: We investigated medical comorbidities in patients with functional seizures (FS) and those with epilepsy (idiopathic generalized epilepsies [IGEs] or temporal lobe epilepsy [TLE]). We hypothesized that the nature of medical comorbidities differs between these three groups. This might be helpful to postulate on the pathophysiology of FS. Materials and Methods: In a retrospective study, all adult patients with a diagnosis of IGE, TLE, or FS were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Iran, from 2008 until 2020. The three groups of patients were matched with regard to their age. Age, sex, and medical …

Fibroblast Growth Factor 15/19 Expression, Regulation, And Function: An Overview, Greg Guthrie, Caitlin Vonderohe, Douglas Burrin

Children’s Nutrition Research Center Staff Publications

Since the discovery of fibroblast growth factor (FGF)-19 over 20 years ago, our understanding of the peptide and its role in human biology has moved forward significantly. A member of a superfamily of paracrine growth factors regulating embryonic development, FGF19 is unique in that it is a dietary-responsive endocrine hormone linked with bile acid homeostasis, glucose and lipid metabolism, energy expenditure, and protein synthesis during the fed to fasted state. FGF19 achieves this through targeting multiple tissues and signaling pathways within those tissues. The diverse functional capabilities of FGF19 is due to the unique structural characteristics of the protein and …

Cardiovascular Risk Stratification In Diabetic Retinopathy Via Atherosclerotic Pathway In Covid-19/Non-Covid-19 Frameworks Using Artificial Intelligence Paradigm: A Narrative Review., Smiksha Munjral, Mahesh Maindarkar, Puneet Ahluwalia, Anudeep Puvvula, Ankush Jamthikar, Tanay Jujaray, Neha Suri, Sudip Paul, Rajesh Pathak, Luca Saba, Renoh Johnson Chalakkal, Suneet Gupta, Gavino Faa, Inder M Singh, Paramjit S Chadha, Monika Turk, Amer M Johri, Narendra N Khanna, Klaudija Viskovic, Sophie Mavrogeni, John R Laird, Gyan Pareek, Martin Miner, David W Sobel, Antonella Balestrieri, Petros P Sfikakis, George Tsoulfas, Athanasios Protogerou, Durga Prasanna Misra, Vikas Agarwal, George D Kitas, Raghu Kolluri, Jagjit Teji, Mustafa Al-Maini, Surinder K Dhanjil, Meyypan Sockalingam, Ajit Saxena, Aditya Sharma, Vijay Rathore, Mostafa Fatemi, Azra Alizad, Vijay Viswanathan, Padukode R Krishnan, Tomaz Omerzu, Subbaram Naidu, Andrew Nicolaides, Mostafa M Fouda, Jasjit S Suri

Heart and Vascular Articles

Diabetes is one of the main causes of the rising cases of blindness in adults. This microvascular complication of diabetes is termed diabetic retinopathy (DR) and is associated with an expanding risk of cardiovascular events in diabetes patients. DR, in its various forms, is seen to be a powerful indicator of atherosclerosis. Further, the macrovascular complication of diabetes leads to coronary artery disease (CAD). Thus, the timely identification of cardiovascular disease (CVD) complications in DR patients is of utmost importance. Since CAD risk assessment is expensive for low-income countries, it is important to look for surrogate biomarkers for risk stratification …

The Efficacy Of Tailored Text Messages To Improve Medication Adherence And Lifestyle Changes For Patients With Type 2 Diabetes Mellitus, Vanessa B. Silverio

Evidence-Based Practice Project Reports

Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by increased amounts of glucose in the blood, and is the seventh leading cause of death in the United States (United Health Foundation [UHF]), 2021). T2DM can be effectively treated with medication and behavioral lifestyle modifications. Even small improvements in glycemic control can reduce the risk for debilitating complications such as heart disease, stroke, kidney disease, sepsis, and retinopathy (Wang et al., 2021, Haider et al., 2019). The purpose of this evidence-based practice (EBP) project was to identify the most effective intervention for improving medication adherence, lifestyle changes, and hemoglobin …

Feasibility And Efficacy Of Bisphosphonate Use For The Prevention Of Bone And Muscle Loss, Laura E. Flores

Theses & Dissertations

Loss of bone and muscle mass often occurs in tandem, increasing the risk of fragility fractures. Whereas many drugs are approved for the treatment of bone loss, there are few treatments available for the concomitant loss of bone and muscle. Identification of a treatment to mitigate pathologic bone and muscle atrophy has the potential to impact countless populations and influence approaches for healthy aging. Bisphosphonates have emerged as a potential treatment for both bone and muscle loss in cellular, murine, and observational human studies. Our findings of modest weight maintenance in postmenopausal women treated with 12-months of risedronate, relative to …

Type 2 Diabetes Mellitus During The Covid-19 Pandemic, Erica Wee

Research Days

Watch recording of live presentation.

Background The prevalence of type 2 diabetes mellitus (T2D) in youth has increased significantly over the past decades secondary to the increased prevalence of obesity. Epidemiologic data estimates that the incidence of youth-onset T2D increased 5% per year between 2002 and 2012. Recent studies have shown that childhood obesity increased with the COVID-19 pandemic. However, if this resulted in increased incidence of T2D has not been well-reported.

Objectives: This study seeks to evaluate new-onset T2D in youth during the COVID-19 pandemic (March 2020 to February 2021). We examined the frequency of new-onset T2D and proportion …

A Case Of Diabulimia In A 23-Year-Old Woman With Extensive Comorbidities, Stephen Poos, Kaitlin Mcgowan, Ashaki Martin

Rowan-Virtua Research Day

Diabulimia is defined as intentionally withholding insulin injections for the purpose of weight loss in the setting of type 1 diabetes mellitus (T1D).

It is characterized as an eating disorder (ED), although it does not yet have DSM diagnosis status.

Recognition of the condition among medical professionals is limited but growing.

Case Report: Octreotide Associated Hyperkalemia, Darren Finn, Eric Maddock, James Espinosa, Andrew Caravello, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

78-year-old female with past medical history of acromegaly status post pituitary adenoma status post resection presents to the emergency department with abdominal pain. ED workup was not significant for any acute intra-abdominal abnormalities; however, incidental finding of hyperkalemia was pertinent to the visit. Patient was treated in the ED for her condition but her potassium levels remained elevated despite repeated saline infusions. Patient was ultimately admitted to the hospital where it was discovered that she had recently been switched from octreotide injections to an oral somatostatin analogue Mycapssa. We believe that this patient’s hyperkalemia was caused by octreotide-induced insulin suppression …

Wernicke’S Encephalopathy Secondary To Hyperemesis Gravidarum, Mohammad Rattu, Alexander Norinsky, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Wernicke’s encephalopathy (WE) is a neurological disorder secondary to thiamine deficiency that is precipitated by administration of glucose-containing fluids prior to thiamine supplementation. Though WE is typically diagnosed among alcoholics (12.5%), the prevalence among nonalcoholics can vary from 0.04-0.13%. Around 30-40% of patients with underlying thiamine deficiency will only experience one of the symptoms from the typical triad, with the complete triad (encephalopathy, oculomotor dysfunction/nystagmus, and ataxia) only evident among 5-16% of the population. Among the non-alcoholic patient population presenting with WE, a history of vomiting is more frequent. While nausea affects around 80% of pregnant women, an extreme form …

Painless Scrotal Ulcers Become Something Unexpected: A Rare Case Of Scrotal Calciphylaxis, Riddhima Issar, Jinisha Patwa, Yvette Wang

Rowan-Virtua Research Day

Calciphylaxis is a rare vascular disorder that presents with painful skin necrosis due to calcium accumulation in skin and adipose tissue. Most commonly, cutaneous manifestations of calciphylaxis are seen on the buttocks, thighs and extremities. Very few cases have presented unconventional locations of these calcified eschars and ulcers such as the penis and scrotum. Risk factors for this disease include chronic kidney disease, hyperparathyroidism, long-term hemodialysis and diabetes. This case presents an atypical presentation of painless scrotal ulcers.

A high degree of clinical suspicion in patients with ESRD on HD and T2DM is needed to effectively reach a diagnosis of …

Case Report: Thyrotoxic Hypokalemic Periodic Paralysis, Kelly Schuitema, Wayne Tamaska, Robin Lahr

Rowan-Virtua Research Day

Thyrotoxic crisis, or thyroid storm, is an acute, life threatening event caused by hyperthyroidism with mortality up to 8-25% that can present with multi-system organ involvement. It is a rare, but well studied complication in the emergency department but can lead to further, less common complications. In this study we will discuss a case of thyrotoxic hypokalemic periodic paralysis. Thyrotoxic hypokalemic periodic paralysis (TPP) most commonly affects Asian men. The key features of the syndrome include acute onset of hypokalemia and paralysis. The hypokalemic aspect of the disorder is secondary to the shift intracellularly by thyroid hormones’ sensitization of Na+/K+-ATPase …

Case Study Of Metformin-Induced Lactic Acidosis, Kajel Patel, Kishan B. Patel

Rowan-Virtua Research Day

Metformin induced lactic acidosis is when high levels of metformin cause dangerously high levels of lactic acid. Here is a case report of a 72-year-old female who came in for nausea, vomiting, and diarrhea found to have a high suspicion for metformin induced lactic acidosis. She stabilized in the emergency department, nephrology and ICU was contacted, and she went for emergent dialysis. For many patients the prognosis of metformin induced lactic acidosis is poor. This patient was made comfort care by her family.

Improving Transition To Adult Care Discussion In A Diabetes Clinic, Erica Wee, Erica Zarse, Lindsay Baldridge

Research Days

Problem Statement: Diabetes mellitus is a chronic condition requiring complex care. Adolescents with diabetes face challenges when transitioning to an adult care setting which can lead to suboptimal glycemic control and emergence of complications. It is important for a pediatric diabetes clinic to provide support and prepare adolescents for success when they transfer to adult care.

Aim Statement: In our diabetes clinic, patients are eligible for transition assessment if they are over age 17 years without a documented discussion in the past 1 year. A review of clinic data between October 2021 and November 2021 revealed that an average of …

Elucidating Human Milk Oligosaccharide Biosynthetic Genes Through Network-Based Multi-Omics Integration, Benjamin P Kellman, Anne Richelle, Jeong-Yeh Yang, Digantkumar Chapla, Austin W T Chiang, Julia A Najera, Chenguang Liang, Annalee Fürst, Bokan Bao, Natalia Koga, Mahmoud A Mohammad, Anders Bech Bruntse, Morey W Haymond, Kelley W Moremen, Lars Bode, Nathan E Lewis

Children’s Nutrition Research Center Staff Publications

Human Milk Oligosaccharides (HMOs) are abundant carbohydrates fundamental to infant health and development. Although these oligosaccharides were discovered more than half a century ago, their biosynthesis in the mammary gland remains largely uncharacterized. Here, we use a systems biology framework that integrates glycan and RNA expression data to construct an HMO biosynthetic network and predict glycosyltransferases involved. To accomplish this, we construct models describing the most likely pathways for the synthesis of the oligosaccharides accounting for >95% of the HMO content in human milk. Through our models, we propose candidate genes for elongation, branching, fucosylation, and sialylation of HMOs. Our …