Endocrinology, Diabetes, and Metabolism Commons^™

Navigating Prediabetes In A Foreign Country: A Qualitative Study Of Self-Management Experiences Among Chinese-Speaking Immigrants In Australia, Min Zhang, Kirsten J. Coppell, Johnny Lo, Lisa Whitehead

Research outputs 2022 to 2026

Aim: Chinese-speaking immigrants in Australia have a higher risk of type 2 diabetes and face more barriers to accessing quality healthcare compared to non-culturally and linguistically diverse populations. This study aimed to explore the self-management experiences of Chinese-speaking Australians with self-reported lived experience of prediabetes following immigration. Design: Qualitative study. Methods: Semi-structured interviews were conducted with 10 purposively selected Australian Chinese-speaking immigrants aged over 40 years. Data collection was undertaken in Perth, Western Australia between April and August 2024. Data were analysed using reflexive thematic analysis. Results: Three themes are presented in this paper: (1) An acculturation journey: Reshaping cultural …

Diet, Gut Microbiota, And Intestinal Permeability: Emerging Mechanisms In Hypertension Pathogenesis, Esha Vashisht, Helen Nguyen, Francine Z. Marques, Matthew Snelson

Research outputs 2022 to 2026

Hypertension is a leading contributor to global morbidity and mortality, arising from the interplay of genetic and environmental risk factors together with the dysregulation of multiple physiological systems involved in blood pressure control. Recent advances have established the gut as a central regulator, implicating the intestinal microbiota and barrier integrity in the modulation of blood pressure. Alterations in the gut microbial consortium, along with changes in levels of metabolites produced by the microbiota, have been associated with blood pressure regulation in animal models and human studies. Key microbial metabolites, including short-chain fatty acids, trimethylamine-N-oxide, and bile acids influence endothelial function, …

Cardiovascular–Kidney–Metabolic Syndrome Through The Lens Of Gut‑Derived Uremic Toxins, Chudan Xu, Matthew Snelson, Francine Z. Marques

Research outputs 2022 to 2026

Cardiovascular–Kidney–Metabolic (CKM) syndrome represents a complex, interconnected cluster of cardiovascular disease, chronic kidney disease, and metabolic disorders such as obesity and type 2 diabetes. These conditions share overlapping metabolic, inflammatory, and vascular pathways, with the gut microbiome increasingly recognised as a key contributor and common underlying risk factor. Uremic toxins, traditionally considered waste products of host and microbial metabolism, are now recognised as active mediators of tissue damage across the CKM spectrum, particularly in the context of impaired renal function. Their production and accumulation are amplified by disrupted intestinal barrier integrity, chronic inflammation, and reduced renal clearance, collectively driving systemic …

Dose–Response Association Between Systemic And Dermatologic Glucocorticoid Use And Type 2 Diabetes Mellitus: A Nationwide Case–Control Study, David Vadsholt, Annika V. Kvist, Chano Sandiramoorthy, Joshua R. Lewis, Peter Vestergaard, Johan Røikjer, Nicklas H. Rasmussen

Research outputs 2022 to 2026

Aims: To investigate the association and dose–response between systemic and topical glucocorticoids and odds of Type 2 diabetes mellitus. Materials and Methods: We conducted a nationwide case–control study using Danish registry data from 2013 to 2021. People aged 40 years or older with incident type 2 diabetes mellitus (n = 149 113) were matched 1:3 with controls (n = 447 339) by age, sex and weighted Charlson Comorbidity Index. Glucocorticoid exposure was defined as ≥ 1 prescription within 1 year before the date of diagnosis and ≥ 2 within 3 years and classified as systemic or topical. Conditional logistic regression …

Triglyceride Glucose Index And Modified Triglyceride Glucose Indices Are Instrumental To Optimize 3p Medical Management For Postpartum Cardiovascular Disease, Dong Lin, Haoxian Tang, Enoch Odame Anto, Yueran Zhou, Shenglan Zhang, Xiulian Deng, Cuihong Tian, Weijie Cao, Zhuoqiao He, Zhisheng Chen, Pengxiang Ying, Yequn Chen, Xuerui Tan

Research outputs 2022 to 2026

Background: Postpartum cardiovascular disease (CVD) following hypertensive disorders of pregnancy (HDP) involves multifactorial mechanisms linking metabolic susceptibility to vascular damage. Identifying predictive biomarkers and modifiable risk factors is crucial for early stratification in the context of predictive, preventive, and personalized medicine (PPPM). We aimed to investigate the association of triglyceride-glucose (TyG) indices with incident CVD in women with prior HDP and to assess the causal relationship using Bayesian weighted Mendelian randomization (BWMR) analysis, with a focus on the implications for PPPM strategies in postpartum management. Methods: In this longitudinal cohort study, 1,642 women with prior HDP from the UK Biobank …

Effectiveness, Reach, Uptake, And Feasibility Of Digital Health Interventions For Culturally And Linguistically Diverse Populations Living With Prediabetes Across The Lifespan: Systematic Review And Meta-Analysis, Lisa Whitehead, Min Zhang, Wai Hang Kwok, Diana Arabiat, Amanda Towell Barnard

Research outputs 2022 to 2026

Background: Culturally and linguistically diverse (CaLD) populations are at a higher risk of developing prediabetes; however, the effectiveness and implementation of digital health interventions for prediabetes management in this population are not well understood. Objective: This review aims to evaluate the effectiveness and implementation of digital health interventions (DHIs) versus usual care for glycemic control in CaLD populations living with prediabetes. Methods: This review aimed to include people of any age living with prediabetes who are from a CaLD background. Experimental and quasi-experimental studies that compare digital health interventions to usual care, waitlist, or active control were eligible. The primary …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Korelasi Kadar Serum Vegf-A Dengan Rasio Albumin-Kreatinin Urin Pada Pasien Penyakit Ginjal Diabetik, Hannie Q. Syaiful, Drajad Priyono, Harnavi Harun, Arina W. Murni, Akmal M. Hanif, Eifel Faheri, Arnelis Arnelis, Vesri Yoga

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic kidney disease (DKD) is a major microvascular complication of diabetes mellitus, characterized by persistent albuminuria and a progressive decline in glomerular filtration rate (GFR), making it a leading cause of chronic kidney disease (CKD) and end-stage renal disease. Vascular endothelial growth factor-A (VEGF-A) is implicated in the pathogenesis of DKD, being overexpressed in the kidneys and contributing to increased vascular permeability, inflammation, and fibrosis. Albuminuria, an early indicator of renal damage in DKD, is a strong predictor of CKD progression and cardiovascular events. The urine albumin-to-creatinine ratio (UACR) is the recommended test for detecting and monitoring albuminuria. …

Effect Of Implementing Safety Nursing Measures For Maintaining Fluid And Electrolyte Balance Among Critically Ill Patients With Acute Pancreatitis, Marwa Abdo

Nursing

Acute pancreatitis is a severe inflammatory condition that affects the pancreas and causes multiple organ failure. High rates of morbidity and mortality are caused by acute pancreatitis. Early fluid resuscitation, within the first 48 hrs., remains the hallmark for acute pancreatitis management. It lowers the incidence of pancreatic necrosis. Therefore, the foundation of treating acute pancreatitis in its early stages is safe fluid resuscitation. Aim: This study aims to evaluate the effect of implementing safety nursing measures for maintaining fluid and electrolyte balance among patients. Study design: A quasi-experimental research design was utilized in this study. Setting: This study was …

Spinach (Spinacia Oleracea L) Flavonoids Are Hydrolyzed During Digestion And Their Bioaccessibility Is Under Stronger Genetic Control Than Raw Material Content, Michael P Dzakovich, Alvin L Tak, Elaine A Le, Rachel P Dang, Benjamin W Redan, Geoffrey A Dubrow

Children’s Nutrition Research Center Staff Publications

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The Effect Of Prednisolone Ingestion And Acute Exercise On Lipocalin-2 And Its Variants In Young Men: A Pilot Randomised Crossover Study, Carlie Bauer, Rhiannon K. Patten, Qiyang Sun, Haoyun Li, Daniels Konja, Mary Woessner, Xuzhu Lin, Andrew Garnham, David L. Hare, Peter R. Ebeling, Marc Sim, Joshua R. Lewis, Yu Wang, Lewan Parker, Itamar Levinger

Research outputs 2022 to 2026

Lipocalin-2 (LCN2) has three main variants; polyaminated (hLCN2) and non-polyaminated (C87A and R81E). The polyaminated form is proposed to positively influence energy control, whereas the non-polyaminated forms negatively impact energy control in mice. Glucocorticoids negatively affect glucose regulation and exercise has a positive effect. We hypothesise that glucocorticoids will suppress, while exercise will increase hLCN2, and decrease C87A and R81E, which will be associated with improved insulin sensitivity. In a randomised crossover design, nine young healthy men (aged 27.8 ± 4.9 years; BMI 24.4 ± 2.4 kg/m2) completed 30 min of high-intensity aerobic exercise (90–95% heart rate reserve) after glucocorticoid …

Sleep-Disordered Breathing Subtypes And Future Diet Quality In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Cecilia Castro-Diehl, Tianyi Huang, Alexis C Wood, Jerome I Rotter, Stephen S Rich, Tamar Sofer, Susan Redline, Heming Wang

Children’s Nutrition Research Center Staff Publications

Objectives: Sleep-disordered breathing (SDB) and diet quality impact cardiometabolic disease, but few studies have examined if SDB influences diet quality. This study estimated the association between SDB subtypes (with and without sleepiness) and future diet quality in the Multi-Ethnic Study of Atherosclerosis.

Methods: Probable SDB was characterized by self-reported physician-diagnosed sleep apnea (PDSA) or habitual snoring and subtyped by presence or absence of sleepiness. A food frequency questionnaire measured diet 1.6 years before, and 7.8 years after SDB assessment. Diet quality was measured with the Alternate Healthy Eating Index-2010 (AHEI). Mean differences in AHEI at follow-up by SDB subtypes were …

Predicting Five-Year Comorbid Bipolar Disorder After Attention-Deficit/Hyperactivity Disorder Diagnosis: A Population-Based Machine Learning Approach, Yen-Shan Yang, Chih-Wei Hsu, Liang-Jen Wang, Kuo-Chuan Hung, Yang-Chieh Brian Chen, Chih-Sung Liang, Mu-Hong Chen

Children’s Nutrition Research Center Staff Publications

Background

Early detection and accurate prediction of bipolar disorders (BDs) comorbidity in individuals with attention-deficit/hyperactivity disorder (ADHD) are clinically critical. This study used machine-learning methods to identify features predictive of subsequent BD among patients initially diagnosed with ADHD.

Methods

We analyzed claims from the Taiwan National Health Insurance Research Database (2000–2013) and included patients aged ≥ 12 years with at least two diagnoses of ADHD. Predictor features included demographics (sex, age at ADHD onset), healthcare utilization (psychiatric outpatient visit counts), comorbidities (International Classification of Diseases–coded diagnoses), psychiatric medications (Anatomical Therapeutic Chemical–coded prescriptions), and family psychiatric history. All features were extracted …

A Class Of Benzofuranoindoline-Bearing Heptacyclic Fungal Ripps With Anticancer Activities, Qiuyue Nie, Fanglong Zhao, Xuerong Yu, Mithun C Madhusudhanan, Caleb Chang, Siting Li, Sandipan Roy Chowdhury, Bryce Kille, Andy Xu, Rory Sharkey, Chunxiao Sun, Hongzhi Zeng, Shuai Liu, Dishu Zhou, Xin Yu, Kevin Yang, Sandra A C Figueiredo, Maria Zotova, Zichen Hu, Alan Y Du, Dongyin Guan, Rui Tang, Todd Treangen, Jin Wang, Pedro N Leão, Yang Gao, Junjie Chen, Peng Liu, Hans Renata, Xue Gao

Children’s Nutrition Research Center Staff Publications

Ribosomally synthesized and post-translationally modified peptides (RiPPs) are a promising source of new pharmaceuticals, yet the therapeutic potential of fungal RiPPs remains largely underexplored. Here, we report asperigimycins as a distinct class of fungal RiPPs, featuring a unique heptacyclic scaffold consisting of a benzofuranoindoline core and three additional macrocycles, primarily assembled by six distinct fungi-specific DUF3328 oxidases. Inspired by the enhancement of anticancer activity through the N-terminal pyroglutamate in naturally occurring asperigimycins C and D, we chemically modify the inactive asperigimycin B with a series of lipid substitutions at its N-terminus. A derivative with a C-11 linear fatty …

Hypercalcemia Of Down Syndrome., Seth Lmb, Melissa Litao, Nasreen Talib, Jacob M. Redel

Manuscripts, Articles, Book Chapters and Other Papers

We present a case of hypercalcemia in a 12-month-old female with Down syndrome. The patient presented with significant weight loss (810 g since her 6-month visit) and severe growth failure (weight 5.8 kg, -4.5 SDs). Laboratory evaluation revealed severe hypercalcemia with appropriately suppressed PTH and 1,25-hydroxyvitamin D levels. Renal ultrasound confirmed medullary nephrocalcinosis. After excluding common etiologies, the patient was diagnosed with hypercalcemia of Down syndrome, also termed Abnormal Calcium, Calcinosis, Creatinine in Down syndrome. Treatment with intravenous fluids, calcitonin, and transition to a low-calcium formula (Calcilo XD) normalized serum calcium levels. The patient maintained normal calcium levels on restricted …

Transcriptional Coregulator Zmiz1 Modulates Estrogen Responses That Are Essential For Healthy Endometrial Function, Sylvia C Hewitt, Frank Orellana, Ryan M Marquardt, Myeongjin Yi, Cynthia J Willson, Mark Y Chiang, Yong Song, Goutham Venkata Naga Davuluri, Christopher Day, Ramakrishna Kommagani, Joseph Rodriguez, Asgerally T Fazleabas, John P Lydon, Francesco J Demayo

Faculty, Staff and Students Publications

Estrogen is a critical regulator of endometrial health. Aberrant estrogen stimulation can result in infertility, endometrial cancer, and endometriosis. Here, we identified Zinc Finger MIZ-Type Containing 1 (Zmiz1) as a coregulator of uterine estrogen signaling. ZMIZ1 is colocalized with an estrogen receptor α–binding (ESR1-binding) super enhancer. ZMIZ1 mutations are found in endometrial cancer and its RNA levels trend toward reduction in endometrium of patients with endometriosis. ZMIZ1 is dynamically expressed in human endometrial tissues during the menstrual cycle. Disrupting ZMIZ1 in cultured human endometrial stromal cells resulted in impaired cell proliferation and decidual differentiation. Ablation of Zmiz1 using …

Cumulative Triglyceride-Glucose Index And Hypertension Risk: A Longitudinal Cohort Study, Zhaogui Wu, Dan Wu, Sichi Xu, Yan Borné, Yulong Lan, Shuohua Chen

Research outputs 2022 to 2026

Background: Prior research has established a positive association between the single-measured triglyceride-glucose (TyG) index and hypertension. Nevertheless, longitudinal studies addressing the enduring impact of TyG index on incident hypertension are lacking. This study sought to explore the association between cumulative TyG index (cum-TyG) and incident hypertension, especially obesity-related hypertension (ORHT). Methods: A total of 21,017 individuals [mean (SD) age: 48.5 ± 11.7 years, male (%): 14,544 (69.2)] without hypertension were recruited from the Kailuan Study. The cum-TyG was determined by multiplying the mean TyG index by the time intervals between successive visits. Multivariable Cox regression models were used to investigate …

Cognitive Frailty And Cardiometabolic Risk In Middle-Aged And Older Adults: Evidence From The Uk And China, Haiyang Yan, Jingjing Lang, Chengfeng Li, Samaneh Eftekhariranjbar, Guoyan Jiang, Jing Lei, Lixin Sun, Carlos J. Toro-Huamanchumo, Zhongyang Guan

Research outputs 2022 to 2026

Background: Cognitive frailty, a novel construct integrating cognitive and physical deficits, is increasingly recognized in aging research. Aims: This study aimed to examine the associations between cognitive frailty and cardiometabolic risk in two nationally representative cohorts from China and the United Kingdom. Methods: We analyzed data from 7,628 participants in the China Health and Retirement Longitudinal Study (CHARLS) and 4,703 participants from the English Longitudinal Study of Ageing (ELSA), all aged ≥ 50 years. Frailty was assessed using the frailty index (FI) in the main analysis. Cox proportional hazards models were applied to estimate hazard ratios (HRs) for incident cardiometabolic …

Hypophosphatemia Across The Lifespan, Madhuni Herath, Richard Prince, Craig F. Munns, Albert Kim

Research outputs 2022 to 2026

No abstract provided.

Barriers And Facilitators To Lifestyle Behavior Change And Goal Setting In Adolescents With Polycystic Ovary Syndrome., Manasa Gadiraju, Joy Y. Kim, Erin M. Green, Alexandra Macmillan Uribe, Honghui Chang, Tania S. Burgert, Melissa D. Olfert, Heidi Vanden Brink

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: To identify barriers and facilitators to lifestyle modifications and goal setting and characterize goal setting for adolescents with polycystic ovary syndrome (PCOS).

METHODS: Retrospective chart review of registered dietitian nutritionist (RDN) nutrition notes from 118 adolescents with PCOS 11-21 years evaluated at a multi-specialty PCOS clinic. Goals, barriers, and facilitators were coded using open coding and a priori objectives and characterized for emerging themes using qualitative content analysis.

RESULTS: Five major themes of barriers and facilitators to behavior change emerged: interest and motivation, family involvement, resources and food environment, taste preferences, and self-efficacy. RDNs set ≥3 goals with 52%, …