2023 Department of Pediatrics Academic Annual Report

Pediatric Endocrinology & Diabetes

PEDIATRIC FACULTY Dr. Ambika Ashraf.........................................Director | Professor Dr. Hussein Abdul-Latif.....................................................Professor Dr. Joycelyn Atchison.......................................................Professor Dr. Nicole Barnes...............................................Assistant Professor Dr. Giovanna Beauchamp...............................Assistant Professor Dr. Christy Foster...............................................Assistant Professor Dr. Margaret Marks............................................Assistant Professor Dr. Leen Matalka................................................Assistant Professor Dr. Gail Mick.........................................................................Professor Dr. Sajal Patel......................................................Assistant Professor Dr. Jessica Schmitt............................................Assistant Professor Dr. Mary Lauren Scott.....................................Associate Professor

FEATURED RESEARCH Research from the UAB Division of Pediatric Endocrinology & Diabetes spans from the bench to the bedside. The division works in close collaboration with members of the UAB Comprehensive Diabetes Center, Nutrition Obesity Research Center (NORC), Gregory Fleming James Cystic Fibrosis Research Center, and the UAB Center for Clinical and Translational Science. The division’s research focuses on type 1 diabetes, type 2 diabetes, lipid disorders, lipoprotein metabolism, congenital hypothyroidism, thyroid nodules, thyroid and parathyroid disorders, polycystic ovary syndrome, non alcoholic fatty liver disease, dietary intervention and epigenetics. Christy Foster, M.D., is evaluating epigenetic changes in adolescents with obesity and type 2 diabetes (T2D). In collaboration with faculty in the School of Public Health and Diabetes Research Center, this project is looking at what signatures are present in the epigenome in adolescents with incident T2D compared to controls. Assessments will be done of social determinants of health to assess modifiers of the epigenome changes. This work is supported by a pilot award for $100,000 over two years from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) supplemental emerging scientist award. As part of this work, the aim is to evaluate the difference between epigenetic age and chronological age in African American adolescents with obesity and T2D compared to other groups of age, sex and race matched adolescents. This study will also allow us to perform larger epigenome-wide association studies to identify loci of interest involved in obesity that may be impacted in epigenetic age acceleration. Longer-term goals include conducting studies longitudinally and evaluating if interventions could alter the advanced epigenetic age. Research into Hybrid Diabetes An increasing number of children are identified with hybrid diabetes (HD); i.e., insulin resistance with positive diabetes associated autoantibodies (DAA). Ambika Ashraf, M.D., and Jessica Schmitt, M.D., aimed to compare characteristics of children with HD to those with type 1 diabetes (T1D) and type 2 diabetes (T2D) at diagnosis and after two years. A retrospective review was conducted at a university children’s hospital for patients 0–19 years of age with new-onset diabetes diagnosis from 2016–2020. Patients who had a c-peptide and four DAA measurements were included in analysis. Phenotypic and metabolic differences were seen in youth with T1D, HD and T2D at diagnosis and two-year follow-up and included: age, ethnicity, weight, HDL-levels and c-peptide metrics. At two years, all subjects with HD remained insulin dependent while some with T2D were not, indicating the need for targeted interventions to address the pathogenesis. Type 2 Diabetes The prevalence of T2D in youth is increasing in the United States, primarily among minorities, with Black and Hispanic youth showing the greatest increase. Neither the reason for the increase nor the mechanism underlying the disproportionate risk in minority youth is known. Barbara Gower, Ph.D., interim chair and professor in the UAB Department of Nutrition Sciences and Dr. Ashraf have received more than $3.7 million from the National Institutes of Health to study the increasing prevalence of diabetes in youth as part of a DIABETES RESEARCH Epigenetics

2023 Academic Annual Report

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