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Endocrinology
Research
The Section of Endocrinology is actively involved in research to further the understanding of endocrine problems in the developing child and to improve the diagnosis and care of these children. The primary areas of interest of faculty in the Section include the development of efficient and cost-effective approaches to endocrine diagnosis to replace older stimulation testing protocols, as well as the use of aromatase inhibitors to treat disorders of maturation and gynecomastia. In addition, the Section is a national leader in the study of insulin resistance and associated morbidity in obese and sedentary children.
Faculty Research Interests
Dr. Michael Kappy is involved in a variety of research projects, primarily assessing adrenal function in primary care settings. He is also collaborating with members of the Section of General Academic Pediatrics on vitamin D status in children with epidermolysis bullosa. As a member of the Lawson Wilkins Pediatric Endocrine Society’s Drug and Therapeutics Committee, Dr. Kappy published two position statements in Pediatrics in 2008: the use of recombinant IGF-I in poorly-growing children; and Vitamin D deficiency and its prevention. The American Academy of Pediatrics subsequently endorsed the group’s recommendation. In addition, in collaboration with Dr. Roger Giller, Heidi Bailey, PA-C, MS, and Jane Gralla, PhD, Dr. Kappy has conducted a study of the development of hypothyroidism in children undergoing hematopoietic stem cell transplantation.
Dr. Megan Moriarty’s research focuses on the metabolic changes that occur during puberty and how these changes are influenced by obesity. In particular, she is currently working on a study to examine the hypothesis that obese adolescents fail to recover their prepubertal insulin sensitivity at the end of puberty, leading to stress on the ability of the pancreas to make insulin and increasing the risk for early development of type 2 diabetes. She is undertaking a a longitudinal project to compare changes in insulin sensitivity and secretion in normal weight and obese adolescents from early puberty to puberty completion, as well as to examine the impact of pharmacologic and lifestyle interventions to prevent these changes.
Dr. Kristen Nadeau is interested in both basic science and clinical research, focusing on the areas of insulin resistance, obesity, and type 2 diabetes in children, as well as on the gender differences in insulin resistance during adolescence. She has demonstrated that insulin resistance in humans is associated with a block in insulin’s PI3-kinase pathway, but not its Mitogen Activate Protein-kinase pathway (Erk), helping to explain the variable effects of insulin resistance on pathophysiology. She has also examined the regulation of SREBP-1, a transcription factor important to the control of lipid synthesis by insulin as a way of understanding the ectopic lipid deposition characteristic of insulin resistance in humans. Her clinical research has focused on the defects in exercise capacity that occur in patients with type 2 diabetes and has completed studies examining exercise capacity, ectopic hepatic and muscle lipid deposition and their correlates in adolescents with T2DM.
Dr. Philip Zeitler is Study Chair and Principal Investigator of the Colorado Clinical Center of a national multicenter, 7-year trial examining treatment alternatives in adolescent type 2 diabetes (TODAY). Among other areas of investigation, this trial examines approaches to the promotion of life-style change, as well as the effects of type 2 diabetes and its treatment on cardiovascular risk and psychosocial functioning among affected teenagers. In addition, Dr. Zeitler is co-investigator with Dr. Richard Hamman, in the Colorado School of Public Health, on an NIH-funded study (SEARCH-CC) to examine fitness, cardiovascular, genetic, and dietary risk factors in children with type 2 diabetes, compared to those with type 1 and to normal age and gender-matched controls. As an ancillary to this project, Dr. Zeitler, along with Dr. Nadeau and other SEARCH-CC investigators, is undertaking a project to rigorously measure insulin resistance in type 1 and type 2 patients in order to develop simple clinical predictors of resistance. Drs. Zeitler and Nadeau and colleagues in the Department of Medicine have developed a protocol to study exercise and cardiovascular function in obese insulin-resistant adolescents and adolescents with type 2 diabetes. Drs. Zeitler and Nadeau have recently published a new book entitled Insulin Resistance: Childhood Precursors and Adult Disease. Dr. Zeitler is collaborating with Dr. Nicole Tartaglia in the Section of Developmental and Behavioral Pediatrics on a study of the effects of testosterone therapy on cognitive and behavioral development of boys with Klinefelter syndrome and other sex chromosome anomalies.
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