The Section of Endocrinology, Diabetes and Metabolism is a national leader in research leading to the development of new insights into the treatment of endocrine diseases and disorders. Investigative research in the areas of diabetes, hypertension, thyroid and sleep disorders has been highly developed by the Endocrine faculty. This work is conducted in our basic research laboratories as well as our clinical facilities.
Diabetes research has long been an important focus for investigation at The University of Chicago. Research into the causes, complications, diagnosis and treatment of diabetes and other endocrine disorders continues to be the base upon which a great many investigator initiated research projects. Diabetes-related research is focused on areas as diverse as peptide and protein structure, pancreatic ß-cell biology, genetic studies, receptor structure and hormone signaling, growth factors and cell proliferation, endocrine system interrelationships, lipoproteins and atherogenesis, gene regulation, transcription factor structure and function, endocrine-related gene mutations, autoantibodies and autoimmune disease, immune function and transplantation.
The University of Chicago has a rich tradition of accomplishment in diabetes research. Diabetes research is a particular strength of the Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism and of The University of Chicago in general. Our physicians and researchers are known for their advanced research and innovative treatments for people with diabetes. Many of the fundamental discoveries were made by Chicago faculty members early in this century.
For the nearly past three decades the Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism has been the recipient of an NIH-funded Diabetes Research and Training Center. The Diabetes Research and Training Center’s core laboratories include the Ligand Assay Core, Islet Cell Biology Core, the Molecular Biology and Genetics, Transgenic Core, and the Physiology Core. Each of these laboratories functions at a high capacity and provide services to investigators at The University of Chicago, as well as other institutions.
Diabetes Mellitus Research
The University of Chicago DRTC has been at the forefront of genetic studies of diabetes mellitus. The University of Chicago also has a strong program in pancreatic ß-cell biology. Basic investigations of ß-cell function at the molecular level are stressed.
Thyroid research is another important strength of the Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism. Dr. Refetoff, Cohen, and Dumitrescu are NIH-funded investigators working in various aspects of thyroid research. Together, they form an invaluable training resource to incoming fellows as well as provide a firm intellectual basis for fostering new clinical and translational research projects. The Thyroid Research Group interacts through an organized series of seminars and laboratory meetings in order to promote direct interaction among faculty, postdoctoral fellows, and laboratory staff for ongoing critical review and feedback. Our faculty members have achieved major breakthroughs in treatment protocols for thyroid cancer, thyroid autoimmunity and the treatment of congenital thyroid diseases. Trainees of the Thyroid Research Group have become leaders in academic medicine in the USA and abroad.
Diabetes Prevention Program at The University of Chicago
The University of Chicago was selected by NIH as a clinical study site for the NIDDK Diabetes Prevention Program (DPP). This area of Chicago is comprised primarily by African-Americans, a target-population identified by the NIDDK as at high risk for diabetes.
Polycystic Ovarian Syndrome (PCOS)
PCOS develops when the ovaries overproduce androgens (e.g. testosterone). Androgen overproduction often results from overproduction of LH (luteinizing hormone), which is produced by the pituitary gland. Research also suggests that when insulin levels in the blood are high enough, the ovary can be stimulated to produce more testosterone. That is, the combination of having ovaries which are responsive to insulin and high insulin levels in the blood can result in the overproduction of testosterone.
Several faculty members in the section of Endocrinology, Diabetes and Metabolism are conducting studies on the roles of sleep and circadian rhythmicity in glucose regulation and hormonal release and their implications for the aging process and the development of age-related chronic conditions such as type 2 diabetes. Several projects are focused on the prevalence and implications of sleep disorders in diabetes and endocrine conditions, such as the polycystic ovary syndrome and adult growth hormone deficiency. A number experimental protocols for in vivo assessment of beta cell function, including the use of oscillatory glucose infusion to entrain insulin pulsations have been developed.
Osteoporosis and Metabolic Bone Disease
Bone mineral density (BMD) is not a perfect predictor of fractures, primarily because it measures bone quantity but not its quality or trabecular structure, which also influences. Assessment of trabecular structure, particularly if obtained in a non-invasive and practical way, would provide significant additional information to aid clinicians in diagnosing and treating osteoporosis. We are developing a new method for non-invasive assessment of bone structure using Radiographic Texture Analysis (RTA) performed on radiographic and densitometric bone images. Studies are underway investigating whether information derived from RTA improves the assessment of bone fragility and facilitates monitoring of pharmacological therapy for osteoporosis.
The second area of research interest is investigating racial and individual differences in the risk of developing osteoporosis and other complications of long term therapy with glucocorticoids. It is well known that are large individual differences in the probability of developing complications of glucocorticoid therapy. The reasons for these differences are not clear yet are very important in guiding physicians in selecting patients for who need aggressive evaluation and treatment of glucocorticoid-induced osteoporosis. We are looking for possible genetic or phenotypic differences that underlie the vulnerability to glucocorticoid-induced osteoporosis.
Islet Cell Transplantation
The Section of Endocrinology, Diabetes and Metabolism has recently been established as a Center for Islet Transplantation to develop new ways of inducing immune tolerance and improving management of Type 1 diabetes and other immune system disorders. These initiatives add to the solid core of research programs that Endocrinology faculty are actively pursuing – from the biologic and genetic basis of normal glucose tolerance to understanding the basic aspects of insulin-secreting cell function through biophysics and cell biology, and from studies which aim to identify people at risk for diabetes prior to the onset of elevated glucose concentrations to investigations which aim to develop novel approaches to the early diagnosis and treatment of Type 1 and Type 2 diabetes.