Altered Fat-Burning in Infants with Congenital Disorders

Dr. Catherina Pinnaro

Almost immediately after birth, we begin burning fat for energy and warmth. Recently, members of our division studied whether this process is altered in infants with congenital disorders. The study focused on two specific disorders: congenital hypothyroidism and cystic fibrosis. The peer-reviewed study is now available online (PubMed link). The results indicate that infants with these disorders burn less fat than normal. Surprisingly, however, these infants burned relatively more of a specific fatty acid—linoleic acid. One possible explanation for this finding relates to higher levels of inflammation in these infants. This finding is particularly important for cystic fibrosis, as it may help explain why this condition often causes lifelong linoleic acid deficiency. The manuscript’s lead author is Dr. Pinnaro from our division, with Dr. Norris serving as the senior author.

The Influence of X Depends on Which Parent It Comes From

Dr. Catherina Pinnaro

Nope, the newest research results from Dr. Pinnaro are not related to a social media platform formerly represented by a blue bird. Rather, her latest research publication deals with the X-chromosome and how it modifies the risk a person has to develop diabetes. Specifically, the new results show that persons with Turner syndrome who inherited just a single X-chromosome have a higher risk of elevated blood sugar levels if that X-chromosome came from their mother compared to if it came from their father. The manuscript describing the results has been accepted for publication in the journal Hormone Research in Paediatrics (link to article on PubMed). The results may have implications for diabetes in the general population, as males necessarily inherit their X from their mother and for females the impact of risk differences between their two X chromosomes could be influenced by which parent each came from. Dr. Norris from our division also contributed to the manuscript.

Dr. Pinnaro Elected to the Society for Pediatric Research

Dr. Catherina Pinnaro

The Society for Pediatric Research (SPR) was founded in 1929 and serves “to cultivate a diverse network of child health researchers through collaboration, community, mentorship, and advocacy“. Election to the SPR is selective, recognizing productive, independent, active researchers who are conducting hypothesis-driven research in a field related to pediatrics. We are thus proud to announce that our faculty Dr. Cat Pinnaro has been elected to the SPR, effective January 1st, 2024. Dr. Pinnaro received her medical training at New York Medical College. She then completed a pediatric residency followed by a pediatric endocrinology fellowship, both at the University of Iowa. During this time she was a trainee in both the Physician Scientist Training Program and the T32 diabetes research program and earned a Masters in Translational Biomedicine. She has developed an independent research program focused on identifying genetic modifiers that influence the manifestations of karyotypic disorders. She has contributed to the understanding of diabetes as a complication of Turner syndrome and has established expertise in researching the impact of insulin delivery technology. Dr. Pinnaro already has published 19 articles appearing in the PubMed database, despite being an early stage investigator. She successfully competed for an NIH K23 career development award. Additionally, she is an active clinical member of our pediatric endocrinology and diabetes program. Finally, she provides important service to the state and region by being the (volunteer) Medical Director for Hertko Hollow Diabetes Camp for children, located in central Iowa. Congratulations Dr. Pinnaro for this well earned honor of being elected to the SPR.

Better Understanding of an Uncommon Form of Turner Syndrome

Dr. Catherina Pinnaro

Turner syndrome is a genetic condition cause by complete or partial loss of an X chromosome in a person who otherwise would have an XX karyotype. There are multiple ways in which the X chromosome can be missing or partially lost. Sometimes, a person with Turner syndrome will have a mixture of cells in their body. An uncommon form of Turner syndrome occurs when some cells are have only one X chromosome (45,X karyotype) and other cells have three X chromosomes – termed 45,X/47,XXX mosaicism. The health implications of this form of Turner syndrome have not been well studied until now. A group of Turner syndrome experts across the United States, including our own Dr. Pinnaro, have cooperated to combine their experiences. Their findings are now published in the American Journal of Medical Genetics (PubMed link). They found that features of this form of Turner syndrome could be more subtle than more common forms. Because Turner syndrome can cause a wide variety of rare but serious health concerns, it is important for persons with Turner syndrome to receive medical care in a specialized clinic, such as the one staffed at our center by Dr. Pinnaro and Dr. Alexandrou.

Dr. Pinnaro Recognized for her Outstanding Teaching

Dr. Catherina Pinnaro

On May 31st, Dr. Pinnaro received the Excellence in Clinical Coaching award from the Graduate Medical Education office. This award is given to faculty who are distinguished as outstanding clinical teachers of resident and fellow physicians. Comments written about Dr. Pinnaro’s teaching include a reflection of her approach to hospital rounds where she is renowned for “probing each learner with thought-provoking questions to assess their understanding, empowering the learners to take ownership of the patients, and dropping clinical pearls about even the mundane patient.” Congratulations Dr. Pinnaro, and thank you for your outstanding clinical teaching efforts.

Drs. Curtis and Pinnaro Provide Invited Commentary on Pubertal Timing

A variety of pathological processes can induce puberty earlier than otherwise would normally occur. When a child enters puberty, an important question is whether the timing is abnormally early. Pediatric endocrinologists are often the arbitrators of this question. Data defining the normal ages of puberty start are thus important. Data suggest that normal timing varies depending on a child’s genetics and environment. A recent publication in JAMA Network Open reports data collected from over 100,000 youth with Asian American, Native Hawaiian, and/or Pacific Islander heritage (link to article). To help interpret the findings, Drs. Vanessa Curtis and Catherina Pinnaro from our division were asked to provide their commentary on the article. Their commentary can be found here (link, which has link to the open source full text). They conclude that “[the] study […] emphasizes the necessity for precision and the pitfalls encountered when using race and ethnicity as a proxy for genetic background.”

JDRF Diabetes Fundraising Walk

The JDRF is a philanthropic, nonprofit organization that raises funds to support research aimed at curing, preventing, and better treating type 1 diabetes. On Saturday, May 11, the JDRF held its annual fundraising walk in Cedar Rapids. Our Division, led by Drs. Pinnaro and Alexandrou, organized a team of walkers to help the cause. Walkers from our division on the team included Drs. Alexandrou and Pinnaro, nurse practitioner Alex, diabetes nurses Haylee and Sue, pharmacist Lisa, our administrator Teresa, and research coordinator Emma, as well as spouses, kids, and a few of our dogs! As an unexpected perk, team members got to meet Iowa basketball star forward Hannah Stuelke (pictured below with nurse Sue and Dr. Alexandrou).

L->R: diabetes nurse Sue, Iowa basketball star Hannah Stuelke, Dr. Alexandrou.

Our Division’s Scholarship Well Represented at National Pediatric Endocrine Society Meeting

Each year, pediatric endocrinologists from around the world attend the “PES Annual Meeting”, hosted by the Pediatric Endocrine Society (PES). The mission of the PES is primarily to “advance and promote the endocrine health and well being of children and adolescents“.  This year, several Division members submitted abstracts describing new research and advances for review by the PES. The following were selected for presentation at this years PES meeting, which was just held May 2-5 in Chicago.

  • Dr. Eirene Alexandrou: “Gonadotropin-Releasing Hormone Agonist Therapy in Patients Undergoing Dialysis – A Cautionary Tale!” – selected for a poster presentation. Co-author from our division on this work is Dr. Akhila Ramakrishna.
  • Dr. Ben Palmer: “Adolescent-driven Retrospective Glucose Data Self-Review is Associated with Improved Glycemic Control in Type 1 Diabetes Mellitus.” – selected for a poster presentation. Co-authors from our division on this work are Dr. Catherina Pinnaro, Dr, Andrew Norris, and Dr. Michael Tansey.
  • Dr. Catherina Pinnaro: “Influence of X Chromosome Parent-of-origin on Glycemia in Individuals with Turner syndrome” – selected for an prestigious oral presentation. Co-author from our division on this work is Dr. Andrew Norris.
  • Dr. Akhila Ramakrishna: “A rare case of a female with 47 XXY ovo-testicular DSD.” – selected for an prestigious oral presentation.

Congratulations to all for helping advance the field of Pediatric Endocrinology.

“Forty Under 40”: Dr. Pinnaro Recognized for her Regional Impact

Dr. Catherina Pinnaro

We are delighted to report that Dr. Pinnaro from our division has been recognized by the Corridor Business Journal for her significant impact on her community and business. The award is reserved for early career impact, with a criteria that the person be under age 40. Forty individuals in the Cedar Rapids / Iowa City corridor region are selected annually. Dr. Pinnaro is a physician scientist, dividing her professional time between taking care of patients and directing a research program aimed at better understand health and disease. Her clinical work is focused on caring for pediatric patients with diabetes or other endocrine disorders. Her research program is focused on better understanding diabetes in persons with Turner syndrome and honing technology-based treatments for diabetes. In describing her approach to medicine and research, she relates that “I am motivated by trying to solve dynamic problems that may need out-of-the-box strategies.” She and the other recipients were recognized at an awards dinner on October 19th. We are fortunate to have Dr. Pinnaro on our team and congratulate her for her achievement.

A New Registry to Inform Healthcare for Turner Syndrome

Dr. Catherina Pinnaro

Dr. Pinnaro is part of the leadership team that has created a new national registry to track the health of persons with Turner syndrome. The initiative has been named the “Inspiring New Science to Guide Healthcare in Turner Syndrome (InsighTS)” Registry. The leadership group of the InsighTS Registry has now published their study’s design and goals. The publication’s abstract can be found on PubMed at the following link. Persons with Turner syndrome have unique health risks, and ideally should be seen regularly in a clinic with Turner syndrome expertise, such as the one at the University of Iowa Stead Family Children’s Hospital (2023 link to the Turner syndrome clinic) headed by Dr. Alexandrou and Dr. Pinnaro.