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Pinar Gumus Balikcioglu

Associate Professor of Pediatrics
Pediatrics, Endocrinology
DUMC Box 102820, Durham, NC 27710
3000 Erwin Road, Suite 200, Durham, NC 27710

Selected Publications


Sex Differences in Branched-chain Amino Acid and Tryptophan Metabolism and Pathogenesis of Youth-onset Type 2 Diabetes.

Journal Article J Clin Endocrinol Metab · March 15, 2024 OBJECTIVES: Insulin resistance is associated with elevations in plasma branched-chain amino acids (BCAAs). BCAAs compete with aromatic amino acids including tryptophan for uptake into β cells. To explore relationships between BCAAs and tryptophan metabolis ... Full text Link to item Cite

Catabolism of fats and branched-chain amino acids in children with Type 1 diabetes: Association with glycaemic control and total daily insulin dose.

Journal Article Endocrinol Diabetes Metab · November 2023 OBJECTIVE: Hyperglycaemia in Type 1 diabetes (T1D) results from an absolute insulin deficiency. However, insulin resistance (IR) may exacerbate glycaemic instability in T1D and contribute to long-term cardiovascular complications. We previously showed that ... Full text Link to item Cite

Branched-chain α-keto acids and glutamate/glutamine: Biomarkers of insulin resistance in childhood obesity.

Journal Article Endocrinol Diabetes Metab · January 2023 OBJECTIVES: Insulin resistance (IR) in adolescents with obesity is associated with a sex-dependent metabolic 'signature' comprising the branched-chain amino acids (BCAAs), glutamate/glutamine, C3/C5 acylcarnitines and uric acid. Here, we compared the level ... Full text Link to item Cite

Disrupted Circadian Rhythm of Epinephrine in Males With Youth-Onset Type 2 Diabetes.

Journal Article J Endocr Soc · December 15, 2022 CONTEXT: Blood pressure and plasma catecholamines normally decline during sleep and rapidly increase in early morning. This is blunted in adults with type 2 diabetes (T2D). OBJECTIVE: We hypothesize that increased sympatho-adrenal activity during sleep dif ... Full text Link to item Cite

The Coronavirus Disease 2019 Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 Diabetes.

Journal Article J Pediatr · December 2022 OBJECTIVES: To evaluate the frequency and severity of new cases of youth-onset type 2 diabetes in the US during the first year of the pandemic compared with the mean of the previous 2 years. STUDY DESIGN: Multicenter (n = 24 centers), hospital-based, retro ... Full text Open Access Link to item Cite

Pediatric Diabetes on the Rise: Trends in Incident Diabetes During the COVID-19 Pandemic.

Journal Article J Endocr Soc · April 1, 2022 CONTEXT: The effects of the coronavirus disease 2019 (COVID-19) pandemic on the incident cases of pediatric type 1 diabetes (T1D) and type 2 diabetes (T2D) are not clear. OBJECTIVE: To identify trends in incidence and presentation of pediatric new-onset T1 ... Full text Link to item Cite

The Perfect Storm: Rapid Progression of Diabetic Ketoacidosis in Pediatric Diabetes in the Setting of COVID-19

Journal Article AACE Clinical Case Reports · November 1, 2021 Objective: The coronavirus disease 2019 (COVID-19) pandemic has introduced countless challenges to the medical field. Although pediatric patients have been reported to have lower rates of COVID-19 mortality, the presence of pre-existing conditions can heig ... Full text Cite

Impact of lifestyle Intervention on branched-chain amino acid catabolism and insulin sensitivity in adolescents with obesity.

Journal Article Endocrinol Diabetes Metab · July 2021 UNLABELLED: Insulin resistance in adolescents with obesity associates with a sex-dependent metabolic 'signature' comprising branched-chain amino acids (BCAAs), glutamate and C3/C5 acylcarnitines (C3/C5), implicating altered flux through BCAA catabolic path ... Full text Link to item Cite

The 24-hour average concentration of cortisol is elevated in obese African-American youth with type 2 diabetes.

Journal Article J Diabetes Complications · July 2021 INTRODUCTION: 24-h average (IC) plasma concentrations of cortisol and growth hormone are lower in obese youth and adults without Type 2 diabetes (T2D) compared to lean subjects. Here we examined IC-cortisol and IC-growth hormone levels in obese youth with ... Full text Link to item Cite

Pediatric Giant Prolactinoma Presenting With Acute Obstructive Hydrocephalus and Intracranial Hypertension

Journal Article Journal of the Endocrine Society · May 3, 2021 AbstractBackground: Pediatric prolactinomas (PP) are rare but represent 50% of all pediatric pituitary adenomas. Girls are affected more frequently than boys, although PP tend to be larger and more aggressiv ... Full text Cite

Branched-Chain Amino Acid Catabolism and Cardiopulmonary Function Following Acute Maximal Exercise Testing in Adolescents.

Journal Article Front Cardiovasc Med · 2021 Background: To provide energy for cardiopulmonary function and maintenance of blood glucose, acute aerobic exercise induces lipolysis, fatty acid oxidation (FAO), glycolysis, and glycogenolysis/gluconeogenesis. These adaptations are mediated by increases i ... Full text Link to item Cite

Macronutrient Regulation of Ghrelin and Peptide YY in Pediatric Obesity and Prader-Willi Syndrome.

Journal Article J Clin Endocrinol Metab · October 2015 BACKGROUND: The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. OBJECTIVE: We compared effects of high-carbohydrate (HC) and high-fat (HF) meals and GH therapy on g ... Full text Link to item Cite

Sex differences in biomarkers associated with insulin resistance in obese adolescents: metabolomic profiling and principal components analysis.

Journal Article J Clin Endocrinol Metab · December 2014 OBJECTIVE: Obesity and insulin resistance (IR) predispose to type 2 diabetes mellitus. Yet only half of obese adolescents have IR and far fewer progress to type 2 diabetes mellitus. We hypothesized that amino acid and fatty acid metabolites may serve as bi ... Full text Link to item Cite

Screening for hormonal, monogenic, and syndromic disorders in obese infants and children.

Journal Article Pediatr Ann · September 2014 The prevalence of pediatric obesity in the United States is nearly 17%. Most cases are "exogenous", resulting from excess energy intake relative to energy expenditure over a prolonged period of time. However, some cases of obesity are "endogenous", associa ... Full text Link to item Cite

Identification and screening for hormonal and syndromic disorders in obese infants and children

Journal Article Pediatric Annals: a journal of continuing pediatric education · 2014 Cite

Relationship of body mass index and GAD65 antibody status on β-cell secretion at diabetes onset in African-American children.

Journal Article J Pediatr Endocrinol Metab · 2013 Abstract Body mass and anti-pancreatic antibody status potentially influences the presentation of diabetes in children. We hypothesized that anti-pancreatic auto-antibody positive patients with new onset diabetes would have lower levels of insulin and C-pe ... Full text Link to item Cite

Virilizing adrenocortical adenoma associated with acquired anhydrosis in an adolescent girl

Journal Article J Pediatr Endocr Met · 2011 Adrenocortical tumors are rare in childhood and adolescence. Virilization, alone or in combination with signs of overproduction of other adrenal hormones, is the most common clinical presentation. Here we report an unusual case of an African-American femal ... Cite

Not ready for prime time.

Journal Article J Pediatr Endocrinol Metab · 2011 Full text Link to item Cite

Sex Differences in Branched-chain Amino Acid and Tryptophan Metabolism and Pathogenesis of Youth-onset Type 2 Diabetes.

Journal Article J Clin Endocrinol Metab · March 15, 2024 OBJECTIVES: Insulin resistance is associated with elevations in plasma branched-chain amino acids (BCAAs). BCAAs compete with aromatic amino acids including tryptophan for uptake into β cells. To explore relationships between BCAAs and tryptophan metabolis ... Full text Link to item Cite

Catabolism of fats and branched-chain amino acids in children with Type 1 diabetes: Association with glycaemic control and total daily insulin dose.

Journal Article Endocrinol Diabetes Metab · November 2023 OBJECTIVE: Hyperglycaemia in Type 1 diabetes (T1D) results from an absolute insulin deficiency. However, insulin resistance (IR) may exacerbate glycaemic instability in T1D and contribute to long-term cardiovascular complications. We previously showed that ... Full text Link to item Cite

Branched-chain α-keto acids and glutamate/glutamine: Biomarkers of insulin resistance in childhood obesity.

Journal Article Endocrinol Diabetes Metab · January 2023 OBJECTIVES: Insulin resistance (IR) in adolescents with obesity is associated with a sex-dependent metabolic 'signature' comprising the branched-chain amino acids (BCAAs), glutamate/glutamine, C3/C5 acylcarnitines and uric acid. Here, we compared the level ... Full text Link to item Cite

Disrupted Circadian Rhythm of Epinephrine in Males With Youth-Onset Type 2 Diabetes.

Journal Article J Endocr Soc · December 15, 2022 CONTEXT: Blood pressure and plasma catecholamines normally decline during sleep and rapidly increase in early morning. This is blunted in adults with type 2 diabetes (T2D). OBJECTIVE: We hypothesize that increased sympatho-adrenal activity during sleep dif ... Full text Link to item Cite

The Coronavirus Disease 2019 Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 Diabetes.

Journal Article J Pediatr · December 2022 OBJECTIVES: To evaluate the frequency and severity of new cases of youth-onset type 2 diabetes in the US during the first year of the pandemic compared with the mean of the previous 2 years. STUDY DESIGN: Multicenter (n = 24 centers), hospital-based, retro ... Full text Open Access Link to item Cite

Pediatric Diabetes on the Rise: Trends in Incident Diabetes During the COVID-19 Pandemic.

Journal Article J Endocr Soc · April 1, 2022 CONTEXT: The effects of the coronavirus disease 2019 (COVID-19) pandemic on the incident cases of pediatric type 1 diabetes (T1D) and type 2 diabetes (T2D) are not clear. OBJECTIVE: To identify trends in incidence and presentation of pediatric new-onset T1 ... Full text Link to item Cite

The Perfect Storm: Rapid Progression of Diabetic Ketoacidosis in Pediatric Diabetes in the Setting of COVID-19

Journal Article AACE Clinical Case Reports · November 1, 2021 Objective: The coronavirus disease 2019 (COVID-19) pandemic has introduced countless challenges to the medical field. Although pediatric patients have been reported to have lower rates of COVID-19 mortality, the presence of pre-existing conditions can heig ... Full text Cite

Impact of lifestyle Intervention on branched-chain amino acid catabolism and insulin sensitivity in adolescents with obesity.

Journal Article Endocrinol Diabetes Metab · July 2021 UNLABELLED: Insulin resistance in adolescents with obesity associates with a sex-dependent metabolic 'signature' comprising branched-chain amino acids (BCAAs), glutamate and C3/C5 acylcarnitines (C3/C5), implicating altered flux through BCAA catabolic path ... Full text Link to item Cite

The 24-hour average concentration of cortisol is elevated in obese African-American youth with type 2 diabetes.

Journal Article J Diabetes Complications · July 2021 INTRODUCTION: 24-h average (IC) plasma concentrations of cortisol and growth hormone are lower in obese youth and adults without Type 2 diabetes (T2D) compared to lean subjects. Here we examined IC-cortisol and IC-growth hormone levels in obese youth with ... Full text Link to item Cite

Pediatric Giant Prolactinoma Presenting With Acute Obstructive Hydrocephalus and Intracranial Hypertension

Journal Article Journal of the Endocrine Society · May 3, 2021 AbstractBackground: Pediatric prolactinomas (PP) are rare but represent 50% of all pediatric pituitary adenomas. Girls are affected more frequently than boys, although PP tend to be larger and more aggressiv ... Full text Cite

Branched-Chain Amino Acid Catabolism and Cardiopulmonary Function Following Acute Maximal Exercise Testing in Adolescents.

Journal Article Front Cardiovasc Med · 2021 Background: To provide energy for cardiopulmonary function and maintenance of blood glucose, acute aerobic exercise induces lipolysis, fatty acid oxidation (FAO), glycolysis, and glycogenolysis/gluconeogenesis. These adaptations are mediated by increases i ... Full text Link to item Cite

Macronutrient Regulation of Ghrelin and Peptide YY in Pediatric Obesity and Prader-Willi Syndrome.

Journal Article J Clin Endocrinol Metab · October 2015 BACKGROUND: The roles of macronutrients and GH in the regulation of food intake in pediatric obesity and Prader-Willi Syndrome (PWS) are poorly understood. OBJECTIVE: We compared effects of high-carbohydrate (HC) and high-fat (HF) meals and GH therapy on g ... Full text Link to item Cite

Sex differences in biomarkers associated with insulin resistance in obese adolescents: metabolomic profiling and principal components analysis.

Journal Article J Clin Endocrinol Metab · December 2014 OBJECTIVE: Obesity and insulin resistance (IR) predispose to type 2 diabetes mellitus. Yet only half of obese adolescents have IR and far fewer progress to type 2 diabetes mellitus. We hypothesized that amino acid and fatty acid metabolites may serve as bi ... Full text Link to item Cite

Screening for hormonal, monogenic, and syndromic disorders in obese infants and children.

Journal Article Pediatr Ann · September 2014 The prevalence of pediatric obesity in the United States is nearly 17%. Most cases are "exogenous", resulting from excess energy intake relative to energy expenditure over a prolonged period of time. However, some cases of obesity are "endogenous", associa ... Full text Link to item Cite

Identification and screening for hormonal and syndromic disorders in obese infants and children

Journal Article Pediatric Annals: a journal of continuing pediatric education · 2014 Cite

Relationship of body mass index and GAD65 antibody status on β-cell secretion at diabetes onset in African-American children.

Journal Article J Pediatr Endocrinol Metab · 2013 Abstract Body mass and anti-pancreatic antibody status potentially influences the presentation of diabetes in children. We hypothesized that anti-pancreatic auto-antibody positive patients with new onset diabetes would have lower levels of insulin and C-pe ... Full text Link to item Cite

Virilizing adrenocortical adenoma associated with acquired anhydrosis in an adolescent girl

Journal Article J Pediatr Endocr Met · 2011 Adrenocortical tumors are rare in childhood and adolescence. Virilization, alone or in combination with signs of overproduction of other adrenal hormones, is the most common clinical presentation. Here we report an unusual case of an African-American femal ... Cite

Not ready for prime time.

Journal Article J Pediatr Endocrinol Metab · 2011 Full text Link to item Cite

Virilizing para-adrenocortical adenoma associated with idiopathic-acquired generalized anhidrosis in an adolescent girl.

Journal Article J Pediatr Endocrinol Metab · 2011 Adrenocortical tumors are rare in childhood and adolescence. Virilization, alone or in combination with signs of overproduction of other adrenal hormones, is the most common clinical presentation. Here we report an unusual case of an African-American femal ... Full text Link to item Cite

The relationship of insulin secretion and GAD65 antibody levels at diagnosis on glycemic control in type 2 diabetes.

Journal Article J Pediatr Endocrinol Metab · October 2010 OBJECTIVE: To determine if pretreatment insulin and C-peptide levels together with antibody status are predictive of HbAlc levels before and during therapy in obese African-American youth with type 2 diabetes. METHODS: Records of African-American patients ... Full text Link to item Cite

Acute cardiac effects of carbon monoxide poisoning in children.

Journal Article Eur J Emerg Med · August 2010 OBJECTIVE: Carbon monoxide (CO)-induced cardiotoxicity has been investigated infrequently in children and reports of its cardiovascular effects are limited to isolated case reports. Our aims were to describe acute cardiac effects and associated factors wit ... Full text Link to item Cite

A comprehensive evaluation of the enzymatic and nonenzymatic antioxidant systems in childhood asthma.

Journal Article J Allergy Clin Immunol · July 2008 BACKGROUND: Even though there is ample evidence on the oxidative stress in asthma, there is limited information on the antioxidant defense systems. OBJECTIVES: To conduct a comprehensive evaluation of various components of both enzymatic and nonenzymatic a ... Full text Link to item Cite

Gianotti-Crosti syndrome as the only manifestation of primary Epstein-Barr virus infection: a case report.

Journal Article Turk J Pediatr · 2008 Gianotti-Crosti syndrome (GCS) presents as a symmetric erythematous papular and papulovesicular eruption of the face, extremities, and buttocks, and usually occurs in young children. GCS has been classically associated with hepatitis B virus, as well as ra ... Link to item Cite