Andrea HaqqAndrea Haqq, MD

Office:    6-002E Li Ka Shing Centre for Health Research Innovation
Mail:      University of Alberta, Edmonton, AB Canada, T6G 2E1
Phone:   (780)-492-0015 (Research Office)
Fax:       (780)-492-0979
Email:    haqq@ualberta.ca

 

 

 Dr. Haqq is currently recruiting strong candidates at the Masters or PhD level

 

Current Position

 

Associate Professor, University of Alberta, Faculty of Medicine and Dentistry, Pediatric Department, Division of Pediatric Endocrinology

 

Adjunct Professor, University of Alberta, Faculty of Agriculture, Life & Environmental Sciences, Department of Agricultural, Food and Nutritional Science (AFNS)

 

Research Area

Dr. Haqq's clinical translational research has centered on the neuroendocrinology of energy balance in childhood obesity. We have demonstrated that children with PWS have unusual biochemical features that may explain their uncontrollable appetites and excess weight gain. Foremost among these is a paradoxical elevation of ghrelin, an appetite-stimulating hormone. Dietary or pharmacologic approaches to therapy based on reducing ghrelin levels or limiting ghrelin action might prevent or reverse obesity in children with PWS.

For reasons unknown, some obese individuals are protected from developing metabolic co-morbidities such as glucose intolerance and cardiovascular disease. PWS provides a unique model that may help to explain this phenomenon of the “healthy obese” patient. Studies from our laboratories showed that PWS is associated with relative hypoinsulemia and hypersensitivity to insulin action, associated with hyperadiponectinemia, low levels of interleukin 6 and C-reactive protein, and relatively low visceral fat deposition. The relative insulin sensitivity may protect children and adults with PWS from development of metabolic co-morbidities. Preliminary ongoing studies suggest that the preservation of insulin sensitivity might be explained by the differential patterns of fat distribution in PWS and other obese subjects. Ongoing studies of the developmental changes in fat distribution in PWS and non-syndromic obesity may shed new light on the pathogenesis of insulin resistance and life-threatening metabolic complications of obesity.

Further translational clinical research goals include understanding the regulation of ghrelin and other neuropeptides’ (adiponectin, adropin, obestatin, Peptide YY, leptin) in the context of childhood disorders of energy balance including PWS and general childhood obesity.

Most recent work focuses on the characterization of autonomic nervous system (ANS) dysfunction in childhood obesity and examination of the relationship between ANS dysfunction, body fat distribution and metabolic profile in obese children. To further elucidate this relationship, ANS function in obese children will be compared to children with a unique genetic model of obesity and ANS dysfunction called Prader-Willi Syndrome (PWS).

Dr. Haqq has assumed leadership roles in the general pediatric endocrine community. She has served on the international Pediatric Endocrine Society (PES) Obesity Committee and the Drug and Therapeutics Committee. Through her involvement in these committees, she has contributed to the development of several manuscripts that provide state of the art reviews and practice guidelines for pediatric endocrinologists in areas of management of type I and type 2 diabetes and childhood obesity. Her current research efforts are supported by Canadian Institutes of Health Research (CIHR) operating grants and project grants from the Foundation for Prader-Willi Research (FPWR), the Prader-Willi Syndrome Association of Alberta, the Alberta Diabetes Institute and Women & Children’s Health Research Institute, University of Alberta.

 

Current Research Activities

Our ongoing program of research broadly examines the pathophysiology of obesity and its complications (including insulin resistance and type 2 diabetes) in genetic forms of childhood obesity and applies these novel findings to the prevention and treatment of childhood obesity in general. We believe that this complex area of biomedical research examining the genetic underpinnings of childhood obesity necessitates collaboration with other international experts in complementary fields. Therefore, our productive collaborative team currently maintains active international collaborations with the following Institutions:

 

  • The Scripps Research Institute, USA
  • University of Cambridge, United Kingdom
  • Duke University, USA
  • Children's Hospital of Philadelphia, USA
  • National Institutes of Health, USA
  • Columbia University, USA
  • Oregon Health & Science University, USA
  • California State University, Fullerton, USA

Our primary research areas include further understanding the genetic contributions of childhood obesity and design of novel therapies for childhood obesity.  Our program is funded by CIHR, the Foundation for Prader-Willi Research (FPWR), the University of Alberta`s Women and Children Health Research Institute (WCHRI) and the ADI. These projects are human clinical studies all currently actively recruiting additional subjects. For further information on our studies, please contact myself or my research associate, Michelle Mackenzie, PhD at 780-248-5481 or michelle.mackenzie@ualberta.ca


Biography

 

Andrea M. Haqq, M.D., M.H.S. is an Associate Professor of Pediatrics and Adjunct Professor in the Department of Agricultural, Food and Nutritional Science (AFNS) at the University of Alberta. She is a practicing pediatric endocrinologist at the Stollery Children’s Hospital, University of Alberta.  Dr. Haqq has a strong clinical and research interest in disorders of energy balance in humans including childhood obesity and its complications (insulin resistance and type 2 diabetes), Prader-Willi Syndrome (PWS) and other genetic forms of childhood obesity, and hypothalamic-derived obesity.  Her basic research has focused on understanding the molecular role of the melanocortin-4 receptor (MC4-R), which plays an important role in energy homeostasis in both rodents and humans.

 

Other Activities and Affiliations

 

Clinical Activity:

I am a practicing pediatric endocrinologist at the Stollery Children’s Hospital where I care for children with Type 1 and 2 diabetes and general endocrine disorders (hypothalamic-pituitary dysfunction; disorders of growth, thyroid function, and sexual development).  I have special expertise in caring for children with Prader-WIlli Syndrome and morbid early-onset obesity and its complications.

Membership on Panels, Boards, Working Groups, Networks

1998-present                        Fellow of Royal College of Physicians and Surgeons of Canada (FRCP(C))

1997-present                        Fellow of American Academy of Pediatrics (FAAP)

2002-present                        Endocrine Society-Active member          

2003-present                        Pediatric Endocrine Society (PES) member

2006-2008                           Abstract reviewer for Pediatric Academic Societies’ Annual Meeting

2006-present                        Member, The Obesity Society

2006-present                        Member, Society for Pediatric Research

2009-present                        Resident Research Committee, University of Alberta

2009-present                        Member, Canadian Obesity Network

2010-present                        Member, The Women and Children’s Health Research Institute

2010-present                        Member, Alberta Diabetes Institute

2011-present                        Member, Alberta Diabetes Institute, Research Coordinating Committee

2010-present                        Obesity Committee, Pediatric Endocrine Society

2010-2012                           Canadian Diabetes Association Peer Review Panel, Metabolism Section

2010-present                        Scientific Planning Committee for Canadian Pediatric Endocrinology Group (CPEG) Annual meeting

2011                                    Abstract reviewer for Canadian National Obesity Summit

2013    Reviewer for Pediatric Academic Societies Abstracts

2013    Reviewer for the Canadian Diabetes Association

2003-present                      Active ad-hoc Journal reviewer: Journal of Clinical Endocrinology an Metabolism; European Journal of Clinical Nutrition; Obesity Research; Journal of Pediatrics; Journal of the American College of Nutrition; Diabetes, Pediatric Diabetes, Applied Physiology, Nutrition, and Metabolism, Endocrinology, and New England Journal of Medicine

Unique Research Contributions


Hormonal regulation of strength and endurance exercise in childhood obesity and Prader-Willi Syndrome:  

In collaboration with Dr. Daniela Rubin (PI, UC Fullerton), we have contributed to studies evaluating the hormonal regulation of exercise in childhood obesity and Prader-Willi Syndrome compared to healthy controls. Our programs share opportunities between UC Fullerton and University of Alberta to provide outstanding mentorship to trainees involved in this program of research.

Metabolic Profiling of obesity

I was a collaborative team member in a Duke University project led by Dr. Chris Newgard, PhD which performed detailed metabolic profiling (hormones, cytokines, metabolites, and physiologic variables) of obese and lean individuals. We identified a unique branched-chain amino acid (BCAA)-related metabolite signature in obese individuals that is suggestive of increased catabolism of BCAA and correlated with insulin resistance [Newgard et al. Cell Metabolism 2009 9(4):311]. Another study examined the mechanism behind rapid improvement in glycemic control following gastric bypass surgery (GBP) as compared to identical weight loss achieved by dietary means. A decrease in total and branched chain amino acids (AAs) was seen uniquely in the GBP group only and this correlated with levels of insulin resistance (HOMA-IR).[Newgard et al. Sci Transl Med. 2011 3(80):80re2].

Pathophysiology of childhood obesity:  

We have characterized a unique metabolic phenotype of a genetic obesity syndrome called Prader-Willi Syndrome (PWS). We have shown that PWS children have high fasting and post-prandial levels of total ghrelin, an orexigenic peptide produced in the stomach. Ghrelin stimulates appetite and induces weight gain in humans when administered at pharmacologic doses. In contrast, total ghrelin levels are suppressed in children with “exogenous” obesity (due to overeating) or with obesity caused by mutations in leptin or the melanocortin-4 receptor [Haqq et al., J Clin Endocrinol Metab. 2003;88(1):174]. We have also demonstrated higher levels of total and HMW adiponectin, increased insulin sensitivity and lower CRP and IL-6 in PWS children compared to obese controls [Haqq et al., J Clin Endocrinol Metab. 2011 96(1):E225].

 

Selected Publications

Castner D, Rubin DA, Judelson D, Haqq AM.  Effects of adiposity and Prader-Willi syndrome on post-exercise heart rate recovery.  Journal of Obesity 2013: 384167, 2013.

Rubin DA, Cano-Sokoloff N, Castner D, Judelson DA, Wright P, Duran A, Haqq AM.  Update on body composition and bone density in children with Prader-Willi Syndrome.  Hormone Research in Pediatrics 79(5):  271-6, 2013.

van der Klaauw Agatha A., Keogh Julia M., Henning Elana, Blackwood Anthea, Haqq AM, Purnell Jonathan Q., Farooqi, Sadaf.  Postprandial total ghrelin suppression is modulated by melanocortin signalling in humans.  Journal of Clinical Endocrinology & Metabolism 98(2):  E288-92, 2013.

Haqq AM, DeLorey DS, Sharma AM, Freemark M, Kreier F, Mackenzie ML, and Richer LP. Autonomic nervous system dysfunction in obesity and Prader-Willi Syndrome: current evidence and implications for future obesity therapies. Clinical Obesity 1: 175-183, 2012.

Laferrere B, Arias S, Swerdlow N, Gorroochurn P, Bose M, Bawa B, Teixeira J, Stevens RD, Wenner BR, Bain JR, Muehlbauer MJ, Haqq A, Lien L, Shah S, Svetkey LS, Newgard CB: Differential metabolic impact of gastric bypass versus dietary intervention in obese diabetic persons despite identical weight loss. Science Translational Medicine 3(80):80re2, 2011.

Haqq AM, Muehlbauer MJ, Newgard CB, Grambow SC, and Freemark M: The metabolic phenotype of Prader-Willi Syndrome (PWS) in childhood: heightened insulin sensitivity relative to body mass index. Journal of Clinical Endocrinology and Metabolism 96(1):E225-232, 2011.

Zeitler P, Haqq A, Rosenbloom A, Glaser N; for the Drugs and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Hyperglycemic Hyperosmolar Syndrome in Children: Pathophysiologic Considerations and Suggested Guidelines for Treatment. The Journal of Pediatrics 158(1):9-14, 2011.

Glaser NS, Geller DH, Haqq A, Gitelman S, Malloy M; The Lawson Wilkins Pediatric Endocrine Society Committee on Drugs and Therapeutics: Detecting and treating hyperlipidemia in children with Type 1 Diabetes Mellitus: are standard guidelines applicable to this special population? Pediatric Diabetes 12(4pt2):442-459.

Han JC, Muehlbauer MJ, Cui HN, Newgard CB, and Haqq AM: Lower serum brain-derived neurotrophic factor (BDNF) in patients with Prader-Willi Syndrome (PWS) compared with obese and lean control subjects. Journal of Clinical Endocrinology & Metabolism 95:3532-3536, 2010.

Newgard CB, An J, Bain JR, Muehlbauer MJ, Stevens RD, Lien LF, Haqq AM, Shah SH, Arlotto M, Slentz CA, Rochon J, Gallup D, Ilkayeva O, Wenner BR, Yancy WE, Eisenson H, Musante G, Surwit R, Millington DS, Butler MD, and Svetkey LP: A branched-chain amino acid-related metabolic signature that differentiates obese and lean humans and contributes to insulin resistance Cell Metabolism 9: 311–326, 2009. PMID: 19356713

Lien LF,*  Haqq AM,* Arlotto M, Slentz CA, Muehlbauer MJ, McMahon RL, Rochon J, Gallup D, Bain JR, Ilkayeva O, Wenner BR, Stevens RD, Millington DS, Muoio DM, Butler MD, Newgard CB, and Svetkey LP.  Study of the Effect of Diet on Metabolism and Nutrition (STEDMAN) Project: Comprehensive metabolic profiling during weight loss and regain in obese humans.  *These authors contributed equally.  OMICS: A Journal of Integrative Biology 13: 21-35, 2009. PMID: 19290809

Haqq AM, Grambow SC, Muehlbauer M, Newgard CB, Svetkey LP, Carrel AL, Yanovski JA, Purnell JQ and Freemark MS: Regulation of fasting ghrelin and satiety hormones in normal control and Prader-Willi Syndrome (PWS) children: changes during development. Clinical Endocrinology 69: 911-920, 2008. PMID: 18710462

Rubin DA, McMurray RG, Harrell JS, Hackney AC and Haqq AM: Do surrogate markers for adiposity relate to cytokines in adolescents? Journal of Investigative Medicine 56: 786-792, 2008. PMID: 18525454


Select Book Chapters

“Syndromic Obesity”. In Pediatric Obesity: Etiology, Pathogenesis and Treatment, Michael Freemark, editor, Humana Press, 2010.

“Prader-Willi Syndrome: A model of disordered energy homeostasis.” In Energy Metabolism and Obesity: Research and Clinical Applications, Patricia Donohoue, editor, Humana Press, 2010

 

Trainees

 

I supervise many medical students, pediatric residents and clinical fellows in my role as a pediatric endocrinologist at Stollery Children’s Hospital. I also have supervised multiple undergraduate students, graduate students and basic/clinical postdoctoral fellows in a variety of disciplines including pediatric endocrinology, genetics, nutrition, kinesiology and surgery.

 

Acknowledgments

We are grateful for the ongoing generous research donation support from many parent-driven organizations including the PWS Association of Alberta and Foundation for Prader-Willi Research (FPWR)-Canada/USA. We thank many families and patients who give generously of their time to participate in our clinical research studies detailed above.