Ewch i’r prif gynnwys
Aled Rees  MBBCh FRCP PhD

Yr Athro Aled Rees

(e/fe)

MBBCh FRCP PhD

Athro Sefydliad Arloesi Endocrinoleg, Niwrowyddoniaeth ac Iechyd Meddwl

Yr Ysgol Meddygaeth

cymraeg
Siarad Cymraeg

Trosolwyg

Mae gen i ddiddordeb ymchwil clinigol a throsiadol mewn sawl agwedd ar endocrinoleg, gyda ffocws penodol ar endocrinoleg atgenhedlu, clefyd y thyroid ac anhwylderau steroid.

Mae fy astudiaethau presennol yn defnyddio cofnodion iechyd electronig, dadansoddi genetig ac MRI uwch i ddeall effaith yr amgylchedd hormonaidd mewn bywyd cynnar ar ganlyniadau iechyd tymor hir. Mae fy ngrŵp wedi nodweddu canlyniadau metabolig, iechyd meddwl a cardiofasgwlaidd hirdymor cleifion â Syndrom Ofari Polysystig (PCOS), ac mae'n archwilio effaith PCOS ar ddefnyddio adnoddau iechyd a baich economaidd. Rydym wedi cynnal astudiaethau ffisiolegol i ddangos newid microstructure, metaboledd a swyddogaeth serebrofasgwlaidd yn y boblogaeth hon, ac rydym yn archwilio'r potensial ar gyfer therapi ymarfer corff a blocâd androgen i addasu'r risgiau hyn.

Mae ein hastudiaeth ddilynol hirdymor o blant a anwyd i famau yn y treial Sgrinio Thyroid Antenatal Rheoledig (CATS) yn cynnwys MRI uwch a gynhaliwyd yng Nghanolfan Ymchwil Delweddu'r Ymennydd Prifysgol Caerdydd (CUBRIC) i archwilio effaith statws thyroid mamol diwygiedig ar niwroddatblygiad. Rydym wedi defnyddio Banc Data SAIL i ddangos mwy o risg o ddigwyddiadau cardiofasgwlaidd mewn cleifion sydd â Gwrthwynebiad i Hormon Thyroid-Beta, gyda'r bwriad o archwilio therapïau newydd a allai liniaru'r risg hon. 

Mae ein gwaith mewn anhwylderau steroid wedi dangos gwerth cortisol poer fel dewis arall i fesur serwm ar gyfer diagnosis annigonolrwydd adrenal. Rydym yn cymryd rhan mewn treialon clinigol mewn Hyperplasia Adrenal Cynhenid sydd wedi dod â chyffuriau newydd i'r farchnad, ac rydym yn cydweithio ar astudiaethau aml-ganolfan (CAHASE2) i nodweddu canlyniadau clefydau yn yr anhwylder hwn. 

 

 

Cyhoeddiad

2024

2023

2022

2021

2020

2019

2018

2017

2016

2015

2014

2013

2012

2011

2010

2009

2008

2007

2006

2003

2002

1992

Articles

Book sections

  • Rice, S. J. and Rees, D. A. 2011. DHEA and vascular function. In: Watson, R. R. ed. DHEA in Human Health and Aging. Boca Raton, Fl: CRC Press, pp. 375-388.

Books

Ymchwil

Current projects

My current studies use advanced MRI to understand the impact of the hormonal environment in early life on cognition and neurodevelopment. My group has shown altered white matter microstructure and cognitive ability in young women with Polycystic Ovary Syndrome (PCOS), building on previous epidemiological and basic science studies which have established the long-term metabolic and cardiovascular outcomes in this patient population. Our long-term follow-up study of children born to mothers in the Controlled Antenatal Thyroid Screening (CATS) trial will enable us to assess the effects of thyroid hormone exposure in pregnancy on neurodevelopment, using the state-of-the-art MRI facilities in the new Cardiff University Brain Research Imaging Centre (CUBRIC).

Recent studies have also sought to explore the potential utility of extracellular vesicles, including those derived from adipocytes, as biomarkers and mediators of cardiometabolic risk in patients with obesity and PCOS.

Funding

2015-2017 “Cell-derived microparticles as mediators of obesity-induce vascular disease”; Type: Clinical Research Fellowship (to Witczak); Principal Investigator: Rees DA; Co-Investigators: James PJ, Witczak J; Agency: Royal College of Physicians; Budget: £120,417

2015-2018 “Extracellular vesicle transport in the circulation – a missing link between adipocytes and accelerated vascular dysfunction”;Type: Project Grant; Principal Investigator: James PJ; Co-Investigators: Rees DA, Ludgate M, Lewis T, Clayton A, O’Donnell V. Agency: British Heart Foundation; Budget: £226,891

2014-2017“Measurement of pathologically relevant microvesicle populations in obesity-driven cardiovascular disease”;Type: PhD studentship; Principal Investigator:James PJ; Co-Investigator: Rees DA; Agency: Cardiff University College of Biomedical & Life Sciences; Budget: £75,000

2014-2017“Can we prevent generation of pro-thrombotic and pro-coagulant extracellular vesicle populations in blood via a simple dietary intervention?” Type: PhD studentship; Principal Investigator: Rees DA; Co-Investigator: James PJ; Agency: National Institute for Social Care and Health Research; Budget: £66,926

2014-2015“Diabetes Research Network Statistician” Type: Grant. Principal Investigator: Rees DA; Co-Investigator: Dayan C; Agency: National Institute for Social Care and Health Research; Budget: £53,344

2012-2015 “The interface between adipose tissue-derived microvesicles and vascular endothelium in polycystic ovary syndrome”;Type: PhD studentship; Principal Investigator: Rees DA; Co-Investigator: James PJ; Agency: Cardiff University Ewen Maclean Bequest Scholarship; Budget: £66,402

2012-2013 “Anthropometric and metabolic correlates of sympathetic nervous system activity in young women with PCOS: a functional MRI study”; Type: Early Career Award; Principal Investigator: Rees DA; Co-Investigator: Lansdown A; Agency: Society for Endocrinology; Budget: £10,000

2012-2013 “A pilot study to determine whether complement activation modulates lipid metabolism in health and disease” Type: Wellcome Trust ISSF Fellowship; Principal Investigator: Lewis R; Co-Investigators: Rees DA, Morgan BP; Agency: Wellcome Trust; Budget: £44,130

2011-2014 “Influence of regional adiposity on endothelial effects of LDL cholesterol in Polycystic Ovary Syndrome”; Type: PhD studentship; Principal Investigator: James PJ; Co-Investigator: Rees DA; Agency: Cardiff University John Nixon Bequest Scholarship; Budget: £68,412

Impact

I have established a large cohort of young patients with Polycystic Ovary Syndrome (PCOS), using this as a common (5-10% premenopausal women) clinical model of metabolically unhealthy obesity and early life vascular risk.

I employed a series of non-invasive cardiovascular methodologies to carefully phenotype the cohort and demonstrate the importance of insulin resistance and central obesity as independent cardiovascular risk markers. My group undertook a randomised, double blind, placebo-controlled trial to show that metformin improves vascular function in women with PCOS; this study was incorporated into the US Androgen excess-PCOS Society guidelines for cardiovascular disease prevention in 2010.

I have also exploited the power of the Clinical Practice Research Database to define the natural history of PCOS, confirming an increased risk of type 2 diabetes and several adverse pregnancy outcomes. In collaboration with Professor Philip James (Cardiff Metropolitan University) our group has shown that circulating extracellular vesicles may mediate some of these risks and highlighted the potential for apheresis as a treatment modality.

My recent studies with Dr Mike O’Sullivan (King’s College London) show that young women with PCOS have reduced cognitive function and altered white matter microstructure. I also hold a strong interest in steroid disorders; in adrenal disease, I have led two clinical trials to re-define method-specific reference limits to the synacthen test and explore the effects of DHEA on vascular function. I collaborated with Professor Richard Ross (Sheffield University) and others to establish the UK Congenital Adrenal Hyperplasia (CAH) Adult Study Executive (2005-), which has defined the health outcomes of adults with CAH.

I disseminate my work regularly via engagement with patient groups, the Society For Endocrinology and the media (S4C, Radio Cymru).

Addysgu

I contribute to the delivery, design and assessment of the undergraduate medical curriculum from years 1 through to 5, and play an active role in postgraduate medical teaching at local and national levels.

Undergraduate

I deliver ward-based and outpatient teaching to year 3-5 students, and supervise student selected component (SSC) projects in years 3 and 5. Following the introduction of the C21 undergraduate curriculum in Cardiff, I completed the Medical Education Orientation Programme (MEOP), became a tutor on ‘reproductive hormones’ for the Platform in Clinical Science in phase 1a (year 1) and case-based writing lead (‘Diabetes in an older person’) for phase 1b (year 2). I am an academic mentor for medical undergraduates and have been an examiner at medical finals for the last 10 years. I regularly host students on the Erasmus exchange programme.

Beyond my University commitments, I also organise monthly small group teaching on Endocrinology for year 3-5 students undertaking placements at the University Hospital of Wales; based on sustained excellence from student feedback I was awarded a Certificate of Teaching Excellence from Cardiff and Vale University Health Board in 2010. I deliver an annual lecture to dental undergraduates on steroid disorders.

On a UK level, I helped develop a set of National Standards, adopted jointly by the Society for Endocrinology, the Association of British Clinical Diabetologists (ABCD) and Diabetes UK, for undergraduate education in Endocrinology and Diabetes, benchmarked against Tomorrow’s Doctors (2012). In 2014 I was invited to edit and author Clinical Endocrinology and Diabetes at a Glance, a leading UK undergraduate text series in clinical medicine, which is due for publication in 2015.

Postgraduate

As the academic lead on the Specialist Training Committee for Endocrinology and Diabetes in Wales, I have established a neuroendocrine teaching programme for specialist registrars. Supported by a grant from the Society for Endocrinology, I introduced a poster presentation session and developed undergraduate and postgraduate prizes at the annual Welsh Endocrine and Diabetes Society (WEDS) meeting. Subsequently, as chair of WEDS, I organised the first Society for Endocrinology Regional Clinical Cases meeting to be held in Wales (2013). I was selected as a Convenor for the Society for Endocrinology Clinical Update course (2012-present), where I design and deliver teaching on neuroendocrine tumours, inherited endocrine neoplasia, hyponatraemia and hypoglycaemia to over 200 Specialist Registrars and Consultants annually.

In recognition of my commitment to undergraduate and postgraduate teaching, I was elected to the Academy of Medical Educators in 2013.

Bywgraffiad

Education and qualifications

  • 2013: MAcadMEd
  • 2010: FRCP, London
  • 2002: PhD (Neuroendocrinology) University of Wales College of Medicine, Cardiff, UK
  • 1996: MRCP, London
  • 1993: MB, BCh (Hons), University of Wales College of Medicine, Cardiff, UK

Career overview

  • 2015 - present: Reader in Neuroendocrinology and Honorary Consultant Endocrinologist, Neurosciences and Mental Health Research Institute, Cardiff University
  • 2006 - 2015: Senior Lecturer and Honorary Consultant Endocrinologist, Cardiff University
  • 2003 – 2006: Clinical Lecturer in Endocrinology, Cardiff University
  • 2001 – 2003: Specialist Registrar in Endocrinology, South Wales
  • 1998 – 2001: Society for Endocrinology Clinical Endocrinology Trust Research Fellow, University of Wales College of Medicine, Cardiff
  • 1997 – 1998: Wellcome Trust Clinical Training Fellow, University of Wales College of Medicine, Cardiff
  • 1996 – 1997: Registrar in General Medicine, Royal Gwent Hospital, Newport
  • 1994 – 1996: Senior House Officer in Medicine, South Wales
  • 1993 – 1994: House Officer in Medicine and Surgery, University Hospital of Wales and Llandough Hospital

Anrhydeddau a dyfarniadau

  • 2015 – present: Associate Editor, Clinical Endocrinology
  • 2005: Novartis European Young Investigator Award. Characterisation of the role of extracellular signal-regulated kinases in growth hormone action: insights from novel human growth hormone 1 (GH1) gene mutations.

Aelodaethau proffesiynol

  • Fellow of the Royal College of Physicians
  • Association of Physicians of Great Britain and Ireland
  • Association of Clinical Professors of Medicine
  • Society for Endocrinology (UK)
  • The Endocrine Society (USA)
  • European Society of Endocrinology
  • European Neuroendocrine Tumour Society
  • UK and Ireland Neuroendocrine Tumour Society
  • British Medical Association
  • Society of Physicians in Wales

Pwyllgorau ac adolygu

  • 2011 - 2015: Member of the School of Medicine Higher Degree committee
  • 2007 – 2010: Member of the Research Governance group

External committees

  • 2016 – present: Member of the National Institute for Health Research Metabolic and Endocrine Specialty Group
  • 2015 – present: Member of the Society for Endocrinology Finance committee
  • 2015 – present: Executive group member of the Diabetes Research Unit Cymru
  • 2014 – present: Chair, Welsh Endocrine and Diabetes Society
  • 2012 – present: Faculty member, Society for Endocrinology Clinical Update meeting
  • 2010 – present: Research and Development Lead, Medicine Board, Cardiff & Vale University Health Board
  • 2014 – 2016: Editorial Board, Scientific Reports
  • 2012 – 2016: Member of the Society for Endocrinology Clinical committee
  • 2011 – 2016: Committee member of the UK Acromegaly study group
  • 2009 – 2013: Editorial Board, Clinical Endocrinology
  • 2007 – 2014: Member of the Specialist Training Committee, Endocrinology and Diabetes, Wales Deanery
  • 2005 – 2014: Committee member of the Congenital Adrenal Hyperplasia Adult Study Executive

Themâu ymchwil

Arbenigeddau

  • Endocrinoleg