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Professor Aled Rees

Professor Aled Rees

Professor of Endocrinology, Neuroscience & Mental Health Research Institute

School of Medicine

Welsh speaking

I have a clinical and translational research interest in many aspects of endocrinology, with a particular focus on neuroendocrinology.

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, mental health and cardiovascular outcomes in this patient population. Ongoing trials will establish the potential for exercise therapy to modify these risks.

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).

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

  • 2019 - present: Professor of Endocrinology and Honorary Consultant Endocrinologist, Neuroscience and Mental Health Research Institute, Cardiff University
  • 2015 - 2019: Reader in Neuroendocrinology and Honorary Consultant Endocrinologist, Neuroscience 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

Honours and awards

  • 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.
  • 2015 – 2017: Associate Editor, Clinical Endocrinology
  • 2017 - present: Senior Editor, Clinical Endocrinology

Professional memberships

  • 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
  • Welsh Endocrine and Diabetes Society

Speaking engagements

  • 2019: British Endocrine Societies meeting, Brighton, UK
  • 2019: British Society for Paediatric Endocrinology and Diabetes, Cardiff, UK
  • 2019: Endocrine Society's 101st Annual Meeting and Expo, New Orleans, USA
  • 2019: Androgen excess and PCOS Society, New Orleans, USA
  • 2019: Society of Physicians in Wales, Portmeirion, UK
  • 2018: RCPE Symposium: Diabetes and Endocrinology, Edinburgh, UK
  • 2016: Acute and general medicine conference, Royal College of Physicians, London, UK
  • 2016: Endocrinology Update, Royal College of Physicians, London, UK
  • 2016: British Endocrine Societies meeting, Brighton, UK
  • 2015: (Meet the Professor) Endocrine Society’s 97th Annual Meeting and Expo, San Diego, USA
  • 2015: British Endocrine Societies meeting, Edinburgh, UK
  • 2014: Acute and general internal medicine, Royal College of Physicians/Society of Physicians in Wales, Cardiff, UK
  • 2014: British Endocrine Societies meeting, Liverpool, UK
  • 2014: Midlands regional endocrine meeting, Birmingham, UK
  • 2013: South West regional endocrine meeting, Taunton, UK
  • 2010: Acute and general internal medicine, Royal College of Physicians/Society of Physicians in Wales, Cardiff, UK

Committees and reviewing

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

External committees

  • 2018 - present: Society for Endocrinology Council
  • 2016 – present: National Institute for Health Research Metabolic and Endocrine Specialty Group
  • 2015 – present: Society for Endocrinology Finance committee
  • 2018 – present: DRU Cymru External Advisory Board
  • 2014 – present: Chair, Welsh Endocrine and Diabetes Society
  • 2010 – present: Research and Development Lead, Medicine Board, Cardiff & Vale University Health Board
  • 2015 – 2018: Executive group member of the Diabetes Research Unit Cymru
  • 2012 – 2018: Faculty member, Society for Endocrinology Clinical Update meeting
  • 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

2019

2018

2017

2016

2015

2014

2013

2012

2011

2010

2009

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2003

2002

1992

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.

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

2019-2021 "Effects of high-intensity interval training versus moderate-intensity steady-state training on mental health, cognitive and cardiometabolic outcomes in young women with Polycystic Ovary Syndrome: a pilot randomised, controlled trial"; Type: Project Grant; Principal Investigator: Rees DA; Agency: The Waterloo Foundation; Budget: £56,709.

2018-2020 "Effects of gestational thyroid hormone exposure on ADHD risk: insights into neurodevelopment using advanced MRI"; Type: Clinical Research Fellowship (to Scholz); Principal Investigator: Rees DA; Agency: Royal College of Physicians (Lewis Thomas Gibbon Jenkins of Briton Ferry Fellowship); Budget: £30,000

2018-2020 "Treatment of suboptimal maternal thyroid function as a window to mechanisms of childhood brain development and function"; Type: Project Grant; Principal Investigator: Rees DA; Agency: The Waterloo Foundation; Budget: £59,531

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).

Past projects

  • Co-Supervisor for Donna Matthew (PhD) - Measurement of pathologically relevant adipocyte-derived extracellular vesicles (awarded 2019)
  • Co-Supervisor for Christopher Morgan (PhD) - Exploration of the epidemiology, costs and treatment of diabetes using routine data sources (awarded 2019)
  • Co-Supervisor for Justyna Witczak (MD) - Characterisation of circulating extracellular vesicles in human obesity (awarded 2019)
  • Co-Supervisor for Nick Burnley-Hall (PhD) - Effects of inorganic nitrite and nitrate on production and function of extracellular vesicles (awarded 2017)
  • Co-Supervisor for Maneesh Udiawar (MD) - Cardiometabolic and neuroimaging correlates of cognitive function in Polycystic Ovary Syndrome (awarded 2017)
  • Co-Supervisor for Nadia El-Farhan (PhD) - Evaluation of serum and salivary cortisol responses to Synacthen stimulation (awarded 2017)
  • Co-Supervisor for Andrew Lansdown (MD) - Anthropometric and metabolic correlates of Sympathetic Nervous system activation in women with Polycystic Ovary Syndrome (awarded 2017)
  • Co-Supervisor for Laurence Thornhill (MD) - The effect of thienopyridines and non-thienopyridines on nitric oxide metabolism in patients with stable angina (awarded 2016)
  • Co-Supervisor for Elizabeth Ellins (PhD) - Novel strategies for clinical investigation and risk management in patients with dyslipidaemia (awarded 2016)
  • Co-Supervisor for Emma Rees (PhD) - The effects of obesity and pre-diabetic conditions on ventricular-arterial coupling in women (awarded 2016)
  • Co-Supervisor for Katie Connolly (PhD) - Adipocyte-derived extracellular vesicles: characterisation and function (awarded 2016)
  • Co-Supervisor for Anna de Lloyd (MD) - Effects of subclinical hypothyroidism on bone mineral density and cardiometabolic risk: genetic and immune influences (awarded 2015)
  • Co-Supervisor for Gareth Willis (PhD) - In vivo and in vitro characterisation and function of microparticles in models of cardiovascular disease (awarded 2015)
  • Co-Supervisor for Rosie Hocking (MD) - Stratification of cardiometabolic risk in Polycystic Ovary Syndrome: is visceral fat a major player? (awarded 2015)
  • Co-Supervisor for Hemanth Bolusani (MD) - A randomised, double blind, crossover study of the effects of CLA isomers on inflammation, body composition, metabolic profiles and vascular function in subjects with metabolic syndrome (awarded 2014)
  • Co-Supervisor for Mousumi Biswas (MD) - Clinical correlates of hypogonadism in type 2 diabetes (awarded 2012)
  • Co-Supervisor for Atul Kalhan (MD) - Identification and biological role of adenosine receptors in neuroendocrine tumours (awarded 2011)
  • Co-Supervisor for Neera Agarwal (PhD) - In vitro and in vivo models investigating pharmacological modulators of the metabolic syndrome (awarded 2010)
  • Co-Supervisor for Irina Cozma (MD) - Effects of somatostatin receptor modulation in Graves’ Ophthalmopathy (awarded 2009)
  • Co-Supervisor for Sam Rice (PhD) - In vitro and in vivo analysis of the effects of dehydroepiandrosterone on metabolic and vascular risk (awarded 2009)