About

Mizuho Mimoto is an Associate Clinical Professor in the Department of Medicine at UC San Diego. Her research focuses on various aspects of endocrinology and molecular biology, including the clinical recognition and evaluation of patients with inherited serum thyroid hormone-binding protein mutations, and the genetic and molecular mechanisms underlying thyroid function and metabolic regulation. Her work has contributed to understanding the implications of serum albumin mutations on thyroid tests, as well as the metabolic effects of dietary selenium deficiency and endocrine-disrupting chemicals. Her scientific contributions include studies on glucagon-like peptide-1 receptor agonists for obstructive sleep apnea, the regulation of erythropoiesis by GATA2 and Wnt signaling pathways, and the interactions of the nucleosome remodeling and deacetylase complex in primitive erythropoiesis. Mimoto's research also encompasses gene manipulation in Xenopus laevis to model human birth defects, and the molecular pathways involved in embryonic development and hematopoietic specification. Her work is characterized by a focus on translating molecular and genetic insights into clinical understanding of endocrine and developmental disorders.

Research topics

• Medicine
• Internal medicine
• Radiology
• Physiology
• Biology
• Endocrinology
• Chemistry
• Cardiology
• Urology

Selected publications

• Disentangling the Effects of Chromosomal Versus Hormonal Sex on Insulin Resistance

  Metabolism · 2026-03-05

  article
  PublisherDOI

• Glucagon-like peptide-1 receptor agonists for the treatment of obstructive sleep apnea

  Current Opinion in Pulmonary Medicine · 2025-08-22 · 4 citations

  articleOpen access

  PURPOSE OF REVIEW: This review highlights the emerging data on the use of incretin therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RA) and dual GLP-1RA and glucose-dependent insulinotropic peptide (GIP) receptor agonists, on the treatment of obstructive sleep apnea (OSA). Given known cardiometabolic and neurocognitive consequences of OSA, optimizing treatment is essential. In the setting of widespread research efforts and clinical implementation of dual agonists in managing OSA, obesity and other cardiometabolic diseases, this review is timely. RECENT FINDINGS: Several randomized controlled trials and meta-analyses have shown GLP-1 and GIP receptor agonists to reduce apnea-hypopnea index (AHI) and body weight in patients with OSA. This impact has been demonstrated with the use of pharmacotherapy alone and in combination with traditional positive airway pressure (PAP) therapy. GLP-1RA may positively affect OSA through reducing systemic inflammation and decreasing adiposity, including via hormone changes, delayed gastric emptying, and central mechanisms impacting appetite regulation and sleep-wakefulness. SUMMARY: Novel pharmacological advances in individuals with OSA and obesity have shown promise in cardiometabolic disease control. Longitudinal follow-up to monitor the efficacy and adverse effects of incretin therapies, and further comparison studies with PAP therapy, are warranted.

  PublisherOA PDFDOI

• 12591 Screening For Metabolic Dysfunction-Associated Steatotic Liver Disease In Diabetes Clinics

  Journal of the Endocrine Society · 2024-10-01

  articleOpen access

  Abstract Disclosure: D. D'Annibale: None. M. Mimoto: None. R. Lis: None. A. Deioma: None. H. Patton: None. Screening for Metabolic Dysfunction-Associated Steatotic Liver Disease in Diabetes Clinics Background: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with Type 1 (T1D) or Type 2 diabetes (T2D) is elevated, ranging from 22% in T1D to >55% in T2D. However, MASLD screening is not standard in diabetes clinics. The Fibrosis-4 (FIB-4) score and transient elastography (TE) are non-invasive tools to identify those at risk for MASLD and liver fibrosis. To identify at-risk individuals and determine the prevalence of undiagnosed MASLD in our Veterans with diabetes and elevated BMI, we developed a screening protocol using FIB-4 and TE. Methods: Veterans with T1D or T2D and elevated BMI seen in diabetes clinic were prospectively screened. Patients with prior TE or liver disease were excluded. In phase 1, patients were offered in-clinic TE during their visit. In phase 2, a FIB-4 determined referral to TE or hepatology. Results: 274 patients were screened over 8 months. Of 102 qualifying patients in phase 1, 28 had in-clinic TE; of these, 7 (25%) had a kPa of 8 or greater, indicating increased risk of fibrosis, and 16 (57.1%) had a CAP score >280, indicating severe steatosis.In phase 2, a FIB-4 was ordered in 157 qualifying patients. Of 110 completed tests, the FIB-4 was <1.3 (low risk), 1.3–2.6 (indeterminate risk) and >2.6 (high risk) in 61 (55.5%), 44 (40%) and 5 (4.5%), respectively. Patients were referred to TE (indeterminate) or hepatology (high risk). To date, 21 patients have undergone TE, 5 (23.8%) had a kPa of 8 or greater and 11 (52.4%) had a CAP score >280. Conclusions In Veterans with T1D or T2D and elevated BMI, both of our screening protocols identified those with severe steatosis (57.1% vs 52.4%) by TE at rates similar to those reported in the literature. Increased risk of fibrosis by TE was identified in ∼24-25% of our screened population. The high prevalence of undiagnosed MASLD in our Veteran population supports the need for screening in diabetes clinics. Increased provider awareness and point-of-care TE may increase access to screening and improve early diagnosis. Presentation: 6/2/2024

  PublisherOA PDFDOI

• Short-Term Treatment With Teriparatide Restores Independent Ambulation in a Patient With Glucocorticoid-Induced Osteonecrosis of the Knees and Ankles

  Journal of the Endocrine Society · 2021-05-01 · 1 citations

  articleOpen accessSenior author

  Abstract Teriparatide is a well-established treatment for osteoporosis. It is emerging as a promising treatment for osteonecrosis of the jaw and may be superior to alendronate for treating glucocorticoid-induced osteonecrosis of the femoral head and reduce collapse progression. However, few studies have investigated its efficacy in treating steroid-induced osteonecrosis affecting other sites such as the knee and ankle. Osteonecrosis treatment at these sites in early stages is limited to protected weight bearing and pain management. Surgical management is required for advanced stages. This case describes an unusual presentation of steroid-induced osteonecrosis in the bilateral lower extremities and illustrates the potential benefit of teriparatide as an alternative to surgery in managing this debilitating condition. A 25-year-old male with a history of a heart transplant for viral myocarditis was admitted to the hospital for severe bilateral lower extremity pain. His post-transplant course was complicated by giant cell myocarditis, treated with a prednisone taper from 80 mg to 7.5 mg daily over the course of one year. MRI showed diffuse osteonecrosis in the distal femora, medial femoral condyles, bilateral proximal tibias, left distal tibia, and bilateral ankles. A bone density test showed only mildly low bone mass with Z-scores of -0.8 at the right femur, -1.3 at the left femur and -1.3 at the lumbar spine. Due to progressive osteonecrosis on imaging and a decline in functional status over the next two months, following a discussion of risks, benefits and alternatives, he was started on daily teriparatide injections. Prior to therapy, he was using a walker and had difficulty ambulating more than a few feet. Within a month of teriparatide initiation, he reported improvement in both pain and mobility, and was able to walk independently into clinic. MRI two months later demonstrated no new lesions and significant improvement in previously necrotic areas. Our case highlights the importance of considering osteonecrosis at atypical locations in patients on chronic glucocorticoid therapy. It also demonstrates a promising role for teriparatide in treating steroid-induced osteonecrosis atypical sites and without concurrent osteoporosis.

  PublisherOA PDFDOI

• Dietary Selenium Deficiency Partially Mimics the Metabolic Effects of Arsenic

  Nutrients · 2021 · 4 citations

  • Endocrinology
  • Internal medicine
  • Chemistry

  Chronic arsenic exposure via drinking water is associated with diabetes in human pop-ulations throughout the world. Arsenic is believed to exert its diabetogenic effects via multiple mechanisms, including alterations to insulin secretion and insulin sensitivity. In the past, acute arsenicosis has been thought to be partially treatable with selenium supplementation, though a potential interaction between selenium and arsenic had not been evaluated under longer-term exposure models. The purpose of the present study was to explore whether selenium status may augment arsenic's effects during chronic arsenic exposure. To test this possibility, mice were exposed to arsenic in their drinking water and provided ad libitum access to either a diet replete with selenium (Control) or deficient in selenium (SelD). Arsenic significantly improved glucose tolerance and decreased insulin secretion and β-cell function in vivo. Dietary selenium deficiency resulted in similar effects on glucose tolerance and insulin secretion, with significant interactions between arsenic and dietary conditions in select insulin-related parameters. The findings of this study highlight the complexity of arsenic's metabolic effects and suggest that selenium deficiency may interact with arsenic exposure on β-cell-related physiological parameters.

  PublisherOA PDFDOI

• Serendipity and the Second Malignancy: Clear Cell Renal Carcinoma Workup Revealing a Paraaortic Paraganglioma With Post-Operative Vasoplegia

  Journal of the Endocrine Society · 2021 · 1 citations

  Senior authorCorresponding
  • Medicine
  • Radiology
  • Internal medicine

  Abstract Pheochromocytoma and paraganglioma (PPGL) are neuroendocrine tumors requiring careful pre- and post-operative management to dampen fluctuations in catecholamines. These lesions are not typically biopsied due to risk of catecholamine-induced hemodynamic instability. This case illustrates the importance of considering PPGL in patients without typical symptoms, and highlights challenges with post-operative blood pressure management following use of phenoxybenzamine. A 52 year old man presented with a 40 lb weight loss. PET/CT revealed a right renal mass, enlarged retroperitoneal lymph nodes, and increased uptake in retroperitoneal and paraaortic lesions. Paraaortic lymph node biopsy was consistent with paraganglioma. This finding was unexpected as the patient did not report palpitations, paroxysmal hypertension, or diaphoresis. He had no family history of neuroendocrine tumors. Fortunately, he had no adverse effects during biopsy despite subsequent testing showing elevated plasma metanephrines (271 pg/mL, normal ≤ 57 pg/mL) and normetanephrines (770 pg/mL, normal ≤ 148 pg/mL). I-123 MIBG scan revealed an enlarged left paraaortic mass with increased activity consistent with paraganglioma. He started preoperative alpha blockade with phenoxybenzamine 14 days prior to surgery. Propranolol was added 10 days later to provide combined sympathetic blockade. The patient underwent partial right nephrectomy and resection of the paraaortic mass. Pathology showed renal cell carcinoma (RCC) and paraganglioma, respectively. On post-operative day 1, maintenance fluids were discontinued and he developed palpitations and tachycardia to 140 beats per minute, with blood pressure in the 130s/80s. RCC associated pulmonary embolism, beta-blocker withdrawal, and vasoplegia due to phenoxybenzamine use and paraganglioma resection were considered. The patient was treated with 4 additional liters of normal saline over the next two days to address post-operative vasoplegia, and his tachycardia resolved. Genetic testing for neuroendocrine tumor syndromes including Von Hippel-Lindau (VHL) is ongoing. Clinical Lessons: 1. PPGL should be considered in patients with newly identified intraabdominal masses, even in patients without typical symptoms of catecholamine excess to avoid high risk biopsy. 2. Paraganglioma resection is associated with vasoplegia due to post-operative reduction in circulating catecholamines. 3. The covalent, irreversible alpha antagonist phenoxybenzamine accumulates in adipose tissue, and clinical effects can last up to 7 days after discontinuation. Hypotension can be avoided with aggressive fluid resuscitation. Beta antagonists should be used with caution as they may precipitate hypotension. 4. For patients presenting with paraganglioma and renal cell cancer, genetic syndromes including VHL or RAPTAS etiologies should be considered.

  PublisherDOI

• Clinical recognition and evaluation of patients with inherited serum thyroid hormone-binding protein mutations

  Journal of Endocrinological Investigation · 2019-07-27 · 29 citations

  reviewOpen access1st author
  PublisherOA PDFDOI

• Evaluation and Treatment of Hirsutism in Premenopausal Women

  JAMA · 2018-03-09 · 32 citations

  articleOpen access1st authorCorresponding

  Hirsutism is defined as excessive terminal (coarse) hair growth in male androgen-dependent areas and is distinguished from hypertrichosis (generalized nonsexual excessive hair growth). Hirsutism affects 5% to 10% of women worldwide and can lead to significant emotional distress and expense 1,2 involving medications, cosmetics, and hair removal procedures. Hirsutism is a clinical diagnosis based on the Ferriman-Gallwey (FG) score, which rates hair growth from 0 to 4 in 9 androgen-dependent areas. In the US general population, a normal score is less than 8; mild, 8-15; and severe, greater than 15. 1 Polycystic ovary syndrome, associated with abnormally increased androgen levels, accounts for 75% to 80% of hirsutism. 1 Another 5% to 20% of cases are due to idiopathic hirsutism, which is diagnosed in the absence of increased androgen levels. Importantly, the current guideline recognizes and recommends treating patient-important hirsutism, defined as hair growth that causes distress in the absence of an abnormal hirsutism score. 1,

  PublisherOA PDFDOI

• Homozygous Mutation in Human Serum Albumin and Its Implication on Thyroid Tests

  Thyroid · 2018-04-20 · 6 citations

  articleOpen access1st author

  An individual with familial dysalbuminemic hyperthyroxinemia (FDH) due to a homozygous mutation (c.653G>A, p.R218H) in the human serum albumin (HSA) gene is reported. The patient was identified during evaluation of abnormal thyroid tests in a large family with multiple levels of consanguinity. He showed a greater increase in total thyroxine (T4) relative to that observed in heterozygous family members. The higher affinity of mutant HSA for T4, together with the large molar excess of HSA relative to thyroid hormones in serum, results in preferential association of T4 with the mutant rather than wild-type HSA in heterozygous individuals. The twofold greater amount of T4 bound to the mutant HSA in the homozygote, relative to heterozygotes, is an adaptive requirement to maintain a normal free T4 concentration.

  PublisherOA PDFDOI

• A Novel Homozygous Selenocysteine Insertion Sequence Binding Protein 2 (SECISBP2, SBP2) Gene Mutation in a Turkish Boy

  Thyroid · 2018-06-08 · 23 citations

  article

  SECISBP2 is an essential factor in selenoprotein synthesis, and its mutations result in a multiorgan syndrome, including abnormal thyroid hormone metabolism. A 10-year-old obese Turkish boy born to consanguineous parents presented with high thyroxine, low triiodothyronine, high reverse triiodothyronine, and normal or slightly elevated thyrotropin. He also had attention-deficit disorder and muscle weakness but no delay in growth or bone age. Sequencing of genomic DNA revealed a novel c.800_801insA, p.K267Kfs*2 mutation, homozygous in the proband and heterozygous in both parents and his brother. Studies showed reduction in several selenoproteins in serum and fibroblasts.

  PublisherDOI

Frequent coauthors

• Kenro Kusumi

  Arizona State University

  10 shared

• Danielle A. D'Annibale

  University of California San Diego Medical Center

  9 shared

• Heather Patton

  9 shared

• Raphaêl Lis

  University of California San Diego Medical Center

  9 shared

• Jan L. Christian

  University of Utah

  7 shared

• Sally L. Dunwoodie

  Victor Chang Cardiac Research Institute

  6 shared

• Robert M. Sargis

  University of Illinois Chicago

  5 shared

• Joshua D. Gibson

  4 shared

Education

• Ph.D., Molecular and Computational Biology

  University of California, San Diego

  2007

• M.S., Molecular and Computational Biology

  University of California, San Diego

  2003

• B.S., Molecular and Computational Biology

  University of California, San Diego

  2001