Lily C. Chao, MD

Clinical Associate Professor of Pediatrics (Clinician Educator)

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My research interest centers on mechanisms that regulate muscle metabolism and growth. As the largest organ in the human body, skeletal muscle plays an indispensible function in glucose utilization and metabolism. In addition to its metabolic function, coordinated contractility of skeletal muscle powers body movement and exercise performance.

The nuclear receptor Nur77 (also known as NR4A1) integrates glucose metabolism in multiple tissues. We previously demonstrated that in skeletal muscle, Nur77 directs the transcription of a number of genes linked to glucose utilization. More recently, we identified Nur77 as a regulator of muscle mass and myofiber size in mice. These findings have led us to examine the crosstalk between muscle metabolism and growth. To address this question, we have active research projects investigation the function of Nur77 expression in muscle development, regeneration, and diabetic myopathy. Findings from these studies will broaden our fundamental knowledge of the signaling pathways that integrate metabolism and muscle mass, and may have translational applications in conditions such as diabetes, muscular dystrophy, cancer, cachexia, as well as other forms of muscle wasting.


  • Endocrine Society: Early Investigator Award, 2014
  • Pediatric Endocrine Society: Clinical Research Scholar, 2013
  • Pasadena Magazine’s Top Doctors, 2011-2014
  • Society of Pediatric Research: Fellow’s Basic Research Award, 2007
  • Howard Hughes Medical Institute-National Institutes of Health: Research Scholar, 1999


  • Qualitative Study Guiding the Design of a Person-Centered Shared Medical Appointment Model to Optimize Diabetes Care Delivery Sci Diabetes Self Manag Care. 2024 Jun 21; 26350106241258999. . View in PubMed
  • Decline in case rates of youth onset type 2 diabetes in year three of the COVID-19 pandemic J Pediatr Endocrinol Metab. 2024 Apr 25; 37(4):360-362. . View in PubMed
  • Glucagon-like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes in Youth touchREV Endocrinol. 2023 May; 19(1):38-45. . View in PubMed
  • Continuous Glucose Monitoring versus Standard of Care in Adolescents With Type 2 Diabetes: A Pilot Randomized Cross-Over Trial J Diabetes Sci Technol. 2023 09; 17(5):1419-1420. . View in PubMed
  • Youth-onset type 2 diabetes mellitus: an urgent challenge Nat Rev Nephrol. 2023 03; 19(3):168-184. . View in PubMed
  • Risk Factors for Hyperosmolar Hyperglycemic State in Pediatric Type 2 Diabetes Pediatr Diabetes. 2023; 2023. . View in PubMed
  • Association Between COVID-19 and Severity of Illness for Children With Hyperglycemic Crisis Hosp Pediatr. 2023 09 01; 13(9):794-801. . View in PubMed
  • The Coronavirus Disease 2019 Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 DiabetesJ Pediatr. 2022 12; 251:51-59. e2. . View in PubMed
  • Diabetes Distress in Young Adults With Youth-Onset Type 2 Diabetes: TODAY2 Study Results Diabetes Care. 2022 03 01; 45(3):529-537. . View in PubMed
  • Once-Weekly Dulaglutide for the Treatment of Youths with Type 2 Diabetes N Engl J Med. 2022 08 04; 387(5):433-443. . View in PubMed
  • ErratumSpike in Diabetic Ketoacidosis Rates in Pediatric Type 2 Diabetes During the COVID-19 Pandemic. Diabetes Care 2021;44:1451-1453. Diabetes Care. 2021 Dec; 44(12):2812. . View in PubMed
  • SARS-CoV2 infects pancreatic beta cells in vivo and induces cellular and subcellular disruptions that reflect beta cell dysfunction Res Sq. 2021 Jul 20. . View in PubMed
  • Spike in Diabetic Ketoacidosis Rates in Pediatric Type 2 Diabetes During the COVID-19 Pandemic Diabetes Care. 2021 06; 44(6):1451-1453. . View in PubMed
  • Impact of COVID-19 on Youth With Type 2 Diabetes: Lessons Learned From a Pediatric Endocrinologist and a Psychologist Front Endocrinol (Lausanne). 2021; 12:650492. . View in PubMed
  • Glycemic control in youth-onset type 2 diabetes correlates with weight loss Pediatr Diabetes. 2020 11; 21(7):1116-1125. . View in PubMed
  • Meeting Report: 2018 Annual Meeting of the Endocrine Society, Chicago IL (March 17-20, 2018), Selected Highlights Pediatr Endocrinol Rev. 2018 Sep; 16(1):209-215. . View in PubMed
  • Nur77 deletion impairs muscle growth during developmental myogenesis and muscle regeneration in mice PLoS One. 2017; 12(2):e0171268. . View in PubMed
  • The orphan nuclear receptor Nur77 is a determinant of myofiber size and muscle mass in mice Mol Cell Biol. 2015 Apr; 35(7):1125-38. . View in PubMed
  • Nkx61 regulates islet ß-cell proliferation via Nr4a1 and Nr4a3 nuclear receptors. Proc Natl Acad Sci U S A. 2014 Apr 08; 111(14):5242-7. . View in PubMed
  • Progesterone receptor in the vascular endothelium triggers physiological uterine permeability preimplantation Cell. 2014 Jan 30; 156(3):549-62. . View in PubMed
  • The macrophage LBP gene is an LXR target that promotes macrophage survival and atherosclerosis J Lipid Res. 2014 06; 55(6):1120-30. . View in PubMed
  • Reciprocal regulation of hepatic and adipose lipogenesis by liver X receptors in obesity and insulin resistance Cell Metab. 2013 Jul 02; 18(1):106-17. . View in PubMed
  • Bone marrow NR4A expression is not a dominant factor in the development of atherosclerosis or macrophage polarization in mice J Lipid Res. 2013 Mar; 54(3):806-815. . View in PubMed
  • Skeletal muscle Nur77 expression enhances oxidative metabolism and substrate utilization J Lipid Res. 2012 Dec; 53(12):2610-9. . View in PubMed
  • SIRT1 regulation-it ain’t all NAD Mol Cell. 2012 Jan 13; 45(1):9-11. . View in PubMed
  • TLE3 is a dual-function transcriptional coregulator of adipogenesis Cell Metab. 2011 Apr 06; 13(4):413-427. . View in PubMed
  • Insulin resistance and altered systemic glucose metabolism in mice lacking Nur77 Diabetes. 2009 Dec; 58(12):2788-96. . View in PubMed
  • Preserved glucose tolerance in high-fat-fed C57BL/6 mice transplanted with PPARgamma-/-, PPARdelta-/-, PPARgammadelta-/-, or LXRalphabeta-/- bone marrow J Lipid Res. 2009 Feb; 50(2):214-24. . View in PubMed
  • Inhibition of adipocyte differentiation by Nur77, Nurr1, and Nor1 Mol Endocrinol. 2008 Dec; 22(12):2596-608. . View in PubMed
  • Nur77 coordinately regulates expression of genes linked to glucose metabolism in skeletal muscle Mol Endocrinol. 2007 Sep; 21(9):2152-63. . View in PubMed
  • Meeting report: the 35th Annual Meeting of the Lawson Wilkins Pediatric Endocrine Society (LWPES) Toronto May 4-6, 2007 Pediatr Endocrinol Rev. 2007 Sep; 5(1):516-25. . View in PubMed
  • Liver X receptors are regulators of adipocyte gene expression but not differentiation: identification of apoD as a direct target J Lipid Res. 2004 Apr; 45(4):616-25. . View in PubMed
  • Differential effects of rosiglitazone on skeletal muscle and liver insulin resistance in A-ZIP/F-1 fatless mice Diabetes. 2003 Jun; 52(6):1311-8. . View in PubMed
  • Activation of liver X receptor improves glucose tolerance through coordinate regulation of glucose metabolism in liver and adipose tissue Proc Natl Acad Sci U S A. 2003 Apr 29; 100(9):5419-24. . View in PubMed
  • Adipose tissue is required for the antidiabetic, but not for the hypolipidemic, effect of thiazolidinediones J Clin Invest. 2000 Nov; 106(10):1221-8. . View in PubMed
  • Suppression of food intake and growth by amino acids in Drosophila: the role of pumpless, a fat body expressed gene with homology to vertebrate glycine cleavage system Development. 1999 Dec; 126(23):5275-84. . View in PubMed
  • Assembly of the cleavage and polyadenylation apparatus requires about 10 seconds in vivo and is faster for strong than for weak poly(A) sites Mol Cell Biol. 1999 Aug; 19(8):5588-600. . View in PubMed
  • Poly(A)-driven and poly(A)-assisted termination: two different modes of poly(A)-dependent transcription termination Mol Cell Biol. 1998 Jan; 18(1):276-89. . View in PubMed