NURSING RESEARCHER JOYCE KING INTEGRATES THE BASIC AND CLINICAL SCIENCES

Assistant Professor of Nursing Joyce King has spent a 20-year career integrating deep, lifelong interests into her work.

"I've always been fascinated by physiology, since my first undergraduate course," says King. "And I've been interested in women's health since I first taught prenatal classes as a student project." King's professional life has evolved to combine these two areas of focus. Today, she teaches graduate-level physiology and pathophysiology classes at Emory while pursuing basic scientific research into fat-cell metabolism, teaching gynecology to nurse-midwifery students and conducting a busy midwifery practice with Emory Women's Care.

It is rare that such a complicated career path is fully mapped out in advance, yet one can usually discern patterns in hindsight. Not long after obtaining her BSN in 1973 from Southern Adventist University in Tennessee, King entered Vanderbilt's pioneering family nurse practitioner (FNP) program, earning an MSN there in 1976. Her subsequent experience as an FNP opened her eyes to the role women play in health care. Not only were the majority of her clients women, she observed, but those women were almost always the gatekeepers of the health care of their husbands and children.

After coming to Emory in 1983 to teach and to coordinate the OB-Gyn nurse practitioner program, King sought out the necessary course work to become a certified nurse midwife (CNM). "By that point I had come to the realization that, for me, being a nurse midwife was the ultimate for a nurse who is focused on women's health care," she says. Her move from an FNP role to a CNM role was made easier by the mentoring of several Emory nurse midwifery faculty, especially, she says, Dr. Elizabeth Sharp. It was also Sharp who counseled her along another fork in her career path, when she decided to pursue a PhD in physiology at Emory.

Hard-Core Science

King studies in Emory's Department of Physiology, where her doctoral studies were guided by noted endocrinologist Mario DiGirolamo, MD-a mentor who now collaborates with King on research and publications.

King's current research is looking at the hormonal and other physiologic changes that take place in adipose tissue during pregnancy. In particular, she is interested in commonalities that might exist between obesity-related insulin resistance and the insulin-resistant state that occurs during pregnancy. Her goal is to discover a trigger during pregnancy that results in the mother's stored glucose being diverted to her fetus.

"If such a mechanism exists," she says, "and can be identified, it could possibly lead to treatments for gestational diabetes."

King points out that much of her work so far has been prompted by and based on observational research of fat cell metabolism-and that the NIH and other major funding arms will require a more mechanistic approach (i.e., what is going on inside the cell with regard to DNA, mRNA, etc.) before they are willing to commit substantial amounts of money.

"The Faculty Scientist Award has freed me over the past year to shore up the basic science element of my research," she says, "and it has given me time to work on grant proposals as well."

This past January, King published an article in Obesity Research that examined how fat cells from different parts of the body respond to insulin. Studying lean versus obese male rats, she noted that fat cells from mesenteric adipose tissue of obese rats produce significantly more lactate than fat cells elsewhere, and that these specific fat cells tend to be insulin resistant. Later this year, using funds from her Faculty Scientist Award, King will begin a pilot study of fat-cell physiology in pregnant rats.

The award also enabled King, this past summer, to immerse herself in an intensive study of cell and molecular biology at the prestigious Woods Hole (Massachusetts) Marine Biological Laboratory.

This advanced training-she was one of only 36 researchers selected worldwide, and the only nurse-equips her to study intercellular mechanisms and gives her the kind of hard-core scientific tools she needs to attract additional grant support.