Todd Cade
Principal Investigator
Professor of Orthopaedic Surgery
Member of Duke Molecular Physiology Institute
Contact Information


The overall goal of our laboratory is to study innovative and precision rehabilitation strategies to enhance cardiometabolic health. Through our studies, we aim to determine how to exercise mode, frequency, intensity, and concomitant therapies (nutritional/pharmacologic/gene therapy) modulate physiologic and molecular mediators of cardiometabolic function, primarily focusing on a substrate (e.g., amino acid, glucose, fatty acid) metabolism, energetic, and functional abnormalities in skeletal muscle and heart. We study metabolic diseases, including Barth syndrome and other pediatric and adult cardiomyopathies, HIV-related metabolic syndrome, diabetes mellitus, and obesity. We are also interested in the effect of precision exercise during pregnancy on maternal and offspring health in women with obesity and diabetes. Our lab employs methodology used to measure whole-body substrate metabolism by stable isotope tracers and mass spectrometry, molecular mediators by metabolomics and extracellular vesicle analyses, heart and skeletal muscle energetics by magnetic resonance spectroscopy (MRS), exercise tolerance assessment by graded exercise testing and indirect calorimetry, cardiac function by echocardiography, vascular function by peripheral arterial tonometry and vascular ultrasound, body composition analysis by dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography, muscle strength by isokinetic dynamometry, and daily physical activity by actigraphy.



  • Exercise Testing (VO2)
  • Isokinetic dynamometry (strength)
  • Indirect calorimetry
  • Body Composition (DXA/BodPod)
  • Glucose tolerance (OGTT)
  • Stable isotope tracers
  • Cardiac/SM energetics (MRS)
  • Muscle/fat biopsies
  • Cardiac fx (echo)
  • Vascular fx (small and large vessel)
  • Cardiac metabolism (PET)


Current Members

Research Coordinator/Exercise Physiologist
DPT Student


Selected Publications

  • Schweitzer GG, Ditzenberger GL, Hughey CC, Finck BN, Martino MR, Pacak CA, Byrne BB, Cade WT. Elevated Liver Glycogenolysis Mediates Higher Blood Glucose During Acute Exercise in Barth Syndrome. PLoS One 2023 Aug 31;18(8):e0290832.
  • Cade WT, Mittendorfer B, Patterson BW, Haire-Joshu D, Cahill AG, Stein RI, Schechtman KB, Tinius RA, Brown K, Klein S. Effect of excessive gestational weight gain on insulin sensitivity and insulin kinetics in women with overweight/obesity. Obesity (Silver Spring) 2022 Oct;30(10):2014-2022. PMID: 36150208 PMCID: PMC9512396
  • Bohnert KL, Ditzenberger G, Bittel AJ, de Las Fuentes L, Corti M, Pacak CA, Taylor C, Byrne BJ, Reeds DN, Cade WT. Resistance exercise training with protein supplementation improves skeletal muscle strength and quality of life in late adolescents and young adults with Barth syndrome: A pilot study. JIMD Rep. 2021 Aug 9;62(1):74-84. 
  • Cade WT, Bohnert KL, Peterson LR, Patterson BW, Bittel AJ, Okunade AL, de Las Fuentes L, Steger-May K, Bashir A, Schweitzer GG, Chacko SK, Wanders RJ, Pacak CA, Byrne BJ, & Reeds DN. Blunted Fat Oxidation upon Submaximal Exercise is Partially Compensated by Enhanced Glucose Metabolism in Children, Adolescents, and Young Adults with Barth Syndrome. J Inherit Metab Dis. 2019 May;42(3):480-493. PMID: 30924938 PMCID: PMC6483838
  • Cade WT, Bohnert KL, Reeds DN Bittel AJ, de las Fuentes L, Bashir A, Pacak CA, Byrne BJ, Gropler RJ, Peterson LR. Altered myocardial glucose and fatty acid metabolism are associated with lower cardiac function in young adults with Barth syndrome. J Nucl Cardiol, 2019 Nov 8. doi: 10.1007/s12350-019-01933-3
  • Cade WT, Bohnert KL, Reeds DN, Peterson LR, Bittel AJ, Bashir A, Byrne BJ, & Taylor CL. Peak oxygen uptake (VO2peak) across childhood, adolescence, and young adulthood in Barth syndrome: data from cross-sectional and longitudinal studies. PLoS One. 2018 May 24: 13(5): e0197776.
  • Bittel AJ, Bohnert KL, Reeds DN, Peterson LR, Corti M, Taylor C, Byrne BJ, & Cade WT. Reduced muscle strength in Barth Syndrome may be improved by resistance exercise training; a pilot study. JIMD Rep. 2018;41:63-72.
  • Bashir A, Bohnert KL, Reeds DN, Peterson LR, Bittel AJ, de las Fuentes L, Pacak CA, Byrne BJ, & Cade WT. Impaired cardiac and skeletal muscle bioenergetics in children, adolescents, and young adults with Barth Syndrome. Physiol Rep. 2017 Feb;5(3). PMID: 28196853; PMCID: 5309577.
  • Cade WT, Tinius RA, Reeds DN, Patterson BW, & Cahill AG. Maternal glucose, fatty acid kinetics,
    and infant birth weight in obese women with type 2 diabetes. Diabetes. 2016 2016 Apr;65(4):893-901. PMID: 26861786

  • Spencer CT, Byrne BJ, Bryant RM, Margossian R, Maisenbacher M, Breitenger P, Benni PB, Redfearn S, Marcus E, & CadeWT. Impaired Cardiac Reserve and Severely Diminished Skeletal Muscle Oxygen Utilization Mediate Exercise Intolerance in Barth Syndrome: Am J Physiol Heart Circ Physiol, 2011 Nov;301(5): H2122-9. PMID: 21873497

Research Opportunities

If you are interested in joining the PRIME team, contact

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