Dr. Alka Kanaya is an Associate Professor in the Departments of Medicine, Epidemiology and Biostatistics at the University of California San Francisco. Trained in Internal Medicine and Epidemiology, over the past decade she has mentored several individuals at different levels in their training and developed a thriving program of multidisciplinary collaborative research focused on diabetes and cardiovascular disease epidemiology and prevention. Dr. Kanaya is at an ideal stage of her career for a K24 grant. Support from this award would allow her to leverage her research program to develop the careers of new patient-oriented researchers. She is currently funded by the NHLBI to conduct a prospective cohort study of South Asians called the MASALA study which is modeled on the existing Multi-Ethnic Study of Atherosclerosis (MESA) to understand the antecedents of diabetes and cardiovascular disease in this high risk ethnic group. With the support of the K24, Dr. Kanaya will extend the research program by adding measurements of ectopic fat and adipokines to the MASALA study cohort and make comparisons to four other U.S. ethnic groups in MESA. The Overall Aims of this K24 proposal are: (1) To measure ectopic fat depots and adipokines among 900 South Asians in the MASALA study and to describe and compare ectopic fat depots and adipokines between the South Asians and the four MESA ethnic groups after adjusting for age and overall body size. (2) To test the hypothesis that higher ectopic fat will be associated with worsened glucose tolerance;that adipokines will explain the association between the ectopic fat depots and glucose tolerance status;and that the increased prevalence of diabetes among the South Asians compared to the MESA ethnic groups will be explained by the ectopic fat depot and adipokines. (3) To test the hypothesis that higher amounts of ectopic fat will be associated with greater subclinical atherosclerosis;that adipokines will explain the association between the ectopic fat depots and subclinical atherosclerosis;and that the difference in subclinical atherosclerosis prevalence among the South Asians compared to the MESA ethnic groups can be explained by the ectopic fat depot and adipokines. (4) To determine whether baseline levels of ectopic fat are independently associated with incident cardiovascular events among South Asians after adjusting for traditional cardiovascular risk factors;and whether differences in CVD outcomes between South Asians and the MESA ethnic groups can be explained by the ectopic fat depot and adipokine levels. The K24 would insure sufficient time to pursue this natural progression of Dr. Kanaya's research while protecting time to devote to mentoring future clinical investigators in patient-oriented research. The plans for development, research, and mentoring were designed to complement each other and to create a synergistic effect of mentoring and research in patient-oriented research. The proposed mentoring, research, and career development activities actively leverage existing infrastructure, resources, and training initiatives provided by NIH, including Dr. Kanaya's active research program and the Clinical and Translational Science Institute (CTSI) at UCSF.

Public Health Relevance

South Asian (Indian, Pakistani, Bangladeshi, Nepali, and Sri Lankan) individuals have high rates of diabetes cardiovascular disease that are not explained by traditional risk factors. We are currently establishing a longitudinal study of South Asians to identify risk factors linked to diabetes, subclinical atherosclerosis and incident cardiovascular disease. The short term goal of this project are to add novel measures of ectopic fat and fat-derived hormones to this cohort study of South Asians and to compare the prevalence of these fat stores to four other ethnic groups in the United States, and determine if they explain the observed high rates of disease. The long-term goal is to create interventions to lessen disease risk once we establish the key risk factors in this high risk ethnic group. This project will be used as a vehicle to train and mentor new clinical investigators on performing patient-oriented research.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
1K24HL112827-01A1
Application #
8441395
Study Section
Special Emphasis Panel (ZHL1-CSR-X (O1))
Program Officer
Aviles-Santa, Larissa
Project Start
2013-08-01
Project End
2018-05-31
Budget Start
2013-08-01
Budget End
2014-05-31
Support Year
1
Fiscal Year
2013
Total Cost
$116,504
Indirect Cost
$7,877
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Jin, Yichen; DiPietro, Loretta; Kandula, Namratha R et al. (2018) Associations Between Television Viewing and Adiposity Among South Asians. J Racial Ethn Health Disparities 5:1059-1062
Kanaya, Alka M (2018) India's Call to Action-Prioritize Chronic Cardiovascular Disease. JAMA Intern Med 178:373-374
Mehta, Anurag; Patel, Jaideep; Al Rifai, Mahmoud et al. (2018) Inflammation and coronary artery calcification in South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Atherosclerosis 270:49-56
Kandula, Namratha R; Cooper, Andrew J; Schneider, John A et al. (2018) Personal social networks and organizational affiliation of South Asians in the United States. BMC Public Health 18:218
Deol, Rupinder; Lee, Kathryn A; Kandula, Namratha R et al. (2018) Risk of Obstructive Sleep Apnoea is Associated with Glycaemia Status in South Asian Men and Women in the United States. Obes Med 9:1-6
Al Rifai, Mahmoud; Cainzos-Achirica, Miguel; Kanaya, Alka M et al. (2018) Discordance between 10-year cardiovascular risk estimates using the ACC/AHA 2013 estimator and coronary artery calcium in individuals from 5 racial/ethnic groups: Comparing MASALA and MESA. Atherosclerosis 279:122-129
Bhupathiraju, Shilpa N; Guasch-Ferré, Marta; Gadgil, Meghana D et al. (2018) Dietary Patterns among Asian Indians Living in the United States Have Distinct Metabolomic Profiles That Are Associated with Cardiometabolic Risk. J Nutr 148:1150-1159
Chiang, Janet M; Stanczyk, Frank Z; Kanaya, Alka M (2018) Vitamin D Levels, Body Composition, and Metabolic Factors in Asian Indians: Results from the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Pilot Study. Ann Nutr Metab 72:223-230
Needham, Belinda L; Mukherjee, Bhramar; Bagchi, Pramita et al. (2018) Acculturation Strategies and Symptoms of Depression: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health 20:792-798
Mongraw-Chaffin, Morgana; Gujral, Unjali P; Kanaya, Alka M et al. (2018) Relation of Ectopic Fat with Atherosclerotic Cardiovascular Disease Risk Score in South Asians Living in the United States (from the Mediators of Atherosclerosis in South Asians Living in America [MASALA] Study). Am J Cardiol 121:315-321

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