Metabolic Syndrome and Atherosclerosis in South Asians

描述(由申请人提供)： Alka Kanaya是加州大学旧金山分校普通内科医学助理教授。她的长期职业目标是建立一个以人群为基础的前瞻性南亚成年人队列，以研究导致这一研究不足的人群发病率高得不同的临床心血管疾病的前驱因素。在Stephen Hulley博士和Morris SChambelan博士的指导下，Kanaya博士提出了一个全面的多学科职业发展计划，包括遗传流行病学和高级统计课程，在葡萄糖和脂肪代谢和基因研究领域的两个独立的临床研究学徒，以及实际的队列管理经验。这项名为《居住在美洲的南亚人的代谢综合征和动脉粥样硬化》(Masala)的研究计划是对南亚人社区样本的横断面研究，目的是确定胰岛素抵抗、代谢综合征、身体脂肪分布、脂肪细胞因子、脂肪减少和血栓形成因素是否与亚临床动脉粥样硬化独立相关。这项研究以国家心肺血液研究所正在进行的一项研究(动脉粥样硬化的多种族研究)为基础，采用相同的抽样方法、资格标准、实验室分析和动脉粥样硬化测量，以实现跨多种族的有效比较。这项研究将招募150名年龄在55岁至84岁之间、没有心血管疾病的南亚人。符合条件的参与者将参加综合临床研究中心6小时的访问，接受空腹血液测试、频繁采样的静脉葡萄糖耐量测试、问卷调查、人体测量、血压、全身地塞米松、颈动脉超声以及心脏和腹部CT扫描。本研究的目的是：(1)确定人群中胰岛素抵抗(IR)、代谢综合征和动脉粥样硬化的患病率。 (2)检验内脏脂肪和脂肪细胞因子与胰岛素抵抗相关，以及胰岛素抵抗、脂肪亚组分和血栓形成标志物与动脉粥样硬化独立于传统心脏危险因素与动脉粥样硬化相关的假说；(3)检验南亚人与参加MESA的其他种族相比有更高的代谢特征和动脉粥样硬化患病率的假设，以及胰岛素抵抗和代谢因素解释南亚人动脉粥样硬化患病率增加的假设。(摘要结束)

DESCRIPTION (provided by applicant): Alka Kanaya is Assistant Professor of Medicine at the University of California, San Francisco, in the Division of General Internal Medicine. Her long-term career goal is to develop a prospective population-based cohort of South Asian adults to examine the antecedants of clinical cardiovascular disease responsible for the disparately high rates of disease in this understudied population. Under the mentorship of Drs. Stephen Hulley and Morris Schambelan, Dr. Kanaya proposes a comprehensive multidisciplinary career development plan composed of genetic epidemiology and advanced statistical coursework, two separate clinical research apprenticeships in the fields of glucose and lipid metabolism and genetic studies, and practical cohort management experience. The research plan, titled the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA), is a cross-sectional study of a community-based sample of South Asians to determine whether insulin resistance, the metabolic syndrome, body fat distribution, adipocytokines, lipid subtractions, and thrombosis factors are independently associated with subclinical atherosclerosis. This study is modeled on an ongoing National Heart Lung and Blood Institute study (the Multi-Ethnic Study of Atherosclerosis) with identical sampling methods, eligibility criteria, lab assays and atherosclerosis measures to allow for efficient comparisons across multiple ethnic groups. The study will recruit 150 South Asians between the ages of 55 and 84 without cardiovascular disease. Eligible participants will attend a General Clinical Research Center for a 6-hour visit to undergo fasting blood tests, frequently sampled intravenous glucose tolerance test, questionnaire, body anthropometry, blood pressure, whole body DEXA, carotid ultrasound, and cardiac and abdominal CT scan. Objectives of this study are to: (1) determine the prevalence of insulin resistance (IR), the metabolic syndrome, and atherosclerosis among South Asians; (2) test the hypotheses that visceral adiposity and adipocytokines are associated with IR, and that IR, lipid subfractions, and a thrombosis marker are associated with atherosclerosis independent of traditional cardiac risk factors; and (3) test the hypotheses that South Asians have higher prevalence of metabolic features and atherosclerosis compared with other ethnic groups enrolled in MESA, and that IR and metabolic factors explain the increased prevalence of atherosclerosis in South Asians. (End of Abstract)