Ectopic fat and atherosclerosis in South Asians

描述（由申请人提供）：Alka Kanaya博士是加州旧金山弗朗西斯科医学、流行病学和生物统计学系的副教授。在内科和流行病学的培训，在过去的十年里，她已经指导了几个人在不同的水平，在他们的培训和开发一个蓬勃发展的计划 多学科合作研究的重点是糖尿病和心血管疾病的流行病学和预防。Kanaya博士正处于她职业生涯的理想阶段，可以获得K24资助。从这个奖项的支持将使她能够利用她的研究计划，以发展新的面向患者的研究人员的职业生涯。她目前由NHLBI资助进行一项名为MASALA研究的南亚人前瞻性队列研究，该研究以现有的动脉粥样硬化多种族研究（梅萨）为模型，以了解这个高风险种族群体中糖尿病和心血管疾病的前因。在K24的支持下，Kanaya博士将通过在MASALA研究队列中增加异位脂肪和脂肪因子的测量来扩展研究计划，并与梅萨的其他四个美国种族群体进行比较。本K24提案的总体目标是：（1）测量MASALA研究中900名南亚人的异位脂肪库和脂肪因子，并在调整年龄和整体体型后描述和比较南亚人和四个梅萨种族群体之间的异位脂肪库和脂肪因子。(2)检验以下假设：较高的异位脂肪将与葡萄糖耐量恶化相关;脂肪因子将解释异位脂肪库与葡萄糖耐量状态之间的相关性;以及与梅萨种族组相比，南亚人糖尿病患病率增加将由异位脂肪库和脂肪因子解释。(3)检验以下假设：异位脂肪含量越高，亚临床动脉粥样硬化越严重;脂肪因子可以解释异位脂肪库与亚临床动脉粥样硬化之间的关系;以及异位脂肪库和脂肪因子可以解释南亚人与梅萨种族之间亚临床动脉粥样硬化患病率的差异。(4)确定在调整传统心血管危险因素后，异位脂肪的基线水平是否与南亚人的心血管事件独立相关;以及南亚人和梅萨种族群体之间的CVD结局差异是否可以通过异位脂肪库和脂肪因子水平来解释。 K24将确保有足够的时间来追求Kanaya博士的研究的自然进展，同时保护时间来指导未来的临床研究人员进行以患者为导向的研究。发展、研究和指导计划旨在相互补充，并在以患者为导向的研究中创造指导和研究的协同效应。拟议的指导，研究和职业发展活动积极利用NIH提供的现有基础设施，资源和培训计划，包括Kanaya博士的积极研究计划和UCSF的临床和转化科学研究所（CTSI）。

DESCRIPTION (provided by applicant): 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.