Ectopic Fat and Atherosclerosis in South Asians

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Investigator: Alka M. Kanaya, MD
Sponsor: NIH National Heart, Lung, and Blood Institute

Location(s): United States

Description

Dr. Kanaya is conducting 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. 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 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 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.

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.