Metabolic Syndrome and Atherosclerosis in South Asians

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

Location(s): United States


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.