UCSF DIABETES, ENDOCRINOLOGY & METABOLISM TRAINING PROGRAM FACULTY RESEARCH SUMMARIES

Translational Research in Obesity and Type 2 Diabetes

My research is focused in the fields of type 2 diabetes and obesity, specifically in understanding their complex interrelationship and whether certain biomarkers and characteristics of overweight people can predict those at greatest risk of developing diabetes.  I began this research during my fellowship by exploring the role of overall body fat (measured by body mass index) and regional body fat (measured by waist circumference) and incident cardiovascular disease and mortality among postmenopausal women. I collaborated with colleagues who were investigators in the Heart and Estrogen/Progestin Replacement Study to perform this secondary data analysis. We found that waist circumference was a stronger determinant of future cardiovascular mortality than BMI, but that diabetes mediated this risk.

Since this time, I focused my efforts on understanding novel biomarkers secreted from adipose tissue that may be responsible for the metabolic sequelae associated with obesity. I have assayed adiponectin from frozen serum specimens from a longitudinal cohort coordinated by UCSF, the Health, Aging and Body Composition Study. I performed a series of analyses finding that abdominal visceral adiposity, when directly measured by CT scan, is significantly associated with type 2 diabetes and that adiponectin and other cytokines and peptides (collectively termed as adipocytokines) produced by adipose tissue explain this association. We have also found strong relationships with visceral adiposity and risk of developing diabetes and cardiovascular disease over 5 years of follow-up with some of these biomarkers playing important mediating roles. 

Selected References

Kanaya AM, Herrington D, Vittinghoff E, Lin F, Grady D, Bittner V, Cauley J, Barrett-Connor E. Glycemic effects of hormone therapy: the Heart and Estrogen/progestin Replacement Study. Annals of Int Med 2003; 138:1-9.

Kanaya AM, Vittinghoff E, Shlipak M, Resnick HE, Visser M, Grady D, Barrett-Connor E. Association of total and central obesity with mortality in postmenopausal women. Am J Epidemiol 2003; 158(12):1161-1170.

Kanaya AM, Harris T, Goodpaster B, Tylavsky F, Cummings S. Adipocytokines attenuate the association between visceral adiposity and diabetes. Diabetes Care 2004; 27(6): 1375-1380.

Kanaya AM, Herrington D, Vittinghoff E, Lin F, Bittner V, Cauley JA, Hulley S, Barrett-Connor E. Impaired fasting glucose and cardiovascular outcomes in postmenopausal women. Annals Int Med 2005; 142:813-820.

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