Alka Kanaya, MD

Human Metabolism Core Director
M_MED-CORE-DGIM
Research Area
Clinical Research
Epi & Intervention

I have focused my clinical research in understanding the heterogeneity of cardiometabolic disease and what factors are associated with the greatest risk of developing type 2 diabetes and cardiovascular disease. I have developed a three-pronged research program that is unified under this theme. The first arm includes the creation of a South Asian longitudinal cohort to study multilevel risk factors in a very high risk ethnic group. The second arm uses existing data from prospective cohort studies to test biomarkers that predict diabetes and cardiovascular disease. The final arm tests behavioral interventions to prevent the onset of diabetes.
The first arm of my research program has been to establish a community-based prospective cohort of South Asian adults. South Asians have a high prevalence of diabetes and cardiovascular disease. In 2006, with a K23 grant from the NHLBI, we recruited 150 Asian Indians in a pilot cohort study called MASALA (Metabolic syndrome and Atherosclerosis in South Asians Living in America) which was modelled on the Multi-Ethnic Study of Atherosclerosis (MESA). We found that compared to the four ethnic groups in MESA, Indians had higher diabetes and atherosclerosis prevalence, despite having favorable lifestyle behaviors. This unique phenotype--with modest BMI levels but high levels of adiposity and diabetes--provided an ideal population to understand adiposity biomarkers and body composition. With these preliminary data, I received R01 funding in 2010 to expand and prospectively follow a South Asian cohort to 900 individuals at two clinical sites to better chart the natural history of atherosclerosis, also called MASALA (Mediators of Atherosclerosis in South Asians Living in America). We completed the baseline study visit for this large cohort in 2013 and received an R01 renewal to conduct our second clinical examination of the MASALA cohort in 2015. With philanthropic support, we expanded the cohort from 906 to 1,164 South Asian participants who are being followed prospectively for cardiovascular disease events. In 2021, we received another NHLBI R01 to conduct Exam 3 in our surviving MASALA cohort, focusing on cardiovascular function. Our team was also awarded an R01 from NIMHD in 2021 to expand our cohort by enrolling 1,164 Bangladeshi and Pakistani individuals to have greater diversity of South Asians and enough statistical power to determine whether and why there are differences in risk factors among the three largest South Asian American subgroups. This cohort has received national and global attention since it is one of a handful of cohorts studying this high risk population group and MASALA has deeper phenotyping than any other South Asian cohort allowing for opportunities to study many related outcomes.
The second arm of my research program focuses on understanding novel biomarkers that may be responsible for the metabolic sequelae associated with obesity. I have assayed novel biomarkers (adiponectin, F2-isoprostanes, and fluorescent oxidative products) from biospecimens in a longitudinal cohort, 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 adiponectin and PAI-1 explain this association. We have found strong associations, with these adipokines predicting risk of future diabetes, cardiovascular disease, and mortality. Over the past decade, I have been mentoring two investigators, Drs. Meghana Gadgil and Elena Flowers, in developing their research program on developing metabolomic and microRNA biomarkers that are associated with type 2 diabetes risk. These biomarkers improve our etiologic understanding of the links between obesity and diabetes and may soon be useful clinically in improving our risk stratification for diabetes.
The third arm of my research agenda includes testing behavioral interventions to prevent and/or delay the onset of type 2 diabetes in high risk individuals. We completed a translational randomized controlled trial testing the effectiveness of a lifestyle intervention provided by the Berkeley Public Health Department to decrease diabetes risk factors in low-income ethnic minority groups (ref #64, 75). We found that a phone-based lifestyle intervention was effective in promoting weight loss, lowering triglycerides and improving diet. I also led a randomized controlled trial of restorative yoga vs. stretching in overweight and less active adults with the metabolic syndrome (PRYSMS study). We randomized 180 individuals at two clinical centers and found that restorative yoga significantly improved fasting glucose levels compared to stretching. These behavioral interventions will offer clinicians and patients helpful alternatives in reducing their risk for diabetes.
The three arms of my research agenda complement each other and provide fertile ground to develop and test new hypotheses with the ultimate goal of better caring for patients at high risk of diabetes and cardiovascular disease.

Publications

Design of MOSAAIC (Multi-Ethnic Observational Study in American Asian and Pacific Islander Communities).

JACC. Asia

Ahn J, Ahsan H, Anderson GL, Aschebrook-Kilfoy B, Beery D, Carrick W, Celedón JC, Chan KCG, Chen Y, Ðoàn LN, Fang CY, Floyd JS, Hayes RB, Henderson V, Hong Y, Hsing AW, Hsu L, Hu FB, Jin JL, John EM, Kanaya AM, Kaplan RC, Kibriya MG, Kim K, Kushida C, Lampe JW, Li S, Lu Y, Ma GX, Mau MKLM, Maunakea AK, Mendoza JA, Neuhouser ML, Newman JD, Odden MC, Palaniappan L, Park SL, Randal F, Rhew IC, Santos S, Soliman EZ, Thyagarajan B, Hsin-Chun Tsai J, VoPham T, Wang P, Wion E, Yan Y, Yi SS, Zhu L, MOSAAIC Investigators

Demographic and Clinical Factors Associated With SARS-CoV-2 Anti-Nucleocapsid Antibody Response Among Previously Infected US Adults: The C4R Study.

Open forum infectious diseases

Demmer RT, Wu C, Kim JS, Sun Y, Balte P, Cushman M, Boyle R, Tracy RP, Styer LM, Bell TD, Anderson MR, Allen NB, Schreiner PJ, Bowler R, Schwartz DA, Lee JS, Xanthakis V, Rock JM, Bievenue R, Pirzada A, Doyle M, Regan EA, Make BJ, Kanaya AM, Kandula NR, Wenzel SE, Coresh J, Isasi CR, Raffield LM, Elkind MSV, Howard VJ, Ortega VE, Woodruff P, Cole SA, Henderson JM, Mantis NJ, Oelsner EC

Classifying COVID-19 hospitalizations in epidemiology cohort studies: The C4R study.

PloS one

Oelsner EC, Krishnaswamy A, Rustamov R, Balte PP, Ali T, Allen NB, Andrews HF, Anugu P, Arynchyn A, Bateman LA, Cai J, Chang H, Chen L, Elkind MSV, Floyd JS, Gabriel KP, Gharib SA, Gutierrez JD, Stukovsky KH, Howard VJ, Isasi CR, Jager L, Jin L, Judd SE, Kanaya AM, Kandula NR, Kelly MR, Khan SS, Kucharska-Newton A, Lee JS, Levitan EB, Lewis CE, Make BJ, Malloy K, Manly JJ, Mauger D, Min YI, Murabito JM, Murphy CG, Norwood AF, O'Connor GT, Ortega VE, Patel AA, Pirzada A, Regan EA, Ring KB, Rosamond WD, Schwartz DA, Shikany JM, Sotres-Alvarez D, Tarlton C, Tse J, Meneses EMU, Vankineni M, Wenzel SE, Woodruff PG, Xanthakis V, Yang JH, Zakai NA, Zhang Y, Post WS

Epidemiologic Features of Recovery From SARS-CoV-2 Infection.

JAMA network open

Oelsner EC, Sun Y, Balte PP, Allen NB, Andrews H, Carson A, Cole SA, Coresh J, Couper D, Cushman M, Daviglus M, Demmer RT, Elkind MSV, Gallo LC, Gutierrez JD, Howard VJ, Isasi CR, Judd SE, Kanaya AM, Kandula NR, Kaplan RC, Kinney GL, Kucharska-Newton AM, Lackland DT, Lee JS, Make BJ, Min YI, Murabito JM, Norwood AF, Ortega VE, Pettee Gabriel K, Psaty BM, Regan EA, Sotres-Alvarez D, Schwartz D, Shikany JM, Thyagarajan B, Tracy RP, Umans JG, Vasan RS, Wenzel SE, Woodruff PG, Xanthakis V, Zhang Y, Post WS

Demographic and Clinical Factors Associated With SARS-CoV-2 Spike 1 Antibody Response Among Vaccinated US Adults: the C4R Study.

Nature communications

Kim JS, Sun Y, Balte P, Cushman M, Boyle R, Tracy RP, Styer LM, Bell TD, Anderson MR, Allen NB, Schreiner PJ, Bowler RP, Schwartz DA, Lee JS, Xanthakis V, Doyle MF, Regan EA, Make BJ, Kanaya AM, Wenzel SE, Coresh J, Isasi CR, Raffield LM, Elkind MSV, Howard VJ, Ortega VE, Woodruff P, Cole SA, Henderson JM, Mantis NJ, Parker MM, Demmer RT, Oelsner EC

Reflecting on a Year at the Helm of Diabetes Care.

Diabetes care

Kahn SE, Anderson CAM, Buse JB, Selvin E, Angell SY, Aroda VR, Cheng AYY, Danne T, Echouffo-Tcheugui JB, Fitzpatrick SL, Gadgil MD, Gastaldelli A, Gloyn AL, Green JB, Jastreboff AM, Kanaya AM, Kandula NR, Kovesdy CP, Laiteerapong N, Nadeau KJ, Pettus J, Pop-Busui R, Posey JE, Powe CE, Rebholz CM, Rickels MR, Sattar N, Shaw JE, Sims EK, Utzschneider KM, Vella A, Zhang C

"The Times They Are A-Changin'" at Diabetes Care.

Diabetes care

Kahn SE, Anderson CAM, Buse JB, Selvin E, Angell SY, Aroda VR, Castle JR, Cheng AYY, Danne T, Echouffo-Tcheugui JB, Florez JC, Gadgil MD, Gastaldelli A, Green JB, Jastreboff AM, Kanaya AM, Kandula NR, Kovesdy CP, Laiteerapong N, Nadeau KJ, Pop-Busui R, Powe CE, Rebholz CM, Rickels MR, Sattar N, Shaw JE, Sims EK, Utzschneider KM, Vella A, Zhang C

Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study: Study Design.

American journal of epidemiology

Oelsner EC, Krishnaswamy A, Balte PP, Allen NB, Ali T, Anugu P, Andrews H, Arora K, Asaro A, Barr RG, Bertoni AG, Bon J, Boyle R, Chang AA, Chen G, Coady S, Cole SA, Coresh J, Cornell E, Correa A, Couper D, Cushman M, Demmer RT, Elkind MSV, Folsom AR, Fretts AM, Gabriel KP, Gallo L, Gutierrez J, Han MLK, Henderson JM, Howard VJ, Isasi CR, Jacobs DR, Judd SE, Mukaz DK, Kanaya AM, Kandula NR, Kaplan R, Kinney GL, Kucharska-Newton A, Lee JS, Lewis CE, Levine DA, Levitan EB, Levy B, Make B, Malloy K, Manly JJ, Mendoza-Puccini C, Meyer KA, Min YI, Moll M, Moore WC, Mauger D, Ortega VE, Palta P, Parker MM, Phipatanakul W, Post WS, Postow L, Psaty BM, Regan EA, Ring K, Roger VL, Rotter JI, Rundek T, Sacco RL, Schembri M, Schwartz DA, Seshadri S, Shikany JM, Sims M, Hinckley Stukovsky KD, Talavera GA, Tracy RP, Umans JG, Vasan RS, Watson K, Wenzel SE, Winters K, Woodruff PG, Xanthakis V, Zhang Y, Zhang Y, C R Investigators FT

Knowledge Gaps, Challenges, and Opportunities in Health and Prevention Research for Asian Americans, Native Hawaiians, and Pacific Islanders: A Report From the 2021 National Institutes of Health Workshop.

Annals of internal medicine

Kanaya AM, Hsing AW, Panapasa SV, Kandula NR, G Araneta MR, Shimbo D, Wang P, Gomez SL, Lee J, Narayan KMV, Mala Mau MKL, Bose S, Daviglus ML, Hu FB, Islam N, Jackson CL, Kataoka-Yahiro M, Kauwe JSK, Liu S, Ma GX, Nguyen T, Palaniappan L, Setiawan VW, Trinh-Shevrin C, Tsoh JY, Vaidya D, Vickrey B, Wang TJ, Wong ND, Coady S, Hong Y

Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study: Study Design.

medRxiv : the preprint server for health sciences

Oelsner EC, Allen NB, Ali T, Anugu P, Andrews H, Asaro A, Balte PP, Barr RG, Bertoni AG, Bon J, Boyle R, Chang AA, Chen G, Cole SA, Coresh J, Cornell E, Correa A, Couper D, Cushman M, Demmer RT, Elkind MSV, Folsom AR, Fretts AM, Gabriel KP, Gallo L, Gutierrez J, Han MK, Henderson JM, Howard VJ, Isasi CR, Jacobs DR, Judd SE, Mukaz DK, Kanaya AM, Kandula NR, Kaplan R, Krishnaswamy A, Kinney GL, Kucharska-Newton A, Lee JS, Lewis CE, Levine DA, Levitan EB, Levy B, Make B, Malloy K, Manly JJ, Meyer KA, Min YI, Moll M, Moore WC, Mauger D, Ortega VE, Palta P, Parker MM, Phipatanakul W, Post W, Psaty BM, Regan EA, Ring K, Roger VL, Rotter JI, Rundek T, Sacco RL, Schembri M, Schwartz DA, Seshadri S, Shikany JM, Sims M, Hinckley Stukovsky KD, Talavera GA, Tracy RP, Umans JG, Vasan RS, Watson K, Wenzel SE, Winters K, Woodruff PG, Xanthakis V, Zhang Y, Zhang Y, C4R Investigators

The Upcoming Epidemic of Heart Failure in South Asia.

Circulation. Heart failure

Martinez-Amezcua P, Haque W, Khera R, Kanaya AM, Sattar N, Lam CSP, Harikrishnan S, Shah SJ, Kandula NR, Jose PO, Narayan KMV, Agyemang C, Misra A, Jenum AK, Bilal U, Nasir K, Cainzos-Achirica M

Novel loci for adiponectin levels and their influence on type 2 diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals.

PLoS genetics

Dastani Z, Hivert MF, Timpson N, Perry JR, Yuan X, Scott RA, Henneman P, Heid IM, Kizer JR, Lyytikäinen LP, Fuchsberger C, Tanaka T, Morris AP, Small K, Isaacs A, Beekman M, Coassin S, Lohman K, Qi L, Kanoni S, Pankow JS, Uh HW, Wu Y, Bidulescu A, Rasmussen-Torvik LJ, Greenwood CM, Ladouceur M, Grimsby J, Manning AK, Liu CT, Kooner J, Mooser VE, Vollenweider P, Kapur KA, Chambers J, Wareham NJ, Langenberg C, Frants R, Willems-Vandijk K, Oostra BA, Willems SM, Lamina C, Winkler TW, Psaty BM, Tracy RP, Brody J, Chen I, Viikari J, Kähönen M, Pramstaller PP, Evans DM, St Pourcain B, Sattar N, Wood AR, Bandinelli S, Carlson OD, Egan JM, Böhringer S, van Heemst D, Kedenko L, Kristiansson K, Nuotio ML, Loo BM, Harris T, Garcia M, Kanaya A, Haun M, Klopp N, Wichmann HE, Deloukas P, Katsareli E, Couper DJ, Duncan BB, Kloppenburg M, Adair LS, Borja JB, DIAGRAM+ Consortium, MAGIC Consortium, GLGC Investigators, MuTHER Consortium, Wilson JG, Musani S, Guo X, Johnson T, Semple R, Teslovich TM, Allison MA, Redline S, Buxbaum SG, Mohlke KL, Meulenbelt I, Ballantyne CM, Dedoussis GV, Hu FB, Liu Y, Paulweber B, Spector TD, Slagboom PE, Ferrucci L, Jula A, Perola M, Raitakari O, Florez JC, Salomaa V, Eriksson JG, Frayling TM, Hicks AA, Lehtimäki T, Smith GD, Siscovick DS, Kronenberg F, van Duijn C, Loos RJ, Waterworth DM, Meigs JB, Dupuis J, Richards JB, Voight BF, Scott LJ, Steinthorsdottir V, Dina C, Welch RP, Zeggini E, Huth C, Aulchenko YS, Thorleifsson G, McCulloch LJ, Ferreira T, Grallert H, Amin N, Wu G, Willer CJ, Raychaudhuri S, McCarroll SA, Hofmann OM, Segrè AV, van Hoek M, Navarro P, Ardlie K, Balkau B, Benediktsson R, Bennett AJ, Blagieva R, Boerwinkle E, Bonnycastle LL, Boström KB, Bravenboer B, Bumpstead S, Burtt NP, Charpentier G, Chines PS, Cornelis M, Crawford G, Doney AS, Elliott KS, Elliott AL, Erdos MR, Fox CS, Franklin CS, Ganser M, Gieger C, Grarup N, Green T, Griffin S, Groves CJ, Guiducci C, Hadjadj S, Hassanali N, Herder C, Isomaa B, Jackson AU, Johnson PR, Jørgensen T, Kao WH, Kong A, Kraft P, Kuusisto J, Lauritzen T, Li M, Lieverse A, Lindgren CM, Lyssenko V, Marre M, Meitinger T, Midthjell K, Morken MA, Narisu N, Nilsson P, Owen KR, Payne F, Petersen AK, Platou C, Proença C, Prokopenko I, Rathmann W, Rayner NW, Robertson NR, Rocheleau G, Roden M, Sampson MJ, Saxena R, Shields BM, Shrader P, Sigurdsson G, Sparsø T, Strassburger K, Stringham HM, Sun Q, Swift AJ, Thorand B, Tichet J, Tuomi T, van Dam RM, van Haeften TW, van Herpt T, van Vliet-Ostaptchouk JV, Walters GB, Weedon MN, Wijmenga C, Witteman J, Bergman RN, Cauchi S, Collins FS, Gloyn AL, Gyllensten U, Hansen T, Hide WA, Hitman GA, Hofman A, Hunter DJ, Hveem K, Laakso M, Morris AD, Palmer CN, Rudan I, Sijbrands E, Stein LD, Tuomilehto J, Uitterlinden A, Walker M, Watanabe RM, Abecasis GR, Boehm BO, Campbell H, Daly MJ, Hattersley AT, Pedersen O, Barroso I, Groop L, Sladek R, Thorsteinsdottir U, Wilson JF, Illig T, Froguel P, van Duijn CM, Stefansson K, Altshuler D, Boehnke M, McCarthy MI, Soranzo N, Wheeler E, Glazer NL, Bouatia-Naji N, Mägi R, Randall J, Elliott P, Rybin D, Dehghan A, Hottenga JJ, Song K, Goel A, Lajunen T, Doney A, Cavalcanti-Proença C, Kumari M, Timpson NJ, Zabena C, Ingelsson E, An P, O'Connell J, Luan J, Elliott A, McCarroll SA, Roccasecca RM, Pattou F, Sethupathy P, Ariyurek Y, Barter P, Beilby JP, Ben-Shlomo Y, Bergmann S, Bochud M, Bonnefond A, Borch-Johnsen K, Böttcher Y, Brunner E, Bumpstead SJ, Chen YD, Chines P, Clarke R, Coin LJ, Cooper MN, Crisponi L, Day IN, de Geus EJ, Delplanque J, Fedson AC, Fischer-Rosinsky A, Forouhi NG, Franzosi MG, Galan P, Goodarzi MO, Graessler J, Grundy S, Gwilliam R, Hallmans G, Hammond N, Han X, Hartikainen AL, Hayward C, Heath SC, Hercberg S, Hillman DR, Hingorani AD, Hui J, Hung J, Kaakinen M, Kaprio J, Kesaniemi YA, Kivimaki M, Knight B, Koskinen S, Kovacs P, Kyvik KO, Lathrop GM, Lawlor DA, Le Bacquer O, Lecoeur C, Li Y, Mahley R, Mangino M, Martínez-Larrad MT, McAteer JB, McPherson R, et al

The effects of adiponectin and leptin on changes in bone mineral density.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

Barbour KE, Zmuda JM, Boudreau R, Strotmeyer ES, Horwitz MJ, Evans RW, Kanaya AM, Harris TB, Cauley JA, Health ABC Study

Adipokines and the risk of fracture in older adults.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

Barbour KE, Zmuda JM, Boudreau R, Strotmeyer ES, Horwitz MJ, Evans RW, Kanaya AM, Harris TB, Bauer DC, Cauley JA

Insulin-like growth factor-1.

Journal of the American Geriatrics Society

Colbert LH, Rosen CJ, Goodpaster BH, Newman AB, Kritchevsky SB, Satterfield S, Kanaya AM, Taaffe DR, Harris TB