Alka Kanaya, MD
Alka Kanaya, M.D., is an Associate Professor of Medicine in the Division of General Internal Medicine at the University of California, San Francisco (UCSF). She trained in clinical epidemiology during her 2 year General Internal Medicine fellowship at UCSF. She completed her internship and residency training in Primary Care, Internal Medicine at UCSF in 1998, and served as Chief Medical Resident at Moffitt-Long Hospital from 1998-1999. She earned her M.D. degree from the University of California, San Francisco in 1995 and a Bachelor of Science degree in Biochemistry from the University of California, Davis in 1990.
Dr. Kanaya began her research career in type 2 diabetes by conducting a meta-analysis of observational studies to examine whether there was a difference in cardiovascular outcomes between men and women with diabetes. She found that when you controlled for age, hypertension, hypercholesterolemia, and smoking, the relative risk of cardiovascular outcomes was similarly elevated for both sexes. She has analyzed data from a large trial of postmenopausal women (the Heart and Estrogen/progestin Replacement Study) to examine the effect of hormone therapy on future diabetes and found that women randomized to hormones had a significantly reduced risk of incident diabetes. More recently, she studied the relationship of overall and abdominal obesity on cardiovascular outcomes. She found that a measure of central obesity (waist-hip ratio (WHR)) was significantly associated with both diabetes and coronary heart disease, more so than overall body fat (body-mass index). This finding introduced her to the field of abdominal adiposity and adipose tissue biology.
Dr. Kanaya has focused her clinical research in the field of type 2 diabetes and obesity and has developed a three-pronged research program. The first arm consists of using existing cohort studies to test novel biomarkers that predict diabetes and cardiovascular disease. The second arm is to create a South Asian cohort to study these risk factors in a very high risk group. The final arm is to test behavioral interventions to prevent the onset of diabetes.
The first arm of her research program focuses on understanding novel biomarkers secreted from adipose tissue that may be responsible for the metabolic sequelae associated with obesity. She assayed adiponectin, a fat-derived hormone or adipocytokine, from over 3,000 frozen serum specimens from a longitudinal cohort and performed a series of analyses finding that abdominal adiposity when directly measured by CT scan was significantly associated with type 2 diabetes and that proteins produced by adipose tissue, explain this association. She has found strong links between visceral adiposity and adipocytokines predicting risk of diabetes, cardiovascular disease, and mortality.
The second arm of her research program has been to establish a population-based cohort of South Asian adults with the MASALA study. Compared to the four ethnic groups in MESA (Whites, African Americans, Latinos, and Chinese Americans), South Asians had higher diabetes prevalence and subclinical atherosclerosis despite having favorable lifestyle risk factors. She will be testing whether fat-derived hormones have a greater impact in South Asians and explain the higher prevalence of diabetes and atherosclerosis compared to the other ethnic groups. She will be expanding this cohort to follow prospectively to determine the impact of novel biomarkers.
The third arm includes testing behavioral interventions to prevent diabetes in high risk individuals. Dr. Kanaya is conducting 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. She has also completed a pilot randomized controlled trial to test the feasibility and effectiveness of Restorative yoga in overweight adults with the metabolic syndrome. She found that Restorative yoga was feasible with trends toward improvements in waist circumference and blood pressure in the yoga group compared to the control group.
The three arms of her research agenda 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.
Dr. Kanaya is a general internist at UCSF, and sees patients in General Medicine Clinic at Mount Zion (1545 Divisadero Street, Suite 100). She cares for a panel of 300 patients with a broad range of medical problems. As a part of her teaching responsibilities, Dr. Kanaya instructs residents and students in care of their patients at the Mount Zion General Medicine Clinic, and leads a research seminar for fellows.