Faculty ProfilesAlka Kanaya, MD
San Francisco, CA 94115
I have focused my clinical research in the field of type 2 diabetes and obesity and have developed a three-pronged research program that is unified under this theme. 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 my research program focuses on understanding novel biomarkers secreted from adipose tissue that may be responsible for the metabolic sequelae associated with obesity. I assayed adiponectin from over 3,000 frozen serum specimens from a longitudinal cohort and have performed a series of analyses finding that abdominal visceral adiposity when directly measured by CT scan is significantly associated with type 2 diabetes and adipocytokines, proteins produced by adipose tissue, explain this association. We have found strong links between visceral adiposity and adipocytokines predicting risk of diabetes, cardiovascular disease, and mortality.
The second arm of my research program has been to establish a population-based cohort of South Asian adults. South Asians have very high prevalence of diabetes and cardiovascular disease and have been poorly studied. With a K23 grant from the NHLBI, I recruited 150 South Asians in a pilot cohort study which was modelled on the existing Multi-Ethnic Study of Atherosclerosis (MESA). In this project, called the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA study), we have examined the relationship between metabolic factors and atherosclerosis measured by carotid ultrasound and coronary artery calcium. We found that compared to the four ethnic groups in MESA (Whites, African Americans, Latinos, and Chinese Americans), South Asians had higher diabetes prevalence despite having favorable lifestyle risk factors. I received additional funding to study endothelial function in this cohort through the American Heart Association and we finished our second clinical examination visits in January 2010. I have been awarded a new R01 grant to expand and prospectively follow this South Asian cohort at two clinical sites to chart the natural history of diabetes and atherosclerosis and test novel risk factors. I have submitted another R01 grant to create a new multi-dimensional tool to measure cultural beliefs and adaptations among South Asian Americans. This project will involve both qualitative and quantitative methods and will help us understand cultural risk factors for cardiovascular disease in this high risk ethnic group.
The third arm includes testing behavioral interventions to prevent diabetes in high risk individuals. We have conducted 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. I have also completed a pilot randomized controlled trial to test the feasibility of Restorative yoga in overweight adults with the metabolic syndrome. We 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. I have been awarded an R01 grant to test this intervention vs. a stretching control group in a multicenter randomized controlled trial called PRYSMS which is currently underway.
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.
Education and Training
|Location||Degree or Training||Specialty||Date|
|University of California, San Francisco||M.D.||School of Medicine||1995|
|University of California, San Francisco||Residency||School of Medicine|
Related Web Sites
In the News
- MASALA Study Examines South Asian Heart Disease Risks (Apr 06, 2016)
- WSJ - Broader Understanding of Heart Disease Risk (Jan 25, 2016)
- NYT - The Heart Disease Conundrum (Nov 28, 2015)
- Pacific Islanders, South Asians and Filipinos Have Higher Rates of Diabetes Than All Other Ethnic Groups (Oct 15, 2012)
- Inexpensive Approach to Preventing Type 2 Diabetes Shows Promise in UCSF Study (Jun 15, 2012)
Recent Articles (152)
Nadimpalli S, Keita A, Wang J, Kanaya A, Kandula N, Gans KM, Talegawkar S. Are Experiences of Discrimination Related to Poorer Dietary Intakes Among South Asians in the MASALA Study? J Nutr Educ Behav. 2017 Sep 14.
Forman DE, Santanasto AJ, Boudreau R, Harris T, Kanaya AM, Satterfield S, Simonsick EM, Butler J, Kizer JR, Newman AB. Impact of Incident Heart Failure on Body Composition Over Time in the Health, Aging, and Body Composition Study Population. Circ Heart Fail. 2017 Sep; 10(9).
Patel J, Al Rifai M, Cainzos-Achirica M, Kandula NR, Kanaya AM, Khera A, Blumenthal RS, Nasir K, Blaha MJ, Joshi PH. Family History of CHD Is Associated With Severe CAC in South Asians: Comparing the MASALA and MESA Studies. JACC Cardiovasc Imaging. 2017 Aug; 10(8):958-960.
Needham BL, Mukherjee B, Bagchi P, Kim C, Mukherjea A, Kandula NR, Kanaya AM. Acculturation Strategies and Symptoms of Depression: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health. 2017 Jul 26.
Kandula N, Ahmed M, Dodani S, Gupta L, Hore P, Kanaya A, Khowaja A, Mathur A, Mehta D, Misra R, Paracha M, Bharmal N, Aghhi M, Leng J, Gany F. Cardiovascular Disease & Cancer Risk Among South Asians: Impact of Sociocultural Influences on Lifestyle and Behavior. J Immigr Minor Health. 2017 May 10.
Gujral UP, Vittinghoff E, Mongraw-Chaffin M, Vaidya D, Kandula NR, Allison M, Carr J, Liu K, Narayan KMV, Kanaya AM. Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups in the United States: A Cross-sectional Analysis of Two Cohort Studies. Ann Intern Med. 2017 May 02; 166(9):628-636.
Shea MK, Booth SL, Weiner DE, Brinkley TE, Kanaya AM, Murphy RA, Simonsick EM, Wassel CL, Vermeer C, Kritchevsky SB. Circulating Vitamin K Is Inversely Associated with Incident Cardiovascular Disease Risk among Those Treated for Hypertension in the Health, Aging, and Body Composition Study (Health ABC). J Nutr. 2017 May; 147(5):888-895.
Anand S, Kondal D, Montez-Rath M, Zheng Y, Shivashankar R, Singh K, Gupta P, Gupta R, Ajay VS, Mohan V, Pradeepa R, Tandon N, Ali MK, Narayan KM, Chertow GM, Kandula N, Prabhakaran D, Kanaya AM. Prevalence of chronic kidney disease and risk factors for its progression: A cross-sectional comparison of Indians living in Indian versus U.S. cities. PLoS One. 2017; 12(3):e0173554.
Talegawkar SA, Jin Y, Kandula NR, Kanaya AM. Cardiovascular health metrics among South Asian adults in the United States: Prevalence and associations with subclinical atherosclerosis. Prev Med. 2017 Mar; 96:79-84.
Shah BM, Shah S, Kandula NR, Gadgil MD, Kanaya AM. Psychosocial Factors Associated with Subclinical Atherosclerosis in South Asians: The MASALA Study. J Immigr Minor Health. 2016 Dec; 18(6):1317-1327.
Garg SK, Lin F, Kandula N, Ding J, Carr J, Allison M, Liu K, Herrington D, Vaidya D, Vittinghoff E, Kanaya AM. Ectopic Fat Depots and Coronary Artery Calcium in South Asians Compared With Other Racial/Ethnic Groups. J Am Heart Assoc. 2016 Nov 17; 5(11).
Klein OL, Aviles-Santa L, Cai J, Collard HR, Kanaya AM, Kaplan RC, Kinney GL, Mendes E, Smith L, Talavera G, Wu D, Daviglus M. Hispanics/Latinos With Type 2 Diabetes Have Functional and Symptomatic Pulmonary Impairment Mirroring Kidney Microangiopathy: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care. 2016 Nov; 39(11):2051-2057.
Bharmal NH, McCarthy WJ, Gadgil MD, Kandula NR, Kanaya AM. The Association of Religious Affiliation with Overweight/Obesity Among South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Relig Health. 2016 Jul 26.
Nadimpalli SB, Kanaya AM, McDade TW, Kandula NR. Self-reported discrimination and mental health among Asian Indians: Cultural beliefs and coping style as moderators. Asian Am J Psychol. 2016 Sep; 7(3):185-194.
Kandula NR, Puri-Taneja A, Victorson DE, Dave SS, Kanaya AM, Huffman MD. Mediators of Atherosclerosis in South Asians Living in America: Use of Web-Based Methods for Follow-Up and Collection of Patient-Reported Outcome Measures. JMIR Res Protoc. 2016 Jun 08; 5(2):e95.
Pankow JS, Decker PA, Berardi C, Hanson NQ, Sale M, Tang W, Kanaya AM, Larson NB, Tsai MY, Wassel CL, Bielinski SJ. Circulating cellular adhesion molecules and risk of diabetes: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabet Med. 2016 Jul; 33(7):985-91.
Larsen BA, Wassel CL, Kritchevsky SB, Strotmeyer ES, Criqui MH, Kanaya AM, Fried LF, Schwartz AV, Harris TB, Ix JH. Association of Muscle Mass, Area, and Strength With Incident Diabetes in Older Adults: The Health ABC Study. J Clin Endocrinol Metab. 2016 Apr; 101(4):1847-55.
Sharma S, Batsis JA, Coutinho T, Somers VK, Hodge DO, Carter RE, Sochor O, Kragelund C, Kanaya AM, Zeller M, Park JS, Køber L, Torp-Pedersen C, Lopez-Jimenez F. Normal-Weight Central Obesity and Mortality Risk in Older Adults With Coronary Artery Disease. Mayo Clin Proc. 2016 Mar; 91(3):343-51.
Shah AD, Kandula NR, Lin F, Allison MA, Carr J, Herrington D, Liu K, Kanaya AM. Less favorable body composition and adipokines in South Asians compared with other US ethnic groups: results from the MASALA and MESA studies. Int J Obes (Lond). 2016 Apr; 40(4):639-45.
Kim C, Kong S, Krauss RM, Stanczyk FZ, Reddy ST, Needham BL, Kanaya AM. Endogenous Sex Steroid Hormones, Lipid Subfractions, and Ectopic Adiposity in Asian Indians. Metab Syndr Relat Disord. 2015 Dec; 13(10):445-52.
Reinders I, Murphy RA, Martin KR, Brouwer IA, Visser M, White DK, Newman AB, Houston DK, Kanaya AM, Nagin DS, Harris TB. Body Mass Index Trajectories in Relation to Change in Lean Mass and Physical Function: The Health, Aging and Body Composition Study. J Am Geriatr Soc. 2015 Aug; 63(8):1615-21.
Gujral UP, Narayan KM, Pradeepa RG, Deepa M, Ali MK, Anjana RM, Kandula NR, Mohan V, Kanaya AM. Comparing Type 2 Diabetes, Prediabetes, and Their Associated Risk Factors in Asian Indians in India and in the U.S.: The CARRS and MASALA Studies. Diabetes Care. 2015 Jul; 38(7):1312-8.
Araneta MR, Kanaya AM, Hsu WC, Chang HK, Grandinetti A, Boyko EJ, Hayashi T, Kahn SE, Leonetti DL, McNeely MJ, Onishi Y, Sato KK, Fujimoto WY. Optimum BMI cut points to screen asian americans for type 2 diabetes. Diabetes Care. 2015 May; 38(5):814-20.
Needham BL, Kim C, Mukherjee B, Bagchi P, Stanczyk FZ, Kanaya AM. Endogenous sex steroid hormones and glucose in a South-Asian population without diabetes: the Metabolic Syndrome and Atherosclerosis in South-Asians Living in America pilot study. Diabet Med. 2015 Sep; 32(9):1193-200.
Shah AD, Schmidt H, Sen S, Shlipak MG, Kanaya AM. The association between body composition and cystatin C in South Asians: results from the MASALA study. Obes Res Clin Pract. 2015 Mar-Apr; 9(2):180-3.
Phelan S, Kanaya AM, Ma Y, Vittinghoff E, Barrett-Connor E, Wing R, Kusek JW, Orchard TJ, Crandall JP, Montez MG, Brown JS. Long-term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study. Int J Urol. 2015 Feb; 22(2):206-12.
Shah AD, Vittinghoff E, Kandula NR, Srivastava S, Kanaya AM. Correlates of prediabetes and type II diabetes in US South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Ann Epidemiol. 2015 Feb; 25(2):77-83.
Kandula NR, Kanaya AM, Liu K, Lee JY, Herrington D, Hulley SB, Persell SD, Lloyd-Jones DM, Huffman MD. Association of 10-year and lifetime predicted cardiovascular disease risk with subclinical atherosclerosis in South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. J Am Heart Assoc. 2014 Oct 02; 3(5):e001117.
Kositsawat J, Kuchel GA, Tooze JA, Houston DK, Cauley JA, Kritchevsky SB, Strotmeyer ES, Kanaya AM, Harris TB, Johnson KC, Barry LC. Vitamin D insufficiency and abnormal hemoglobin a1c in black and white older persons. J Gerontol A Biol Sci Med Sci. 2015 Apr; 70(4):525-31.
Corey SM, Epel E, Schembri M, Pawlowsky SB, Cole RJ, Araneta MR, Barrett-Connor E, Kanaya AM. Effect of restorative yoga vs. stretching on diurnal cortisol dynamics and psychosocial outcomes in individuals with the metabolic syndrome: the PRYSMS randomized controlled trial. Psychoneuroendocrinology. 2014 Nov; 49:260-71.
Jih J, Mukherjea A, Vittinghoff E, Nguyen TT, Tsoh JY, Fukuoka Y, Bender MS, Tseng W, Kanaya AM. Using appropriate body mass index cut points for overweight and obesity among Asian Americans. Prev Med. 2014 Aug; 65:1-6.
Kanaya AM, Herrington D, Vittinghoff E, Ewing SK, Liu K, Blaha MJ, Dave SS, Qureshi F, Kandula NR. Understanding the high prevalence of diabetes in U.S. south Asians compared with four racial/ethnic groups: the MASALA and MESA studies. Diabetes Care. 2014 Jun; 37(6):1621-8.
Kanaya AM, Kandula NR, Ewing SK, Herrington D, Liu K, Blaha MJ, Srivastava S, Dave SS, Budoff MJ. Comparing coronary artery calcium among U.S. South Asians with four racial/ethnic groups: the MASALA and MESA studies. Atherosclerosis. 2014 May; 234(1):102-7.
Khan H, Kalogeropoulos AP, Zannad F, Marti CN, Wilson PW, Georgiopoulou VV, Kanaya AM, Newman AB, Schelbert E, Harris TB, Kritchevsky S, Yancy C, Gheorghiade M, Fonarow GC, Butler J. Incident heart failure in relation to vascular disease: insights from the Health, Aging, and Body Composition Study. Eur J Heart Fail. 2014 May; 16(5):526-34.
Klein OL, Okwuosa T, Chan C, Schreiner P, Kanaya AM, Liu K, Green D. Changes in procoagulants track longitudinally with insulin resistance: findings from the coronary artery risk development in young adults (CARDIA) study. Diabet Med. 2014 Apr; 31(4):462-5.
Kanaya AM, Araneta MR, Pawlowsky SB, Barrett-Connor E, Grady D, Vittinghoff E, Schembri M, Chang A, Carrion-Petersen ML, Coggins T, Tanori D, Armas JM, Cole RJ. Restorative yoga and metabolic risk factors: the Practicing Restorative Yoga vs. Stretching for the Metabolic Syndrome (PRYSMS) randomized trial. J Diabetes Complications. 2014 May-Jun; 28(3):406-12.
Gadgil MD, Anderson CA, Kandula NR, Kanaya AM. Dietary patterns in Asian Indians in the United States: an analysis of the metabolic syndrome and atherosclerosis in South Asians Living in America study. J Acad Nutr Diet. 2014 Feb; 114(2):238-43.
Lipska KJ, Inzucchi SE, Van Ness PH, Gill TM, Kanaya A, Strotmeyer ES, Koster A, Johnson KC, Goodpaster BH, Harris T, De Rekeneire N. Elevated HbA1c and fasting plasma glucose in predicting diabetes incidence among older adults: are two better than one? Diabetes Care. 2013 Dec; 36(12):3923-9.
Gujral UP, Narayan KM, Kahn SE, Kanaya AM. The relative associations of ß-cell function and insulin sensitivity with glycemic status and incident glycemic progression in migrant Asian Indians in the United States: the MASALA study. J Diabetes Complications. 2014 Jan-Feb; 28(1):45-50.
Mukherjea A, Underwood KC, Stewart AL, Ivey SL, Kanaya AM. Asian Indian views on diet and health in the United States: importance of understanding cultural and social factors to address disparities. Fam Community Health. 2013 Oct-Dec; 36(4):311-23.
Doyle TA, de Groot M, Harris T, Schwartz F, Strotmeyer ES, Johnson KC, Kanaya A. Diabetes, depressive symptoms, and inflammation in older adults: results from the Health, Aging, and Body Composition Study. J Psychosom Res. 2013 Nov; 75(5):419-24.
Milaneschi Y, Cesari M, Simonsick EM, Vogelzangs N, Kanaya AM, Yaffe K, Patrignani P, Metti A, Kritchevsky SB, Pahor M, Ferrucci L, Penninx BW. Lipid peroxidation and depressed mood in community-dwelling older men and women. PLoS One. 2013; 8(6):e65406.
Kanaya AM, Dobrosielski DA, Ganz P, Creasman J, Gupta R, Nelacanti V, Vogel-Claussen J, Herrington D. Glycemic associations with endothelial function and biomarkers among 5 ethnic groups: the Multi-Ethnic Study of Atherosclerosis and the Mediators of Atherosclerosis in South Asians Living in America studies. J Am Heart Assoc. 2013 Feb 06; 2(1):e004283.
Coutinho T, Goel K, Corrêa de Sá D, Carter RE, Hodge DO, Kragelund C, Kanaya AM, Zeller M, Park JS, Kober L, Torp-Pedersen C, Cottin Y, Lorgis L, Lee SH, Kim YJ, Thomas R, Roger VL, Somers VK, Lopez-Jimenez F. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of "normal weight central obesity". J Am Coll Cardiol. 2013 Feb 05; 61(5):553-60.
Casillas A, Leng M, Liu K, Hernandez A, Shrager S, Kanaya A. A long way from home: comparing mental health measures between foreign and U.S.-born Latinos in the Multi-Ethnic Study of Atherosclerosis (MESA). J Health Care Poor Underserved. 2012 Nov; 23(4):1719-32.
Karter AJ, Schillinger D, Adams AS, Moffet HH, Liu J, Adler NE, Kanaya AM. Elevated rates of diabetes in Pacific Islanders and Asian subgroups: The Diabetes Study of Northern California (DISTANCE). Diabetes Care. 2013 Mar; 36(3):574-9.
Qi Q, Menzaghi C, Smith S, Liang L, de Rekeneire N, Garcia ME, Lohman KK, Miljkovic I, Strotmeyer ES, Cummings SR, Kanaya AM, Tylavsky FA, Satterfield S, Ding J, Rimm EB, Trischitta V, Hu FB, Liu Y, Qi L. Genome-wide association analysis identifies TYW3/CRYZ and NDST4 loci associated with circulating resistin levels. Hum Mol Genet. 2012 Nov 01; 21(21):4774-80.
Kanaya AM, Santoyo-Olsson J, Gregorich S, Grossman M, Moore T, Stewart AL. The Live Well, Be Well study: a community-based, translational lifestyle program to lower diabetes risk factors in ethnic minority and lower-socioeconomic status adults. Am J Public Health. 2012 Aug; 102(8):1551-8.
Waring AC, Rodondi N, Harrison S, Kanaya AM, Simonsick EM, Miljkovic I, Satterfield S, Newman AB, Bauer DC. Thyroid function and prevalent and incident metabolic syndrome in older adults: the Health, Ageing and Body Composition Study. Clin Endocrinol (Oxf). 2012 Jun; 76(6):911-8.
Hsu WC, Boyko EJ, Fujimoto WY, Kanaya A, Karmally W, Karter A, King GL, Look M, Maskarinec G, Misra R, Tavake-Pasi F, Arakaki R. Pathophysiologic differences among Asians, native Hawaiians, and other Pacific Islanders and treatment implications. Diabetes Care. 2012 May; 35(5):1189-98.
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, 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, Meisinger C, Melzer D, Meyre D, Mitchell BD, Mukherjee S, Naitza S, et al. 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 Genet. 2012; 8(3):e1002607.
Agarwal S, Jacobs DR, Vaidya D, Sibley CT, Jorgensen NW, Rotter JI, Chen YD, Liu Y, Andrews JS, Kritchevsky S, Goodpaster B, Kanaya A, Newman AB, Simonsick EM, Herrington DM. Metabolic Syndrome Derived from Principal Component Analysis and Incident Cardiovascular Events: The Multi Ethnic Study of Atherosclerosis (MESA) and Health, Aging, and Body Composition (Health ABC). Cardiol Res Pract. 2012; 2012:919425.
Cesari M, Kritchevsky SB, Nicklas B, Kanaya AM, Patrignani P, Tacconelli S, Tranah GJ, Tognoni G, Harris TB, Incalzi RA, Newman AB, Pahor M. Oxidative damage, platelet activation, and inflammation to predict mobility disability and mortality in older persons: results from the health aging and body composition study. J Gerontol A Biol Sci Med Sci. 2012 Jun; 67(6):671-6.
Phelan S, Kanaya AM, Subak LL, Hogan PE, Espeland MA, Wing RR, Burgio KL, DiLillo V, Gorin AA, West DS, Brown JS. Weight loss prevents urinary incontinence in women with type 2 diabetes: results from the Look AHEAD trial. J Urol. 2012 Mar; 187(3):939-44.
Anderson AL, Harris TB, Tylavsky FA, Perry SE, Houston DK, Lee JS, Kanaya AM, Sahyoun NR. Dietary patterns, insulin sensitivity and inflammation in older adults. Eur J Clin Nutr. 2012 Jan; 66(1):18-24.
Barbour KE, Zmuda JM, Boudreau R, Strotmeyer ES, Horwitz MJ, Evans RW, Kanaya AM, Harris TB, Cauley JA. The effects of adiponectin and leptin on changes in bone mineral density. Osteoporos Int. 2012 Jun; 23(6):1699-710.
Shah A, Hernandez A, Mathur D, Budoff MJ, Kanaya AM. Adipokines and body fat composition in South Asians: results of the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA) study. Int J Obes (Lond). 2012 Jun; 36(6):810-6.
Barbour KE, Zmuda JM, Boudreau R, Strotmeyer ES, Horwitz MJ, Evans RW, Kanaya AM, Harris TB, Bauer DC, Cauley JA. Adipokines and the risk of fracture in older adults. J Bone Miner Res. 2011 Jul; 26(7):1568-76.
Santoyo-Olsson J, Cabrera J, Freyre R, Grossman M, Alvarez N, Mathur D, Guerrero M, Delgadillo AT, Kanaya AM, Stewart AL. An innovative multiphased strategy to recruit underserved adults into a randomized trial of a community-based diabetes risk reduction program. Gerontologist. 2011 Jun; 51 Suppl 1:S82-93.
Coutinho T, Goel K, Corrêa de Sá D, Kragelund C, Kanaya AM, Zeller M, Park JS, Kober L, Torp-Pedersen C, Cottin Y, Lorgis L, Lee SH, Kim YJ, Thomas R, Roger VL, Somers VK, Lopez-Jimenez F. Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data. J Am Coll Cardiol. 2011 May 10; 57(19):1877-86.
Kanaya AM, Adler N, Moffet HH, Liu J, Schillinger D, Adams A, Ahmed AT, Karter AJ. Heterogeneity of diabetes outcomes among asians and pacific islanders in the US: the diabetes study of northern california (DISTANCE). Diabetes Care. 2011 Apr; 34(4):930-7.
Landau M, Kurella-Tamura M, Shlipak MG, Kanaya A, Strotmeyer E, Koster A, Satterfield S, Simsonick EM, Goodpaster B, Newman AB, Fried LF. Correlates of insulin resistance in older individuals with and without kidney disease. Nephrol Dial Transplant. 2011 Sep; 26(9):2814-9.
Kanaya AM, Wassel CL, Stoddard PJ, Harris TB, Cummings SR, Kritchevsky SB, Goodpaster BH, Green C, Satterfield S, Gross MD. F2-isoprostanes and adiposity in older adults. Obesity (Silver Spring). 2011 Apr; 19(4):861-7.
Fiocco AJ, Kanaya AM, Lindquist KM, Harris TB, Satterfield S, Simonsick EM, Kuller L, Rosano C, Yaffe K. Plasma F2-isoprostane level and cognitive function over eight years in non-demented older adults: Findings from the Health ABC Study. Prostaglandins Leukot Essent Fatty Acids. 2011 Jan-Feb; 84(1-2):57-61.
Lipska KJ, De Rekeneire N, Van Ness PH, Johnson KC, Kanaya A, Koster A, Strotmeyer ES, Goodpaster BH, Harris T, Gill TM, Inzucchi SE. Identifying dysglycemic states in older adults: implications of the emerging use of hemoglobin A1c. J Clin Endocrinol Metab. 2010 Dec; 95(12):5289-95.
Schafer AL, Vittinghoff E, Lang TF, Sellmeyer DE, Harris TB, Kanaya AM, Strotmeyer ES, Cawthon PM, Cummings SR, Tylavsky FA, Scherzinger AL, Schwartz AV. Fat infiltration of muscle, diabetes, and clinical fracture risk in older adults. J Clin Endocrinol Metab. 2010 Nov; 95(11):E368-72.
Delgadillo AT, Grossman M, Santoyo-Olsson J, Gallegos-Jackson E, Kanaya AM, Stewart AL. Description of an academic community partnership lifestyle program for lower income minority adults at risk for diabetes. Diabetes Educ. 2010 Jul-Aug; 36(4):640-50.
Kostek MC, Devaney JM, Gordish-Dressman H, Harris TB, Thompson PD, Clarkson PM, Angelopoulos TJ, Gordon PM, Moyna NM, Pescatello LS, Visich PS, Zoeller RF, Seip RL, Garcia M, Li R, Zmuda JM, Delmonico MJ, Kanaya A, Hoffman EP. A polymorphism near IGF1 is associated with body composition and muscle function in women from the Health, Aging, and Body Composition Study. Eur J Appl Physiol. 2010 Sep; 110(2):315-24.
Koster A, Stenholm S, Alley DE, Kim LJ, Simonsick EM, Kanaya AM, Visser M, Houston DK, Nicklas BJ, Tylavsky FA, Satterfield S, Goodpaster BH, Ferrucci L, Harris TB. Body fat distribution and inflammation among obese older adults with and without metabolic syndrome. Obesity (Silver Spring). 2010 Dec; 18(12):2354-61.
Kanaya AM, Wassel CL, Mathur D, Stewart A, Herrington D, Budoff MJ, Ranpura V, Liu K. Prevalence and correlates of diabetes in South asian indians in the United States: findings from the metabolic syndrome and atherosclerosis in South asians living in america study and the multi-ethnic study of atherosclerosis. Metab Syndr Relat Disord. 2010 Apr; 8(2):157-64.
Wang ET, de Koning L, Kanaya AM. Higher protein intake is associated with diabetes risk in South Asian Indians: the Metabolic Syndrome and Atherosclerosis in South Asians Living in America (MASALA) study. J Am Coll Nutr. 2010 Apr; 29(2):130-5.
Houston DK, Ding J, Lee JS, Garcia M, Kanaya AM, Tylavsky FA, Newman AB, Visser M, Kritchevsky SB. Dietary fat and cholesterol and risk of cardiovascular disease in older adults: the Health ABC Study. Nutr Metab Cardiovasc Dis. 2011 Jun; 21(6):430-7.
Njajou OT, Kanaya AM, Holvoet P, Connelly S, Strotmeyer ES, Harris TB, Cummings SR, Hsueh WC. Association between oxidized LDL, obesity and type 2 diabetes in a population-based cohort, the Health, Aging and Body Composition Study. Diabetes Metab Res Rev. 2009 Nov; 25(8):733-9.
Stenholm S, Koster A, Alley DE, Houston DK, Kanaya A, Lee JS, Newman AB, Satterfield S, Simonsick EM, Visser M, Harris TB, Ferrucci L. Joint association of obesity and metabolic syndrome with incident mobility limitation in older men and women--results from the Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci. 2010 Jan; 65(1):84-92.
Spies C, Farzaneh-Far R, Na B, Kanaya A, Schiller NB, Whooley MA. Relation of obesity to heart failure hospitalization and cardiovascular events in persons with stable coronary heart disease (from the Heart and Soul Study). Am J Cardiol. 2009 Oct 01; 104(7):883-9.
Cohen BE, Barrett-Connor E, Wassel CL, Kanaya AM. Association of glucose measures with total and coronary heart disease mortality: does the effect change with time? The Rancho Bernardo Study. Diabetes Res Clin Pract. 2009 Oct; 86(1):67-73.
Hu D, Pawlikowska L, Kanaya A, Hsueh WC, Colbert L, Newman AB, Satterfield S, Rosen C, Cummings SR, Harris TB, Ziv E. Serum insulin-like growth factor-1 binding proteins 1 and 2 and mortality in older adults: the Health, Aging, and Body Composition Study. J Am Geriatr Soc. 2009 Jul; 57(7):1213-8.
Phelan S, Kanaya AM, Subak LL, Hogan PE, Espeland MA, Wing RR, Burgio KL, Dilillo V, Gorin AA, West DS, Brown JS. Prevalence and risk factors for urinary incontinence in overweight and obese diabetic women: action for health in diabetes (look ahead) study. Diabetes Care. 2009 Aug; 32(8):1391-7.
Butler J, Kalogeropoulos A, Georgiopoulou V, de Rekeneire N, Rodondi N, Smith AL, Hoffmann U, Kanaya A, Newman AB, Kritchevsky SB, Vasan RS, Wilson PW, Harris TB. Serum resistin concentrations and risk of new onset heart failure in older persons: the health, aging, and body composition (Health ABC) study. Arterioscler Thromb Vasc Biol. 2009 Jul; 29(7):1144-9.
Sarma AV, Kanaya A, Nyberg LM, Kusek JW, Vittinghoff E, Rutledge B, Cleary PA, Gatcomb P, Brown JS. Risk factors for urinary incontinence among women with type 1 diabetes: findings from the epidemiology of diabetes interventions and complications study. Urology. 2009 Jun; 73(6):1203-9.
Brinkley TE, Nicklas BJ, Kanaya AM, Satterfield S, Lakatta EG, Simonsick EM, Sutton-Tyrrell K, Kritchevsky SB. Plasma oxidized low-density lipoprotein levels and arterial stiffness in older adults: the health, aging, and body composition study. Hypertension. 2009 May; 53(5):846-52.
Kanaya AM, Lindquist K, Harris TB, Launer L, Rosano C, Satterfield S, Yaffe K. Total and regional adiposity and cognitive change in older adults: The Health, Aging and Body Composition (ABC) study. Arch Neurol. 2009 Mar; 66(3):329-35.
Hsu FC, Kritchevsky SB, Liu Y, Kanaya A, Newman AB, Perry SE, Visser M, Pahor M, Harris TB, Nicklas BJ. Association between inflammatory components and physical function in the health, aging, and body composition study: a principal component analysis approach. J Gerontol A Biol Sci Med Sci. 2009 May; 64(5):581-9.
Poehls J, Wassel CL, Harris TB, Havel PJ, Swarbrick MM, Cummings SR, Newman AB, Satterfield S, Kanaya AM. Association of adiponectin with mortality in older adults: the Health, Aging, and Body Composition Study. Diabetologia. 2009 Apr; 52(4):591-5.
Sarma AV, Kanaya AM, Nyberg LM, Kusek JW, Vittinghoff E, Rutledge B, Cleary PA, Gatcomb P, Brown JS. Urinary incontinence among women with type 1 diabetes--how common is it? J Urol. 2009 Mar; 181(3):1224-30; discussion 1230.
Zhang MH, Spies C, Ali S, Kanaya AM, Schiller NB, Whooley MA. Adiponectin and inducible ischemia in patients with stable coronary heart disease: data from the Heart and Soul study. Atherosclerosis. 2009 Jul; 205(1):233-8.
Ix JH, Wassel CL, Kanaya AM, Vittinghoff E, Johnson KC, Koster A, Cauley JA, Harris TB, Cummings SR, Shlipak MG. Fetuin-A and incident diabetes mellitus in older persons. JAMA. 2008 Jul 09; 300(2):182-8.
Koster A, Patel KV, Visser M, van Eijk JT, Kanaya AM, de Rekeneire N, Newman AB, Tylavsky FA, Kritchevsky SB, Harris TB. Joint effects of adiposity and physical activity on incident mobility limitation in older adults. J Am Geriatr Soc. 2008 Apr; 56(4):636-43.
Sutton-Tyrrell K, Venkitachalam L, Kanaya AM, Boudreau R, Harris T, Thompson T, Mackey RH, Visser M, Vaidean GD, Newman AB. Relationship of ankle blood pressures to cardiovascular events in older adults. Stroke. 2008 Mar; 39(3):863-9.
Shin MJ, Kanaya AM, Krauss RM. Polymorphisms in the peroxisome proliferator activated receptor alpha gene are associated with levels of apolipoprotein CIII and triglyceride in African-Americans but not Caucasians. Atherosclerosis. 2008 Jun; 198(2):313-9.
Seligman HK, Bindman AB, Vittinghoff E, Kanaya AM, Kushel MB. Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002. J Gen Intern Med. 2007 Jul; 22(7):1018-23.
Ruhl CE, Harris TB, Ding J, Goodpaster BH, Kanaya AM, Kritchevsky SB, Simonsick EM, Tylavsky FA, Everhart JE. Body mass index and serum leptin concentration independently estimate percentage body fat in older adults. Am J Clin Nutr. 2007 Apr; 85(4):1121-6.
Wassel Fyr CL, Kanaya AM, Cummings SR, Reich D, Hsueh WC, Reiner AP, Harris TB, Moffett S, Li R, Ding J, Miljkovic-Gacic I, Ziv E. Genetic admixture, adipocytokines, and adiposity in Black Americans: the Health, Aging, and Body Composition study. Hum Genet. 2007 Jun; 121(5):615-24.
Tice JA, Kanaya A, Hue T, Rubin S, Buist DS, Lacroix A, Lacey JV, Cauley JA, Litwack S, Brinton LA, Bauer DC. Risk factors for mortality in middle-aged women. Arch Intern Med. 2006 Dec 11-25; 166(22):2469-77.
Yaffe K, Kanaya AM, Lindquist K, Hsueh WC, Cummings SR, Beamer B, Newman A, Rosano C, Li R, Harris T. PPAR-gamma Pro12Ala genotype and risk of cognitive decline in elders. Neurobiol Aging. 2008 Jan; 29(1):78-83.
Huang AJ, Brown JS, Kanaya AM, Creasman JM, Ragins AI, Van Den Eeden SK, Thom DH. Quality-of-life impact and treatment of urinary incontinence in ethnically diverse older women. Arch Intern Med. 2006 Oct 09; 166(18):2000-6.
Kanaya AM, Wassel Fyr C, Vittinghoff E, Havel PJ, Cesari M, Nicklas B, Harris T, Newman AB, Satterfield S, Cummings SR. Serum adiponectin and coronary heart disease risk in older Black and White Americans. J Clin Endocrinol Metab. 2006 Dec; 91(12):5044-50.
Maraldi C, Volpato S, Kritchevsky SB, Cesari M, Andresen E, Leeuwenburgh C, Harris TB, Newman AB, Kanaya A, Johnson KC, Rodondi N, Pahor M. Impact of inflammation on the relationship among alcohol consumption, mortality, and cardiac events: the health, aging, and body composition study. Arch Intern Med. 2006 Jul 24; 166(14):1490-7.
Shorr RI, de Rekeneire N, Resnick HE, Yaffe K, Somes GW, Kanaya AM, Simonsick EM, Newman AB, Harris TB. Glycemia and cognitive function in older adults using glucose-lowering drugs. J Nutr Health Aging. 2006 Jul-Aug; 10(4):297-301.
Brown JS, Vittinghoff E, Lin F, Nyberg LM, Kusek JW, Kanaya AM. Prevalence and risk factors for urinary incontinence in women with type 2 diabetes and impaired fasting glucose: findings from the National Health and Nutrition Examination Survey (NHANES) 2001-2002. Diabetes Care. 2006 Jun; 29(6):1307-12.
Huang AJ, Thom DH, Kanaya AM, Wassel-Fyr CL, Van den Eeden SK, Ragins AI, Subak LL, Brown JS. Urinary incontinence and pelvic floor dysfunction in Asian-American women. Am J Obstet Gynecol. 2006 Nov; 195(5):1331-7.
Nicklas BJ, Cesari M, Penninx BW, Kritchevsky SB, Ding J, Newman A, Kitzman DW, Kanaya AM, Pahor M, Harris TB. Abdominal obesity is an independent risk factor for chronic heart failure in older people. J Am Geriatr Soc. 2006 Mar; 54(3):413-20.
Kanaya AM, Wassel Fyr C, Vittinghoff E, Harris TB, Park SW, Goodpaster BH, Tylavsky F, Cummings SR. Adipocytokines and incident diabetes mellitus in older adults: the independent effect of plasminogen activator inhibitor 1. Arch Intern Med. 2006 Feb 13; 166(3):350-6.
Brown JS, Wing R, Barrett-Connor E, Nyberg LM, Kusek JW, Orchard TJ, Ma Y, Vittinghoff E, Kanaya AM. Lifestyle intervention is associated with lower prevalence of urinary incontinence: the Diabetes Prevention Program. Diabetes Care. 2006 Feb; 29(2):385-90.
Yende S, Tuomanen EI, Wunderink R, Kanaya A, Newman AB, Harris T, de Rekeneire N, Kritchevsky SB. Preinfection systemic inflammatory markers and risk of hospitalization due to pneumonia. Am J Respir Crit Care Med. 2005 Dec 01; 172(11):1440-6.
Sahyoun NR, Anderson AL, Kanaya AM, Koh-Banerjee P, Kritchevsky SB, de Rekeneire N, Tylavsky FA, Schwartz AV, Lee JS, Harris TB. Dietary glycemic index and load, measures of glucose metabolism, and body fat distribution in older adults. Am J Clin Nutr. 2005 Sep; 82(3):547-52.
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 with coronary artery disease. Ann Intern Med. 2005 May 17; 142(10):813-20.
Spies C, Otte C, Kanaya A, Pipkin SS, Schiller NB, Whooley MA. Association of metabolic syndrome with exercise capacity and heart rate recovery in patients with coronary heart disease in the heart and soul study. Am J Cardiol. 2005 May 15; 95(10):1175-9.
Kanaya AM, Wassel Fyr CL, de Rekeneire N, Shorr RI, Schwartz AV, Goodpaster BH, Newman AB, Harris T, Barrett-Connor E. Predicting the development of diabetes in older adults: the derivation and validation of a prediction rule. Diabetes Care. 2005 Feb; 28(2):404-8.
Snijder MB, Visser M, Dekker JM, Goodpaster BH, Harris TB, Kritchevsky SB, De Rekeneire N, Kanaya AM, Newman AB, Tylavsky FA, Seidell JC. Low subcutaneous thigh fat is a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health ABC Study. Diabetologia. 2005 Feb; 48(2):301-8.
Nicklas BJ, Penninx BW, Cesari M, Kritchevsky SB, Newman AB, Kanaya AM, Pahor M, Jingzhong D, Harris TB. Association of visceral adipose tissue with incident myocardial infarction in older men and women: the Health, Aging and Body Composition Study. Am J Epidemiol. 2004 Oct 15; 160(8):741-9.
Ruhl CE, Everhart JE, Ding J, Goodpaster BH, Kanaya AM, Simonsick EM, Tylavsky FA, Harris TB. Serum leptin concentrations and body adipose measures in older black and white adults. Am J Clin Nutr. 2004 Sep; 80(3):576-83.
Yaffe K, Blackwell T, Kanaya AM, Davidowitz N, Barrett-Connor E, Krueger K. Diabetes, impaired fasting glucose, and development of cognitive impairment in older women. Neurology. 2004 Aug 24; 63(4):658-63.
Jackson RA, Vittinghoff E, Kanaya AM, Miles TP, Resnick HE, Kritchevsky SB, Simonsick EM, Brown JS. Urinary incontinence in elderly women: findings from the Health, Aging, and Body Composition Study. Obstet Gynecol. 2004 Aug; 104(2):301-7.
Kanaya AM, Barrett-Connor E, Gildengorin G, Yaffe K. Change in cognitive function by glucose tolerance status in older adults: a 4-year prospective study of the Rancho Bernardo study cohort. Arch Intern Med. 2004 Jun 28; 164(12):1327-33.
Kanaya AM, Vittinghoff E, Shlipak MG, Resnick HE, Visser M, Grady D, Barrett-Connor E. Association of total and central obesity with mortality in postmenopausal women with coronary heart disease. Am J Epidemiol. 2003 Dec 15; 158(12):1161-70.
Jha AK, Varosy PD, Kanaya AM, Hunninghake DB, Hlatky MA, Waters DD, Furberg CD, Shlipak MG. Differences in medical care and disease outcomes among black and white women with heart disease. Circulation. 2003 Sep 02; 108(9):1089-94.
Kanaya AM, Herrington D, Vittinghoff E, Lin F, Grady D, Bittner V, Cauley JA, Barrett-Connor E. Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2003 Jan 07; 138(1):1-9.
Kanaya AM, Grady D, Barrett-Connor E. Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis. Arch Intern Med. 2002 Aug 12-26; 162(15):1737-45.
Kanaya AM, Harris F, Volpato S, Pérez-Stable EJ, Harris T, Bauer DC. Association between thyroid dysfunction and total cholesterol level in an older biracial population: the health, aging and body composition study. Arch Intern Med. 2002 Apr 08; 162(7):773-9.
Brown JS, Vittinghoff E, Kanaya AM, Agarwal SK, Hulley S, Foxman B. Urinary tract infections in postmenopausal women: effect of hormone therapy and risk factors. Obstet Gynecol. 2001 Dec; 98(6):1045-52.