Where do you work, for how long, and who with?
I work across the Epidemiology and Biostatistics Department, and the Office of Energetics at the University of Alabama at Birmingham (UAB), USA. I moved here from the Institute of Psychiatry at Kings College London, two years ago. I am lucky enough to collaborate with a large multi-disciplinary team at UAB. My mentors are Dr Donna Arnett, Chair of the Epidemiology Department and president-elect of the American Heart Association, and Dr David Allison, Distinguished Professor, Associate Dean for Science & Director of the Office of Energetics and Nutrition & Obesity Research Centre. I collaborate extensively with nutrition researchers, neuropsychologists, lipidologists and statisticians.
What are your primary areas of research? What are your aims in these areas?
My primary area of research is insulin resistance. My goals are twofold: 1- to develop intermediate phenotypes of insulin resistance, by combining biological measures (such as lipoprotein particle size) into traits that associated highly with insulin resistance. And 2- to use these traits to understand how environmental factors such as diet and lifestyle mediate the genetic influences that associate with these markers. I hope that this will help us better understand the etiology of insulin resistance, and design better interventions for insulin resistant patients.
What contributions have you made to these areas so far? What is the broader importance of your contributions to these areas?
So far I have created a new trait that reflects an individual's pattern of lipoprotein particle sizes across the three fractions of lipoprotein: very low-density (VLDL), low-density (LDL) and high-density (HDL). This trait associates with the metabolic syndrome (the physical manifestation of insulin resistance) and can separate out those with the most extreme insulin resistant features from all those with the metabolic syndrome. I have used this trait to identify genetic variants that associate with this form of dyslipidaemia. The importance of this work to clinicians is that we can now start to understand where in the genome the biological pathways involved in insulin resistance originate. This will give loci for examining gene regulation changes, and we can start to piece together lifestyle interventions that may reduce the insulin resistant state.
What directions do you expect your research in these areas to take in the near future?
I am starting to examine gene regulation differences in insulin resistance. I am also writing a grant for an exercise intervention. In the future I expect to bring these areas (genetic, epigenetic, and environmental) together to understand and reduce insulin resistance.
What do you consider to be the most important recent developments in your areas of research?
The recognition of insulin resistance and the metabolic syndrome as a 'pre-diabetic' state has allowed us to intervene early and prevent the development of Type II Diabetes. The recognition that there are individual differences in treatment / intervention response and the development of new interventions such as High Intensity Interval Training (HIIT) are vital turning points in understanding and treating Type II Diabetes.
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