# Role of visceral adipose tissue in frailty among patients with Idiopathic Pulmonary Fibrosis

> **NIH NIH K23** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $170,856

## Abstract

PROJECT SUMMARY/ABSTRACT
In this application for a 5-year K23 Career Development Award, I propose mentored research and career
development leading to a career as an independent clinical and translational investigator in interstitial lung
disease (ILD). The goal of this project is to identify the role of body composition in frailty among subjects with
idiopathic pulmonary fibrosis (IPF). The prevalence of IPF is rising, currently affecting 1 in 200 older adults. There
is no cure for IPF. The only available medications slow disease progression but do not reverse disease. Frailty
affects up to 50% of IPF patients, and is characterized by decreased physiologic reserve and increased
susceptibility to severe manifestations of acute insults. The most common causes of death in IPF are acute
insults. Frailty is thus a potentially modifiable risk factor for morbidity and mortality in IPF.
This proposal builds on my preliminary work showing that (1) greater visceral adipose tissue (VAT) is associated
with increased frailty, (2) subjects with both sarcopenia and visceral obesity are at greater risk of frailty than
those with sarcopenia alone, (3) there may be distinct endotypes of exercise limitation defined by high
inflammation alone or low inflammation with high VAT, and (4) down-regulation of the growth hormone (GH) axis
may link VAT and frailty. Under the mentorship of Dr. R Graham Barr, I propose to evaluate the roles of body
composition by bioelectrical impedance assay (co-mentor Gallagher), inflammation, and neuroendocrine
dysregulation associated with frailty risk using a machine-learning approach (co-mentor Valeri). I will also
evaluate the role of growth hormone axis dysregulation in sarcopenia with visceral obesity in a rigorous overnight
protocol (co-mentor Freda). I propose to perform this in two NHLBI-funded prospective cohorts: Dr. Garcia’s
Families-At-Risk for ILD (R01HL103676) and Dr. Singer’s Advanced Lung Disease Lung Transplantation Study
(R01HL134851).
With guidance from my mentors, I have crafted a 5-year career development plan that includes training in body
composition analysis (Dr. Gallagher), measurement of complex endocrine systems (Dr. Freda), clinical trials (Dr.
Freda), biostatistics (Dr. Valeri), aging in interstitial lung disease (Dr. Garcia), and epidemiology (Dr. Barr). In the
last two years of this award, I will apply for R01 funding and transition to independence. The proposed activities
will prepare me to conduct patient-oriented research to evaluate the role of body composition in outcomes in
ILD. I will also acquire the skills and training required to design and conduct clinical trials targeting novel
pathways to prevent and treat frailty in ILD.

## Key facts

- **NIH application ID:** 10055250
- **Project number:** 1K23HL150280-01A1
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Michaela Restivo Anderson
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $170,856
- **Award type:** 1
- **Project period:** 2020-09-15 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10055250

## Citation

> US National Institutes of Health, RePORTER application 10055250, Role of visceral adipose tissue in frailty among patients with Idiopathic Pulmonary Fibrosis (1K23HL150280-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10055250. Licensed CC0.

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