# Obesity in Pulmonary Arterial Hypertension

> **NIH NIH K23** · UNIVERSITY OF PENNSYLVANIA · 2021 · $193,950

## Abstract

PROJECT SUMMARY
 This proposal describes a five-year training program for the development of a career in clinical research
with a scientific focus on understanding the role of obesity in pulmonary arterial hypertension (PAH). This
proposal will serve as a vehicle to developing into an independent investigator. To that end, we have
established a training plan that includes mentoring, course-work, didactic educational activities, and hands-on
research. Steven Kawut, MD, MS, (the primary mentor) is a tenured Professor of Medicine and Epidemiology.
He has a track record of successfully mentoring fellows and junior faculty and holds a K24 to support his
mentoring activities. An advisory committee has been assembled to guide the candidate's career development.
 The application focuses on three specific aims. First, in a large prospective cohort of incident patients with
PAH, we will examine the impact of obesity measured by body mass index on survival and quality of life
outcomes as measured by a general health related quality of life (QOL) questionnaire, the 12-item Medical
Outcomes Short Form survey, and a disease-specific QOL questionnaire, the emPHasis-10. The planned
analysis will allow for adjustment for potential confounders including disease severity, age, sex, race, ethnicity,
socioeconomic status, and insurance coverage.
 Second, in a retrospective cohort of patients with PAH from the University of Pennsylvania, we will
measure thoracic visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) using chest computed
tomography and will examine the association of between VAT:SAT ratio and pulmonary hemodynamics and
outcomes in this cohort, adjusting for potential confounders including age, sex, race/ethnicity and disease
subtype. We will use causal mediation analysis to examine whether progranulin, an adipokine, is a mediator of
these associations.
 Third, we will enroll patients with PAH in a prospective cohort and will obtain serial measurements of body
fat using dual-energy X-ray absorptiometry along with serial echocardiograms over the course of one year. We
will determine the associations between changes in body fat mass and RV strain over time adjusting for
potential confounders including age, sex, disease subtype, disease severity and PAH therapy.
 Together, these three aims illuminate different phenotypes of obesity and their association with outcomes
in PAH. By combining these novel techniques, the applicant hopes to begin to define the different phenotypes
of obesity and understand the underlying pathobiologic processes in the hopes of identifying potential novel
therapeutic targets to improve survival and quality of life of patients with PAH.

## Key facts

- **NIH application ID:** 10163252
- **Project number:** 5K23HL141584-04
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Nadine Al-Naamani
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $193,950
- **Award type:** 5
- **Project period:** 2018-06-10 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10163252

## Citation

> US National Institutes of Health, RePORTER application 10163252, Obesity in Pulmonary Arterial Hypertension (5K23HL141584-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10163252. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*