MyMedR

Fulltext Risk factors for hip fracture in Asian men and women: the Asian osteoporosis study

Lau EM, Suriwongpaisal P, Lee JK, Das De S, Festin MR, Saw SM, et al.

J. Bone Miner. Res., 2001 Mar;16(3):572-80.

PMID: 11277276 DOI: 10.1359/jbmr.2001.16.3.572

The objectives of the Asian Osteoporosis Study (AOS) were to determine risk factors for hip fracture in men and women in four Asian countries, that is, Singapore, Malaysia, Thailand, and the Philippines. A total of 451 men and 725 women (aged 50 years and over) with hip fractures were compared with an equal number of community controls. A standardized questionnaire was administered by interview. The following relative risks (RRs) were found in women and men by multiple logistic regression: dietary calcium intake < 498 mg/day, 2.0 for women (95% CI, 1.5-2.8) and 1.5 for men (95% CI, 1.0-2.2); no load bearing activity in the immediate past, 2.0 for women (95% CI, 1.4-2.7) and 3.4 for men (95% CI, 2.3-5.1); no vigorous sport activities in young adulthood, 7.2 for women (95% CI, 4.0-13.0) and 2.4 for men (95% CI, 1.6-3.6); cigarette smoking, 1.5 for men (95% CI, 1.0-2.1); alcohol consumption 7 days a week, 2.9 for women (95% CI, 1.0-8.6) and 1.9 for men (95% CI, 1.1-3.2); fell twice or more in the last 12 months, 3.0 for women (95% CI, 1.8-4.8) and 3.4 for men (95% CI, 1.8-6.6); a history of fractures after 50 years of age, 1.8 for women (95% CI, 1.1-2.9) and 3.0 for men (95% CI, 1.6-5.6); a history of stroke, 3.8 for women (95% CI, 2.0-7.1) and 3.6 for men (95% CI, 1.8-7.1); use of sedatives, 2.5 for women (95% CI, 1.0-6.3) and 3.0 for men (95% CI, 1.0-9.7); and use of thyroid drugs, 7.1 for women (95% CI, 2.0-25.9) and 11.8 for men (95% CI, 1.3-106.0). Women who were 1.56 m or taller had an RR of 2.0 (95% CI, 1.3-3.0) for hip fracture and men who were 1.69 m or taller had an RR of 1.9 (95% CI, 1.2-3.1) for hip fracture. Based on these findings, primary preventive programs for hip fracture could be planned in Asia.

Does education explain ethnic differences in myopia prevalence? A population-based study of young adult males in Singapore

Wu HM, Seet B, Yap EP, Saw SM, Lim TH, Chia KS

Optom Vis Sci, 2001 Apr;78(4):234-9.

PMID: 11349931

PURPOSE: To study interethnic variation in myopia prevalence and severity in young adult males in Singapore and to determine whether these variations are related to differences in education level.

METHODS: A population-based survey of refractive errors in a cohort of 15,095 military conscripts between July 1996 and June 1997 using noncycloplegic autorefraction and a standard questionnaire. Prevalence rates of myopia (

Hip fracture incidence rates in Singapore 1991-1998

Koh LK, Saw SM, Lee JJ, Leong KH, Lee J, National Working Committee on Osteoporosis

Osteoporos Int, 2001;12(4):311-8.

PMID: 11420781

In this population-based study, we determined the incidence rates of hip fracture among Singapore residents aged 50 years and above. Information was obtained from a centralized database system which captured admissions with the primary diagnosis of a closed hip fracture (ICD-9 codes 820, 820.0, 820.2 and 820.8, n = 12,927) from all health care establishments in the country from 1991 to 1998 inclusive. After removing duplicates, hospital transfers, readmissions and non-acute care admissions, the total number of hip fractures was 9406. Based on the national population census 1990 (n = 464,100) and yearly population estimates, the age-adjusted hip fracture rates for 1991-1998 (per 100,000) were 152 in men and 402 in women. This was 1.5 and over 5 times higher than corresponding rates in the 1960s. From 1991 to 1998, these hip fracture rates tended to increase by 0.7% annually in men and by 1.2% annually in women. Among the three major racial groups, in men, the Chinese had significantly higher age-adjusted hip fracture rates (per 100,000): 168 (95% confidence interval (CI) 158-178) compared with 128 (95% CI 105-152) for Indians and 71 (95% CI 54-88) for Malays. A similar pattern occurred in women: 410 (95% CI 395-425), for Chinese compared with 361 (95% CI 290-432) for Indians and 264 (95% CI 225-303) for Malays. Since the 1960s, the main increases in hip fracture rates have been seen in the Chinese and Malays, with the rates in Indians appearing to decrease. Hip fracture incidence rates in Singapore have risen rapidly over the past 30-40 years, particularly in women, and are now among the highest in Asia. Significant racial differences in hip fracture rates occur within the same community. Time trends in hip fracture rates differed between races.

The incidence of hip fracture in four Asian countries: the Asian Osteoporosis Study (AOS)

Lau EM, Lee JK, Suriwongpaisal P, Saw SM, Das De S, Khir A, et al.

Osteoporos Int, 2001;12(3):239-43.

PMID: 11315243 DOI: 10.1007/s001980170135

The Asian Osteoporosis Study (AOS) is the first multicenter study to document and compare the incidence of hip fracture in four Asian countries. Hosital discharge data for the year 1997 were obtained for the Hong Kong SAR, Singapore, Malaysia and Thailand (Chiang Mai). The number of patients who were 50 years of age and older and who were discharged with a diagnosis of hip fracture (ICD9 820) was enumerated. The age-specific incidence rates were deduced and were directly adjusted to the US white population in 1989. The age-adjusted rates for men and women (per 100,000) are as follows: Hong Kong, 180 and 459; Singapore, 164 and 442; Malaysia, 88 and 218; Thailand, 114 and 289; compared with US White rates of 187 in men and 535 in women, published in 1989. We conclude that there is moderate variation in the incidence of hip fracture among Asian countries. The rates were highest in urbanized countries. With rapid economic development in Asia, hip fracture will prove to be a major public health challenge.

Prevalence of Parkinson disease in Singapore: Chinese vs Malays vs Indians

Tan LC, Venketasubramanian N, Hong CY, Sahadevan S, Chin JJ, Krishnamoorthy ES, et al.

Neurology, 2004 Jun 08;62(11):1999-2004.

PMID: 15184604

OBJECTIVE: To investigate the prevalence of Parkinson disease (PD) in Singapore and compare the rates between Singaporean Chinese, Malays, and Indians.

METHODS: A three-phase community-based survey among a disproportionate random sample of 15,000 individuals (9,000 Chinese, 3,000 Malays, 3,000 Indians) aged 50 years and above who live in central Singapore was conducted. In phase 1, trained interviewers conducted a door-to-door survey using a validated 10-question questionnaire. In phase 2, medical specialists examined participants who screened positive to any of the questions. Participants suspected to have PD had their diagnosis confirmed in phase 3 by a movement disorders specialist.

RESULTS: The participation rate was 67% among 22,279 eligible individuals. Forty-six participants with PD were identified of which 16 were newly diagnosed cases. The prevalence rate of PD for those aged 50 and above in Singapore was 0.30% (95% CI: 0.22 to 0.41), age-adjusted to US 1970 census. The prevalence rates increased significantly with age. The age-adjusted prevalence rates among Chinese (0.33%, 95% CI: 0.22 to 0.48), Malays (0.29%, 95% CI: 0.13 to 0.67), and Indians (0.28%, 95% CI: 0.12 to 0.67) were the same (p = 1.0).

CONCLUSIONS: The prevalence of PD in Singapore was comparable to that of Western countries. Race-specific rates were also similar to previously reported rates and similar among the three races. Environmental factors may be more important than racially determined genetic factors in the development of PD.

Prevalence of stroke among Chinese, Malay, and Indian Singaporeans: a community-based tri-racial cross-sectional survey

Venketasubramanian N, Tan LC, Sahadevan S, Chin JJ, Krishnamoorthy ES, Hong CY, et al.

Stroke, 2005 Mar;36(3):551-6.

PMID: 15692124

Stroke prevalence data among mixed Asian populations are lacking. Prevalence rates of stroke were studied among Singaporeans aged > or =50 years of Chinese, Malay, and Indian origin.

The age of menopause and the menopause transition in a multiracial population: a nation-wide Singapore study

Loh FH, Khin LW, Saw SM, Lee JJ, Gu K

Maturitas, 2005 Nov-Dec;52(3-4):169-80.

PMID: 16257608

To describe the prevalence of menopausal symptoms, define the mean age of menopause, and determine contributory factors, which influence the experience of symptoms among Singaporean women of different racial groups.

Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore

Saw SM, Goh PP, Cheng A, Shankar A, Tan DT, Ellwein LB

Br J Ophthalmol, 2006 Oct;90(10):1230-5.

PMID: 16809384

To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore.

Rationale and methodology for a population-based study of eye diseases in Malay people: The Singapore Malay eye study (SiMES)

Foong AW, Saw SM, Loo JL, Shen S, Loon SC, Rosman M, et al.

Ophthalmic Epidemiol, 2007 Jan-Feb;14(1):25-35.

PMID: 17365815

Although there are approximately 200 million people of Malay ethnicity living in Asia, the burden and risk factors of blinding eye diseases in this ethnic group are unknown. This study summarizes the rationale and study design of a population-based study of eye diseases among adult Malays in Singapore.

Retinal vascular caliber, blood pressure, and cardiovascular risk factors in an Asian population: the Singapore Malay Eye Study

Sun C, Liew G, Wang JJ, Mitchell P, Saw SM, Aung T, et al.

Invest Ophthalmol Vis Sci, 2008 May;49(5):1784-90.

PMID: 18436813 DOI: 10.1167/iovs.07-1450

To describe the relationship of retinal vascular caliber with cardiovascular risk factors in an Asian population.

Determinants of the optic cup to disc ratio in an Asian population: the Singapore Malay Eye Study (SiMES)

Amerasinghe N, Wong TY, Wong WL, Mitchell P, Shen SY, Loon SC, et al.

Arch. Ophthalmol., 2008 Aug;126(8):1101-8.

PMID: 18695105 DOI: 10.1001/archopht.126.8.1101

To describe the distribution and determinants of the optic cup to disc ratio (CDR) in Malay adults in Singapore.

Association of raised liver transaminases with physical inactivity, increased waist-hip ratio, and other metabolic morbidities in severely obese children

Lee YS, Kek BL, Poh LK, Saw SM, Loke KY

J Pediatr Gastroenterol Nutr, 2008 Aug;47(2):172-8.

PMID: 18664869 DOI: 10.1097/MPG.0b013e318162a0e5

To identify factors associated with raised alanine transaminase, aspartate transaminase, and gamma-glutaryl transferase in severely obese children

Prevalence and risk factors of retinal arteriolar emboli: the Singapore Malay Eye Study

Cheung N, Lim L, Wang JJ, Islam FM, Mitchell P, Saw SM, et al.

Am J Ophthalmol, 2008 Oct;146(4):620-4.

PMID: 18639861 DOI: 10.1016/j.ajo.2008.05.033

To examine the prevalence and risk factors of retinal arteriolar emboli, a risk predictor of stroke, in an Asian population.

Ethnic differences in Singapore's dementia prevalence: the stroke, Parkinson's disease, epilepsy, and dementia in Singapore study

Sahadevan S, Saw SM, Gao W, Tan LC, Chin JJ, Hong CY, et al.

J Am Geriatr Soc, 2008 Nov;56(11):2061-8.

PMID: 19016940 DOI: 10.1111/j.1532-5415.2008.01992.x

To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians.

Fulltext Polymorphisms at newly identified lipid-associated loci are associated with blood lipids and cardiovascular disease in an Asian Malay population

Tai ES, Sim XL, Ong TH, Wong TY, Saw SM, Aung T, et al.

J Lipid Res, 2009 Mar;50(3):514-520.

PMID: 18987386 DOI: 10.1194/jlr.M800456-JLR200

We conducted a cross-sectional study of Malay participants aged 40-80 years (n = 2,932) to examine the associations between polymorphisms at newly identified, lipid-associated loci with blood lipid levels and prevalent cardiovascular disease (CVD) in a Malay population in Asia. A polymorphism adjacent to the TRIB1 locus (rs17321515) was associated with elevated total cholesterol and LDL-cholesterol (LDL-C) after adjustment for age and sex (both P values <0.007) and with increased risk of coronary heart disease and CVD [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.03-1.46; and OR 1.2, 95% CI 1.02-1.42, respectively] under an additive model of inheritance. In addition, using recessive models of inheritance, polymorphisms on chromosome 19 adjacent to the CILP2 and PBX4 loci (rs16996148) and on chromosome 1 at the GALNT2 locus (rs4846914) were associated with elevated HDL-C (P = 0.005) and lower LDL-C (P = 0.048), respectively. Although novel, the former is consistent with the association between this polymorphism and lower blood triglycerides observed in the initial studies conducted in populations of European ancestry. Neither showed statistically significant association with CVD. These observations should form the basis of further investigation to identify the causative polymorphisms at this locus, and also to understand the mechanistic roles that this protein may play in lipoprotein metabolism in Asians and other populations.

Prevalence and risk factors of ocular trauma in an urban south-east Asian population: the Singapore Malay Eye Study

Loon SC, Tay WT, Saw SM, Wang JJ, Wong TY

Clin Exp Ophthalmol, 2009 May;37(4):362-7.

PMID: 19594562 DOI: 10.1111/j.1442-9071.2009.02035.x

To describe the prevalence and risk factors of ocular trauma in an urban Asian population.

Polymorphisms identified through genome-wide association studies and their associations with type 2 diabetes in Chinese, Malays, and Asian-Indians in Singapore

Tan JT, Ng DP, Nurbaya S, Ye S, Lim XL, Leong H, et al.

J Clin Endocrinol Metab, 2010 Jan;95(1):390-7.

PMID: 19892838 DOI: 10.1210/jc.2009-0688

CONTEXT:
Novel type 2 diabetes mellitus (T2DM) susceptibility loci, identified through genome-wide association studies (GWAS), have been replicated in many European and Japanese populations. However, the association in other East Asian populations is less well characterized.

OBJECTIVE:
To examine the effects of SNPs in CDKAL1, CDKN2A/B, IGF2BP2, HHEX, SLC30A8, PKN2, LOC387761, and KCNQ1 on risk of T2DM in Chinese, Malays, and Asian-Indians in Singapore.

DESIGN:
We genotyped these candidate single-nucleotide polymorphisms (SNPs) in subjects from three major ethnic groups in Asia, namely, the Chinese (2196 controls and 1541 cases), Malays (2257 controls and 1076 cases), and Asian-Indians (364 controls and 246 cases). We also performed a metaanalysis of our results with published studies in East Asians.

RESULTS:
In Chinese, SNPs in CDKAL1 [odds ratio (OR) = 1.19; P = 2 x 10(-4)], HHEX (OR = 1.15; P = 0.013), and KCNQ1 (OR = 1.21; P = 3 x 10(-4)) were significantly associated with T2DM. Among Malays, SNPs in CDKN2A/B (OR = 1.22; P = 3.7 x 10(-4)), HHEX (OR = 1.12; P = 0.044), SLC30A8 (OR = 1.12; P = 0.037), and KCNQ1 (OR = 1.19-1.25; P = 0.003-2.5 x 10(-4)) showed significant association with T2DM. The combined analysis of the three ethnic groups revealed significant associations between SNPs in CDKAL1 (OR = 1.13; P = 3 x 10(-4)), CDKN2A/B (OR = 1.16; P = 9 x 10(-5)), HHEX (OR = 1.14; P = 6 x 10(-4)), and KCNQ1 (OR = 1.16-1.20; P = 3 x 10(-4) to 3 x 10(-6)) with T2DM. SLC30A8 (OR = 1.06; P = 0.039) showed association only after adjustment for gender and body mass index. Metaanalysis with data from other East Asian populations showed similar effect sizes to those observed in populations of European ancestry.

CONCLUSIONS:
SNPs at T2DM susceptibility loci identified through GWAS in populations of European ancestry show similar effects in Asian populations. Failure to detect these effects across different populations may be due to issues of power owing to limited sample size, lower minor allele frequency, or differences in genetic effect sizes.

Fulltext Collagen-related genes influence the glaucoma risk factor, central corneal thickness

Vithana EN, Aung T, Khor CC, Cornes BK, Tay WT, Sim X, et al.

Hum Mol Genet, 2011 Feb 15;20(4):649-58.

PMID: 21098505 DOI: 10.1093/hmg/ddq511

Central corneal thickness (CCT) is a risk factor of glaucoma, the most common cause of irreversible blindness worldwide. The identification of genetic determinants affecting CCT in the normal population will provide insights into the mechanisms underlying the association between CCT and glaucoma, as well as the pathogenesis of glaucoma itself. We conducted two genome-wide association studies for CCT in 5080 individuals drawn from two ethnic populations in Singapore (2538 Indian and 2542 Malays) and identified novel genetic loci significantly associated with CCT (COL8A2 rs96067, p(meta) = 5.40 × 10⁻¹³, interval of RXRA-COL5A1 rs1536478, p(meta) = 3.05 × 10⁻⁹). We confirmed the involvement of a previously reported gene for CCT and brittle cornea syndrome (ZNF469) [rs9938149 (p(meta) = 1.63 × 10⁻¹⁶) and rs12447690 (p(meta) = 1.92 × 10⁻¹⁴)]. Evidence of association exceeding the formal threshold for genome-wide significance was observed at rs7044529, an SNP located within COL5A1 when data from this study (n = 5080, P = 0.0012) were considered together with all published data (reflecting an additional 7349 individuals, p(Fisher) = 1.5 × 10⁻⁹). These findings implicate the involvement of collagen genes influencing CCT and thus, possibly the pathogenesis of glaucoma.

Quantitative and qualitative retinal microvascular characteristics and blood pressure

Cheung CY, Tay WT, Mitchell P, Wang JJ, Hsu W, Lee ML, et al.

J Hypertens, 2011 Jul;29(7):1380-91.

PMID: 21558958 DOI: 10.1097/HJH.0b013e328347266c

The present study examined the effects of blood pressure on a spectrum of quantitative and qualitative retinal microvascular signs.

Independent impact of area-level socioeconomic measures on visual impairment

Zheng Y, Lamoureux E, Finkelstein E, Wu R, Lavanya R, Chua D, et al.

Invest Ophthalmol Vis Sci, 2011;52(12):8799-805.

PMID: 21969296 DOI: 10.1167/iovs.11-7700

It is known that a person's socioeconomic status (SES; individual-level SES) is closely correlated with his or her degree of visual impairment. Whether there is an independent relationship between area-level measures of SES (e.g., living in a lower SES environment) and visual impairment is unclear. This study describes the associations of area-level SES with visual impairment.

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