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Biomedical subjects

K S Chia

Publications and source records attributed to K S Chia.

At least 37 records · Page 2Linked to original sources
PubMed2001

Myopia and night lighting in children in Singapore.

AIM: To examine the role of night time lighting and myopia in children in Singapore METHODS: A cross sectional study was conducted on 1001 children in two Singapore schools. Cycloplegic refraction and A-scan biometry measurements were made in both eyes. A detailed questionnaire was completed by the parents to obtain information on night time lighting, near work activity, educational and demographic factors. RESULTS: There was no difference in myopia prevalence rates in children exposed to night time light (33.1%) compared with children who slept in the dark (31.4%) before age 2. In addition, vitreous chamber depth was not related to night light (p = 0.58) before age 2. These results remained even after controlling for near work. CONCLUSION: Myopia is not associated with night light in Asian populations.

Anterior Chamber↗
PubMed2001

Academic achievement, close up work parameters, and myopia in Singapore military conscripts.

AIM: To determine the relation of refractive error to environmental factors, including close up work, in Singapore military conscripts. METHODS: A cross sectional study was conducted on 429 Singapore military conscripts. Non-cycloplegic refraction and A-scan biometry were performed in both eyes. A detailed questionnaire was administered by in-person interview to obtain information about current and past near work activity, extra tuition lessons, educational experiences, and family demographics. RESULTS: Myopia associated with the conscript having been educated in the (gifted, special, or express) educational streams (adjusted odds ratio (OR) = 3.8, 95% confidence interval CI 2.0-7.3), and having completed pre-university education (OR=4.1, 95% CI 1.9-8.8). The reported close up work activity at age 7 years did correlate with age of onset of myopia (p<0.001). In parallel, supplemental tuition lessons in primary school has (OR=2.6, 95% CI 1.4-4.9) associated with conscript myopia. Parental myopia was positively associated with myopia (p<0.001), but this relation disappeared when adjusted for environmental factors. Current (p=0.83) and past close up work activity at age 7 years (p=0.13) did not correlate with myopia. CONCLUSION: Educational level and educational stream positively related to myopia. A relation was observed with reported close up work activity in early childhood and with tuition classes during elementary school, but not with current close up work activity. These results underscore the strong influence of environment in myopia pathogenesis but a role for close up work activity remains indeterminate.

Adult↗
PubMed2001

Renal dysfunction in workers exposed to inorganic lead.

INTRODUCTION: We studied the relationship between renal dysfunction and occupational lead exposure in a local factory. MATERIALS AND METHODS: A cross-sectional study with a cohort component was conducted with 55 male workers of a factory producing PVC stabilisers as subjects. Workers from this factory have been followed up with 6-monthly blood lead measurements since 1982. Two indices of overall lead exposure, i.e. the number of times a worker's blood lead exceeded 40 micrograms/dL (PbB40) and cumulative blood lead index (PbBint), were obtained from this data. Recent blood lead concentration (PbB) was measured. 4-hour creatinine clearance and various other urinary and serum markers of renal dysfunction were used as effect indices. RESULTS: There was no relationship between PbB and any of the renal markers. However, creatinine clearance decreased significantly (P < 0.001) with increasing PbB40 and PbBint after adjustment for age and smoking habits. Urinary albumin (Ualb), urinary alpha-1 microglobulin (U alpha 1m), urinary beta-2 microglobulin (U beta 2m) and urinary retinol-binding protein (URBP) increased significantly with both increasing PbB40 and PbBint. Total urinary activity of N-acetyl-beta-D-glucosaminidase (NAG-T) and its heat-stable isoenzyme (NAG-B) increased significantly with increasing PbB40. A significant difference in renal parameters occurred when PbB40 was 1 or more. CONCLUSIONS: We have found a positive association between overall lead exposure and renal dysfunction. The renal parameters were significantly higher among those who had at least one episode of blood lead above 40 micrograms/dL. Our findings also strengthen the case for the use of Ualb, U alpha 1m, U beta 2m, URBP, NAG-T and NAG-B as early markers of lead nephropathy.

Adult↗
PubMed2001

Genes, work and health.

Explore the source record for details and available documents.

Genetic Predisposition to Disease↗
PubMed2000

Incidence of ischaemic heart disease and stroke in Chinese, Malays and Indians in Singapore: Singapore Cardiovascular Cohort Study.

INTRODUCTION: This is the first prospective cohort study in Singapore to describe the incidence of ischaemic heart disease (IHD) and stroke among Chinese, Malays and Asian Indians. MATERIALS AND METHODS: The Singapore Cardiovascular Cohort Study is a longitudinal follow-up study on a general population cohort of 5920 persons drawn from 3 previous cross-sectional surveys. Morbidity and mortality from IHD and stroke were ascertained by record linkage using a unique identification number with the death registry, Singapore Myocardial Infarct Registry and in-patient discharge databases. RESULTS: There were 193 first IHD events and 97 first strokes during 52,806 person-years of observation. The overall incidence of IHD was 3.8/1000 person-years and that of stroke was 1.8/1000 person-years. In both males and females, Indians had the highest IHD incidence, followed by Malays and then Chinese. For males after adjusting for age, Indians were 2.78 times (95% CI 1.86, 4.17; P < 0.0001) and 2.28 times (95% CI 1.34, 3.88; P = 0.002) more likely to get IHD than Chinese and Malays respectively. For females after adjusting for age, Indians were 1.97 times (95% CI 1.07, 3.63; P = 0.03) and 1.37 times (95% CI 0.67, 2.80; P = 0.39) more likely to get IHD than Chinese and Malays respectively. For stroke, male Chinese and Indians had higher incidence than Malays (though not statistically significant). However, in females, Malays had the highest incidence of stroke, being 2.57 times (95% CI 1.31, 5.05; P = 0.008) more likely to get stroke than Chinese after adjustment for age. CONCLUSIONS: This prospective study of both mortality and morbidity has confirmed the higher risk of IHD in Indians. It has also found that Malay females have a higher incidence of stroke, which deserves further study because of its potential public health importance.

Adult↗
PubMed2000

Myopia: gene-environment interaction.

INTRODUCTION: Myopia has reached epidemic proportions in Japan, Hong Kong, Taiwan and Singapore. This review summarises the evidence for environmental and genetic factors as well as gene-environment interaction for myopia for both epidemiologic studies as well as animal models. METHODS: A literature review was conducted after a Medline search on articles on the genetic or environmental aetiology of myopia in animal or epidemiologic studies. Articles on the methodology of gene-environment studies were also reviewed. All articles reviewed were articles published in peer-reviewed journals. RESULTS: Cross-sectional studies have found a positive association between myopia and near work activity such as reading and writing. Likewise, laboratory research has shown that environmental factors such as visual deprivation may lead to the development of myopia in animals. While linkage studies in humans are currently being conducted to identify possible markers for myopia in the human genome, several neurotransmitters, modulators and growth factors that influence refractive development have already been identified in animal models that may help identify candidate genes. Epidemiologic studies have also evaluated the combined effects of hereditary factors, environmental factors and gene-environment interaction on myopia development. CONCLUSIONS: Both genes and environmental factors may be related to myopia. There are no conclusive studies at present, however, that identify the nature and extent of possible gene-environment interaction. Further linkage analysis, affected sib-pair studies, and family-based association studies may better identify the nature of gene-environment interaction.

Animals↗
PubMed1997

Helicobacter pylori infection and gastric emptying of indigestible solids in patients with dysmotility-like dyspepsia.

BACKGROUND: The role of Helicobacter pylori and gastric motility in dysmotility-like dyspepsia is unclear. The aim of this study was to determine whether delayed gastric emptying of indigestible solids and H. pylori infection are associated with dysmotility-like dyspepsia. METHODS: Thirty-two healthy volunteers and 72 patients fulfilling the criteria of dysmotility-like dyspepsia received a gastric emptying test using radiopaque markers, and the H. pylori status was determined by histology. RESULTS: Twenty-seven percent of volunteers were H. pylori-positive, compared with 32% in the dyspeptic groups (P = NS). Gastric emptying was significantly slower in dyspeptic patients than controls and in H. pylori-positive patients than H. pylori-negative patients. Subjects with gastroparesis have a higher chance of developing dysmotility-like dyspepsia (odds ratio (OR), 2.5) than subjects with normal gastric emptying. Subjects with H. pylori and gastroparesis have an increased likelihood of developing dysmotility-like dyspepsia (OR, 4.3) than if either factor were present alone. CONCLUSION: Our data suggest that gastroparesis alone and gastroparesis and H. pylori infection are associated with dysmotility-like dyspepsia.

Adult↗
PubMed1996

Three-year follow-up of serial nerve conduction among lead-exposed workers.

OBJECTIVES: The purpose of this study was to investigate the serial nerve conduction parameters of a group of lead-exposed workers and determine their correlation with the serial blood lead results over a three-year period. A "nonresponse" level (defined as no significant changes in the nerve conduction in response to changes in the blood lead level of each exposed worker observed over the period of study) was also determined for blood lead in respect to the peripheral nerves. METHODS: Seventy-two male workers from a lead battery manufacturing factory were followed at six-month intervals for three years. At each follow-up, the blood lead level was determined and nerve conduction tests (ulnar and median nerves) were conducted. A group of 82 unexposed subjects served as referents. RESULTS: Significant differences were observed for some of the mean values of the median nerve conduction parameters between the exposed and reference groups. The 28 exposed workers who completed the follow-up were divided into the following two blood lead categories: < 40 micrograms. 100 ml-1 (< 1.93 micromol.l-1 and > or = 40 micrograms. 100 ml-1 (> or = 1.93 micromol.l-1. In the latter, the median motor conduction velocity, median distal latency, median amplitude, ulnar motor conduction velocity, and ulnar amplitude were significantly correlated (adjusted for age and within-subject variation) with the blood lead levels, but not so in the former. CONCLUSIONS: According to the three-year serial results, the "nonresponse" level for blood lead with respect to the peripheral nerves would be < 40 micrograms.100 ml-1 (< 1.93 micromol. l-1).

Adult↗
PubMed1996

Regression analysis of biomedical research data based on a repeated measure or cluster sample.

Research in biology and medicine often entails estimating the effect of an exposure variable X on a response variable Y from a cluster sample, that is, where X and Y may be measured repeatedly from the same subject (cluster), or X and Y may be measured from two or more subjects based on some related grouping such as a litter or household (cluster). Typically, regression analysis of the data is performed ignoring the subject or grouping (cluster) identity. This analytical approach has two drawbacks. First, the statistical inference of the regression coefficient of Y on X (beta) ignored cluster identity will likely be biased. More serious though, is that beta ignored cluster identity will likely be quite discrepant from the average within-cluster beta. It is the latter that is of relevance to the research question. Indeed it is not clear what beta ignored cluster identity really conveys. We describe a multiple regression model for the analysis of data from a cluster sample. The model treats the cluster as a nominal confounding variable to be adjusted. The idea is to represent the cluster by a set of dummy variables to be included as explanatory variables in the regression model. This model gives the average within-cluster beta with valid statistical inference. Numeric examples were used to illustrate the application of the dummy variable multiple regression model. This statistical method can be implemented by any software package that includes multiple regression, and virtually all commercial packages include this procedure.

Cluster Analysis↗
PubMed1996

Biomarkers: a molecular approach to cancer epidemiology.

The rapidly evolving field of molecular epidemiology represents a paradigm shift in medical research, illustrating the convergence of basic, clinical and epidemiologic research, as well as the application of laboratory methods to population studies. As a complement and improvement to traditional epidemiologic approaches, the use of biomarkers offers more accurate exposure assessment at an individual level, better understanding of the biological mechanism of carcinogenesis by tracking a continuum of events between exposure and disease, as well as the ability to discern host or genetic factors that may account for variations in cancer susceptibility among individuals or ethnic populations. Further, biomarkers have also proved useful in cancer diagnosis and prognosis. This article attempts to review the latest progress in molecular cancer epidemiology and to summarise the current state of research in Singapore.

Biomarkers, Tumor↗
PubMed1996

Molecular epidemiology: issues in study design and statistical analysis.

Traditional analytical epidemiology is directed at identifying the association between risk factors and occurrence of disease by using crude exposure data derived from questionnaires or clinical measures, and taking clinical disease as the end point. With the rapid development in molecular biology and laboratory methods, it is now possible to use biomarkers which are capable of identifying molecular events for epidemiologic research. This improved sensitivity enables us to develop a mechanistic understanding of disease causation: a step closer to the unravelling of the "black box" of traditional epidemiology. Biomarkers may be classified as internal indicators of exposure (biomarkers of exposure), indicators of preclinical adverse effect (biomarkers of effect) or indicators of an intrinsic or acquired susceptibility to disease (biomarkers of susceptibility). Biomarkers provide a better definition of exposure and disease status and consequently they could help to reduce misclassification bias in both exposure and disease, reduce the follow-up time in prospective studies, as well as identify possible interactions between risk factors on disease occurrence. However, a biomarker needs to be validated and its distribution in large populations described before it can be used profitably for aetiologic research. Also, the use of biomarkers in epidemiologic research raises other interesting epidemiological and statistical issues like confounding, effect modification and the analysis of repeated measurements. Molecular epidemiology is a multidisciplinary endeavour which comprises molecular biology, epidemiology and biostatistics. Clearly then, to carry out research in this field profitably, the molecular biologist, epidemiologist and biostatistician must acquire not only expertise in their respective fields, but also an integrated understanding of all three fields. The molecular biologist is not merely a laboratory bench worker; the epidemiologist, a field data-collector and the biostatistician, a number cruncher. They must work together to pry open the "black box" to gain a greater insight into how risk factors operate to initiate disease onset and ultimately to make use of this knowledge base to implement preventive measures.

Biomarkers↗
PubMed1995

Lead-induced nephropathy: relationship between various biological exposure indices and early markers of nephrotoxicity.

Lead nephropathy in adults is silent and insidious, characterized by the absence of proteinuria in its early phase. Of the early markers of nephrotoxicity, urinary N-acetyl-beta-D-glucosaminidase (NAG) appears to be the only one that is elevated in early lead nephropathy. However, the elevation in urinary NAG activity may be a response to a sharp increase in renal burden of lead. Its usefulness as a marker of chronic lead nephropathy is thus in doubt. There is a need, then, to identify a reliable early biological indicator of lead-induced kidney damage. Furthermore, there is also a need to identify suitable markers of chronic exposure to describe meaningful dose-response and dose-effect relationships. Traditionally, blood lead (PbB) was used, but the current blood lead level (PbBrec) is more an indicator of recent exposure. Time-integrated blood lead indices (PbBint) derived from repeated serial PbB measurements can be used as indices of chronic exposure. In 128 lead-exposed workers, the PbBint was the most important exposure variable in describing the variability in urinary alpha 1-microglobulin (U alpha 1 m), urinary beta 2-microglobulin (U beta 2m), and urinary retinol binding protein (URBP). U alpha 1m was the only marker that was significantly higher in the exposed group, with a good dose-response and dose-effect relationship with PbBint. The lack of dose-response and dose-effect relationships in other studies may be due to inappropriate exposure markers as well as less sensitive response markers. PbBint has a better correlation than PbBrec. Furthermore, U alpha 1m may be the most sensitive of the markers because of its higher molecular weight.

Adolescent↗
PubMed1995

Glomerular function of lead-exposed workers.

Among lead-exposed workers, there is evidence of increased mortality from chronic renal diseases (nephritis and nephrosis). Epidemiological studies using early markers of nephropathy among lead-exposed workers failed to demonstrate early renal changes. This study is aimed at assessing the glomerular function of 137 lead-exposed subjects and at evaluating whether changes in markers of glomerular function are related to exposure indices derived from longitudinal blood lead data. A control group of 153 postal workers was also investigated. Several exposure indices were derived for the exposed workers, including a time-integrated index Pb in blood (PbB)int and the number of times the PbB was above critical values (PbB400, PbB500, PbB600). Through multiple linear regression analysis, PbBint was the best predictor of variation in serum beta 2-microglobulin (S beta 2m) and alpha 1-microglobulin (S alpha 1m) and urinary albumin (UA1b). A small but statistically significant difference in the mean beta 2m was found. S beta 2m was also the only marker showing a significantly higher prevalence rate ratio (PRR) of abnormalities among lead-exposed workers. Though there was no clear dose-response relationship with PbBint as the index of dose, all the 15 subjects with abnormal S beta 2m in the older age group were found in the highest PbBint group. Furthermore, of the 8 subjects with low 4-h creatinine clearance (CrCl4h), 6 had abnormal levels of beta 2m. Two subjects with CrCl4h of less than 75 ml/min/1.74 m2 had high PbBint values, thus suggesting that high blood lead levels over a prolonged time may be associated with decreased CrCl4h. Though the long-term significance of elevated S beta 2m and UA1b is unclear, their association with high PbBint and decreasing CrCl4h indicate a potentially adverse effect. Their relationship with PbB400 and PbB600 suggests that the threshold of 700 micrograms/l for PbB may not prevent the occurrence of lead nephropathy.

Adolescent↗