Publications by authors named "Woon Puay Koh"

Background: There are scarce data on risk factors for epithelial ovarian cancer (EOC) in Asian populations. Our goal was to advance knowledge on reproductive -related risk factors for EOC in a large population of Asian women.

Methods: This study used pooled individual data from baseline questionnaires in 11 prospective cohorts (baseline years, 1958-2015) in the Asia Cohort Consortium.

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  • Glycated haemoglobin (HbA1c), a key marker for diabetes, was investigated in older adults without cardiovascular disease to see its role in predicting myocardial ageing.
  • A study with 247 participants showed significant correlations between HbA1c levels and various left atrial strain measures, indicating changes in heart function.
  • The findings suggest that HbA1c could be a useful biomarker for assessing heart health risks related to ageing, regardless of whether an individual has diabetes.
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  • The study explored the connection between sleep duration during midlife and the development of depressive symptoms in late life among 14,361 participants in the Singapore Chinese Health Study.
  • It found that sleeping 5 hours or less during midlife increased the risk of depression in later years, while longer sleep (9 hours or more) did not show a significant link at that time.
  • In late life, both insufficient and excessive sleep were associated with depressive symptoms, indicating that sleep duration issues remain relevant throughout aging.
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  • * Researchers found that the average age girls start their periods is about 14 years, but it has been getting younger over the past 100 years.
  • * Different countries showed different trends, with some like China having ups and downs, while others like Japan and Singapore had a steady decline in the average age.
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  • The study examined how vegetable and fruit intake during midlife affects the chances of experiencing physical frailty later in life among Chinese adults in Singapore, using a prospective cohort design over 20 years.
  • Results showed that higher vegetable consumption was linked to lower odds of frailty, particularly in areas like weakness measured by handgrip strength, while fruit intake did not show a significant impact.
  • Further analysis indicated that the association between vegetable intake and reduced frailty diminished when accounting for specific nutrients like β-carotene and folate, suggesting these nutrients might play a crucial role in the observed effects.
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Purpose: Antibodies to select Epstein-Barr virus proteins can diagnose early-stage nasopharyngeal carcinoma (NPC). We have previously shown that IgA against Epstein-Barr virus nuclear antigen 1 (EBNA1) can predict incident NPC in high- and intermediate-risk cohorts 4 years before diagnosis. Here, we tested EBNA1 variants, with mutants, to define the sequence requirements for an NPC risk assay.

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Background: Although red meat consumption has been associated with risk of atherosclerotic coronary artery disease and stroke, no prospective study has examined this with the risk of chronic limb-threatening ischemia (CLTI).

Methods: In a prospective study of 63,257 Chinese in Singapore, who were aged 45-74 years old at recruitment, diet was assessed via a validated semi-quantitative food frequency questionnaire. Incident CLTI cases were ascertained via linkage with nationwide hospital records for lower extremity amputation or angioplasty for peripheral arterial disease.

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While rapid demographic changes in Asia are driving the incidence of chronic aging-related diseases, the limited availability of high-quality in vivo data hampers our ability to understand complex multi-factorial contributions, including gut microbial, to healthy aging. Leveraging a well-phenotyped cohort of community-living octogenarians in Singapore, we used deep shotgun-metagenomic sequencing for high-resolution taxonomic and functional characterization of their gut microbiomes (n = 234). Joint species-level analysis with other Asian cohorts identified distinct age-associated shifts characterized by reduction in microbial richness, and specific Alistipes and Bacteroides species enrichment (e.

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Objective: The objective of this study was to compare race- and ethnicity-specific BMI cutoffs for the three classes of obesity based on equivalent risk of type 2 diabetes (T2D).

Methods: Participants without T2D were included from the UK Biobank, the China Health and Nutrition Survey, and the Singapore Chinese Health Study. Poisson regressions with restricted cubic splines were applied to determine BMI cutoffs for each non-White race and ethnicity for equivalent incidence rates of T2D at BMI values of 30.

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  • The study examines the relationship between body mass index (BMI) and the risks of developing colorectal cancer (CRC) and dying from it in the Asian population, highlighting rising obesity rates and CRC incidence.
  • The research pooled data from 17 cohort studies spanning from 1984 to 2002, with a median follow-up of 15.2 years and included nearly 620,000 participants for CRC incidence and over 650,000 for CRC-related mortality.
  • Results indicate that higher BMI significantly increases the risk of incident CRC, with greater risks seen for those classified as obese, especially for colon cancer compared to rectal cancer, and a similar pattern was noted for CRC-related deaths.
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Background: Adult height has been associated with handgrip strength, which is a surrogate marker of physical frailty. However, it is uncertain if this association is causative or due to confounding bias.

Methods: We evaluated pairwise associations among handgrip strength, adult height, and genetically determined height (using a polygenic score [PGS] for height in a mediation framework and a 2-sample Mendelian randomization approach) by means of a multivariable regression model using a prospective cohort of Chinese living in Singapore.

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Background: Cognitive impairment (CI) raises risks for unplanned healthcare utilisation and expenditures and for premature mortality. It may also reduce risks for planned expenditures. Therefore, the net cost implications for those with CI remain unknown.

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Purpose: To assess the association of a polygenic risk score (PRS) for functional genetic variants with the risk of developing breast cancer.

Methods: Summary data-based Mendelian randomization (SMR) and heterogeneity in dependent instruments (HEIDI) were used to identify breast cancer risk variants associated with gene expression and DNA methylation levels. A new SMR-based PRS was computed from the identified variants (functional PRS) and compared to an established 313-variant breast cancer PRS (GWAS PRS).

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Background: It is unclear if improving diet quality after midlife could reduce the risk of physical frailty at late life. We aimed to associate changes in diet quality after midlife with physical frailty at late life.

Methods: Diet quality in 12,580 participants from the Singapore Chinese Health Study was assessed with the Dietary Approaches to Stop Hypertension (DASH) scores at baseline (1993-1998; mean age 53 years) and follow-up 3 (2014-2016; mean age 73 years).

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  • A study investigated the link between fruit and vegetable intake in midlife and the risk of depressive symptoms later in life in a cohort of Chinese adults living in Singapore, involving 13,738 participants.
  • Researchers found that higher fruit consumption was associated with a lower likelihood of depressive symptoms, particularly with fruits like oranges and bananas, suggesting a dose-response relationship.
  • Conversely, vegetable intake did not show a significant effect on depressive symptoms, leading to recommendations for increased fruit consumption to potentially improve mental health outcomes in older age.
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Preclinical and limited epidemiological studies suggest that oxidative stress may be implicated in geriatric depression. Our study investigated the association between midlife dietary total antioxidant capacity (TAC) and depressive symptoms in late life among 13,712 participants in a population-based cohort of Chinese in Singapore. At baseline (1993-1998), intake of antioxidants from diet and supplements at a mean age of 52.

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  • A study was conducted using data from 968,738 adults across 20 cohort studies in Asia to investigate the link between diabetes and liver cancer incidence and mortality.
  • The findings revealed that adults with diabetes had a significantly higher risk of being diagnosed with liver cancer (hazard ratio of 1.97) and dying from it (adjusted hazard ratio of 1.97) compared to those without diabetes.
  • The robust results, supported by a two-stage meta-analysis, contribute valuable evidence to the understanding of liver cancer risks among diabetic populations in Asian countries.
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Setting: Although age at menopause has been linked to higher risk of physical frailty in later life, little is known about other reproductive factors.

Objectives: Our study aimed to investigate the associations between 1) age at menarche, 2) age at natural menopause, 3) duration of reproductive period, 4) number of children, 5) use of oral contraceptives (OCP), and 6) use of hormone replacement therapy (HRT) with the risk of physical frailty in late life.

Design: We used data from 5934 women of the Singapore Chinese Health Study who experienced natural menopause, and participated in the third follow-up interviews when physical frailty was assessed.

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Unlabelled: Limited data are reported on the association between low-carbohydrate diet (LCD) score, a comprehensive measure of dietary pattern according to sources of carbohydrate, fat, and protein, and risk of hepatocellular carcinoma (HCC). We evaluated this score with HCC risk in the Singapore Chinese Health Study, a prospective cohort of 63,275 middle-aged and elderly Chinese living in Singapore and recruited during 1993-1998 period. LCD scores were derived from the semi-quantitative food frequency questionnaire at baseline.

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The female predominance of gallbladder cancer (GBC) has led to a hypothesis regarding the hormone-related aetiology of GBC. We aimed to investigate the association between female reproductive factors and GBC risk, considering birth cohorts of Asian women. We conducted a pooled analysis of 331,323 women from 12 cohorts across 4 countries (China, Japan, Korea, and Singapore) in the Asia Cohort Consortium.

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Purpose: DNA methylation alterations are widespread in acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS), some of which appear to have evolved independently of somatic mutations in epigenetic regulators. Although the presence of somatic mutations in peripheral blood can predict the risk of development of AML and MDS, its accuracy remains unsatisfactory.

Experimental Design: We performed global DNA methylation profiling in a case control study nested within the Singapore Chinese Health Study to evaluate whether DNA methylation alterations were associated with AML/MDS development.

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Converging evidence suggests that handgrip strength is linked to cognition in older adults, and this may be subserved by shared age-related changes in brain function and structure. However, the interplay among handgrip strength, brain functional connectivity, and cognitive function remains poorly elucidated. Hence, our study sought to examine these relationships in 148 community-dwelling older adults.

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Background: A high body mass index (BMI, kg/m) is associated with decreased risk of breast cancer before menopause, but increased risk after menopause. Exactly when this reversal occurs in relation to menopause is unclear. Locating that change point could provide insight into the role of adiposity in breast cancer etiology.

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  • - The study analyzed lung cancer risk related to reproductive factors among 308,949 Asian women across four countries, finding inconsistent results in previous research.
  • - Parous women (those who have given birth) were found to have a significantly lower risk of lung cancer incidence and mortality compared to nulliparous women, especially among smokers.
  • - Higher ages at first childbirth were associated with decreased lung cancer risk, while hormone replacement therapy users showed a greater likelihood of developing non-small cell lung cancer. Future research is needed to explore these findings further.
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