Tai Hing Lam

The University of Hong Kong, Hong Kong, Hong Kong

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Publications (538)2318.05 Total impact

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    ABSTRACT: To examine the association between white blood cell count (WBC) and metabolic syndrome (MS) in an older Chinese population. Three thousand and twenty men and 7,256 women aged 50-85 years were recruited and received a medical check-up including measurement of complete blood count, blood pressure, obesity indices, fasting total, LDL-, HDL-cholesterol, triglycerides, glucose and c-reactive protein (CRP). Information on socioeconomic and lifestyle factors was also collected. Vascular risk factors including waist circumference, body mass index, triglyceride, total-, LDL-cholesterol, CRP and systolic and diastolic blood pressures were all positively associated with WBC in both men and women (p from 0.0085 to <0.001). The risk of MS increased significantly with higher total WBC, with adjusted odds ratios (95% confident interval) for second and third tertiles of 1.86 (1.43, 2.42), 2.56 (1.98, 3.32) in men and 1.67 (1.46, 1.90), 2.66 (2.34, 3.03) in women, respectively. Neutrophil and lymphocyte were strongly correlated with total WBC and showed similar association with the MS. There is a strong relationship between total WBC, neutrophil and lymphocyte and the constellation of MS components and associated vascular risk in this older Chinese population.
    Atherosclerosis 02/2008; 201(2):418-24. · 3.71 Impact Factor
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    ABSTRACT: Valid measurements of self-reported physical activity are very limited in Chinese populations, especially the elderly. Therefore, we examined the validity and reliability of the Chinese version of the International Physical Activity Questionnaire (IPAQ-C) in older Chinese people. Two hundred twenty-four older adults (66.1% women, 33.9% men, mean age 65.2 +/- 5.7 yr) were randomly selected from the Guangzhou Biobank Cohort Study, a prospective cohort of older Chinese in Southern China. To examine the test-retest reliability, the participants completed the IPAQ-C twice during a 7-d interval. The criterion validity of the IPAQ-C was tested with pedometry. Good reliability was observed between the repeated IPAQ-C, with intraclass correlation coefficients (ICC) ranging from 0.81 to 0.89. Total activity measured by IPAQ-C correlated moderately with the pedometer-measured steps (partial r = 0.33 adjusted for sex, age, and education; P < 0.001). The walking domain of IPAQ-C was strongly associated with the number of steps (partial r = 0.58, P < 0.001), but there were no significant associations between other activity domains of the IPAQ-C and the pedometer data. This is the first reported validation study of an international standardized questionnaire (IPAQ-C) in older Chinese adults. Our study shows that the IPAQ-C is adequately valid and reliable for assessing total physical activity and that it may be a useful instrument for generating internationally comparable data on physical activity in this population.
    Medicine &amp Science in Sports &amp Exercise 02/2008; 40(2):303-7. · 4.46 Impact Factor
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    ABSTRACT: In countries that have been industrialized for a long time, but not always elsewhere, low socioeconomic position (SEP) is associated with ischemic heart disease in men. The authors hypothesized that socioeconomic development could, via pubertal sex steroids, promote an atherogenic lipid profile and body shape in men but not in women. Therefore, they examined the associations of SEP with ischemic heart disease risk in a developing-country population. The authors used multivariable regression to examine the associations of SEP with the metabolic syndrome and its components in 9,746 Chinese adults aged >/=50 years from the Guangzhou Biobank Cohort Study, phase 2, recruited in 2005-2006. After adjustment for age, smoking, alcohol use, and physical activity, high SEP at each of three life stages, proxied by parental possesions in childhood, education, and longest held-occupation, was inversely associated with the metabolic syndrome in women but not in men. Higher SEP in men was associated with lower pulse pressure and fasting plasma glucose level but also with greater waist circumference and a lower high density lipoprotein cholesterol level. With socioeconomic development, diet-related hormonal changes at puberty may outweigh the usual protective effect of social advantage in men, with corresponding implications for boys currently undergoing the nutrition transition in the developing world.
    American journal of epidemiology 02/2008; 167(4):419-28. · 4.98 Impact Factor
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    ABSTRACT: The male excess risk of premature ischemic heart disease (IHD) mortality may be partially due to an unknown macro-environmental influence associated with economic development. We examined whether excess male risk of IHD mortality was higher with birth in an economically developed environment. We used multivariable logistic regression in a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998 to compare sex differences in IHD mortality (1,189 deaths in men, 1,035 deaths in women and 20,842 controls) between Hong Kong residents born in economically developed Hong Kong or in contemporaneously undeveloped Guangdong province in China. Younger (35-64 years) native-born Hong Kong men had a higher risk of IHD death than such women (odds ratio 2.91, 95% confidence interval 1.66 to 5.13), adjusted for age, socio-economic status and lifestyle. There was no such sex difference in Hong Kong residents who had migrated from Guangdong. There were no sex differences in pneumonia deaths by birth place. Most of these people migrated as young adults; we speculate that environmentally mediated differences in pubertal maturation (when the male disadvantage in lipids and fat patterning emerges) may contribute to excess male premature IHD mortality in developed environments.
    BMC Public Health 02/2008; 8:32. · 2.32 Impact Factor
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    ABSTRACT: The metabolic syndrome is a predictor of diabetes and coronary events. We hypothesized that it also predicts hypertension. A total of 1,944 subjects (901 men and 1,043 women; age 46 +/- 12 years) from the Hong Kong Cardiovascular Risk Factor Prevalence Survey were recruited in 1995-1996 and restudied in 2000-2004. The prevalence of hypertension and factors predicting its development were determined. In 2000-2004, hypertension was found in 23.2% of the men and 17.2% of the women. Of the 1,602 subjects who were normotensive at baseline, 258 subjects developed hypertension after a median interval of 6.4 years. According to the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) criteria, the hazard ratios associated with the metabolic syndrome were 1.89 (95% confidence interval (CI): 1.41-2.54) and 1.72 (95% CI: 1.24-2.39), respectively. The positive and negative predictive values of the metabolic syndrome for identifying subjects who will develop hypertension in this population were 34.7 and 85.4% (NCEP criteria), and 33.1 and 85.5% (IDF criteria), respectively. The development of hypertension was related to the number of components of the metabolic syndrome (other than raised blood pressure), present in men (P = 0.003) and in women (P = 0.001). Using multivariate analysis, age, baseline systolic blood pressure (SBP), body mass index (BMI), and the triglycerides/high-density lipoprotein (HDL) ratio were found to be significant predictors of the development of hypertension. Compared with optimal blood pressure, the hazards of developing hypertension associated with normal or high-normal blood pressure were 2.31 (95% CI: 1.68-3.17) and 3.48 (95% CI: 2.52-4.81), respectively. Blood pressure, when not optimal, is the predominant predictor of hypertension. The metabolic syndrome contributes to the risk, especially when blood pressure is optimal.
    American Journal of Hypertension 02/2008; 21(1):17-22. · 3.40 Impact Factor
  • Severe Acute Respiratory Syndrome, 01/2008: pages 111 - 130; , ISBN: 9780470755952
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    ABSTRACT: Alkaline phosphatase (ALP) is a biomarker for hepatobiliary and skeletal diseases. It is also raised in sepsis. In atherosclerotic plaques, ALP is expressed. Similar to C-reactive protein (CRP), it may be another marker of systemic inflammation. Therefore, we investigated their association in a Hong Kong Chinese population. Plasma ALP and CRP were measured in 205 subjects (110 men, 95 women; age 55.2+/-11.6 years) in the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 cohort. The blood levels of ALP and CRP were significantly correlated (r=0.30, p<0.001), which was due to a significant correlation in women (r=0.43, p<0.001). In a multivariate model, CRP level was related to ALP (beta=0.18, p=0.008). After adjusting for confounding factors and other liver enzymes, the relationship between ALP and CRP remained significant in women (beta=0.28, p=0.019), but in men, ALP was not an independent determinant of CRP levels. ALP may be another marker of systemic inflammation, especially in women. Whether it provides clinical information additional to CRP requires further study.
    Clinical Chemistry and Laboratory Medicine 01/2008; 46(4):523-7. · 2.96 Impact Factor
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    ABSTRACT: Fibrinogen, an acute phase protein, is an important inflammatory marker that is associated with cardiovascular diseases. We studied the association of three common human fibrinogen-beta gene (FGB) variants, -455G>A, -249C>T, and -148C>T with glycemic parameters in 265 non-diabetic Hong Kong Chinese subjects. Both FGB variants, -455G>A and -148C>T were in complete linkage disequilibrium and were associated with higher levels of plasma fibrinogen and 2-h glucose after a 75-g oral glucose load (p<0.01). Carriers of FGB AC-haplotype, comprising the two nucleotide variants at positions -455 and -249, had higher fibrinogen level (2.64 +/- 0.65 vs 2.42 +/- 0.52 g/L, p=0.002) and 2-h glucose after a 75-g oral glucose load (5.87 +/- 1.14 vs 5.47 +/- 1.22 g/L, p=0.006). The associations were significant in men, but not women. In stepwise multiple regression analysis, AC-haplotype was independently associated with plasma fibrinogen level and 2-h glucose (p=0.002 and 0.010 respectively). This suggests that fibrinogen may play a role in the development of impaired glucose tolerance.
    Disease markers 01/2008; 24(3):167-73. · 2.17 Impact Factor
  • Journal of the American Geriatrics Society 01/2008; 55(12):2090-1. · 4.22 Impact Factor
  • Diabetes care 01/2008; 30(12):3116-8. · 7.74 Impact Factor
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    ABSTRACT: Female height impacts fertility differently in western and nonwestern cultures. Leg length or relatively longer legs comprise key components of height and possibly indicates mate value. We examined the associations between height, its components, and reproductive outcomes in a large Chinese cohort. Multivariable regression was used to assess the association of height, leg length (standing minus sitting height) and relatively longer legs with number of offspring in a cross-sectional sample of 9998 Chinese people aged at least 50 years from Phase 2 of the Guangzhou Biobank Cohort Study recruited in 2005–2006. Older and less educated respondents had more children. Adjusted for age, childhood socioeconomic status (SES), and education, women with longer legs had more offspring; however, there was no such association in men. When stratified by childhood SES (reported parental material possessions), longer legs and relatively longer legs were most strongly associated with more offspring in women from poorer backgrounds. Fertility was specifically associated with longer legs and relatively longer legs in women only. The difference in the association of leg length to number of offspring by childhood SES suggests a preference advantage rather than a physiological advantage in being taller. However, these benefits were specific to reproductive success in women and particularly women from poorer backgrounds suggesting that social factors may have facilitated fertility.
    Evolution and Human Behavior - EVOL HUM BEHAV. 01/2008; 29(6):434-443.
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    ABSTRACT: In western populations, young age of menarche is associated with increased cardiovascular risk. Little is known about the potential impact of menarche on the metabolic syndrome (as a proxy for cardiovascular risk) in rapidly economically developing populations where age of menarche is falling. We sought to determine the relation between age of menarche and the metabolic syndrome in a rapidly developing Chinese population. We carried out a retrospective historical cohort study of 7349 women from the Guangzhou Biobank Cohort Study, China, enrolled in 2003-2004. Cardiovascular risk factors were obtained from physical examination; age of menarche was obtained from self-report. The main outcome measure was the metabolic syndrome and its components. Adjusted for age, education, and number of pregnancies, young age of menarche (<12.5 years) compared with age of menarche > or =14.5 years was associated with a higher risk of the metabolic syndrome (odds ratio = 1.49; 95% confidence interval = 1.22-1.82), central obesity (1.35; 1.10-1.65), raised blood pressure (1.34; 1.09-1.65), raised fasting glucose (1.40; 1.15-1.71), and higher triglyceride levels (1.36; 1.12-1.67). Further adjustment by waist circumference attenuated these effects, but the odds ratios remained elevated. Earlier age of menarche experienced by younger women in China today, now 12.5 years on average in urban populations, may contribute to an increase in the metabolic syndrome and thereby an increase in cardiovascular disease as these women age. These results further highlight the importance of childhood antecedents of adulthood disease.
    Epidemiology 11/2007; 18(6):740-6. · 6.18 Impact Factor
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    ABSTRACT: Better childhood conditions, inferred from height and specifically leg length, are usually protective against ischemic heart disease and its risk factors in Western countries. In other geoethnic populations, height is less clearly protective, casting doubt on there being a biological etiology. To clarify the role of childhood conditions, we examined the associations of height and its components with cardiovascular risk among older Chinese people. We used multivariable regression to examine the associations of height and its components with blood pressure, lipid profile, and diabetes in 10413 older Chinese adults (mean age=64.6 years). After we adjusted for age, gender, socioeconomic status, and lifestyle habits, greater sitting height was associated with diabetes and dyslipidemia. Longer legs were associated with lower pulse pressure and lower low-density lipoprotein cholesterol. We provide indirect anthropometric evidence for the role of pre-pubertal and pubertal exposures on cardiovascular risk. Pubertal exposures are stronger than are prepubertal exposures but may be influenced by osteoporotic decline in old age. Further research should establish whether the observed relations are ethnically specific or relate to the stage or trajectory of socioeconomic development.
    American Journal of Public Health 11/2007; 97(10):1834-41. · 3.93 Impact Factor
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    ABSTRACT: This study investigates the relation of five chronic cardiovascular diseases and diabetes mellitus (DM) to perceived health, and the moderating effects of sex and age. In a community-based cross-sectional telephone survey in Hong Kong, 7730 Chinese aged 25-74 were interviewed in 1994-1996. The odds ratio for poor perceived health associated with each condition was calculated adjusting for age, sex and education. Subjects free from the six conditions were treated as the comparison group. Hypertension, angina, DM, coronary heart disease (CHD) and stroke were significantly associated with poor perceived health. The odds ratio of poor perceived health was significantly greater in men than in women for having more than one condition among DM, CHD and stroke (p=0.02), and insignificantly greater for stroke, CHD and angina. The odds ratios were significantly greater in the young (25-39) versus the old (60-74) for DM (p=0.008) in men and women combined, and for having either DM, CHD or stroke in men (p=0.02). These findings suggest that the relation of DM, CHD and stroke with poor perceived health tends to be stronger in men and younger adults. These findings have implications for health care workers and home carers who need to appreciate that the same condition may have a different perceived impact on persons of different sex and age, and be sensitive to their varying needs.
    Social Science [?] Medicine 11/2007; 65(7):1386-96. · 2.56 Impact Factor
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    ABSTRACT: Sex differences in lipids and body shape, but not diabetes, increase at puberty. Hong Kong Chinese are mainly first or second generation migrants from China, who have shared an economically developed environment for years, but grew up in very different environments in Hong Kong or contemporaneously undeveloped Guangdong, China. We assessed if environment during growth had sex-specific associations with lipids and body shape, but not diabetes. We used multivariable regression in a population-based cross-sectional study, undertaken from 1994 to 1996, of 2537 Hong Kong Chinese residents aged 25 to 74 years with clinical measurements of ischaemic heart disease (IHD) risk, including HDL-cholesterol, ApoB, diabetes and obesity. Waist-hip ratio was higher (mean difference 0.01, 95% CI 0.001 to 0.02) in men, who had grown up in an economically developed rather than undeveloped environment, as was apolipoprotein B (0.05 g/L, 95% CI 0.001 to 0.10), adjusted for age, socio-economic status and lifestyle. In contrast, the same comparison was associated in women with lower waist-hip ratio (-0.01, 95% CI -0.001 to -0.02) and higher HDL-cholesterol (0.05 mmol/L, 95% CI 0.0004 to 0.10). The associations in men and women were significantly different (p-values<0.001). There were no such differences for diabetes. Growth in a developed environment with improved nutrition may promote higher sex-steroids at puberty producing an atherogenic lipid profile and male fat pattern in men but the opposite in women, with tracking of increased male IHD risk into adult life.
    PLoS ONE 10/2007; 2(10):e1070. · 3.53 Impact Factor
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in China, where the population is also exposed to high levels of passive smoking, yet little information exists on the effects of such exposure on COPD. We examined the relation between passive smoking and COPD and respiratory symptoms in an adult Chinese population. We used baseline data from the Guangzhou Biobank Cohort Study. Of 20 430 men and women over the age of 50 recruited in 2003-06, 15,379 never smokers (6497 with valid spirometry) were included in this cross-sectional analysis. We measured passive smoking exposure at home and work by two self-reported measures (density and duration of exposure). Diagnosis of COPD was based on spirometry and defined according to the GOLD guidelines. There was an association between risk of COPD and self-reported exposure to passive smoking at home and work (adjusted odds ratio 1.48, 95% CI 1.18-1.85 for high level exposure; equivalent to 40 h a week for more than 5 years). There were significant associations between reported respiratory symptoms and increasing passive smoking exposure (1.16, 1.07-1.25 for any symptom). Exposure to passive smoking is associated with an increased prevalence of COPD and respiratory symptoms. If this association is causal, we estimate that 1.9 million excess deaths from COPD among never smokers could be attributable to passive smoking in the current population in China. Our findings provide strong evidence for urgent measures against passive smoking in China.
    The Lancet 10/2007; 370(9589):751-7. · 39.21 Impact Factor
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    ABSTRACT: To examine the association between serum c-reactive protein (CRP) concentration and the metabolic syndrome (MS) using the International Diabetes Federation Metabolic Syndrome Guidelines (April, 2005) definition in an older Chinese population. Three thousand and fourteen men and 7275 women aged 50-85 years were recruited and received a full medical check-up including measurement of blood pressure, obesity indices, fasting total, LDL-, HDL-cholesterol, triglycerides, glucose and c-reactive protein. Data describing socioeconomic and lifestyle factors was also collected. Vascular risk factors including waist circumference, weight gain and waist gain since the age of 18, body mass index, waist-hip-ratio, triglyceride, HDL-cholesterol, and systolic and diastolic blood pressures were positively associated with CRP in both men and women (p from <0.001 to 0.016). Compared to those without MS components, adjusted odds ratios for having elevated CRP increased in those with the MS or its components compared those without MS or components (all p<0.001), except for the low HDL-cholesterol in both genders and raised fasting glucose in men. Similarly, the risk of elevated CRP increased with escalating MS components even after adjustment of a range of potential confounders. There is a strong relationship between CRP and the constellation of MS components and associated vascular risk in this older Chinese population.
    Atherosclerosis 10/2007; 194(2):483-9. · 3.71 Impact Factor
  • Early Human Development 09/2007; 83. · 1.93 Impact Factor
  • Early Human Development 09/2007; 83. · 1.93 Impact Factor
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    Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 09/2007; 13(4):332; author reply 332-3.

Publication Stats

7k Citations
2,318.05 Total Impact Points


  • 1982–2014
    • The University of Hong Kong
      • • School of Public Health
      • • Department of Paediatrics and Adolescent Medicine
      • • Department of Community Medicine
      • • Department of Medicine
      Hong Kong, Hong Kong
  • 2013
    • Worcestershire Acute Hospitals NHS Trust
      Worcester, England, United Kingdom
    • University of Glasgow
      • West of Scotland Cancer Surveillance Unit
      Glasgow, Scotland, United Kingdom
  • 2006–2013
    • The George Institute for Global Health
      Sydney, New South Wales, Australia
  • 1995–2013
    • University of Birmingham
      • Department of Public Health, Epidemiology and Biostatistics
      Birmingham, England, United Kingdom
  • 2012
    • University of Ottawa
      Ottawa, Ontario, Canada
    • Universität Heidelberg
      • Faculty of Medicine Mannheim and Clinic Mannheim
      Heidelberg, Baden-Wuerttemberg, Germany
    • University of Texas Southwestern Medical Center
      Dallas, Texas, United States
  • 2004–2012
    • University of Sydney
      • George Institute for Global Health
      Sydney, New South Wales, Australia
  • 2011
    • University of Minnesota Twin Cities
      • Division of Epidemiology and Community Health
      Minneapolis, MN, United States
    • London School of Hygiene and Tropical Medicine
      Londinium, England, United Kingdom
  • 1997–2011
    • The Chinese University of Hong Kong
      • Department of Medicine and Therapeutics
      Hong Kong, Hong Kong
  • 2010
    • University of Oslo
      • Department of Biostatistics
      Oslo, Oslo, Norway
    • University of Groningen
      • Department of Epidemiology
      Groningen, Province of Groningen, Netherlands
  • 2009
    • Medical Research Council (UK)
      Londinium, England, United Kingdom
  • 2008–2009
    • Chinese PLA General Hospital (301 Hospital)
      Peping, Beijing, China
    • Hong Kong SAR Government
      Hong Kong, Hong Kong
  • 2003–2006
    • Queen Mary Hospital
      Hong Kong, Hong Kong
    • Isfahan University of Medical Sciences
      • Epidemiology and Biostatistics Department
      Eşfahān, Ostan-e Esfahan, Iran
  • 2004–2005
    • Imperial College London
      • Department of Infectious Disease Epidemiology
      London, ENG, United Kingdom
  • 2000–2002
    • The University of Hong Kong - Shenzen Hospital
      Hong Kong, Hong Kong
    • Chongqing University of Medical Science
      Ch’ung-ch’ing-shih, Chongqing Shi, China
  • 2001
    • The Hong Kong Polytechnic University
      • Department of Rehabilitation Sciences
      Hong Kong, Hong Kong
  • 1998
    • The University of Sheffield
      Sheffield, England, United Kingdom
  • 1994
    • Fourth Military Medical University
      • Department of Epidemiology
      Xi’an, Liaoning, China
  • 1989–1990
    • Caritas Medical Centre
      Hong Kong, Hong Kong
    • Christian Hospital
      Saint Louis, Michigan, United States