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Background: Endovascular repair of the aortic arch is often unsatisfactory due to poor stent-vessel conformity and inadequate landing zones., Objective: To study the anatomical characteristics of the aortic arch and provide basic information for the development of arch-specific endovascular devices., Materials and Methods: Three-dimensional models were reconstructed in Mimics (image segmentation software) from computed tomography aortograms of 120 elderly Asian patients, by manual segmentation. The centerline of each Three-dimensional aortic model was calculated using a repulsive force field method. Measurements of the aorta and supra-aortic branches were analyzed using Patran (finite-element software). A three-dimensional statistical aortic arch model was built using principal component analysis., Results: The mean diameters of the ascending and descending aorta, and the origins of the innominate, left common carotid, and left subclavian artery were 39.4 ± 6.7, 34.5 ± 7.9, 18.0 ± 3.8, 12.6 ± 2.7, and 14.1 ± 2.5 mm, respectively. The length of the ascending aorta, innominate to left common carotid artery, and left common carotid to left subclavian artery were 62.6 ± 11.4, 12.0 ± 5.6, and 18.7 ± 5.6 mm along the centerline. The mean angle of curvature was 103.8 ± 25 degrees. Principal component analysis of the three-dimensional centerlines derived 3 main modes of variation, which account for 61% of the overall shape range., Conclusion: Aortic arch anatomical information from an elderly Asian population can be useful for the development of future endovascular devices.

Objective: Increased BMI is a robust risk factor for type 2 diabetes. Paradoxically, South Asians have relatively low BMIs despite their high prevalence of type 2 diabetes. We examined the association between BMI and incident type 2 diabetes because detailed prospective cohort data on this topic in Asians are scarce., Research Design and Methods: This study was a prospective analysis of 37,091 men and women aged 45-74 years in the Singapore Chinese Health Study, using Cox regression analysis., Results: Risk of incident type 2 diabetes significantly increased beginning with BMIs 18.5-23.0 kg/m(2)(relative risk 2.47 [95% CI 1.75-3.48]) and continued in a monotonic fashion across the spectrum of BMI. Results were stronger for younger than for older adults., Conclusions: BMIs considered lean and normal in Singaporean Chinese are strongly associated with increased risk of incident type 2 diabetes. This association weakened with advanced age but remained significant.

While some studies have found a positive association between both short and long sleep durations and cardiovascular disease (CVD), others have found an association only with a long or short sleep duration. In addition, there are limited data from non-Western populations on this topic. The authors examined the association between sleep duration and coronary heart disease (CHD) mortality among Chinese adults in Singapore (1993-2006), performing a prospective cohort study among 58,044 participants aged > or =45 years (55.9% women) without preexisting CVD. The main outcome of interest was CHD mortality (n = 1,416). The authors found both short and long sleep durations to be positively associated with CHD mortality, independent of smoking, alcohol intake, and body mass index. Compared with persons with a sleep duration of 7 hours (referent), the multivariable relative risk of CHD mortality for a sleep duration of < or =5 hours was 1.57 (95% confidence interval: 1.32, 1.88); for a sleep duration of > or =9 hours, it was 1.79 (95% confidence interval: 1.48, 2.17). This association persisted in subgroup analyses by sex and body mass index. In a population-based cohort of Chinese adults from Singapore, sleep durations of < or =5 hours and > or =9 hours (versus 7 hours) were modestly associated with CHD mortality. These results suggest that sleep duration may be an important marker for CVD.

Aim: To estimate the relationship between matrix metalloproteinase (MMP)-1 promoter -1607 bp polymorphism and the risk of epithelial ovarian cancer (EOC) in Korean women and to clarify the ethnic difference in genotype distribution of this polymorphism., Methods: Single nucleotide polymorphism (SNP) of MMP-1 promoter -1607 region in 133 EOC patients and 332 cancer-free patients were investigated. Then the associations of this polymorphism with EOC or its clinicopathological parameters were analyzed. In addition, genotype distributions of this polymorphism in Korean women were compared with those of other races by extracting data from the previously published literature., Results: We found no relationship between MMP-1 promoter -1607 bp polymorphism and epithelial ovarian cancer in a Korean population. Furthermore, we found ethnicity-dependent differences in genotype distributions and allele frequencies by comparison with previous articles on this topic. We report significant ethnic differences in the genotype distributions and allele frequencies of the MMP-1 promoter -1607 bp polymorphism., Conclusion: Our results indicate that MMP-1-1607 bp polymorphism shows ethnic diversity, and that the hypothesis that this polymorphism is associated with epithelial ovarian cancer is not supported by this study in a Korean population. Moreover, this finding concurs with results obtained in white Americans and Europeans.

Rationale: Using principal components analysis to examine dietary patterns complements the evaluation of individual food and nutrient intake in relation to health outcomes, but has not yet been applied to nonmalignant respiratory disease or symptoms., Objective: To examine the relation between patterns of dietary intake at baseline and new onset of persistent cough with phlegm in a population-based cohort of Singapore Chinese., Methods: A 165-item validated food frequency questionnaire was administered in-person at baseline in 1993. We identified 623 cases of incident cough with phlegm among 52,325 subjects by telephone interview from 1999 through 2004. We identified two distinct food patterns: a "meat-dim sum" pattern characterized by pork and chicken dim sum foods and noodle dishes, and a "vegetable-fruit-soy" pattern characterized by vegetables, fruit, and soyfood items., Main Results: The meat-dim sum pattern was positively associated with new-onset cough with phlegm (odds ratio, 1.43; 95% confidence interval, 1.08, 1.89; comparing fourth to first quartile, p for trend = 0.02), after adjustment for age, sex, total energy intake, smoking, education, and nonstarch polysaccharide intake, a protective factor for cough with phlegm in this cohort. Weaker associations were seen for more chronic symptoms and for incident asthma. A weak inverse association for the vegetable-fruit-soy pattern disappeared after adjustment for nonstarch polysaccharide intake., Conclusion: A diet rich in meats, sodium, and refined carbohydrates may increase risk of developing cough with phlegm, independently of the apparent beneficial effects of a diet high in fiber in this Singapore Chinese cohort.

Although studies in Western populations have shown that smokers have decreased dietary intakes of antioxidants and other health-related nutrients, this has not been established in oriental populations. This study aimed to identify differences in dietary and lifestyle characteristics between current, former, and never-smokers among middle-aged and older Chinese in Singapore. The subjects, 45-74 y old, were participants in the Singapore Chinese Health Study, a prospective cohort that enrolled 63,257 (27,959 men and 35,298 women) Chinese in Singapore between 1993 and 1998. Data on current dietary habits (using a validated, semiquantitative FFQ) and other lifestyle factors were collected through face-to-face interviews. Mean daily intakes of various nutrients were estimated using a food composition table that was specifically developed for this population. The current smoking rates were 36% in men and 6% in women; an additional 22% of men and 3% of women were former smokers. In both sexes, current smokers were less educated, had lower BMI, led a more sedentary lifestyle, and drank more alcohol and coffee than those who never smoked. Current smokers had dose-dependent decreases in the intakes of a wide range of antioxidants, vitamins, fiber, and calcium, but increases in the intakes of cholesterol and nitrosamines compared with people who never smoked. Former smokers had dietary intakes that either were similar to never-smokers or intermediate between current and never-smokers. Our results are consistent with findings among Western populations, and suggest that the unhealthy diet and lifestyle in smokers occur across diverse cultures.

Chinese populations consume a diet relatively high in isothiocyanates (ITCs), a derivative of cruciferous vegetables known to have cancer-protective effects. This class of compounds is metabolized by the glutathione S-transferase family of enzymes, which are also involved in the detoxification of tobacco-related carcinogens such as polycyclic aromatic hydrocarbons and alkyl halides. We evaluated the association between dietary isothiocyanate intake, GSTM1 and GSTT1 polymorphisms, and lung cancer risk in 420 Chinese women: 233 histologically confirmed lung cancer patients and 187 hospital controls. Among these, 58.8% of cases and 90.3% of controls were lifetime nonsmokers. An allele-specific PCR method was used to detect the presence or absence of the GSTM1 and GSTT1 genes in DNA isolated from peripheral blood. Higher weekly intake of ITCs (above the control median value of 53.0 micromol) reduced the risk of lung cancer to a greater extent in smokers [adjusted odds ratio (OR), 0.31; 95% confidence interval (CI), 0.10-0.98] than nonsmokers (OR, 0.70; 95% CI, 0.45-1.11). The inverse association was stronger among subjects with homozygous deletion of GSTM1 and/or GSTT1. Among nonsmokers with GSTM1-null genotype, higher intake of ITCs significantly reduced the risk of lung cancer (OR, 0.54; 95% CI, 0.30-0.95), an effect not seen among those with detectable GSTM1 (OR, 1.07; 95% CI, 0.50-2.29). Our results, in a Chinese female population, are consistent with the hypothesis that ITC is inversely related to the risk of lung cancer, and we show that among nonsmokers this effect may be primarily confined to GST-null individuals. Conjugation and elimination of ITCs is enhanced in GST-non-null relative to -null individuals, such that the GST metabolic genotype modifies the protective effect of ITCs on lung cancer development.

Background: Epidemiologic studies have identified the plasma homocysteine concentration as a risk factor for atherothrombotic vascular disease. There is little information on the distributions and determinants of homocysteine concentrations in Asian populations., Objective: The present study was designed to examine the relations between genetic and lifestyle factors and plasma homocysteine concentrations among Chinese in Singapore., Design: Plasma total homocysteine, folate, vitamin B-12, and vitamin B-6 concentrations and genetic variation at the methylenetetrahydrofolate reductase (MTHFR) locus were measured in 486 Chinese men and women aged 45-74 y in Singapore. Data on dietary and other lifestyle factors were collected in face-to-face interviews., Results: Men had higher plasma concentrations of total homocysteine than women (P = 0.0001). Age was positively associated with plasma homocysteine in both sexes (P for trend = 0.0001). Plasma concentrations of folate, vitamin B-12, and vitamin B-6 were inversely associated with homocysteine concentrations. Among individuals with low plasma folate, those possessing 2 copies of MTHFR mutant alleles had significantly higher homocysteine concentrations than did those with > or = 1 copy of the wild-type allele. Cigarette smoking, daily coffee consumption, and physical inactivity were positively related to plasma homocysteine concentrations in both sexes (P < 0.05). However, these associations disappeared after adjustment for plasma folate concentrations., Conclusions: Age, sex, plasma folate, vitamin B-12 and B-6 concentrations, and MTHFR genotype are independent determinants of plasma homocysteine in middle-aged and older Chinese in Singapore. These factors combined could account for up to 40% of the total variation in homocysteine concentrations in this Asian population.