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Articles by R. Ma
Total Records ( 3 ) for R. Ma
  G. Ko , W. So , P. Tong , R. Ma , A. Kong , R. Ozaki , C. Chow , C. Cockram and J. Chan
  Aims To develop a simple scoring system for identifying Southern Chinese at risk of diabetes.
Methods The score was derived from a risk factor matching cohort for Type 2 diabetes in Hong Kong Chinese (cohort 1, 2448 subjects without a history of diabetes; age, mean ±  sd 37.2 ± 8.9 years, median 36.0 years; 1649 had risk factors for diabetes and 799 were age-matched control subjects from the community). Two other cohorts were used to validate the risk score (cohort 2, 3734 subjects with risk factors for diabetes; and cohort 3, 1513 participants of a community diabetes survey). All subjects had a 75 g oral glucose tolerance test (OGTT).
Results In cohort 1, 270 (11%) of the subjects were found to have diabetes on OGTT. A risk score system was derived using the β values of the corresponding predictors in the logistic regression analysis. The area under the curve (95% confidence intervals) of the score system was 0.735 (0.705, 0.765). The application of a risk score of ≥ 16 increased the detection rate 2.5–4 times in all three cohorts. A high post-test probability of diabetes of > 60% was derived from a risk score of ≥ 20. Only 10–20 and ∼5% with a score of ≥ 12 and ≥ 16, respectively, are indicated for OGTT. This will considerably improve the yield of OGTT screening.
Conclusions A simple risk score identifies young-to-middle-aged Southern Chinese at high risk for diabetes. Subjects with a score of 16 or above (out of 30) should undergo OGTT for definitive diagnosis of diabetes.
  J. Chan , W. So , G. Ko , P. Tong , X. Yang , R. Ma , A. Kong , R. Wong , F. Le Coguiec , B. Tamesis , T. Wolthers , G. Lyubomirsky and P. Chow
  Aims  The Joint Asia Diabetes Evaluation (JADE) Program is the first web-based program incorporating a comprehensive risk engine, care protocols, clinical decision and self-management support to improve ambulatory diabetes care. The aim was to validate the risk stratification system of the JADE Program using a large prospective cohort.

Methods  The JADE interactive risk engine stratifies patients into different risk levels using results from an annual comprehensive assessment of complications and risk factors. We used a prospective registry consisting of 7534 Type 2 diabetic patients [45.6% men, median (range) age 57 years (13-92)] to perform internal validation of the risk engine.

Results  The JADE Risk Engine categorized patients into four risk levels (from low to high): level 1, n = 4520 (6%); level 2, n = 1468 (19.5%); level 3, n = 4476 (59.4%); and level 4, n = 1138 (15.1%). After a median follow-up period of 5.5 years (mean ± sd 5.4 ± 2.81 years), 763 (10.1%) died, 1129 (14.9%) developed cardiovascular disease (CVD), 282 (3.7%) developed end-stage renal disease and 1400 (18.6%) had at least one of these events. Compared with risk level 1, levels 2, 3 and 4 were associated with 2.8-, 4.7- and 8.6-fold increased risk of clinical end-points. Risk levels 3 and 4 were, respectively, associated with 2.2- and 3.9-fold increased risk for all-cause death and 4.8- and 12.1-fold increased CVD risks.

Conclusion  Based on results from a comprehensive assessment, the JADE Risk Engine successfully categorizes patients into different risk levels to guide clinical management.

  L Li , C Niu and R. Ma

We investigated clone succession and genetic variation of the rotifer Brachionus calyciflorus, in Xihai Pond, Beijing, China, using partial sequence of the COI gene (543 bp). We sampled the rotifer population once per week for 4 weeks in the autumn of 2004, when the water temperature decreased from 27 to 17°C and algal density, correspondingly, from 5.50 x 106 to 3.14 x 106 cells·mL–1. In total of 96 samples, 15 haplotypes were identified, among which 2 distinct lineages (Lineages A and B) were revealed by phylogenetic analysis. Sequence divergence was 12.1% between the two lineages, resembling that of sibling species. The two lineages showed short-term overlap as well as displacement. In the "population" of Lineage A, different responses to environmental variation were observed in the three clades with average sequence divergence ranging from 5.2 to 7.6%. To further investigate the forces shaping the varying pattern of different haplotype clones within the "population" of Lineage A, we selected four frequently collected haplotypes and compared their growth parameters at different algal food (Chlorella pyrenoidosa) concentrations (1 x 106, 6 x 106 and 12 x 106 cells·mL–1) at 25°C or at different temperatures (15, 25 and 35°C) with algal density of 6 x 106 cells·mL–1, respectively. Data derived from life-table demography indicated that the four haplotypes had different reactions to relevant ecological parameters. BC1 clones revealed the highest frequencies, which could be explained by prolific population growth and the build-up of a large resting propagule bank. BC10 and BC11 clones, in contrast to BC1 and BC9 clones, showed no obvious responses to the environmental variations when algal density decreased below 6 x 106 cells·mL–1 or temperature decreased below 25°C.

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