Study of Macro-angiopathy and Microvascular Reactivity in Type 2 Diabetes
- Started in 2011 to study the impact of diabetes in blood vessel function and common diabetes-related complications
- Part of a nationwide, multi-institution consortium to study diabetic kidney disease and retinopathy
- The SMART2D study has been awarded a total of nearly S$5 million in funding by the National Medical Research Council (NMRC) (FY2012 to FY2021)
- The current, third phase of our study aims to recall all of our past participants to study the progression of their disease, with an emphasis on lifestyle factors. In addition to the collection of bio-specimens and follow-up data on diabetic complications, data is being collected on diet, physical activity and frailty
- We have published over 50 papers in peer-reviewed scientific journals and shared our findings at numerous national and international conferences
The SMART2D Cohort Study (Singapore Study of Macro-Angiopathy and micro-vascular Reactivity in Type 2 Diabetes) was first launched in 2011 by Drs Lim Su Chi, Tavintharan Subramaniam, Yeoh Lee Ying and Sum Chee Fang to study the impact of diabetes on blood vessel function and commonly encountered diabetes-related complications among participants with Type 2 Diabetes, funded by the highly competitive National Medical Research Council's (NMRC) Program Project Grant (PPG). Since then, Dr Lim Su Chi has been awarded two additional NMRC Clinical Scientist Individual Research Grants (CS-IRG) to recall all of the initial participants for re-evaluation to study how their disease has progressed in relation to changes in risk factors.
By exploiting the synergy between clinical and genetic epidemiology, SMART2D will continue as a longitudinal study that investigates the relationship between risk factors (genetic and non-genetic), vascular function (i.e. intermediate phenotype - endothelial reactivity and arterial stiffness) and final phenotypes (diabetic foot syndrome, nephropathy, retinopathy, cognitive dysfunction and mood disorders).
The SMART2D study is collaborating with prestigious institutions such as the Genome Institute of Singapore (GIS), National University of Singapore (NUS), National Healthcare Group Polyclinics (NHGP) and the Wellcome Trust Centre for Human Genetics at Oxford, UK. In addition, the cohort is part of a nation-wide, multi-institution consortium (DYNAMO: Diabetes studY in Nephropathy And other Microvascular cOmplications) devoted to studying diabetic kidney disease and retinopathy. Observations from SMART2D have also been published in many renowned peer-reviewed journals and presented at conferences worldwide.
Selected Publications (Manuscript):
- Low S, Ng TP, Lim CL, Moh A, Ang SF, Wang J, Goh KS, Ang K, Tang WE, Kwan PY, Subramaniam T. Association between Lower extremity Skeletal Muscle Mass and impaired cognitive function in Type 2 Diabetes. Scientific Reports. 2020 Feb 19;10(1):1-8.
- Gurung RL, Yiamunaa M, Liu S, Liu JJ, Chan C, Choo RW, Ang K, Sum CF, Tavintharan S, Lim SC. Association of haptoglobin phenotype with incident acute myocardial infarction in Chinese patients with type 2 diabetes. Cardiovascular Diabetology. 2019 Dec 1;18(1):65.
- Low S, Goh KS, Ng TP, Ang SF, Moh A, Wang J, Ang K, Subramaniam T, Sum CF, Lim SC. The prevalence of sarcopenic obesity and its association with cognitive performance in type 2 diabetes in Singapore. Clinical Nutrition. 2019 Nov 4.
- Liu JJ, Liu S, Gurung RL, Ang K, Ee Tang W, Sum CF, Tavintharan S, Hadjadj S, Lim SC. Arterial Stiffness Modulates the Association of Resting Heart Rate With Rapid Renal Function Decline in Individuals With Type 2 Diabetes Mellitus. Arteriosclerosis, thrombosis, and vascular biology. 2019 Nov;39(11):2437-44.
- Dorajoo R, Chang X, Gurung RL, Li Z, Wang L, Wang R, Beckman KB, Adams-Haduch J, Yiamunaa M, Liu S, Meah WY. Loci for human leukocyte telomere length in the Singaporean Chinese population and trans-ethnic genetic studies. Nature Communications. 2019 Jun 6;10(1):1-2.
- Liu JJ, Liu S, Gurung RL, Ching J, Kovalik JP, Tan TY, Lim SC. Urine tricarboxylic acid cycle metabolites predict progressive chronic kidney disease in type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism. 2018 Dec;103(12):4357-64.
- Gurung RL, Dorajoo R, Liu S, Yiamunaa M, Liu JJ, Wang L, Guo L, Yu X, Lim SC. Genetic markers for urine haptoglobin is associated with decline in renal function in type 2 diabetes in East Asians. Scientific Reports. 2018 Mar 23;8(1):1-9.
- Liu JJ, Pek SL, Ang K, Tavintharan S, Lim SC, SMART2D study. Plasma leucine-rich α-2-glycoprotein 1 predicts rapid eGFR decline and albuminuria progression in type 2 diabetes mellitus. The Journal of Clinical Endocrinology & Metabolism. 2017 Oct 1;102(10):3683-91.
- Pek SL, Sum CF, Yeoh LY, Lee SB, Tang WE, Lim SC, Tavintharan S. Association of apolipoprotein-CIII (apoC-III), endothelium-dependent vasodilation and peripheral neuropathy in a multi-ethnic population with type 2 diabetes. Metabolism. 2017 Jul 1;72:75-82.
- Pek SL, Tavintharan S, Wang X, Lim SC, Woon K, Yeoh LY, Ng X, Liu J, Sum CF. Elevation of a novel angiogenic factor, leucine-rich-α2-glycoprotein (LRG1), is associated with arterial stiffness, endothelial dysfunction, and peripheral arterial disease in patients with type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism. 2015 Apr 1;100(4):1586-93.