Karen Siu Ling Lam, MD

JAHA: Tell us about the key findings from your recent article in JAHA.

Dr. Lam: In 1847 Chinese healthy subjects with no known cardiovascular diseases (heart disease or stroke) we found that a high level of adipocyte fatty acid binding protein (A-FABP) in their blood could predict whether they would develop cardiovascular diseases in 12 years. Their risk was increased by 50% for every unit increase in log-transformed A-FABP level, even after taking into consideration the effect of known cardiovascular risk factors like high blood pressure or cholesterol, diabetes and obesity. It should be noted that A-FABP is a hormone released from the fat cells and inflammatory cells with its blood level being elevated in overweight or obese subjects.

JAHA: What are the major implications of this work?

Dr. Lam: The implications are that A-FABP, which has been shown to be associated with increased cardiovascular diseases in animals, probably also contributes to the development of these diseases in humans. Furthermore, we have shown that measuring its level in our blood can potentially help to identify who are at increased risk of cardiovascular diseases and therefore should receive more intensive preventive measures, including healthy life-style and medications to control the known cardiovascular risk factors. Its use as a “risk marker” in this regard is additive to that of “C-reactive protein”, a marker already used in clinical practice to predict the risk of heart disease and stroke.

JAHA: How did you get the idea to do this study?

Dr. Lam: This is the continuation of our research on A-FABP since 2006 when we first demonstrated its presence in the human circulation and its association with obesity and other atherosclerotic risk factors in humans (Clin Chem 2006). We subsequently demonstrated that a high blood level of A-FABP was associated with atherosclerotic changes in the carotid arteries which supply the brain (ATVB 2007), and could predict the development of the metabolic syndrome (Circulation 2007) and type 2 diabetes (Diabetes Care 2007), two conditions which predispose to cardiovascular diseases. A high level of A-FABP also predicted early death after stroke (Neurology 2011). We therefore investigated whether it could predict the development of cardiovascular disease in the subjects in the Hong Kong Cardiovascular Risk Factors Prevalence Study (CRISP) that we have been following up for 12 years.

JAHA: What was your biggest obstacle in completing this study?

Dr. Lam: The greatest difficulty was in getting the study subjects to return for follow-up assessment repeatedly during the 12 years. This was achieved through the patience and dedication of our research nurses and doctors.

JAHA: What was your most unexpected finding?

Dr. Lam: Our most unexpected finding was that the blood level of adiponectin, another hormone from the fat cells which showed some protection against cardiovascular diseases in animal studies, did not show any suggestion of a protective effect in our study.

JAHA: What do you plan to do next, based on these current findings?

Dr. Lam: We plan to collaborate with other centers to establish A-FABP as a predictive marker of cardiovascular disease for clinical use.

JAHA: What do you like to do in your free time?

Dr. Lam: I enjoy jogging, hiking and reading.

JAHA: What is your favorite sports team or musical group?

Dr. Lam: Not applicable.


To read Dr. Lam's full article, click here
Profile originally published January 29, 2013