The PRecision Medicine for Diabetic Individuals: A joint Malaysia-UK Effort (PRIME) research project is funded by the UK-Malaysia Joint Partnership for Non-Communicable Diseases (NCD) grant scheme awarded by the Medical Research Council’s (MRC) Newton-Ungku Omar Fund. This project is a collaborative effort between the UKM Medical Molecular Biology Institute (UMBI) and the University of Dundee (UK). The principal investigators are Prof. Dr. Chim C Lang (University of Dundee) and Prof. Datuk Dr. A Rahman A Jamal (UMBI).
Prof. Dr. Chim C Lang
Prof. Datuk Dr. Rahman Jamal
The PRIME Partnership programme aims to establish interdisciplinary expertise and build partnerships amongst physician-scientists, genetic epidemiologists, big data analysts, machine learning scientists, and policymakers to cohesively deliver multi-level strategies to augment precision medicine for Type 2 Diabetes (T2D) in Malaysia.
The PRIME cohort:
The PRIME cohort comprises 5000 well-phenotyped T2D individuals from The Malaysian Cohort (TMC), the largest and most comprehensive population study in Malaysia. Also, TMC is a government initiative headed by Prof. Datuk Dr. A Rahman A Jamal. TMC has recruited 106,527 participants (aged between 35-70 years) from both urban and rural areas, which consist of 46% Malay, 33% Chinese, 16% Indian, 5% other.
Detailed information of TMC’s participants such as demographic data, biophysical data (including blood pressure and electrocardiograms), fasting blood sugar, lipid, and renal profile are stored digitally in the TMC database. The biospecimens (such as blood, plasma, and urine) are collected, processed, and stored in the TMC biobank. The prevalence of T2D in TMC is 16.6% (n=17,683). Also, longitudinal follow-up data are available for these T2D individuals.
The PRIME project will select 5000 participants with T2D from TMC database. Then, the DNA samples of T2D will be analysed for the Genome-wide genetic association study (GWAS). The GWAS aims to identify the T2D genetic profile among Malaysians. About 10% of the PRIME cohort (n=500) will be invited for a digital retinal imaging scan and some cardiovascular disease (CVD) assessments. The scan and assessments were meant to identify the at-risk individuals of T2D via phenotypic, genetic, and retinal imaging profiles. The outcome of this study will enable the policymakers to come out with population-specific interventions, thus reduce the impact of diabetes in Malaysia.
Working Plans for the PRIME project:
The PRIME project proposes six (6) working plans (WPs) which include:
- Establishment of an interdisciplinary research partnership between Dundee and Malaysia.
- Establishment of the PRIME Cohort, to consolidate Malaysian’s clinical data and to compare it with Scotland’s.
- Generation of Southeast Asian Haplotype via GWAS.
- Retinome project.
- Combinatorial analysis.
- Translational and Evidence-based research. We aim to compare the PRIME cohort to the GoDARTS2 and INSPIRED3 cohorts from Dundee and India, respectively.
The preliminary/pilot data from this study will be a valuable research infrastructure for the future delivery of precision medicine for T2D in Malaysia. Also, by working with healthcare providers throughout Malaysia, we are able to translate the research outcome clinically through the Precision Medicine Exemplars emerged from this project later.
This project will involve key Malaysian stakeholders such as T2D specialists (Assoc. Prof. Dr. Norlaila Mustafa), cardiologists (Datuk Dr. Aizai from the Institut Jantung Negara (www.ijn.com.my)), ophthalmologists (Assoc. Prof. Dr. Jemaima Che Hamzah), the National Diabetes Institute (NADI, www.diabetesmalaysia.com.my), National Heart Association of Malaysia (NHAM, www.malaysianheart.org) and Clinical Research Malaysia (https://clinicalresearch.my). Together, this project is able to support translational medical research in Malaysia.
By combining clinical, retinal, and genomic information, we will demonstrate the feasibility of personalised T2D treatment in Malaysia. Our vision is to develop a low-cost and sustainable precision medicine solution for both urban and rural communities. Hopefully, it will be able to roll out in large-scale government public health programmes in the future.
- Jamal et al. (2015). Cohort Profile: The Malaysian Cohort (TMC) project: A prospective study of non-communicable diseases in a multi-ethnic population. Int J Epidemiol. 44(2):423–431. doi:10.1093/ije/dyu089.
- Hébert et al. (2018). Cohort Profile: Genetics of Diabetes Audit and Research in Tayside Scotland (GoDARTS). Int J Epidemiol. 47(2):380-381j. doi: 10.1093/ije/dyx140.
- Anjana et al. (2020). Novel subgroups of type 2 diabetes and their association with microvascular outcomes in an Asian Indian population: a data-driven cluster analysis: the INSPIRED study. BMJ Open Diabetes Res. Care. 8:e001506. doi: 10.1136/bmjdrc-2020-001506.