A variant (rs3129882) in the genome-wide association study (GWAS)-linked variant [in the human leukocyte antigen (HLA) gene region] has been reported to associate with an increased risk of Parkinson's disease (PD) in Caucasian population. Studies among Chinese are limited. To address this, we analysed rs3129882 in a total of 1312 subjects of Chinese ethnicity from independent Asian centers comprising of 675 controls and 637 PD cases. The rs3129882 variant was associated with a decreased risk in our ethnic Chinese PD patients. Logistic regression analysis taking into consideration variables of age, gender and race showed that allele A reduced the risk of PD via a dominant model [odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.62, 0.96, p = 0.018]. As HLA is a highly polymorphic region, it is possible that ethnic-specific effect or environmental agents may modulate the effect of this GWAS-linked locus in influencing the risk of PD.

To compare the health-related quality of life (HRQoL) and the prevalence of depression of older adults with stage 5 chronic kidney disease (CKD) on haemodialysis versus non-dialysis therapy. Methods: This cross-sectional study was conducted in six haemodialysis centres located in the Klang Valley, Malaysia. We administered the EuroQol EQ-5D and the 4-Item Geriatric Depression Scale (GDS-4) to older adults aged 65 and above with stage 5 CKD (eGFR < 15mL/ min/1.73 m2): 100 participants were undergoing haemodialysis and 100 were on optimal medical therapy for at least 90 days. Demographic and clinical data were collected from the medical records. Independent t-test, Pearson's chi-square test, Fisher's exact test and the Mann-Whitney U test were used to compare participant characteristics, EQ-5D index, EQ VAS and GDS-4. Results: Median age for the haemodialysis population was 71 years; 79% were Chinese, 14% Malay, 6% Indian and 1% were from other ethnic origin. Median age of the non-dialysis population was 73 years; 44% were Chinese, 34% Malay, 20% Indian and 2% were from the other ethnic origin. Gender and co-morbid conditions were not statistically different between the groups. The EQ-5D index was significantly lower in the haemodialysis population, median = 0.673 (IQR 0.363-0.814) compared to those on non-dialysis therapy, median = 0.727 (IQR 0.620-0.848), p = 0.02. The participants on haemodialysis scored lower EQVAS, mean (SD) = 54.9 (13.8) compared to the non-dialysis population, mean (SD) = 62.1 (13.4), p < 0.001. Older adults undergoing haemodialysis were more likely to be depressed (GDS-4: 1-4) than those on non-dialysis therapy, χ 2 = 14.5, p < 0.001, OR 3.17. ConClusions: Among older adults with stage 5 CKD, HRQoL was significantly worse among those undergoing haemodialysis compared to those on non-dialysis therapy. Healthcare providers must move beyond traditional renal-specific goals and aggressively treat symptoms in older people undergoing haemodialysis.

Introduction: ALDH2 is an enzyme involved in major oxidative pathway of alcohol metabolism while GSTM1 is a drug-metabolizing enzyme of acetaldehyde. It has been reported that the mutant ALDH2 allele and the absence of GSTM1 contributes to increased oral cancer risk due to reduced acetaldehyde metabolism. This study aims to determine ALDH2 and GSTM1 polymorphisms and its association with oral cancer risk. Method: An unmatched case-control study was conducted using 163 oral cancer patients and 87 non-cancer subjects selected from the OCRCC database. ALDH2 and GSTM1 genotypes were determined using PCR-RFLP from peripheral blood. Multiple logistic regression was employed to assess association between polymorphisms and oral cancer risk. Results: Most common risk habit was betel-quid chewing (44.0%), followed by smoking (30.4%) and alcohol drinking (29.6%). The prevalence of ALDH2 polymorphism is only 5.7%, while GSTM1 null is seen in 51.2%. Alcohol drinking and the combination of ALDH2 polymorphism and alcohol consumption is significantly associated with increased risk of oral cancer (p < 0.001). Discussion: In this population, although the prevalence of alcohol consumption is low compared to other populations, alcohol drinking has been found to significantly increase oral cancer risk, even after adjusting for confounding factors (age, gender and ethnic) (aOR 6.8, 95% CI 2.6, 18.1). The prevalence of ALDH2 polymorphism was found to be much lower compared to other Asian population such as the Japanese and Taiwanese. In relation to oral cancer risk, no significant association was seen for both the polymorphisms of ALDH2 and GSTM1. However, when analysis was done for the combination of ALDH2 polymorphism and alcohol consumption, those who concurrently exhibit ALDH2 polymorphism and consumed alcohol was found to be 6 times more likely to develop oral cancer (aOR 6.6, 95% CI 2.4, 17.9). No such association was observed for the combination of GSTM1 polymorphism and alcohol consumption. In conclusion, alcohol consumption is a significant independent risk factor for oral cancer among Malaysians while ALDH2 polymorphism together with the habit of alcohol drinking also confers an increased risk for oral cancer.