Professor LAM Siu Ling, Karen

Prof Karen Lam

Emeritus Professor; Honorary Clinical Professor

  • MBBS (Hon.), MRCP(UK), MD (HK), DSc, FRCP (Edin and Lond), FRACP, FHKCP, FHKAM (Medicine)
Professor Karen Lam is Emeritus Professor in Medicine and Clinical Director of the State Key Lab of Pharmaceutical & Biotechnology at the University of Hong Kong. She was the Chief of Endocrinology and Metabolism at the University Department of Medicine and founded the KK Leung Diabetes Centre, Queen Mary Hospital in 1994 as the first comprehensive management and education centre for people with diabetes in Hong Kong. She was the Founding President of Diabetes Hongkong (Honorary President since 2014); a past President of the Hong Kong Society of Endocrine, Metabolism and Reproduction; and a past Chairman of two specialty boards of the HK College of Physicians – Advanced Internal Medicine and Endocrinology, Diabetes & Metabolism as well as the Working Party on Diabetes Care of the Hospital Authority. She is currently the associate editor/editorial board member of several international peer-reviewed journals in diabetes and endocrinology.

Research Profile
Professor Lam has published extensively on clinical, basic and translational research in diabetes and endocrinology, including publications in Diabetes, Diabetes Care, Diabetologia, JCEM,  Circulation, EHJ, Cell Metabolism, PNAS, JCI , Nat Commun, Nat Genet, and others. Heading an integrated research team with strengths and platforms ranging from cell and anima- based research to epidemiological, genetic and clinic-based studies, her current research focuses on the pathogenetic and therapeutic significance of adipokines and hepatokines in diabetes and other obesity-related cardiometabolic disorders. She led the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS; 1995-2018), a population-based cohort study on cardiovascular (CV) risk factors and diseases with the longest follow-up in China, which charted the rise in obesity and metabolic syndrome in Southern China. Together with the Hong Kong West Diabetes Registry (HKWDR) established since 2008, it has provided the database and biobank for investigating the interaction of environmental and genetic factors underlying obesity, diabetes and CV diseases in Chinese (JCEM 2010; Nat Commun 2015, Diabetologia 2017; Nat Genet 2017). The above platforms, database and biobanks have allowed her team to identity novel biomarkers of cardiometabolic diseases and demonstrate their clinical significance, notable examples being the adipocyte fatty acid binding protein (A-FABP), fibroblast growth factor 21 (FGF21) and thrombospondin-2 (TSP-2), which have inspired numerous follow-up studies in the field, from the international community.

Her team was the first to demonstrate that serum levels of A-FABP, a proinflammatory adipokine associated with insulin resistance, are raised in obesity and predict the development of the metabolic syndrome and type 2 diabetes (T2DM) (Clin Chem 2006; Circulation 2007; Diabetes Care 2007). She and her collaborators have subsequently confirmed its clinical significance in diabetic nephropathy (Diabetes Care 2009), stroke (Neurology 2011) and other CV diseases (ATVB 2007; EHJ 2008; JAHA 2013), fatty liver diseases (Hepatology 2009), and obstructive sleep apnoea (ERJ 2009). In preclinical studies, they elucidated its regulation by the C-Jun NH2-terminal kinase (JNK) inflammatory signalling (JBC 2010; Diabetes 2011), highlighted its role in mediating the adipo-vascular inter-talk in obesity through fat transplant studies (Clin Sci 2016) and demonstrated the effectiveness of a small molecule A-FABP inhibitor in treating fatty liver diseases (J Hepatol 2013). More recently, they also demonstrated, in the HKWDR cohort, that A-FABP also predicted renal events and multiple mortality outcomes (Clin Chem 2018; Diabetologia 2019). For FGF21, a hormone previously considered as largely a hepatokine, her paper in Diabetes 2008 provided the first evidence for its markedly increased expression in the adipocytes in obesity, leading to raised circulating levels. She subsequently showed that high FGF21 levels could predict the development of T2DM (Diabetes Care 2011) and distinguish T2DM from autoimmune diabetes (JCEM 2012). As beneficial metabolic effects of FGF21 and its analog are observed in animals and humans, respectively, this paradoxical increase in FGF21 levels suggests that obesity is associated with FGF21 resistance, which likely contributes to the clinical findings by her group and others, that elevated FGF21 levels are associated with atherosclerosis (ATVB 2013) and progressive cardiorenal diseases (JCEM 2015; JAHA 2017). In preclinical studies, her group has also demonstrated that FGF21 mediates a liver-brain cross-talk in glucose metabolism (Diabetes 2014) and that it participates in the body’s response against acute liver injury (Hepatology 2014). Their identification on exome-chip analysis of a functional variant of GCKR that regulates FGF21 levels (Diabetes 2017) further supports the physiological relevance of FGF21 in humans.  Most recently, they have identified TSP-2 as a novel fibrosis marker in patients with steatotic liver diseases, as well as a prognostic marker of cardiac and renal complications in type 2 diabetes. (Diabetes Care 2021; Cardiovasc Diabetol 2022; Nephrol Dial Transplant 2023).

Selected Publications
  1. X Su, CYY Cheung, J Zhong, Y Ru, CHY Fong, CH Lee, CKY Cheung, KSL Lam* (co-corresponding author), A Xu* Z Cai*. Ten metabolites-based algorithm predicts the future development of type 2 diabetes in Chinese. J Adv Res. 2023 Nov 28:S2090-1232(23)00365-X [IF.12.8]
  2. CH Lee, DTW Lui, CYY Cheung, CHY Fong, MAA Yuen, WS Chow, A Xu, KSL Lam*Circulating thrombospondin-2 level for identifying individuals with rapidly declining kidney function trajectory in type 2 diabetes – A prospective study of the Hong Kong West Diabetes Registry. Nephrol Dial Transplan 2023 Feb (In press) [IF:7.186]
  3. CH Lee, MZ Wu, DTW Lui, CHY Fong, QW Ren, SY Su, MMA Yuen, WS Chow, JY Huang, A Xu, KH Yiu, KSL Lam*. Prospective associations of circulating thrombospondin-2 level with heart failure hospitalization, left ventricular remodelling and diastolic function in type 2 diabetes. Cardiovas Diabetol 2022 Nov; 21:231 [IF: 8.949]
  4. CH Lee, WK Seto, DTW Lui, CHY Fong, HY Wan, CYY Cheung, WS Chow, YC Woo, MF Yuen, A Xu*, KSL Lam* (co-corresponding authors). Circulating thrombospondin-2 as a novel fibrosis biomarker of nonalcoholic fatty liver disease in type 2 diabetes. Diabetes Care 2021 Jun [IF:19.112]
  5. PCH Lee, CYY Cheung, YC Woo, DTW Lui, MMA Yuen, CHY Fong, WS Chow, A Xu, KSL Lam. Prospective association of circulating adipocyte fatty acid-binding protein levels with risk of renal outcomes and mortality in type 2 diabetes. Diabetologia 2019; 62:169-77 [IF:10.46]
  6. PCH Lee, CYY Cheung, YC Woo, DTW Lui, MMA Yuen, CHY Fong, WS Chow, A Xu, KSL Lam. Circulating adipocyte fatty acid-binding protein concentrations predict multiple mortality outcomes among men and women with diabetes. Clin Chem 2018; 64: 1496-504 [IF:12.167]
  7. CS Tang, H Zhang, CYY Cheung, M Xu, JCY Ho, Wi Zhou, SS Cherny, Y Zhang, O Holmen, KW Au, H Yu, L Xu, J Jia,  RM Porsch, L Sun, W Xu, H Zheng, LY Wong, Y Mu, J Dou, CHY Fong, Su Wang, X Hung, L Dong, Y Liao, J Wang, LSM Lam, ML Yang, J Chen, CW Siu, G Xie, YC Woo, Y Wu, KCB Tan, K Hveem, BMY Cheung, S Zöllner,  A Xu, YE Chen, CQ Jiang, Y Zhang, TH Lam, S Ganesh, Y Huo, *PC Sham, *KSL Lam, *CJ Willer, *HF Tse, *W Gao. (co-supervising authors) Exome-wide Association Analysis Reveals Novel Coding Sequence Variants Associated with Lipid Traits in Chinese. Nat Commun 2015;6:10206 [IF:16.6]
  8. CH Lee, EYL Hui, YC Woo, CY Yeung, WS Chow, MAM Yuen, CHY Fong, A Xu, KSL Lam. Circulating fibroblast growth factor 21 levels predict progressive kidney disease in subjects with type 2 diabetes and normoalbuminuria. J Clin Endocrinol Metab 2015;100:1368-75  [IF:6.134]
  9. RL Hoo, PC Lee, Mi Zhou, YL Wong, X Hui, A Xu, KSL Lam. Pharmacological inhibition of adipocyte fatty acid binding protein alleviates both acute liver injury and non-alcoholic steatohepatitis in mice. J Hepatol 2013;58:358-64  [IF:17.298]
  10. Y Xiao, A Xu, LSC Law, C Chen, H Li, X Li, L Yang, S Liu, Z Zhou, KSL Lam. Distinct changes in serum fibroblast growth factor 21 level in different subtypes of diabetes. J Clin Endocrinol Metab 2012;97(1):E54-8  [IF:6.134]
  11. X Zhang, A Xu, SK Chung, JH Cresser, G Sweeney, RLC Wong, A Lin, KSL Lam. Selective inactivation of c-Jun NH2-terminal kinase in adipose tissue protects against diet-induced obesity and improves insulin sensitivity in both liver and skeletal muscle in mice. Diabetes 2011;60:486-95  [IF:9.305]
  12. C Chen, BMY Cheung, AWK Tso, Y Wang, LS Law, KL Ong, NMS Wat, A Xu, KSL Lam. High plasma level of fibroblast growth factor 21 is an Independent predictor of type 2 diabetes: a 5.4-year population-based prospective study in Chinese subjects.  Diabetes Care 2011;34:2113-5  [IF:17.155]
  13. AWK Tso, TKY Lam, A Xu, KH Yiu, HF Tse, LSW Li, LSC Law, BMY Cheung, RTF Cheung, KSL Lam. Serum adipocyte fatty acid-binding protein is associated with ischemic stroke and early death. Neurology 2011;76:1968-75  [IF:11.8]
  14. DCY Yeung, A Xu, AWK Tso, WS Chow, NMS Wat, CHY Fong, S Tam, PC Sham, KSL Lam. Circulating levels of adipocyte and epidermal fatty acid-binding proteins in relation to nephropathy staging and macrovascular complications in type 2 diabetic patients. Diabetes Care 2009;32:132-4  [IF: 17.155]
  15. XM Zhang, DCY Yeung, M Karpisek, D Stejskal, F Liu, RLC Wong, *KSL Lam, *A Xu. (*co-corresponding authors). Serum FGF21 levels are increased in obesity and are independently associated with the metabolic syndrome in humans. Diabetes 2008;57:1246-53  [IF:9.305]
  16. A Xu, AWK Tso, BMY Cheung, Y Wang, NMS Wat, CHY Fong, ED Janus, KSL Lam. Circulating adipocyte-fatty acid binding protein levels predict the development of the metabolic syndrome: a 5-year prospective study. Circulation 2007;115:1537-43  [IF:39.922]
  17. DCY Yeung, A Xu, SCW Cheung, NMS Wat, MH Yau, CHY Fong, MT Chau, KSL Lam. Serum adipocyte fatty acid-binding protein levels were independently associated with carotid atherosclerosis. Arterioscler Thromb Vasc Biol 2007;27:1796-802  [IF:7.1]
  18. AWK Tso, A Xu, PC Sham, NMS Wat, Y Wang, CHY Fong, BMY Cheung, ED Janus, KSL Lam. Serum adipocyte fatty acid binding protein as a new biomarker predicting the development of type 2 diabetes - a 10-year prospective study in Chinese. Diabetes Care 2007:30:2667-72  [IF:17.155]

Key Offices
  1. Clinical Director, State Key Laboratory of Pharmaceutical Biotechnology
  2. Founding Director, Research Centre of Heart, Brain, Hormone & Healthy Aging, HKU
  3. Founding Director, KK Leung Diabetes Centre, Queen Mary Hospital
  4. Panel Chair, Health & Medical Research Fund – since 2019
  5. Founding President, Diabetes Hongkong

Editorial Board Memberships
  1. The Journal of Clinical Endocrinology & Metabolism, Associate Editor (since 2019)
  2. Journal of Diabetes Investigation, Associate Editor (since 2009)
  3. Clinical Endocrinology (2012-2016)
  4. Diabetic Medicine, Associate Editor (2003-2007)
  5. Diabetes, Obesity & Metabolism (1998-2011)
  6. Diabetes Research & Clinical Practice (since 1999)
  7. Biological Signals (1990-1997)
  8. Obesity Research & Clinical Practice, Associate Editor (2006-2012)