Multiethnic Cohort (MEC)

This is a prospective cohort of 49,700 community-dwelling Singapore citizens and Permanent Residents, 21 years old and older and of Chinese, Malay or Indian ethnicity. Medical exclusion criteria are cancer, heart disease, stroke, renal failure and serious mental illness. There are 2 baseline recruitment phases: 2004-2010 (n=14,729) and 2013-2016 (n=34,870).

Phase 1

The Multiethnic Cohort was formed by consolidating two existing cohorts recruited in the period 2004 to 2006, the Singapore Prospective Study Program (n=7,015) and the Singapore Cardiovascular Cohort Study (n=1,459), with additional recruitment of 6,255 participants from 2006 till 2010. This resulted in a total of 14,729 participants.

Interview data	Physical examination	Laboratory tests
Socio-demographic characteristics Tobacco use Environmental tobacco smoke Alcohol consumption Diet (FFQ) Physical activity Medication use Medical history Women’s health Family history Health-related Quality of Life (SF-12 / SF-36)	Height, weight, hip and waist circumferences Blood pressure Visual acuity and visual field assessment Fundus photography Ankle Brachial Index Assessment of foot sensory function by monofilament and neurothesiometer	Serum creatinine Fasting / random glucose Glucose tolerance test Blood lipids Urine protein (semi-quantitative) C-reactive protein (hsCRP) Cortisol Insulin Adiponectin

Consent form
Data collection form

Phase 2

From October 2013 to March 2016, another 34,870 new participants, aged 21 to 75 years old, were recruited mostly from public housing estates to expand the Multiethnic Cohort.

Interview data	Physical examination	Laboratory tests
Socio-demographic characteristics Tobacco use Physical activity Medical history Women’s health Psychiatric screening (GHQ-12) Health-related Quality of Life (EQ-5D)	Height, weight, hip and waist circumferences Blood pressure Ankle Brachial Index Skinfold thickness Resting electrocardiogram Assessment of foot sensory function by monofilament and neurothesiometer Hand grip strength	Serum creatinine Fasting / random glucose Glucose tolerance test Blood lipids HbA1c Urine albumin (semi-quantitative)

Consent form
Data collection form

Investigation of host immune responses to the 2009 H1N1 influenza strain in a community-based cohort

Prior to the start of a community outbreak of Influenza A (H1N1) in Singapore in June 2009, 894 participants of the Multiethnic Cohort were enrolled for this sero-epidemiological investigation. From June to October 2009, the participants were interviewed about their medical condition fortnightly. Blood samples were collected right after the peak of the outbreak in August and when the outbreak was subsiding in October. A second series of follow-up was carried out in April to October 2010 to evaluate the level of ongoing H1N1 infection, extent of waning immunity and immunity levels to other previously circulating influenza strains.

 

Revisit of the Multiethnic Cohort Phase 1

The first follow-up of the Multiethnic Cohort Phase 1 began in 2011 with an intensive protocol that included an assessment of health care expenditure, bone densitometry and body fat and lean mass composition, and cardiac computed tomography (CT) for 805 Chinese participants, aged 50 and older. These intensive investigations on the older Chinese ended in 2012. After this, the revisit continued with a less intensive protocol and extended to the rest of the Multiethnic Cohort Phase 1. A total of 6148 were revisited between 2011 and 2016.

Interview data	Physical examination	Laboratory tests
Socio-demographic characteristics Tobacco use Environmental tobacco smoke Alcohol consumption Diet (FFQ) Physical activity Medication use Medical history Women’s health Family history * Health care expenditure * Sun Exposure Health-related Quality of Life (*Health Utility Index Mark 3, SF-36 and EQ-5D) * Fractures Stress Kessler Psychological Distress Scale (K10) Cognitive test (MMSE)	Height, weight, hip and waist circumferences Blood pressure Central aortic blood pressure Ankle Brachial Index Skinfold thickness Resting electrocardiogram Assessment of foot sensory function by monofilament and neurothesiometer Hand grip strength * Bone densitometry * Body fat and lean mass (DEXA) * Subcutaneous abdominal and intra-abdominal fat (CT) * CT calcium scoring	Serum creatinine Fasting glucose Glucose tolerance test Blood lipids HbA1c Urine albumin (semi-quantitative) C-reactive protein (hsCRP) Cortisol Interleukin-6 Interleukin-1 receptor antagonist

* Performed only in the pilot study

Consent form
Data collection form
Consent form used only in pilot study
Data collection form used only in pilot study

Phase 3

Phase 3 of the Multiethnic Cohort began in May 2019 with the aim of adding 30,000 new participants, aged 21 and older, to the cohort and to increase the proportion of the Malay and Indian ethnic groups. These new participants will not be followed up in the ongoing First Follow-up that will end in early 2021.

Interview data	Physical examination	Laboratory tests
Socio-demographic characteristics Diet Tobacco use Alcohol consumption Physical activity Sleep quality (PSQI) Medical history Medication use Women’s health Cognitive screening for aged 40 and over (MMSE) Barthel ADL for aged 65 and over Lawton’s IADL for aged 65 and over Well-being (WHO 5) Health-related Quality of Life (EQ-5D) Psychological distress (K6)	Height, weight, hip and waist circumferences Blood pressure Resting electrocardiogram Hand grip strength Visual acuity Fundus photography Timed-Up-&-Go for aged 40 and over	Serum creatinine Fasting / random glucose Blood lipids HbA1c Urine albumin (semi-quantitative)

Participation Information Sheet
Consent Form for Interview
Consent Form for Screening
Data collection form

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Last updated on 04 March 2020