Northwestern University Feinberg School of Medicine

Institute for Public Health and Medicine

Global Cardiovascular Research at Northwestern: Interview with Professor Kiang Liu

February 1, 2013Liu and team

Professor Kiang Liu (Department of Preventive Medicine and Medicine) has been collaborating with researchers from China, Taiwan, and Japan for more than 30 years, and his passion for cardiovascular epidemiology remains unbounded today. Professor Liu received his undergraduate degree in mathematics at Fu-Jen University in Taiwan followed by his PhD in biostatistics at University of North Carolina-Chapel Hill. He came to Northwestern in 1976 as a post-doctoral research fellow under the mentorship of global cardiovascular research pioneer, Dr. Jeremiah Stamler, and has been at Northwestern even since.

Mark Huffman asked Professor Liu a few questions about his history of recent in the Far East, his ongoing research activities, and plans for the future to learn more about his storied career.

What did you do in your most recent trip to China in January 2013?

I have been invited to join the steering committee for a research study that is funded by the United Kingdom Medical Research Council and led by The George Institute, China (www.georgeinstitute.org.cn), which evaluates changes in family sodium consumption through regular health education classes of fifth grade children in China. Since the average Chinese person consumes 11-12 grams of salt per day (more than double the recommended daily intake), this trial aims to complement prior work led by collaborators at The George Institute, China on reducing sodium intake. The education intervention incorporates cartoons, newsletters, and education sessions with family members, including the primary household cook. I have been asked to help in the development of the study design and review of the study protocol based on my prior work on studies such as INTERSALT and INTERMAP, which have both incorporated 24 hour urinary sodium as a marker for sodium intake.

How did you become involved with researchers in China?

We have a long experience of working with several sites in China. Now we are working with The George Institute, China, but previously we had worked with Fu Wai Hospital, given our relationship with Dr. Yangfeng Wu, who now leads The George Institute, China and had previously worked at Fu Wai Hospital.

Why do you collaborate with Professor Wu and others in China?

We have a long history of collaborating together, starting with the US-PRC (People's Republic of China) study, which lasted for 20 years. Fu Wai Hospital was the major site, and at that time we worked with several senior members at Fu Wai and Prof. Wu played an active role at that time. Our INTERSALT and INTERMAP studies also included Guangdong Peoples Hospital. So there are many studies where we have worked together. I also serve on the steering committee on internal epidemiological studies that include more than 800,000 participants.

What about the future of these collaborations?

There will definitely be opportunities for future collaboration. The deputy director of The George Institute, China, Professor Lijing Yan, trained at Northwestern in the Department of Preventive Medicine, and we have published quite a few papers together using data from CARDIA (Coronary Artery Risk Development in Young Adults) and CHA (Chicago Heart Association) cohort studies. She continues to be interested in writing papers together and developing a training grant for Chinese trainees to come to Northwestern for diabetes research training. There are also opportunities for expansion of collaboration with other established investigators in China, including the likes of Dr. Dong Zhao from Anzhen Hospital, as well.

You also work with the Taiwanese NIH equivalent. Can you tell me a bit about that?

I also serve as co-investigator on a cohort study in Taiwan that evaluates aging in nearly 6,000 participants. We have just completed the first round of examinations and have received funding for follow-up examinations. This project is sponsored by the National Health Research Institute in Taiwan, which is the equivalent of the US National Institutes of Health. The former president of the institute was a colleague through his work on ARIC (Atherosclerosis Risk in Communities) cohort study, where he served as the principal investigator of the central laboratory for that study. He knows of my experience in this area so I was asked to help establish this cohort. This offers an excellent opportunity to compare against our cohort studies at Northwestern, particularly CARDIA and MESA (Multi-Ethnic Study of Atherosclerosis), since they are using similar protocols, which facilitates comparison. I think we can jointly develop ideas and study things like the metabolic signatures of normal weight individuals who develop diabetes, genetic drivers of chronic disease, among other potential areas.

Now, you also work with investigators in Japan, is that right?

Yes, we trained Drs. Hirotsugu Ueshima and Toshihito Katsumura here at Northwestern, who are the former and current chair of health sciences at Shiga University in Japan. They were also heavily involved in INTERSALT and INTERMAP. So we have a long history of collaborations. So now they lead a study on coronary calcium and would like to compare their risk factor/coronary artery calcium relationship with our data from MESA. I managed to help them obtain a limited dataset to facilitate this comparison, which maintains our relationships for future collaboration.

What would you recommend for a trainee who might be interested in this work?

If trainees want to spend a year at these institutions, there is a possibility for fellowship training through intramural grants (Taiwan) or Fulbright funding, particularly since we host fellows from places such as Shiga University (Masaru Sakurai) and plan to host fellows from Taiwan over the next few years. There are certainly opportunities for research training.

Could you imagine a T32 fellow working on these project?

Yes, depending upon the hypothesis. Since biometrics samples are collected widely, there is great opportunity for collaborations and comparisons and there are good questions. For example, in MESA, the average body mass index of Chinese American participants is 24kg/m2, and the average BMI of white participants is 27.8 kg/m2., but the prevalence of diabetes is twice as high for Chinese American participants compared with white participants. The question is why. Is that because of white rice intake, as has been promoted by some researchers at Harvard, for example. We can pursue metabolomic studies to better understand the reasons for these differences. We just need someone to help contribute and lead these efforts.

Is there anything else you think people show know?

In the past, I have kept a low profile of this work because I had mostly done this work on my own time, nights and weekends, since I have so busy with NIH funded studies. I am willing to help further strengthen the relationships and potential opportunities. I definitely think the institutional relationships can be expanded.

If you are an IPHAM member and would like us to highlight one of your collaborations, please send an email to ipham@northwestern.edu.