News: First LKCMedicine PhD by Research student graduates

​Lee Shuen Yee has pipped her fellow PhD batchmates to the post by being the first to graduate from the LKCMedicine PhD by Research programme. Shuen Yee, who is part of the inaugural cohort of PhD students admitted in 2016, successfully defended her thesis in January.

Before enrolling at LKCMedicine, she earned a BSc (Hons) in Sport and Exercise Science at Loughborough University in the UK. It was during her final year there that Shuen Yee, who had until then considered a career supporting elite athletes' performance, discovered where her true interests lay.

"I took the Physical Activity and Health module in my final year at Loughborough University, which I loved, and thought to myself then that if exercise could improve chronic diseases such as Type 2 diabetes and cardiovascular disease, why aren't people exercising more? Since then, I knew I wanted to research broadly in the area of exercise and health," said Shuen Yee.

With only a few exercise physiology labs in Singapore, Shuen Yee was heartened to discover that LKCMedicine Associate Professor of Exercise Physiology Fabian Lim's research interest aligned with hers. Looking at Singapore's rapidly ageing population, Shuen Yee thought that A/Prof Lim's lab would have the resources and expertise she needed to look into how exercise could be the answer to managing the many age-associated chronic diseases.

Lee Shuen Yee wanted to research broadly in the area of exercise and health

"Without a second thought, I applied for the PhD programme, where I knew I could continue my research into exercise and metabolic diseases in a world-class research university," she said. "The answers from my research could perhaps contribute to the existing body of knowledge on health and exercise, and to provide more concrete evidence on the pathways and benefits of exercise on health."

It was quite a leap for Shuen Yee, who took up the PhD programme immediately after her undergraduate studies. For non-clinician applicants, the minimum admission requirement is an Upper Second-Class Honours degree, although a First-Class Honours degree is preferable; while a Master's degree is advantageous.

"I never expected it would be such an emotional rollercoaster ride when you could be upset and desolate one moment when none of your experiments works, and so immensely proud the next when your work is recognised or when all the pieces fit together," said Shuen Yee.

During her four-year PhD journey, Shuen Yee published a total of four papers from her thesis work. The four papers covered different aspects of ageing health: effects of fibroblast growth factor 21 (FGF21) on glucose metabolism with ageing and exercise, age-associated changes in the lung microbiome, effects of FGF21 on age-related decline in bone health, and associations of FGF21 with oxidative stress and arterial stiffness under the influence of ageing and exercise.

"The research questions were always evolving. I chanced upon FGF21 and its effects on metabolism, [which had been] shown largely in animal models and thought it could be the central mediating factor for the positive effects of exercise observed on ageing health," said Shuen Yee about how she narrowed down the topic for her thesis.

Shuen Yee then began experiments to measure physiological concentrations of FGF21 in both active and sedentary individuals, both young and old. She also started to study the available literature to find possible explanations for her results. It was not easy to formulate the research questions and make sense of the data generated, she admitted.

"It was also similarly challenging putting together the lung microbiome paper, from recruiting family subjects—parent and child pairs— to analysing the microbiome sequencing data, something I did not have prior experience in. However, I do think that this is all part of the research process and I have definitely learned a lot through the failures," said Shuen Yee.

Failures led to success and the results speak for themselves.

A chapter from one of her papers "FGF21 mediates the associations between exercise, ageing and glucose regulation" was published in February 2020 in Medicine and Science in Sports & Exercise (MSSE), a premium journal by the American College of Sports Medicine (ACSM) that goes out to 50,000 members and affiliates. She was also invited to write an Active Voice commentary on her research in the weekly electronic ACSM Sports Medicine Bulletin that appeared before her paper, which she co-authored with A/Prof Lim.

"Having Shuen Yee's work appear in MSSE puts LKCMedicine and NTU at the forefront of the international exercise science and sports medicine community, as ACSM is the world's largest professional organisation for sports medicine," said A/Prof Lim.

"It's a double recognition to have her published work selected by ACSM to be featured in the Sports Medicine Bulletin as an Active Voice commentary – I believe we are the first in Singapore to do this," added A/Prof Lim.

Lee Shuen Yee felt that LKCMedicine Associate Professor of Exercise Physiology Fabian Lim's research aligned with hers

This isn't the only feather in Shuen Yee's cap. In her first year, she was appointed Graduate Research Officer at NTU, a prestigious appointment reserved for the most promising and talented young Singaporean researchers at the university. More recently, her paper on the association of FGF21 with oxidative stress and arterial stiffness in young and older adults, published in Antioxidants, was featured on the front cover of the journal.

"These achievements reflect the excellence in Shuen Yee's PhD work and the recognition given to her by the international scholastic community," said A/Prof Lim.

Looking back at her four-year journey, Shuen Yee believes she has learnt the necessary skills to pursue her dreams. "I think that the rigour of the PhD programme, the research skills, critical thinking skills and soft skills gained from my time at LKCMedicine will definitely be helpful regardless of which career path I embark on," said Shuen Yee.

Since completing her PhD, Shuen Yee has moved to the Health Promotion Board of Singapore focusing on policy and population health research on physical activity and lifestyle.