Displaying all 18 publications

Abstract:
Sort:
  1. Yap PS, Krishnan T, Chan KG, Lim SH
    J Microbiol Biotechnol, 2015 Aug;25(8):1299-306.
    PMID: 25381741 DOI: 10.4014/jmb.1407.07054
    This study aimed to investigate the mechanism of action of the cinnamon bark essential oil (CB), when used singly and also in combination with piperacillin, for its antimicrobial and synergistic activity against beta-lactamase TEM-1 plasmid-conferred Escherichia coli J53 R1. Viable count of this combination showed a complete killing profile at 20 h and further confirmed its synergistic effect by reducing the bacteria cell numbers. Analysis on the stability of treated cultures for cell membrane permeability by CB when tested against sodium dodecyl sulfate revealed that the bacterial cell membrane was disrupted by the essential oils. Scanning electron microscopy observation and bacterial surface charge measurement also revealed that CB causes irreversible membrane damage and reduces the bacterial surface charge. In addition, bioluminescence expression of Escherichia coli [pSB1075] and E. coli [pSB401] by CB showed reduction, indicating the possibility of the presence of quorum sensing (QS) inhibitors. Gas-chromatography and mass spectrometry of the essential oil of Cinnamomum verum showed that trans-cinnamaldehyde (72.81%), benzyl alcohol (12.5%), and eugenol (6.57%) were the major components in the essential oil. From this study, CB has the potential to reverse E. coli J53 R1 resistance to piperacillin through two pathways; modification in the permeability of the outer membrane or bacterial QS inhibition.
  2. Yap PS, Yiap BC, Ping HC, Lim SH
    Open Microbiol J, 2014;8:6-14.
    PMID: 24627729 DOI: 10.2174/1874285801408010006
    For many years, the battle between humans and the multitudes of infection and disease causing pathogens continues. Emerging at the battlefield as some of the most significant challenges to human health are bacterial resistance and its rapid rise. These have become a major concern in global public health invigorating the need for new antimicrobial compounds. A rational approach to deal with antibiotic resistance problems requires detailed knowledge of the different biological and non-biological factors that affect the rate and extent of resistance development. Combination therapy combining conventional antibiotics and essential oils is currently blooming and represents a potential area for future investigations. This new generation of phytopharmaceuticals may shed light on the development of new pharmacological regimes in combating antibiotic resistance. This review consolidated and described the observed synergistic outcome between essential oils and antibiotics, and highlighted the possibilities of essential oils as the potential resistance modifying agent.
  3. Yap PS, Lim SH, Hu CP, Yiap BC
    Phytomedicine, 2013 Jun 15;20(8-9):710-3.
    PMID: 23537749 DOI: 10.1016/j.phymed.2013.02.013
    In this study we investigated the relationship between several selected commercially available essential oils and beta-lactam antibiotics on their antibacterial effect against multidrug resistant bacteria. The antibacterial activity of essential oils and antibiotics was assessed using broth microdilution. The combined effects between essential oils of cinnamon bark, lavender, marjoram, tea tree, peppermint and ampicillin, piperacillin, cefazolin, cefuroxime, carbenicillin, ceftazidime, meropenem, were evaluated by means of the checkerboard method against beta-lactamase-producing Escherichia coli. In the latter assays, fractional inhibitory concentration (FIC) values were calculated to characterize interaction between the combinations. Substantial susceptibility of the bacteria toward natural antibiotics and a considerable reduction in the minimum inhibitory concentrations (MIC) of the antibiotics were noted in some paired combinations of antibiotics and essential oils. Out of 35 antibiotic-essential oil pairs tested, four of them showed synergistic effect (FIC≤0.5) and 31 pairs showed no interaction (FIC>0.5-4.0). The preliminary results obtained highlighted the occurrence of a pronounced synergistic relationship between piperacillin/cinnamon bark oil, piperacillin/lavender oil, piperacillin/peppermint oil as well as meropenem/peppermint oil against two of the three bacteria under study with a FIC index in the range 0.26-0.5. The finding highlighted the potential of peppermint, cinnamon bark and lavender essential oils being as antibiotic resistance modifying agent. Reduced usage of antibiotics could be employed as a treatment strategy to decrease the adverse effects and possibly to reverse the beta-lactam antibiotic resistance.
  4. Kashiwagi K, Chono E, Koesters S, Yap PS
    BMC Ophthalmol, 2020 Jun 10;20(1):223.
    PMID: 32522181 DOI: 10.1186/s12886-020-01508-8
    BACKGROUND: Poor persistence with glaucoma therapy can lead to disease progression and subsequent blindness. Persistence with second-line glaucoma combination treatment in a Japanese real-world setting and whether it differed from fixed and unfixed combination drugs was investigated.

    METHODS: This was a retrospective, non-interventional, cohort study using data from a Japanese medical claims database. Patients with glaucoma aged ≥20 years with a first drug claim for glaucoma treatment between 01 July 2005 and 30 October 2014 and with data for > 6 months before and after this first prescription were included. The primary endpoint was duration of drug persistence among glaucoma patients with and without the use of fixed combination drugs in the year following initiation of second-line combination treatment.

    RESULTS: Of 1403 patients included in the analysis, 364 (25.94%) received fixed combination drugs and 1039 (74.06%) received unfixed combination drugs as second-line treatment. Baseline characteristics were generally comparable between the groups. A total of 39.01% of patients on fixed combination drugs, compared with 41.67% of patients on unfixed combination drugs, persisted on their glaucoma drugs 12 months post second-index date. Median persistence durations for the fixed combination drugs and unfixed combination drugs groups were 6 (95% confidence interval [CI]: 5-8) and 7 months (95% CI 6-9), respectively. Patients who received prostaglandin analogs (PGAs) were the most persistent with their treatment (n = 99, 12.84%). Patients diagnosed with primary open-angle glaucoma were less likely to experience treatment modification (hazard ratio [HR]: 0.800, 95% CI 0.649-0.986, P = 0.036), while those diagnosed with secondary glaucoma were more likely to experience treatment modification (HR: 1.678, 95% CI 1.231-2.288, P = 0.001) compared with glaucoma suspects.

    CONCLUSIONS: In this retrospective claims database study, the persistence rate of second-line glaucoma combination treatment was low, with no difference in persistence between glaucoma patients receiving unfixed combination drugs compared with fixed combination drugs. Patients on PGA showed greater persistence rates compared with other treatments.

  5. Foong AL, Sow CF, Ramasamy S, Yap PS
    Int J Med Educ, 2019 Jan 25;10:1-8.
    PMID: 30685752 DOI: 10.5116/ijme.5c30.988d
    Objectives: This study was aimed at determining whether the pre-tertiary education system and ethnicity have any association with the attitudes of medical undergraduates towards communication skills. It also sought to determine if attitudes should have any relationship with communication skills assessment outcomes.

    Methods: A cross-section survey design was performed with 323 participants from two cohorts of medical undergraduates, i.e., first-year (n = 153) and second-year students (n = 170) who completed the Communication Skills Attitude Scale. Participants comprised of the main ethnic groups in Malaysia, i.e., Malays, Chinese and Indians, from different language medium pre-tertiary education backgrounds. Attitude measurements were compared with OSCE outcomes.

    Results: There was a significant difference in Negative Attitude Scale between pre-tertiary education system with attitudes towards communication skills (F (3, 319) = 7.79, p = .001), but no significant difference with Positive Attitude Scale (F (3, 319) = 0.43, p = .649). There was no significant difference between ethnicity and attitudes towards communication skills with PAS (F (2, 320) = 0.66, p = .519) and NAS (F (2, 320) = 1.24, p = .291). Students from Chinese medium education system had stronger negative attitudes with a mean score of 14.7 (n = 56, SD = 3.6) for primary school levels and 15.9 (n = 17, SD = 3.0) for secondary school levels, compared with others. There was no significant prediction of student's attitudes towards assessments outcomes.

    Conclusions: Preliminary findings from the small data pool suggest indicative relationships requiring further studies with more participants and proportionate pre-tertiary education system backgrounds.

  6. Chan EWL, Yap PS, Fazli Khalaf Z
    Geriatr Nurs, 2019 02 11;40(4):380-385.
    PMID: 30765175 DOI: 10.1016/j.gerinurse.2018.12.009
    A cross-sectional study design involving a total of 230 participants, recruited through Alzheimer's Disease Foundation Malaysia (ADFM), was adopted to access and correlate caregiver strain index (CSI) and resilience (RES) levels of the AD caregivers with various patients' and caregivers' factors. Findings revealed that 77.7% of caregivers had a high level of stress, and there was a significant negative correlation between RES and CSI (P 
  7. Wong JKH, Lee KK, Tang KHD, Yap PS
    Sci Total Environ, 2020 Jun 01;719:137512.
    PMID: 32229011 DOI: 10.1016/j.scitotenv.2020.137512
    The ubiquitous occurrences of microplastics in the environment have raised much concern and resulted in voluminous studies related to microplastics. Studies on microplastics pollution of the marine environment have received significantly higher attention compared to those of the freshwater and terrestrial environments. With the impetus to better understand microplastics in the freshwater and terrestrial environments, this review elucidates the findings of >100 articles related to the prevalence, fates and impacts of microplastics therein and the sustainable solutions, mostly in the past 10 years. This review shows the interconnection between terrestrial and freshwater microplastics with wastewater and sewage treatment plants as the most significant contributors of environmental microplastics via sludge and effluent discharges. Microplastics in both ecosystems comprise the primary and secondary forms with the latter resulted from weathering of the former. Besides retaining in soil and infiltrating with rainwater underground, terrestrial microplastics also enter the freshwater environment. The environmental microplastics interact with the biotic and abiotic components resulting in entrainment, settlement, biofouling, degradation, fragmentation and entry into the food chain, with subsequent transfer across the food chain. The abundance of environmental microplastics is attributed to population density and urbanization though tidal cycle, storms, floods and human activities can affect their distribution. The leaching of additives from microplastics poses major health concern and sustainable solutions target at reduction of plastics use and disposal, substitution with bioplastics and wastewater treatment innovations. Further studies on classification, detection, characterization and toxicity of microplastics are necessary to permit more effective formulation of solutions.
  8. Yap PS, Krishnan T, Yiap BC, Hu CP, Chan KG, Lim SH
    J Appl Microbiol, 2014 May;116(5):1119-28.
    PMID: 24779580 DOI: 10.1111/jam.12444
    The aim of this study was to investigate the mode of action of the lavender essential oil (LV) on antimicrobial activity against multi-drug-resistant Escherichia coli J53 R1 when used singly and in combination with piperacillin.
  9. Yang SK, Yusoff K, Ajat M, Wee CY, Yap PS, Lim SH, et al.
    Front Microbiol, 2021;12:635016.
    PMID: 33815320 DOI: 10.3389/fmicb.2021.635016
    Antibiotic-adjuvant combinatory therapy serves as a viable treatment option in addressing antibiotic resistance in the clinical setting. This study was carried out to assess and characterize the adjuvant potential and mode of action of linalool against carbapenemase-producing Klebsiella pneumoniae (KPC-KP). Linalool exhibited bactericidal activity alone (11,250 μg/ml) and in combination with meropenem (5,625 μg/ml). Comparative proteomic analysis showed significant reduction in the number of cytoplasmic and membrane proteins, indicating membrane damage in linalool-treated KPC-KP cells. Upregulation of oxidative stress regulator proteins and downregulation of oxidative stress-sensitive proteins indicated oxidative stress. Zeta potential measurement and outer membrane permeability assay revealed that linalool increases the bacterial surface charge as well as the membrane permeability. Intracellular leakage of nucleic acid and proteins was detected upon linalool treatment. Scanning and transmission electron microscopies further revealed the breakage of bacterial membrane and loss of intracellular materials. Linalool induced oxidative stress by generating reactive oxygen species (ROS) which initiates lipid peroxidation, leading to damage of the bacterial membrane. This leads to intracellular leakage, eventually killing the KPC-KP cells. Our study demonstrated that linalool possesses great potential in future clinical applications as an adjuvant along with existing antibiotics attributed to their ability in disrupting the bacterial membrane by inducing oxidative stress. This facilitates the uptake of antibiotics into the bacterial cells, enhancing bacterial killing.
  10. Yap PS, Cheng WH, Chang SK, Lim SE, Lai KS
    Cells, 2022 Sep 26;11(19).
    PMID: 36230959 DOI: 10.3390/cells11192995
    There has been a resurgence in the clinical use of polymyxin antibiotics such as colistin due to the limited treatment options for infections caused by carbapenem-resistant Enterobacterales (CRE). However, this last-resort antibiotic is currently confronted with challenges which include the emergence of chromosomal and plasmid-borne colistin resistance. Colistin resistance in Klebsiella pneumoniae is commonly caused by the mutations in the chromosomal gene mgrB. MgrB spans the inner membrane and negatively regulates PhoP phosphorylation, which is essential for bacterial outer membrane lipid biosynthesis. The present review intends to draw attention to the role of mgrB chromosomal mutations in membrane permeability in K. pneumoniae that confer colistin resistance. With growing concern regarding the global emergence of colistin resistance, deciphering physical changes of the resistant membrane mediated by mgrB inactivation may provide new insights for the discovery of novel antimicrobials that are highly effective at membrane penetration, in addition to finding out how this can help in alleviating the resistance situation.
  11. Anboo S, Lau SY, Kansedo J, Yap PS, Hadibarata T, Kamaruddin AH
    Heliyon, 2024 Mar 30;10(6):e27348.
    PMID: 38500986 DOI: 10.1016/j.heliyon.2024.e27348
    This paper reports the synthesis of magnetic lipase/Cu3(PO4)2 hybrid nanoflowers via a rapid ultrasonication method. The enzyme immobilization and nanoflower growth mechanism can be described as the (a) Fe2+, Cu2+, and phosphate "binding", (b) metal phosphate crystals formation, (c) formation and growth of metal phosphate crystals to form plate-like structures, and (d) self-assembly of plate structures that forms a flower-like structure. Some factors contributing to the morphology of the hybrid nanoflowers structure includes the time and concentration of lipase were studied. The effect of temperature, pH, and duration on the enzyme immobilization yield were also studied. In addition, the strong magnetic property (9.73 emu g-1) of the nanoflowers resulted in higher retrievability and reusability after repeated usage. Furthermore, the catalytic activity of lipase/Cu3(PO4)2 hybrid nanoflowers was investigated and the ideal conditions were determined whereby, the maximum activity was calculated to be 1511 ± 44 U g-1, showing a catalytic enhancement of 89% in comparison to free lipase. The reusability study showed that, after 5 cycles, the magnetic lipase/Cu3(PO4)2 nanoflowers successfully retained 60% of its initial activity. From the results obtained, it is worth noting that, the magnetic lipase/Cu3(PO4)2 hybrid nanoflowers are highly efficient in industrial biocatalytic applications.
  12. Anboo S, Lau SY, Kansedo J, Yap PS, Hadibarata T, Jeevanandam J, et al.
    Biotechnol Bioeng, 2022 Oct;119(10):2609-2638.
    PMID: 35851660 DOI: 10.1002/bit.28185
    Over the past decade, nanotechnology has been developed and employed across various entities. Among the numerous nanostructured material types, enzyme-incorporated nanomaterials have shown great potential in various fields, as an alternative to biologically derived as well as synthetically developed hybrid structures. The mechanism of incorporating enzyme onto a nanostructure depends on several factors including the method of immobilization, type of nanomaterial, as well as operational and environmental conditions. The prospects of enzyme-incorporated nanomaterials have shown promising results across various applications, such as biocatalysts, biosensors, drug therapy, and wastewater treatment. This is due to their excellent ability to exhibit chemical and physical properties such as high surface-to-volume ratio, recovery and/or reusability rates, sensitivity, response scale, and stable catalytic activity across wide operating conditions. In this review, the evolution of enzyme-incorporated nanomaterials along with their impact on our society due to its state-of-the-art properties, and its significance across different industrial applications are discussed. In addition, the weakness and future prospects of enzyme-incorporated nanomaterials were also discussed to guide scientists for futuristic research and development in this field.
  13. Lai PJ, Ng EV, Yang SK, Moo CL, Low WY, Yap PS, et al.
    3 Biotech, 2020 Jul;10(7):313.
    PMID: 32596098 DOI: 10.1007/s13205-020-02304-3
    To better understand the synergistic antibacterial activity between piperacillin and Lavandula angustifolia essential oil (LEO) against multidrug-resistant Escherichia coli, we performed microarray transcriptomic analysis of LEO when used alone and in combination with piperacillin against the non-treated control. In total, 90 genes were differentially expressed after the combination of LEO and piperacillin treatment. Among the up-regulated genes, nfsB, nemA, fruA, nfsB, nemA are known to control microbial metabolism and nitrotoluene degradation, which were observed only in the LEO-piperacillin combinatory treatment. Four candidate genes from the microarray result, srIA, srID, waaR and nfsB, were validated by qRT-PCR as these genes showed differential expression consistently in the two methods. Biochemical pathway analysis showed that there was upregulation of genes involved in several biological processes including fructose and mannose metabolism, phosphotransferase system (PTS), lipopolysaccharide biosynthesis and nitrotoluene degradation. Genes involved in microbial metabolism in diverse environments were found both up- and down-regulated in LEO-piperacillin combinatory treatment. Our study provides new information concerning the transcriptional changes that occur during the LEO and piperacillin interaction against the multidrug-resistant bacteria and contributes to unravel the mechanisms underlying this synergism.
  14. Yap PS, Ahmad Kamar A, Chong CW, Yap IK, Thong KL, Choo YM, et al.
    Pathog Glob Health, 2016 Sep;110(6):238-246.
    PMID: 27650884
    The prevalence and antibiotic susceptibility of intestinal carriage of Gram-negative bacteria among preterm infants admitted to the neonatal intensive care unit (NICU) in a tertiary teaching hospital in Malaysia were determined. A total of 34 stool specimens were obtained from preterm infants upon admission and once weekly up to two weeks during hospitalization. The presumptive colonies of Escherichia coli and Klebsiella pneumoniae were selected for identification, antibiotic susceptibility testing, and subtyping by using pulsed-field gel electrophoresis (PFGE). Out of 76 Gram-negative isolates, highest resistance was detected for amoxicillin/clavulanate (30.8%, n = 16), ceftriaxone (42.3%, n = 22), ceftazidime (28.8%, n = 15), cefoxitin (28.8%, n = 15), aztreonam (36.5%, n = 19), and polymyxin B (23.1%, n = 12). Three colistin resistant K. pneumoniae have also been detected based on E-test analysis. Thirty-nine isolates of K. pneumoniae and 20 isolates of E. coli were resistant to more than three antimicrobial classes and were categorized as multidrug resistant (MDR). PFGE analysis revealed a higher diversity in pulsotypes for K. pneumoniae (18 pulsotypes) in comparison to E. coli (four pulsotypes). In addition, a total of fifteen pulsotypes was observed from 39 MDR K. pneumoniae. The risk factors for antibiotic resistance were assessed using random forest analysis. Gender was found to be the most important predictor for colistin resistant while length, OFC, and delivery mode were showing greater predictive power in the polymyxin B resistance. This study revealed worrying prevalence rates of intestinal carriage of multidrug-resistant K. pneumoniae and E. coli of hospitalized preterm infants in Malaysia, particularly high resistance to polymyxins.
  15. Sakamoto T, Shimura M, Kitano S, Ohji M, Ogura Y, Yamashita H, et al.
    Graefes Arch Clin Exp Ophthalmol, 2022 Feb;260(2):477-487.
    PMID: 34477927 DOI: 10.1007/s00417-021-05308-8
    PURPOSE: The MERCURY study aimed to evaluate the effects on visual acuity and psychological symptoms, and safety, of ranibizumab and subsequent treatment in patients with diabetic macular oedema (DME) and impaired visual acuity (VA). We report data from the prespecified 12-month interim analysis.

    METHODS: This was a 24-month, phase 4, open-label, single-arm, prospective, observational study conducted at 20 specialised retinal centres in Japan. Participants were 209 patients with DME and impaired VA, not previously treated with either intravitreal or systemic anti-vascular endothelial growth factor (anti-VEGF) agents, who initiated ranibizumab 0.5 mg per investigator discretion. Following ranibizumab administration, patients were treated per routine clinical practice. Other treatments were allowed. The main outcome measure was the mean change in best-corrected VA (BCVA) in logarithmic minimum angle of resolution (logMAR) from baseline to month 12. An exploratory objective was to assess patients' psychological status using the Hospital Anxiety and Depression Scale (HADS).

    RESULTS: The mean ± standard deviation BCVA at baseline was 0.43 ± 0.39 logMAR. The mean number of injections of ranibizumab and anti-VEGF agents from baseline to month 11 was 3.2 ± 2.0 and 3.6 ± 2.4, respectively. The BCVA change from baseline to 12 months was - 0.08 ± 0.34 logMAR (p = 0.011), showing a significant improvement; the HADS-anxiety score also decreased significantly (p = 0.001) and the depression score decreased numerically (p = 0.080).

    CONCLUSION: MERCURY study data confirm the effectiveness of real-world treatment initiated with ranibizumab in Japanese patients with DME. In addition, treatment was able to positively influence anxiety via VA improvement.

  16. Osman AI, Hosny M, Eltaweil AS, Omar S, Elgarahy AM, Farghali M, et al.
    Environ Chem Lett, 2023 Apr 04.
    PMID: 37362012 DOI: 10.1007/s10311-023-01593-3
    Microplastic pollution is becoming a major issue for human health due to the recent discovery of microplastics in most ecosystems. Here, we review the sources, formation, occurrence, toxicity and remediation methods of microplastics. We distinguish ocean-based and land-based sources of microplastics. Microplastics have been found in biological samples such as faeces, sputum, saliva, blood and placenta. Cancer, intestinal, pulmonary, cardiovascular, infectious and inflammatory diseases are induced or mediated by microplastics. Microplastic exposure during pregnancy and maternal period is also discussed. Remediation methods include coagulation, membrane bioreactors, sand filtration, adsorption, photocatalytic degradation, electrocoagulation and magnetic separation. Control strategies comprise reducing plastic usage, behavioural change, and using biodegradable plastics. Global plastic production has risen dramatically over the past 70 years to reach 359 million tonnes. China is the world's top producer, contributing 17.5% to global production, while Turkey generates the most plastic waste in the Mediterranean region, at 144 tonnes per day. Microplastics comprise 75% of marine waste, with land-based sources responsible for 80-90% of pollution, while ocean-based sources account for only 10-20%. Microplastics induce toxic effects on humans and animals, such as cytotoxicity, immune response, oxidative stress, barrier attributes, and genotoxicity, even at minimal dosages of 10 μg/mL. Ingestion of microplastics by marine animals results in alterations in gastrointestinal tract physiology, immune system depression, oxidative stress, cytotoxicity, differential gene expression, and growth inhibition. Furthermore, bioaccumulation of microplastics in the tissues of aquatic organisms can have adverse effects on the aquatic ecosystem, with potential transmission of microplastics to humans and birds. Changing individual behaviours and governmental actions, such as implementing bans, taxes, or pricing on plastic carrier bags, has significantly reduced plastic consumption to 8-85% in various countries worldwide. The microplastic minimisation approach follows an upside-down pyramid, starting with prevention, followed by reducing, reusing, recycling, recovering, and ending with disposal as the least preferable option.
  17. Wu YS, Osman AI, Hosny M, Elgarahy AM, Eltaweil AS, Rooney DW, et al.
    ACS Omega, 2024 Feb 06;9(5):5100-5126.
    PMID: 38343989 DOI: 10.1021/acsomega.3c07047
    Mercury is a type of hazardous and toxic pollutant that can result in detrimental effects on the environment and human health. This review is aimed at discussing the state-of-the-art progress on the recent developments on the toxicity of mercury and its chemical compounds. More than 210 recent works of literature are covered in this review. It first delineates the types (covering elemental mercury, inorganic mercury compounds, organic mercury compounds), structures, and sources of mercury. It then discusses the pharmacokinetic profile of mercury, molecular mechanisms of mercury toxicity, and clinical manifestation of acute and chronic mercury toxicity to public health. It also elucidates the mercury toxicity to the environment and human health in detail, covering ecotoxicity, neurotoxicity diseases, neurological diseases, genotoxicity and gene regulation, immunogenicity, pregnancy and reproductive system damage, cancer promotion, cardiotoxicity, pulmonary diseases, and renal disease. In order to mitigate the adverse effects of mercury, strategies to overcome mercury toxicity are recommended. Finally, some future perspectives are provided in order to advance this field of research in the future.
  18. Wong SF, Yap PS, Mak JW, Chan WLE, Khor GL, Ambu S, et al.
    Environ Health, 2020 04 03;19(1):37.
    PMID: 32245482 DOI: 10.1186/s12940-020-00579-w
    BACKGROUND: Malaysia has the highest rate of diabetes mellitus (DM) in the Southeast Asian region, and has ongoing air pollution and periodic haze exposure.

    METHODS: Diabetes data were derived from the Malaysian National Health and Morbidity Surveys conducted in 2006, 2011 and 2015. The air pollution data (NOx, NO2, SO2, O3 and PM10) were obtained from the Department of Environment Malaysia. Using multiple logistic and linear regression models, the association between long-term exposure to these pollutants and prevalence of diabetes among Malaysian adults was evaluated.

    RESULTS: The PM10 concentration decreased from 2006 to 2014, followed by an increase in 2015. Levels of NOx decreased while O3 increased annually. The air pollutant levels based on individual modelled air pollution exposure as measured by the nearest monitoring station were higher than the annual averages of the five pollutants present in the ambient air. The prevalence of overall diabetes increased from 11.4% in 2006 to 21.2% in 2015. The prevalence of known diabetes, underdiagnosed diabetes, overweight and obesity also increased over these years. There were significant positive effect estimates of known diabetes at 1.125 (95% CI, 1.042, 1.213) for PM10, 1.553 (95% CI, 1.328, 1.816) for O3, 1.271 (95% CI, 1.088, 1.486) for SO2, 1.124 (95% CI, 1.048, 1.207) for NO2, and 1.087 (95% CI, 1.024, 1.153) for NOx for NHMS 2006. The adjusted annual average levels of PM10 [1.187 (95% CI, 1.088, 1.294)], O3 [1.701 (95% CI, 1.387, 2.086)], NO2 [1.120 (95% CI, 1.026, 1.222)] and NOx [1.110 (95% CI, 1.028, 1.199)] increased significantly from NHMS 2006 to NHMS 2011 for overall diabetes. This was followed by a significant decreasing trend from NHMS 2011 to 2015 [0.911 for NO2, and 0.910 for NOx].

    CONCLUSION: The findings of this study suggest that long-term exposure to O3 is an important associated factor of underdiagnosed DM risk in Malaysia. PM10, NO2 and NOx may have mixed effect estimates towards the risk of DM, and their roles should be further investigated with other interaction models. Policy and intervention measures should be taken to reduce air pollution in Malaysia.

Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links