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  1. Ismail NA, Kamaruddin NA, Azhar Shah S, Sukor N
    Clin Endocrinol (Oxf), 2020 06;92(6):509-517.
    PMID: 32073675 DOI: 10.1111/cen.14177
    INTRODUCTION: Primary aldosteronism (PA) contributed to the cardiovascular disease and metabolic alterations independent of the blood pressure level. Evidence exists that aldosterone excess also affects calcium and mineral homeostasis. PA subjects have been shown to have greater prevalence of vitamin D deficiency. However, the impact of vitamin D treatment in this population has never been assessed.

    OBJECTIVE: This study aimed to evaluate the effect of vitamin D treatment on clinical and biochemical outcomes of PA patients.

    METHODS: Two hundred forty hypertensive subjects were screened, 31 had positive ARR, and 17 patients with newly confirmed PA following positive confirmatory test that has not been subjected for definitive treatment were enrolled. Clinical parameter (blood pressure) and biochemical parameters (renal profile, plasma aldosterone concentration, plasma renin activity, serum calcium, vitamin D, intact parathyroid hormone, 24-hour urinary calcium) were measured at baseline and 3 months of treatment with Bio-D3 capsule. Primary outcomes were the changes in the blood pressure and biochemical parameters.

    RESULTS: About 70% of our PA subjects have low vitamin D levels at baseline. Three months following treatment, there were significant: (a) improvement in 25(OH)D levels; (b) reduction in systolic blood pressure and plasma aldosterone concentration; and (c) improvement in the eGFR. The vitamin D deficient subgroup has the greatest magnitude of the systolic blood pressure reduction following treatment.

    CONCLUSIONS: This study demonstrated significant proportion of PA patients has vitamin D insufficiency. Vitamin D treatment improves these interrelated parameters possibly suggesting interplay between vitamin D, aldosterone, renal function and the blood pressure.

    Matched MeSH terms: Humans
  2. Zhen NB, Gaillard F, Walterfang M, Mohd Zain NR, Yoon CK
    Aust N Z J Psychiatry, 2021 02;55(2):224-225.
    PMID: 32720512 DOI: 10.1177/0004867420945786
    Matched MeSH terms: Humans
  3. Chang E, Lim JA, Low CL, Kassim A
    J Nephrol, 2021 02;34(1):97-104.
    PMID: 33394342 DOI: 10.1007/s40620-020-00903-0
    BACKGROUND: Water crisis is becoming a threat to the well-being of the human population worldwide and use of water for healthcare contributes substantially to this resource depletion. Hemodialysis consumes large quantities of water. A huge volume of high purity dialysis water is required to safely perform dialysis treatment. In this process, up to 60-70% of source water is discarded. Many strategies have been suggested to promote green dialysis, and these include reuse of water, however, very few dialysis facilities have taken the preliminary steps to employ it.

    METHODS: We share our experience in a developing country on an innovative reject-water reuse program combining aquaculture, hydroponic and horticulture activities. This is by far the first report on a "green dialysis" project involving aquaponics that reuse dialysis reverse osmosis (RO) reject water.

    RESULTS: Our expereince suggests that reject water can be reused to promote water conservation with encouraging results. It provides a good and biosecure environment for fish breeding and vegetable farming . This project promotes a reduction in carbon footprint, a reduction in water waste, a sustainable organic food source, may lead to income generation, and provides a shared purpose and sense of pride among staff and dialysis patients.

    CONCLUSIONS: Encompassing "environmental protection" practices into a hemodialysis unit can be done with relatively simple and practical steps.

    Matched MeSH terms: Humans
  4. Garweg C, Khelae SK, Chan JYS, Chinitz L, Ritter P, Johansen JB, et al.
    J Cardiovasc Electrophysiol, 2021 07;32(7):1947-1957.
    PMID: 33928713 DOI: 10.1111/jce.15061
    INTRODUCTION: MARVEL 2 assessed the efficacy of mechanical atrial sensing by a ventricular leadless pacemaker, enabling a VDD pacing mode. The behavior of the enhanced MARVEL 2 algorithm during variable atrio-ventricular conduction (AVC) and/or arrhythmias has not been characterized and is the focus of this study.

    METHODS: Of the 75 patients enrolled in the MARVEL 2 study, 73 had a rhythm assessment and were included in the analysis. The enhanced MARVEL 2 algorithm included a mode-switching algorithm that automatically switches between VDD and ventricular only antibradycardia pacing (VVI)-40 depending upon AVC status.

    RESULTS: Forty-two patients (58%) had persistent third degree AV block (AVB), 18 (25%) had 1:1 AVC, 5 (7%) had variable AVC status, and 8 (11%) had atrial arrhythmias. Among the 42 patients with persistent third degree AVB, the median ventricular pacing (VP) percentage was 99.9% compared to 0.2% among those with 1:1 AVC. As AVC status changed, the algorithm switched to VDD when the ventricular rate dropped less than 40 bpm. During atrial fibrillation (AF) with ventricular response greater than 40 bpm, VVI-40 mode was maintained. No pauses longer than 1500 ms were observed. Frequent ventricular premature beats reduced the percentage of AV synchrony. During AF, the atrial signal was of low amplitude and there was infrequent sensing.

    CONCLUSION: The mode switching algorithm reduced VP in patients with 1:1 AVC and appropriately switched to VDD during AV block. No pacing safety issues were observed during arrhythmias.

    Matched MeSH terms: Humans
  5. Hasan SS, Kow CS, Mustafa ZU, Merchant HA
    Expert Rev Respir Med, 2021 08;15(8):1049-1055.
    PMID: 33945381 DOI: 10.1080/17476348.2021.1925546
    Objectives: The question remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths.Methods: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13 April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI).Results: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 - 1.43, n = 652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high dose methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42).Conclusions: In determining equipotent doses for an acute short-course pulse therapy of corticosteroids, the biological half-life of steroids should also be accounted for besides the potency factor. A short duration (3-5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths.
    Matched MeSH terms: Humans
  6. Kamal SM, Dawi NBM, Sim S, Tee R, Nathan V, Aghasian E, et al.
    Technol Health Care, 2020;28(6):675-684.
    PMID: 32200366 DOI: 10.3233/THC-192034
    BACKGROUND: Walking is one of the important actions of the human body. For this purpose, the human brain communicates with leg muscles through the nervous system. Based on the walking path, leg muscles act differently. Therefore, there should be a relation between the activity of leg muscles and the path of movement.

    OBJECTIVE: In order to address this issue, we analyzed how leg muscle activity is related to the variations of the path of movement.

    METHOD: Since the electromyography (EMG) signal is a feature of muscle activity and the movement path has complex structures, we used entropy analysis in order to link their structures. The Shannon entropy of EMG signal and walking path are computed to relate their information content.

    RESULTS: Based on the obtained results, walking on a path with greater information content causes greater information content in the EMG signal which is supported by statistical analysis results. This allowed us to analyze the relation between muscle activity and walking path.

    CONCLUSION: The method of analysis employed in this research can be applied to investigate the relation between brain or heart reactions and walking path.

    Matched MeSH terms: Humans
  7. Kamal SM, Sim S, Tee R, Nathan V, Aghasian E, Namazi H
    Technol Health Care, 2020;28(4):381-390.
    PMID: 31796717 DOI: 10.3233/THC-191965
    BACKGROUND: The human brain controls all actions of the body. Walking is one of the most important actions that deals with the movement of the body. In fact, the brain controls and regulates human walking based on different conditions. One of the conditions that affects human walking is the complexity of path of movement. Therefore, the brain activity should change when a person walks on a path with different complexities.

    OBJECTIVE: In this research we benefit from fractal analysis to study the effect of complexity of path of movement on the complexity of human brain reaction.

    METHODS: For this purpose we calculate the fractal dimension of the electroencephalography (EEG) signal when subjects walk on different paths with different fractal dimensions (complexity).

    RESULTS: The results of the analysis show that the complexity of brain activity increases with the increment of complexity of path of movement.

    CONCLUSION: The method of analysis employed in this research can also be employed to analyse the reaction of the human heart and respiration when subjects move on paths with different complexities.

    Matched MeSH terms: Humans
  8. Naur OM, Anggraini A, Indraswari BW, Wandita S, Wibowo T, Haksari EL
    Med J Malaysia, 2020 05;75(Suppl 1):51-52.
    PMID: 32471969
    Young patients, especially infants with Mucopolysaccharidosis (MPS) have increased risk of recurrent upper and lower respiratory tract infections. A complete schedule of immunisations is crucial to protect children from life-threatening infections. However, in most cases, they often miss scheduled vaccinations due to many factors. This case report describes issues in administering routine immunisations to infants with MPS. It is vital to recognise the indications and contraindications of vaccinations for patients with MPS although all vaccines need detailed study to investigate their safety and immunogenicity. Furthermore, regular educational programs are essential for both parents and health providers.
    Matched MeSH terms: Humans
  9. Ghaleb FA, Al-Rimy BAS, Boulila W, Saeed F, Kamat M, Foad Rohani M, et al.
    Comput Intell Neurosci, 2021;2021:2977954.
    PMID: 34413885 DOI: 10.1155/2021/2977954
    Wireless mesh networks (WMNs) have emerged as a scalable, reliable, and agile wireless network that supports many types of innovative technologies such as the Internet of Things (IoT), Wireless Sensor Networks (WSN), and Internet of Vehicles (IoV). Due to the limited number of orthogonal channels, interference between channels adversely affects the fair distribution of bandwidth among mesh clients, causing node starvation in terms of insufficient bandwidth distribution, which impedes the adoption of WMN as an efficient access technology. Therefore, a fair channel assignment is crucial for the mesh clients to utilize the available resources. However, the node starvation problem due to unfair channel distribution has been vastly overlooked during channel assignment by the extant research. Instead, existing channel assignment algorithms equally distribute the interference reduction on the links to achieve fairness which neither guarantees a fair distribution of the network bandwidth nor eliminates node starvation. In addition, the metaheuristic-based solutions such as genetic algorithm, which is commonly used for WMN, use randomness in creating initial population and selecting the new generation usually leading the search to local minima. To this end, this study proposes a Fairness-Oriented Semichaotic Genetic Algorithm-Based Channel Assignment Technique (FA-SCGA-CAA) to solve node starvation problem in wireless mesh networks. FA-SCGA-CAA maximizes link fairness while minimizing link interference using a genetic algorithm (GA) with a novel nonlinear fairness-oriented fitness function. The primary chromosome with powerful genes is created based on multicriterion links ranking channel assignment algorithm. Such a chromosome was used with a proposed semichaotic technique to create a strong population that directs the search towards the global minima effectively and efficiently. The proposed semichaotic technique was also used during the mutation and parent selection of the new genes. Extensive experiments were conducted to evaluate the proposed algorithm. A comparison with related work shows that the proposed FA-SCGA-CAA reduced the potential node starvation by 22% and improved network capacity utilization by 23%. It can be concluded that the proposed FA-SCGA-CAA is reliable to maintain high node-level fairness while maximizing the utilization of the network resources, which is the ultimate goal of many wireless networks.
    Matched MeSH terms: Humans
  10. Ramlee MH, Seng GH, Ros Felip A, Abdul Kadir MR
    Injury, 2021 Aug;52(8):2131-2141.
    PMID: 33745700 DOI: 10.1016/j.injury.2021.03.017
    An external fixator is a promising medical device that could provide optimum stability and reduce the rate of complications in treating bone fracture during intervention period. It is noted that the biomechanics behaviour of device can be altered by introducing more features such as material suitability and additional components. Therefore, this study was conducted via finite element method to investigate the effects of additional hollow cylinder coated with external fixator screws in treating Type III pilon fracture. Finite element models which have been validated with experimental data were used to simulate stresses at the pin-bone interface and relative micromovement at interfragmentary fractures during swing (70 N load) and stance phases (350 N load). All bones and external fixators were assigned with isotropic material properties while the cartilages were simulated with hyper-elastic. For the hollow cylinder, polyethylene was assigned due to its properties which are equivalent to the bone. From the results, it is found that stresses at the pin-bone interface for the coated screws were reduced to 54% as compared to the conventional fixator. For the micromovement, there was no difference between both models, whereby the value was 0.03 mm. The results supported previously published literature, in which high stresses are unavoidable at the interface, fortunately, those stresses did not exceed the ultimate strength of bone, which is safe for treating patients. In conclusion, if patients are allowed to bear weight bearing, the external fixator with coated screws is a more favourable option to be fixed into the bone to avoid complications at the interface.
    Matched MeSH terms: Humans
  11. Abdul Aziz NA, Toh TH, Loh EC, Capelle DP, Goh KJ, Abdul Latif L, et al.
    PMID: 33726578 DOI: 10.1080/21678421.2021.1893336
    Objective: To compare two ALS staging systems, King's clinical staging and Milano-Torino (MiToS) functional staging, using prospective data from a multi-ethnic cohort of ALS patients. Methods: The stages of disease were determined prospectively based on existing definitions. The two systems were compared for timing of stages using box plots, correspondence using chi-square tests and association using Spearman's rank correlation. Results: The distribution of stages differed between the two systems. The proportions of disease stages of the King's staging system were more evenly distributed whereas in MiToS, there was greater weight seen at the later stages of disease. At the early stages, patients moved consecutively in the MiToS staging system but not in the King's staging system where patients tended to skip stages to reach later stages. Both systems had good correlation (Spearman's rho = 0.869) and the King's stage 4 most frequently corresponded to MiToS stage 2. Conclusion: We found the King's staging was helpful in determining the stages of disease burden, whereas both were helpful in determining the time to functional dependence with MiToS further refining the levels of dependence.
    Matched MeSH terms: Humans
  12. Liew WS, Tang TB, Lin CH, Lu CK
    Comput Methods Programs Biomed, 2021 Jul;206:106114.
    PMID: 33984661 DOI: 10.1016/j.cmpb.2021.106114
    BACKGROUND AND OBJECTIVE: The increased incidence of colorectal cancer (CRC) and its mortality rate have attracted interest in the use of artificial intelligence (AI) based computer-aided diagnosis (CAD) tools to detect polyps at an early stage. Although these CAD tools have thus far achieved a good accuracy level to detect polyps, they still have room to improve further (e.g. sensitivity). Therefore, a new CAD tool is developed in this study to detect colonic polyps accurately.

    METHODS: In this paper, we propose a novel approach to distinguish colonic polyps by integrating several techniques, including a modified deep residual network, principal component analysis and AdaBoost ensemble learning. A powerful deep residual network architecture, ResNet-50, was investigated to reduce the computational time by altering its architecture. To keep the interference to a minimum, median filter, image thresholding, contrast enhancement, and normalisation techniques were exploited on the endoscopic images to train the classification model. Three publicly available datasets, i.e., Kvasir, ETIS-LaribPolypDB, and CVC-ClinicDB, were merged to train the model, which included images with and without polyps.

    RESULTS: The proposed approach trained with a combination of three datasets achieved Matthews Correlation Coefficient (MCC) of 0.9819 with accuracy, sensitivity, precision, and specificity of 99.10%, 98.82%, 99.37%, and 99.38%, respectively.

    CONCLUSIONS: These results show that our method could repeatedly classify endoscopic images automatically and could be used to effectively develop computer-aided diagnostic tools for early CRC detection.

    Matched MeSH terms: Humans
  13. Rogers SN, Alvear A, Anesi A, Babin E, Balik A, Batstone M, et al.
    Head Neck, 2020 03;42(3):498-512.
    PMID: 31833121 DOI: 10.1002/hed.26027
    BACKGROUND: The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL).

    METHODS: Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias.

    RESULTS: There were 2136 patients with a median total number of PCI items selected of 5 (2-10). "Fear of the cancer returning" (39%) and "dry mouth" (37%) were most common. Twenty-five percent (524) reported less than good QOL.

    CONCLUSION: There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL.

    Matched MeSH terms: Humans
  14. Dutta S, Henkel R, Agarwal A
    Andrologia, 2021 Mar;53(2):e13718.
    PMID: 32628294 DOI: 10.1111/and.13718
    Male infertility has a complex etiology, and many times, the cause is unknown. While routine semen analysis provides an overview of basic semen parameters, such as sperm concentration, motility, viability and morphology, a significant overlap of these parameters has been reported in fertile and infertile men. Moreover, conventional semen parameters do not reveal the cellular or molecular mechanisms of sperm dysfunctions leading to infertility. Therefore, sperm functional parameters, including sperm chromatin integrity, are evaluated to provide information on subtle sperm defects that are not routinely identified. Incomplete or defective sperm chromatin condensation increases the susceptibility of the sperm DNA to oxidative damage or other factors. To evaluate sperm chromatin integrity, different methods with varying degrees of diagnostic and prognostic capabilities are available. Among these assays, SCSA, TUNEL and SCD assays are most commonly used. While these assays rather evaluate the DNA directly for damages, the aniline blue and chromomycin A3 stains test for the quality of chromatin condensation. Thus, this review discusses and compares different methods used to evaluate sperm chromatin integrity and condensation, and their inclusion in the routine evaluation of the male infertility.
    Matched MeSH terms: Humans
  15. Chong SC, Ang JK, Hashim H
    Asian J Psychiatr, 2020 Dec;54:102117.
    PMID: 32623189 DOI: 10.1016/j.ajp.2020.102117
    Pathological narcissism or narcissistic personality disorder is commonly characterized by an exaggerated sense of self-importance, condescending attitude, need for excessive admiration, diminished empathy and exploitativeness. In contrast to these overt attributes, there is a different presentation of pathological narcissism which is underrecognized, as one's preoccupation with hypervigilant, self-effacement and proneness to shame in the context of covert grandiose fantasies. This report illustrates a patient who had this subtype of vulnerable narcissism, and how his defence had been activated to preserve own self agency during a session with the doctor by revealing his paraphilic fantasy.
    Matched MeSH terms: Humans
  16. Abdul Wahab AH, Wui NB, Abdul Kadir MR, Ramlee MH
    Comput Biol Med, 2020 12;127:104062.
    PMID: 33096298 DOI: 10.1016/j.compbiomed.2020.104062
    External fixators have been widely used in treating open fractures and have produced excellent outcomes, as they could successfully heal bones. The stability of external fixators lies greatly in their construction. Factors that associated with the stability of the external fixators includes stress, displacement, and relative micromotion. Three-dimensional (3D) models of bone and external fixators were constructed by using 3D modelling software, namely Materialise and SolidWorks, respectively. Three different configurations of external fixators namely Model 1, Model 2, and Model 3 were analysed. Three load cases were simulated to assess the abovementioned factors at the bone, specifically at the fracture site and at the external fixator. Findings showed that the double-cross configuration (Model 3) was the most promising in axial, bending, and torsion load cases as compared to the other two configurations. The no-cross configuration (Model 1) had the highest risk of complication due to high stress, relative micromotion, and displacement in the bending and torsion load cases. On the other hand, the single-cross configuration (Model 2) had the highest risk of complication when applied with axial load. In conclusion, the double-cross locking construct (Model 3) showed the biggest potential to be a new option for medical surgeons in treating patients associated with bone fracture. This new double-cross locking construct showed superior biomechanical stability as compared to single-cross and no-cross configurations in the axial, bending, and torsion load cases.
    Matched MeSH terms: Humans
  17. Li HY, Lin HC, Huang BJ, Kai Lo AZ, Saidin S, Lai CH
    Langmuir, 2020 09 29;36(38):11374-11382.
    PMID: 32902993 DOI: 10.1021/acs.langmuir.0c02297
    Recently, studies on the development and investigation of carbohydrate-functionalized silica nanoparticles (NPs) and their biomedicine applications such as cell-specific targeting and bioimaging has been carried out extensively. Since the number of breast cancer patients has been growing in recent years, potential NPs were being studied in this project for targeting breast cancer cells. Mannose receptors can be found on the surface of MDA-MB-231, which is a kind of human breast cancer cell line. Therefore, we decorated a cyanine 3 fluorescent dye (Cy3) and mannosides on the surface of silica NPs for the purpose of imaging and targeting. Galactoside was also introduced onto the surface of silica NPs acting as a control sample. Various sizes of silica NPs were synthesized by using different amounts of ammonium to investigate the effect of the size of NPs on the cellular uptake rate. The physical properties of these NPs were characterized by scanning electron microscope, dynamic light scattering, and their zeta potential. Cellular experiments demonstrated that mannoside-modified NPs can be uptaken by MDA-MB-231. From the experiment, we found out that the best cellular uptake rate of nanoparticle size is about 250 nm. The MTT assay showed that Man@Cy3SiO2NPs are not cytotoxic, indicating they may have the potential for biomedical applications.
    Matched MeSH terms: Humans
  18. Heng WS, Pore M, Meijer C, Hiltermann TJN, Cheah SC, Gosens R, et al.
    Lung Cancer, 2021 04;154:13-22.
    PMID: 33607458 DOI: 10.1016/j.lungcan.2021.02.002
    OBJECTIVES: Cancer stem cells (CSCs) have been implicated in disease progression of aggressive cancers including small cell lung carcinoma (SCLC). Here, we have examined the possible contribution of CSCs to SCLC progression and aggressiveness.

    MATERIALS AND METHODS: GLC-14, GLC-16 and GLC-19 SCLC cell lines derived from one patient, representing increasing progressive stages of disease were used. CSC marker expressions was determined by RT-qPCR and western blotting analyses, and heterogeneity was studied by CSC marker expression by immunofluorescence microscopy and flow cytometry. Colony formation assays were used to assess stem cell properties and therapy sensitivity.

    RESULTS: Increasing expression of stem cell markers MYC, SOX2 and particularly CD44 were found in association with advancing disease. Single and overlapping expression of these markers indicated the presence of different CSC populations. The accumulation of more homogeneous double- and triple-positive CSC populations evolved with disease progression. Functional characterization of CSC properties affirmed higher proficiency of colony forming ability and increased resistance to γ-irradiation in GLC-16 and GLC-19 compared to GLC-14. GLC-19 colony formation was significantly inhibited by a human anti-CD44 antibody.

    CONCLUSION: The progressive increase of MYC, SOX2 and particularly CD44 expression that was accompanied with enhanced colony forming capacity and resistance in the in vitro GLC disease progression model, supports the potential clinical relevance of CSC populations in malignancy and disease relapse of SCLC.

    Matched MeSH terms: Humans
  19. Khoo YSK, Ghani AA, Navamukundan AA, Jahis R, Gamil A
    Hum Vaccin Immunother, 2020 03 03;16(3):530-538.
    PMID: 31652090 DOI: 10.1080/21645515.2019.1667206
    This review aims to present the unique considerations for manufacturing and the regulation of new vaccines in Muslim-populated countries such as Malaysia. Our specific objectives are to highlight vaccine production and the ingredients of concern, summarize the current mechanism for ruling and recommendations on new vaccines, outline the different steps in decision-making on incorporating a new vaccine into the National Immunization Program, describe its issues and challenges, and explore the commercial viability and challenges of producing local permissible (halal) vaccines. Through this review, we hope readers understand that alternatives are present to replace ingredients of concern in vaccines. Halal certification and introduction of a new vaccine into a program are strictly conducted and health-care providers must be prepared to educate the public on this. At the same time, it is hoped that the production of halal vaccine in Malaysia will promote self-reliance in Muslim-populated countries.
    Matched MeSH terms: Humans
  20. Bhavadharini B, Dehghan M, Mente A, Rangarajan S, Sheridan P, Mohan V, et al.
    PMID: 32423962 DOI: 10.1136/bmjdrc-2019-000826
    OBJECTIVE: Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.

    METHODS: The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes).

    RESULTS: In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake; OR 0.76, 95% CI 0.71 to 0.80, p-trend<0.0001) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone (OR 0.72, 95% CI 0.66 to 0.78, p-trend<0.0001), or consumed jointly with low fat dairy (OR 0.89, 95% CI 0.80 to 0.98, p-trend=0.0005), were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS (OR 1.03, 95% CI 0.77 to 1.38, p-trend=0.13). In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension (HR 0.89, 95% CI 0.82 to 0.97, p-trend=0.02) and diabetes (HR 0.88, 95% CI 0.76 to 1.02, p-trend=0.01). Directionally similar associations were found for whole fat dairy versus each outcome.

    CONCLUSIONS: Higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.

    Matched MeSH terms: Humans
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