Methods: Respondents were recruited from the year 2013 to 2015 from households in Klang Valley (urban area) and several settlements of the Federal Land Development Authority (FELDA) in Selangor (rural area). Data were collected using two questionnaires, a sociodemographic questionnaire and a food frequency questionnaire.
RESULTS: A total of 3,453 adults participated in this study. The mean age of the respondents was 50.9 (±10.23) years. The prevalence of hypertension was 23.3%. Mean dietary sodium consumption was 3.6 (±6.63) grams/day, 1.6 grams higher than the current WHO recommendation. The prevalence of hypertension was higher among males aged 60 years and older; among rural population with low education level; among housewives and those with high dietary sodium intake. After adjusting for age, gender and marital status in a multiple logistic regression analysis, rural location (OR = 5.81) and high sodium intake (OR = 2.33) have been shown to affect the incidence of hypertension.
CONCLUSIONS: A substantial proportion of Malay population in Selangor was hypertensive with a higher sodium intake than the WHO recommendation. Hypertension was associated with rural location and high sodium intake. Sustainable and cost-effective population-based health promotion and prevention interventions using a multi-sectoral approach are needed to ensure sufficient community sodium intake.
METHODOLOGY: A cross-sectional observational study was performed on patients diagnosed with MetS and compared to normal controls. All patients underwent ophthalmic and anthropometric examination, serological and biochemical blood investigations; and ocular imaging using spectral-domain optical coherence tomography. Patients with ocular pathology were excluded. Unpaired t-test was used to compare mean thickness between the two groups. One-way ANOVA with Bonferroni correction for multiple comparisons was used to compare mean thickness between different tertiles of MetS parameters, and a generalized estimating equation was used to correct for inter-eye correlation and to assess association between mean thickness and covariates.
RESULTS: Two hundred and forty-eight eyes from 124 participants (1:1 ratio of MetS patients to controls) were included. Age ranged between 30 to 50 years old, and mean age was 40 ± 6.6 years. RNFL thickness was lower globally (93.6 ± 9.9 μm vs 99.0 ± 9.3, p<0.001) and in the inferior (124.5 ± 17.5 μm vs 131.0 ± 16.4 μm, p = 0.002), superior (117.2 ± 16.0 μm vs 126.3 ± 14.4 μm, p<0.001) and temporal (65.5 ± 10.2 μm vs 69.5 ± 9.8, p = 0.002) sectors in MetS patients compared to controls. Only the central (237.0 ± 14.0 μm vs 243.6 ± 18.0 μm, p = 0.002) and inferior parafoveal (307.8 ± 20.9 vs 314.6 ± 14.6, p = 0.004) area of the macula was significantly thinner. The inferior RNFL sector had the most difference (mean difference = 9.1 μm). The Generalized Estimating Equation found that, after adjusting for age, diastolic blood pressure, BMI, HDL and obesity; the number of MetS components and elevated triglyceride levels were independent risk factors for reduced thickness in global RNFL (β = -4.4, 95% CI = -7.29 to -1.5, p = 0.003) and inferior parafovea (β = -6.85, 95% CI = -11.58 to -2.13, p = 0.004) thickness respectively.
CONCLUSION: RNFL thinning was seen more than macula thinning in MetS patients, suggesting RNFL susceptibility to neurodegeneration than the macula. A higher number of metabolic components and elevated triglyceride levels were independent risk factors for retinal thinning in this group of patients.