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  1. Fulltext Serum lipids and their relationship with other coronary risk factors in healthy subjects in a city clinic
    Khoo KL, Tan H, Liew YM
    Med J Malaysia, 1997 Mar;52(1):38-52.
    PMID: 10968052
    Over a thousand subjects who visited a city private medical clinic for health screening and advice were examined for their lipid profile and other cardiovascular risk factors. The mean TC, TG, LDL-C and HDL-C were 5.43, 1.45, 3.61 and 1.15 mmol/l. Their derived ratios viz, TC:HDL-C and LDL:HDL-C were 5.11 and 3.43 respectively. The prevalence of hyperlipidaemia was moderately high. Of the subjects studied 58.5% had elevated serum cholesterol, 14.8% had raised triglycerides, 64.9% had raised LDL-C and 20.8% had low HDL-C. Male subjects generally showed higher mean values and abnormality frequency in TC, TG, LDL-C, TC:HDL-C and LDL:HDL-C as compared to female subjects. Although significant ethnic differences were not detected for certain lipid parameters (e.g. TC, TG and HDL-C), the Indians appeared to have higher mean lipid values (except HDL-C), and higher percentage abnormality for all the lipid parameters as compared to the Chinese and the Malays. In correlation studies, the following lipid parameters:- TC versus TG, LDL-C, TC:HDL-C; TG versus TC:HDL-C and LDL:HDL-C; LDL-C versus TC:HDL-C and LDL:HDL-C; were positively correlated. On the other hand, TC versus HDL-C, TG versus HDL-C, LDL-C and HDL-C, and HDL-C versus TC:HDL-C and LDL:HDL-C were negatively correlated. The coronary risk factors which generally showed positive correlations with lipid parameters were BMI and blood pressure. Positive correlations were also recorded between fasting blood glucose and TG; uric acid with TG, TC:HDL-C and LDL:HDL-C. In contrast, risk factors of negative correlations were observed between HDL-C and the coronary risk factors of BMI, diastolic blood pressure and uric acid. Smoking showed raised per cent lipid abnormality for TG, HDL-C, TC:HDL-C and LDL:HDL-C. Alcohol consumption also increased the mean level and abnormality frequency for TG. The implication of this investigation is discussed.
    Matched MeSH terms: Body Mass Index
  2. Fulltext The effectiveness of group dietary counselling among non insulin dependent diabetes mellitus (NIDDM) patients in resettlement scheme areas in Malaysia
    Talib R, Ali O, Arshad F, Kadir KA
    Asia Pac J Clin Nutr, 1997 Jun;6(2):84-7.
    PMID: 24394705
    A study was undertaken in FELDA (Federal Land Development Authority) resettlement scheme areas in Pahang, Malaysia, to determine the effectiveness of group dietary counselling in motivating diabetic patients to achieve good dietary habits, and weight and diabetes control. Sixty-one non-insulin dependent diabetes mellitus (NIDDM) patients were randomly assigned to either the experimental or control group. The experimental group received six sessions of group dietary counselling over 5 months and the control group received mass media diabetes-educational program during the same period. The one hour group dietary counselling sessions discussed general knowledge of diabetes, food groups for meal planning, the importance of dietary fibre-rich foods, types of fat in food, exercise and weight control. The experimental group met monthly with a dietitian as a counsellor. Effectiveness was assessed by improvement in food choice, and decline in percentage glycated haemoglobin (total HbA1) or body mass index (BMI). Measurements were made at a baseline visit, every two months during the six month program, and six months afterwards. Patients in the experimental group improved their food choices, resulting in a healthier diet high in unrefined carbohydrates and dietary fibre rich foods, and low in fat. There were significant reductions of their percentage total HbA1 levels and BMI following the counselling sessions, which decreased further six months after the program compared with patients in the control group. Thus group dietary counselling is effective in motivating NIDDM patients to achieve better food choice, and related weight and glycaemic control in a Malaysian setting.
    Matched MeSH terms: Body Mass Index
  3. Fulltext Central obesity, insulin resistance, syndrome X, lipoprotein(a), and cardiovascular risk in Indians, Malays, and Chinese in Singapore
    Hughes K, Aw TC, Kuperan P, Choo M
    J Epidemiol Community Health, 1997 Aug;51(4):394-9.
    PMID: 9328546
    STUDY OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is at least partly explained by central obesity, insulin resistance, and syndrome X (including possible components).
    DESIGN: Cross sectional study of the general population.
    SETTING: Singapore.
    PARTICIPANTS: Random sample of 961 men and women (Indians, Malays, and Chinese) aged 30 to 69 years.
    MAIN RESULTS: Fasting serum insulin concentration was correlated directly and strongly with body mass index (BMI), waist-hip ratio (WHR), and abdominal diameter. The fasting insulin concentration was correlated inversely with HDL cholesterol and directly with the fasting triglyceride concentration, blood pressures, plasminogen activator inhibitor 1 (PAI-1), and tissue plasminogen activator (tPA), but it was not correlated with LDL cholesterol, apolipoproteins B and A1, lipoprotein(a), (Lp(a)), fibrinogen, factor VIIc, or prothrombin fragment (F)1 + 2. This indicates that the former but not the latter are part of syndrome X. While Malays had the highest BMI, Indians had a higher WHR (men 0.93 and women 0.84) than Malays (men 0.91 and women 0.82) and Chinese (men 0.91 and women 0.82). In addition, Indians had higher fasting insulin values and more glucose intolerance than Malays and Chinese. Indians had lower HDL cholesterol, and higher PAI-1, tPA, and Lp(a), but not higher LDL cholesterol, fasting triglyceride, blood pressures, fibrinogen, factor VIIc, or prothrombin F1 + 2.
    CONCLUSIONS: Indians are more prone than Malays or Chinese to central obesity with insulin resistance and glucose intolerance and there are no apparent environmental reasons for this in Singapore. As a consequence, Indians develop some but not all of the features of syndrome X. They also have higher Lp(a) values. All this puts Indians at increased risk of atherosclerosis and thrombosis and must be at least part of the explanation for their higher rates of CHD.
    Matched MeSH terms: Body Mass Index
  4. Fulltext Prevalence of coronary risk factors in a sample of Chinese women in Kuala Lumpur
    Khor GL, Hsu-Hage BH, Sundram K, Wahlqvist ML
    Med J Malaysia, 1997 Dec;52(4):367-76.
    PMID: 10968113
    Several risk factors for cardiovascular disease amongst a sample of urban Chinese women were investigated. These factors included body mass index (BMI), waist hip ratio, total blood cholesterol (TC), HDL-cholesterol and Lp(a) levels, blood pressure, cigarette smoking, family history of chronic disease, dietary habits and frequency of selected food intake. The subjects were found to have coronary risks with respect to BMI and TC level, both of which increased with age of the women. Hypertension, HDL-cholesterol and Lp(a) levels appeared not to pose as risk factors amongst these subjects. Dietary habits and intake showed significant correlations with subjects' BMI status. Health promotion is called for towards reducing the modifiable coronary risk factors.
    Matched MeSH terms: Body Mass Index
  5. Fulltext Food Intake Assessment of Adults in Rural and Urban Areas from Four Selected Regions in Malaysia
    Malays J Nutr, 1997;3(2):-.
    MyJurnal
    An assessment of the daily intake of major nutrients among 409 adults (males and females aged between 18-60 years, normal body mass index) residing in four regions in Malaysia was carried out as part of a major study on energy requirement. Subjects from both urban and rural areas completed a 3-day food record during the study. Mean energy intake among the men and women were 9.05 ± 2.21 MJ/day (2163 kcal/day) and 7.19 ± 1.60 MJ/day (1718 kcal/day) respectively, corresponding to 90% of the Malaysian RDA. A mean of 14% of the total energy was derived from protein, 23% from fat and 63% from carbohydrate. Energy intake amongst male subjects in the rural area (8.47 MJ/day, 2024 kcal) was significantly lower than their urban counterparts (9.52 MJ/day, 2275 kcal). There was no difference in mean energy intake in both the urban (7. 19 MJ/day, 1718 kcal) as well as rural women (7.16 MJ/day, 1711 kcal) corresponding to 86% of the RDA. The distribution of nutrients to the total energy intake amongst rural subjects were 13% for protein in both males and females, 65% for carbohydrate in males and 66% in females and 19% for fat in males and 21% for females. In the urban male and female subjects, the distribution of protein, carbohydrate and fat to the total energy intake were 14%, 55% and 29% and 30% respectively. The rural subjects showed a poorer mean intake of vitamins and minerals compared to the urban subjects. The diets of the male subjects in the rural area were deficient, less than two-third RDA in calcium, riboflavin and niacin. Calcium and iron intakes were less than two-third RDA in both the rural as well as the urban women. The rural women also had a poor intake of vitamin A and niacin. Overall, only protein and vitamin C intake met the RDA in most subjects from rural and urban areas.
    Matched MeSH terms: Body Mass Index
  6. Fulltext Risk Factors among Coronary Heart Disease Patients in the National Heart Institute, Kuala Lumpur
    Malays J Nutr, 1997;3(2):-.
    MyJurnal
    The objective of this study was to determine the levels of knowledge, attitudes and practices with regards to coronary heart disease (CHD) and its risk factors among CHD patients in the Institut Jantung Negara (National Heart Institute), Kuala Lumpur. All patients admitted for CHD during the study period between 5th May 1997 and 24th May 1997 were included in the study. A total of 105 patients were interviewed by using a pretested questionnaire. Four CHD risk factors were included in the study, namely dietary intake, smoking habit, alcohol intake and physical activity. The majority of the patients (92.4%) were above 45 years old. Most of them (85.7%) had at least one chronic health problem such as diabetes mellitus and hypertension before admission into IJN. Their average total blood cholesterol was 6.1 ± 1.3 mmol/L and 75.2% were hypercholesteromic (≥ 5.2 mmol/L). Mean systolic blood pressure was 151.2 ± 27.5 mmHg. The mean body mass index of the patients was 25.9 ± 3.9 kg/m2 and 58.1% were overweight (BMI ≥ 25.0). Almost half of the patients (49.6%) had smoked before but only 8.6% still smoke. Out of the 56 non-Muslim patients, 9 of them (16.1%) consumed alcoholic drinks on a regular basis. Most of the patients reported walking as the only form of exercise that they do. Most of the patients consume rice, vegetables and fruits almost daily. This study indicated significant relationships between (i) knowledge level and attitude towards CHD risk factors (r = 0.624, p < 0.001), (ii) knowledge level and modifying practices related to CHD risk factors (r = 0.316, p < 0.01) and (iii) attitude and modifying practices (r = 0.234, p
    Matched MeSH terms: Body Mass Index
  7. Anthropometric status and resting metabolic rate in users of the areca nut and smokers of tobacco in rural Sarawak
    Strickland SS, Duffield AE
    Ann Hum Biol, 1997 Sep-Oct;24(5):453-74.
    PMID: 9300122
    The areca nut is chewed by many of the world's population, mainly in South and Southeast Asia. Anthropometric data for 458 Sarawaki adults aged over 24 years, measured both in 1990 and in 1996, were examined in relation to use of tobacco and areca nut. Compared to non-smokers, smoking men were significantly taller and slightly (not significantly) thinner in both years, while smoking women were thinner in 1990 and slightly (not significantly) thinner in 1996. In both sexes there was an increase in the mean and range of body mass index (BMI, W/H2) over the 6-year interval. Smoking women showed a significantly smaller increment in BMI after allowing for areca nut use, which was associated with a similar trend, and this finding depended on including areca use in the model. The trend for men was similar. Possible effects of areca use could reflect variation in 'affluence' or conservatism, or appetite suppression. However, resting metabolic rate in 54 men and 70 women aged 24-60 years was associated with areca use. This association appeared to be mediated by the maximum room temperature of the 24 h preceding measurement. In women, a significant curvilinear association of RMR with maximum temperature was found in users of areca nut but not in non-users. In men, RMR was 7% higher (p < 0.05) in users of areca nut than in non-users, after allowing for age, height, weight, the sum of four skinfold thicknesses, and haemoglobin, but the association with maximum temperature was similar in both groups. It is speculated that constituents of areca nut modulate thermoregulatory pathways, resulting in prolonged temperature-dependent and hyperthermic heat production in this population; that males are more responsive to this effect than females; and that by this mechanism, and possibly also through centrally mediated effects on appetite for food, areca use could contribute to long-term variation in energy balance represented by change in BMI.
    Matched MeSH terms: Body Mass Index
  8. Cardiovascular risk factors in non-insulin-dependent diabetics compared to non-diabetic controls: a population-based survey among Asians in Singapore
    Hughes K, Choo M, Kuperan P, Ong CN, Aw TC
    Atherosclerosis, 1998 Jan;136(1):25-31.
    PMID: 9544728
    Cardiovascular risk factors were compared between 126 people with non-insulin-dependent diabetes mellitus (NIDDM) and 530 non-diabetics (controls), in a random sample of people (Chinese, Malays, and Asian Indians) aged 40-69 years from the general population of Singapore. Data were adjusted for age and ethnicity. For both genders, people with NIDDM had higher mean body mass indices, waist-hip ratios and abdominal diameters. They also had a higher prevalence of hypertension, higher mean levels of fasting serum triglyceride, slightly lower mean levels of serum high-density-lipoprotein cholesterol, and higher mean levels of plasma plasminogen activator inhibitor-1 and tissue plasminogen activator (antigen). These factors are components of syndrome X (metabolic syndrome) and increase the risk of atherosclerosis and thrombosis. In contrast, there were no important differences for cigarette smoking, serum total and low-density-lipoprotein cholesterol, serum apolipoproteins A1 and B, plasma factor VIIc and plasma prothrombin fragment 1 + 2. Females with NIDDM, but not males, had a higher mean serum fibrinogen level than non-diabetics, which could explain why NIDDM has a greater cardiovascular effect in females than males. Serum lipoprotein(a) concentrations were lower in people with NIDDM. Mean levels of serum ferritin, a pro-oxidant, were higher in people with NIDDM than controls, but there were no important differences for plasma vitamins A, C and E, and serum selenium, which are anti-oxidants.
    Matched MeSH terms: Body Mass Index
  9. Ethnic differences in correlates of microalbuminuria in NIDDM. The role of the acute-phase response
    Islam N, Kazmi F, Chusney GD, Mattock MB, Zaini A, Pickup JC
    Diabetes Care, 1998 Mar;21(3):385-8.
    PMID: 9540020
    OBJECTIVE: To investigate whether microalbuminuria is associated with markers of the acute-phase response in NIDDM and whether there are ethnic differences in this association among the three main racial groups in Malaysia.

    RESEARCH DESIGN AND METHODS: NIDDM patients of Chinese, Indian, and Malay origin attending a diabetic clinic in Kuala Lumpur, Malaysia, were matched for age, sex, diabetes duration, and glycemic control (n = 34 in each group). Urinary albumin-to-creatinine ratio was measured in an early morning urine sample. Biochemical measurements included markers of the acute-phase response: serum sialic acid, triglyceride, and (lowered) HDL cholesterol.

    RESULTS: The frequency of microalbuminuria did not differ among the Chinese, Indian, and Malay patients (44, 41, and 47%, respectively). In Chinese patients, those with microalbuminuria had evidence of an augmented acute-phase response, with higher serum sialic acid and triglyceride and lower HDL cholesterol levels; and urinary albumin-to-creatinine ratio was correlated with serum sialic acid and triglyceride. The acute-phase response markers were not different in Indians, with microalbuminuria being high in even the normoalbuminuric Indians; only the mean arterial blood pressure was correlated with urinary albumin-to-creatinine ratio in the Indians. Malay NIDDM subjects had an association of microalbuminuria with acute-phase markers, but this was weaker than in the Chinese subjects.

    CONCLUSIONS: Microalbuminuria is associated with an acute-phase response in Chinese NIDDM patients in Malaysia, as previously found in Caucasian NIDDM subjects. Elevated urinary albumin excretion has different correlates in other racial groups, such as those originating from the Indian subcontinent. The acute-phase response may have an etiological role in microalbuminuria.

    Matched MeSH terms: Body Mass Index
  10. The supplementation of levothyroxine among indigenous people in endemic goitre areas: The impact of therapy
    Zaleha MI, Osman A, Iskandar ZA, Sazali S, Ali MM, Roslan I, et al.
    Asia Pac J Clin Nutr, 1998 Jun;7(2):138-50.
    PMID: 24393641
    In order to study the effect of levothyroxine in the treatment of endemic goitre, a longitudinal study was conducted among the Aborigines in Lanai Post and Sinderut Post, situated in an iodine-deficient area located in the district of Kuala Lipis, Pahang. All subjects in the treatment group (Lanai Post) were given 100 µg of levothyroxine per day and were followed for 1 1/2 years. A total of 311 subjects were examined at baseline, 323 on the first, 256 on the second, 239 on the third and 184 on the fourth visit following levothyroxine supplementation. Goitre prevalence, thyroid hormones, thyroid volume, nutritional status, urinary iodine levels, arterial blood pressure and mental performance were determined. Following the intervention, goitre prevalence was significantly reduced in the treatment group (baseline 42.8% vs final visit 13.0%, p<0.0001); however, no significant difference was noted in the control group. Total T4 levels were increased in the treatment group (p<0.0001), while a significant reduction was noted in the control group (p<0.0001). Thyroid-stimulating hormone levels increased significantly in the treatment group following 1 year of intervention, while no significant changes were observed in the control group. As for the thyroid volume, both groups showed a significant increment following the intervention (p<0.0001). With respect to the nutritional status, the treatment group showed a significant increase in body weight following the intervention (p<0.05). In addition, the mid-arm circumference and body mass index also increased after 1 year of intervention. However, the control group showed a reduction in the waist-hip ratio (p<0.0001). Although there was no statistical difference in the waist-hip ratio in the treatment group, there has been a significant reduction observed after 1 year of intervention. At 1 year, a reduction in skinfold thickness was noted in the treatment group while only the triceps and subscapular were increased in the control group. The body fat was decreased in the treatment group following 1 year of intervention (p<0.0001). No particular trend was noted in the urinary iodine excretion in the treatment group, but surprisingly, the levels were increased in the control group (p<0.0001). A significant increase in both systolic and diastolic blood pressures was observed in the treatment group following 1 year of intervention, but the controls showed a reduction in the systolic blood pressure (p<0.0001). Both groups showed a remarkable increase in mental performance, with a more pronounced effect in the treatment group (p<0.05). The correction of iodine deficiency by levothyroxine supplementation has a short-term beneficial effect in reducing the prevalence of goitre and improving the mental ability among the Aborigines in endemic areas; however, proper monitoring and close supervision are needed to maintain compliance.
    Matched MeSH terms: Body Mass Index
  11. Fulltext Nutritional situation of a Chinese community
    Suriah AR, Chong TJ, Yeoh BY
    Singapore Med J, 1998 Aug;39(8):348-52.
    PMID: 9844494
    AIM: To evaluate the anthropometric measurements and dietary intake of the free-living elderly in a Chinese community.
    METHOD: A survey was carried out on 48 male and female subjects aged 60 to 96 years using anthropometric, dietary intake and questionnaire techniques.
    RESULTS: The study indicated female subjects to have more health problems, like pain at the joints (33%), hypertension (17%) and diabetes (27%) as compared to the male subjects. Dietary intake analysis showed the Chinese male subjects to have a higher energy intake (1,623 kcal) compared to the females (1,197 kcal) even though they did not fulfill the recommended dietary intake. The intake for energy, fats and carbohydrates, was found to be significantly different (p < 0.05) between both sexes. Anthropometric measurements indicated male elderly subjects to be significantly heavier (p < 0.05, 55.4 kg) and taller (161.8 cm) than female elderly subjects (49.5 kg; 146.2 cm respectively). About half of the elderly were normal in their BMI (male 55.6%; female 50%) and only 6.6% of the female subjects were obese. More male subjects were found to be underweight (33%) compared to female subjects (17%). Waist hip ratio was 0.92 for male and 0.87 for female.
    CONCLUSION: Our study showed that female elderly subjects had more health problems compared to male elderly subjects. On the whole, the elderly did not fulfill the recommended amount for energy intake while the percentage for carbohydrates, fats and protein from the total calorie intake were not in accordance with the healthy diet guidelines. Anthropometrically, male subjects were heavier and taller than female subjects. Looking at body mass index, most of the male elderly subjects were in the normal to underweight range. With these results, more research is warranted to give a clearer picture of the Chinese elderly in the country.

    Study site: Kampung Baru Tabuh Naning, Alor Gajah, Malacca
    Matched MeSH terms: Body Mass Index
  12. Fulltext Nutrition and ecosystems in Sarawak: The role of the areca nut
    Strickland SS, Duffield AE
    Asia Pac J Clin Nutr, 1998 Dec;7(3/4):300-6.
    PMID: 24393688
    The effects of population pressure on agricultural sustainability in the delicate tropical and subtropical ecosystems have often been thought to explain high prevalence rates of malnutrition in rural South-East Asia. However, recent studies in rural Sarawak suggest that processes of modernisation have resulted in increased variations in energy nutritional status in adults. A contributory factor may be consumption of the areca nut (Malay pinang, of the palm Areca catechu). This is thought to influence energy balance through effects on appetite and resting metabolic rate. Body mass index (BMI, kg/m2) data for 325 Iban men and 438 non-pregnant Iban women, measured in 1990 and again in 1996, have been analysed in relation to areca use, smoking behaviour, socio-economic status, and reported morbidity. Body composition derived from skinfold thickness measurements for 313 men and 382 women was also analysed. The results suggest that use of areca nut is associated with significantly lower age-related increments in BMI and percentage body fat in women after allowing for age, smoking, reported morbidity, and confounding socio-economic factors. Therefore, the impact of recent economic and social development seen in rising prevalences of 'over-nutrition' may be modulated by use of the areca nut.
    Matched MeSH terms: Body Mass Index
  13. Immigrant Health Study. 2. Clinical findings in migrant workers - a pilot study. [Abstract]
    Chia YC, McCarthy S
    JUMMEC, 1998;3:60-61.
    This section only examines the clinical findings and some blood chemistly in these workers. A total of 222 men and 28 women were studied. Their ages ranged from 12 to 57 years, the mean being 30.1 (±7.4). Generally most of the physical examination was normal and no external features of infectious diseases were seen. The mean systolic and diastolic blood pressure was 120 (±13) and 76(±8.7) nun Hg respectively. About 8.4% of the population had elevated blood pressure of 140/90 mmHg or greater. About 12.4% of these man and women were underweight (Body mass index (EMI) less than 19 kg/m2) while 11.2% were either overweight or obese (BMI>25) with the mean being 21.8 (±2.7). Only 3 had BMI greater than 30. Three subjects had a lnitral regurgitation murmur thought to be due to mitral valve prolapse. Four others had tinea cruris, six had insignificant axillary lymph-nodes, five had cervical lymph-nodes of which one was due to carcinoma of the tonsil 30 with shotty inguinal lymph-nodes which was thought to of no pathological significance. Four subjects had crepitations and five had rhonchi in their lungs. A full blood count revealed that 16.65% of the man and 32.1°/o of the women had haemoglobin levels of less than 14gm/dl and 12gm/dl respectively. The most striking abnormality was the high prevalence of eosinophilia. 37% of the subjects had eosinophilia counts of greater than 450/dl. About 19.4% of this study population had fasting blood glucose of greater than 6mmol/l but only 1.3% with fasting blood glucose of greater than 7.8 mmo/l. About 22% of the urine examined revealed pro- teinuria but were otherwise unremarkable for the other parameters. This group of foreign workers was made up of a presumably fairly healthy young population. Attempts to look for infectious disease on physical examination, not surprisingly did not reveal any remarkable findings. It could be that the majority of these subjects already had a examination prior to coming into the country and another one soon after arrival. However an indirect measurement of infectious diseases via the eosinophilic count revealed a high prevalence of parasitic infestations. Attempts to examine the end results of social hardship, be it intrinsic before or appearing after arrival indirectly shoved some degree of suffering. There was a fairly high prevalence of anaemia, especially amongst the women. The body mass index also revealed this population to be generally less obese than other populations. The value of medical check-ups has been debated, especially if it were done as a pre-employment procedure. This pilot study has shown that it is not cost-effective to do physical examination or blood chem- istry and urine analysis in hying to identify infectious diseases in the migrant workers. In the light of the paucity of clinical findings in this pilot study, it would be prudent to review the strategy for examining the health status of migrant workers. Perhaps the physical examination can be dispensed with, and blood andurine analysis beveryfocused and directedin order to maximise the cost- effectiveness of this programme. Certainly the high prevalence of eosinophilia needs further evalua- tion.
    Matched MeSH terms: Body Mass Index
  14. Prevalence of diabetes and ethnic differences in cardiovascular risk factors. The 1992 Singapore National Health Survey
    Tan CE, Emmanuel SC, Tan BY, Jacob E
    Diabetes Care, 1999 Feb;22(2):241-7.
    PMID: 10333940 DOI: 10.2337/diacare.22.2.241
    OBJECTIVE: The purpose of the 1992 Singapore National Health Survey was to determine the current distribution of major noncommunicable diseases and their risk factors, including the prevalence of diabetes and dyslipidemia, in Singapore.

    RESEARCH DESIGN AND METHODS: A combination of disproportionate stratified sampling and systematic sampling were used to select the sample for the survey. The final number of respondents was 3,568, giving a response rate of 72.6%. All subjects fasted for 10 h and were given a 75-g glucose load, except those known to have diabetes. Blood was taken before and 2 h after the glucose load. Diagnosis of diabetes was based on 2-h glucose alone.

    RESULTS: The age-standardized prevalence of diabetes in Singapore residents aged 18-69 years was 8.4%, with more than half (58.5%) previously undiagnosed. Prevalence of diabetes was high across all three ethnic groups. The prevalence of impaired glucose tolerance was 16.1%, that of hypertension was 6.5%, and 19.0% were regular smokers. The total cholesterol (mean +/- SD) of nondiabetic Singaporeans was 5.18 +/- 1.02 mmol/l; 47.9% had cholesterol > 5.2 mmol/l, while 15.4% had levels > 6.3 mmol/l. Mean LDL cholesterol was 3.31 +/- 0.89 mmol/l; HDL cholesterol was 1.30 +/- 0.32 mmol/l, and triglyceride was 1.23 +/- 0.82 mmol/l.

    CONCLUSIONS: Prevalence of diabetes was high across all three ethnic groups. Ethnic differences in prevalence of diabetes, insulin resistance, central obesity, hypertension, smoking, and lipid profile could explain the differential coronary heart disease rates in the three major ethnic groups in Singapore.
    Matched MeSH terms: Body Mass Index
  15. Ethnicity, obstructive sleep apnoea and ischaemic heart disease
    Tan YK, Khoo KL, Low JA, Wong ZW, Theng CT, Ong TH, et al.
    Ann Acad Med Singap, 1999 Mar;28(2):214-6.
    PMID: 10497669
    We studied the relationship between different ethnic groups, obstructive sleep apnoea (OSA) and ischaemic heart disease. Four hundred and thirty-two inpatients from the medical wards were interviewed. Limited overnight sleep studies were done in 129 of those who had habitual snoring, daytime sleepiness based on an Epworth sleepiness scale of 8 or more, or a large neck size of 40 cm or more. There were 315 Chinese (72.9%), 67 Malays (15.5%), 43 Indians (10%) and 3 from other races (1.4%). The prevalence of OSA was 19.7%, 30% and 12% among the Chinese, Malays and Indians, respectively. The prevalence ratio for OSA was 1.52 in Malays using Chinese patients as the baseline (P = 0.07). The median neck circumference was 37 cm in both racial groups. The median body mass index was 22.7 kg/m2 in Chinese compared to 23.6 kg/m2 in Malays. The median apnoea-hypopnoea index was 22.7, 19.0 and 26.9 events/hour among the Chinese, Malays and Indians, respectively. OSA was independently associated with the prevalence of IHD (adjusted prevalence ratio 1.68; 95% CI: 1.15, 2.46; P = 0.009). The prevalence of ischaemic heart disease (IHD) was 31%, 24% and 28% in Chinese, Malays and Indians, respectively. The prevalence ratio for IHD in Malays compared to Chinese was 0.77. After adjusting for OSA, there was an even greater reduction in the risk of IHD (adjusted prevalence ratio 0.70). This suggests that OSA is a confounder in the relationship between race and ischaemic heart disease.
    Matched MeSH terms: Body Mass Index
  16. Fulltext Markers of ventricular tachyarrythmias in patients with acromegaly
    Mohamed AL, Yusoff K, Muttalif AR, Khalid BAk
    Med J Malaysia, 1999 Sep;54(3):338-45.
    PMID: 11045060
    Sudden cardiac death is a known complication of acromegaly. Little is known of the exact mechanism leading to sudden cardiac death in these patients. Ventricular tachyarrhythmias may be an important cause. If this is so, clinical markers of ventricular tachyarrhythmias may be more common in this group of patients. The presence of these markers allow better risk stratification among acromegalic patients.
    Matched MeSH terms: Body Mass Index
  17. Pulse wave velocity as an index of arterial stiffness: a comparison between newly diagnosed (untreated) hypertensive and normotensive middle-aged Malay men and its relationship with fasting insulin
    Ngim CA, Abdul Rahman AR, Ibrahim A
    Acta Cardiol, 1999 Oct;54(5):277-82.
    PMID: 10596307
    BACKGROUND: Arterial stiffness, an aging process which is accelerated by hypertension, is emerging as a useful index of vascular health. There are evidences to suggest that hyperinsulinaemia may be an independent risk factor for coronary artery disease, besides its possible pathogenic role in essential hypertension. The main objectives of this study were to compare arterial stiffness between untreated hypertensives and normotensives and to investigate the relationship between fasting serum insulin and arterial stiffness.

    METHODS: A cross-sectional observational study was designed. Forty normotensive (median age 47 +/- 6 yrs.) and twenty untreated hypertensive Malay men (median age 50 +/- 7 yrs.) without clinical evidence of cardiovascular complications were selected. Pulse wave velocity measured using the automated Complior machine was used as an index of arterial stiffness. Other measurements obtained were blood pressure, body mass index, fasting insulin, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glucose and creatinine level.

    RESULTS: The blood pressure and pulse wave velocity (PWV) were significantly higher in the hypertensives compared to the normotensives (blood pressure 169/100 mm Hg +/- 14/7 vs. 120/80 mm Hg +/- 10/4, p < 0.001; PWV 11.69 m/s +/- 1.12 vs. 8.83 m/s +/- 1.35, p < 0.001). Other variables such as body mass index, fasting insulin, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and haematocrit were comparable among the two groups. Within each group, there was a significant positive correlation between pulse wave velocity and systolic blood pressure (r = 0.76, p < 0.001 in normotensives; r = 0.73, p < 0.001 in hypertensives) and mean arterial pressure (r = 0.74, p < 0.001 in normotensives; r = 0.73, p < 0.001 in hypertensives). No correlation was noted between pulse wave velocity and diastolic blood pressure, age, body mass index, fasting insulin level, cholesterol, HDL-cholesterol, LDL-cholesterol or triglyceride levels.

    CONCLUSION: Arterial stiffness as determined by PWV is increased in newly diagnosed untreated hypertensive subjects even before clinically evident cardiovascular disease. However, arterial stiffness is not correlated with the fasting insulin level in normotensives and newly diagnosed hypertensives.

    Matched MeSH terms: Body Mass Index
  18. Development of a screening tool for detecting undernutrition and dietary inadequacy among rural elderly in Malaysia: simple indices to identify individuals at high risk
    Shahar S, Dixon RA, Earland J
    Int J Food Sci Nutr, 1999 Nov;50(6):435-44.
    PMID: 10719584
    Undernutrition and the consumption of poor diets are prevalent among elderly people in developing countries. Recognising the importance of the early identification of individuals at high nutritional risk, this study aimed to develop a simple tool for screening. A cross-sectional study was conducted on 11 randomly selected villages among the 62 in Mersing District, Malaysia. Undernutrition was assessed using body mass index, plasma albumin and haemoglobin on 285 subjects. Dietary inadequacy (a count of nutrients falling below two-thirds of the Recommended Dietary Allowances) was examined for 337 subjects. Logistic regression analysis was performed to identify significant predictors of undernutrition and dietary inadequacy from social and health factors, and to derive appropriate indices based on these predictions. The multivariate predictors of undernutrition were 'no joint disease', 'smoker', 'no hypertension', 'depended on others for economic resource', 'respiratory disease', 'perceived weight loss' and 'chewing difficulty', with a joint sensitivity of 56% and specificity of 84%. The equivalent predictors of dietary inadequacy were 'unable to take public transport', 'loss of appetite', 'chewing difficulty', 'no regular fruit intake' and 'regularly taking less than three meals per day', with a joint sensitivity of 77% and specificity of 47%. These predictions, with minor modification to simplify operational use, led to the production of a simple screening tool. The tool can be used by public health professionals or community workers or leaders as a simple and rapid instrument to screen individual at high risk of undernutrition and/or dietary inadequacy.
    Matched MeSH terms: Body Mass Index
  19. Fulltext Prevalence of overweight among Malaysian adults from rural communities
    Khor GL, Yusof AM, Tee ES, Kandiah M, Lee Huang MS
    Asia Pac J Clin Nutr, 1999 Dec;8(4):272-9.
    PMID: 24394228
    Assessment of the nutritional status of 4054 households from rural communities in Peninsular Malaysia was undertaken from 1992 to 1995. Body mass index (BMI) and waist-to-hip ratio (WHR) were obtained from a self-selected sample of 1854 men and 2741 women aged >= 18 years. The BMI and WHR results are presented according to gender, age groups and type of community as defined by the main occupation, namely, fishing, rice farming, estate work, rubber and coconut small-holding. The mean BMI for men and women of all age groups are 22.5 kg/m2 and 23.8 kg/m2, respectively. The mean BMI for both genders increases with age between 18.0 and 49.9 years, after which the value declines. The prevalence of pre-obese (BMI >= 25.0-29.9 kg/m2) is 19.8% for men and 28.0% for women. The prevalence of obese men and women (>= 30.0 kg/m2) is 4.2% and 11.1%, respectively. The highest prevalence of pre-obese and obese men is found in the age groups of 30.0-49.9 years, while that for women is in the 40.0-49.9 years age group. The prevalence of pre-obesity and obesity is higher in women than in men for every age group. A similar result was indicated by WHR whereby a higher proportion of women (22.5%) than men (5%) for all ages was found to show central obesity. The prevalence of overweight adults is higher when compared with previous studies on subjects from almost similar rural communities. This study indicated that overweight is on the increase in rural communities, especially among female subjects.
    Matched MeSH terms: Body Mass Index
  20. Fulltext Distribution of body weight, height and body mass index in a national sample of Malaysian adults
    Lim TO, Ding LM, Zaki M, Suleiman AB, Fatimah S, Siti S, et al.
    Med J Malaysia, 2000 Mar;55(1):108-28.
    PMID: 11072496 MyJurnal
    We describe the distribution of body weight, height and body mass index (BMI) by age, sex and ethnicity in Malaysian adults. A national sample of 28,737 individuals aged 20 or older had usable data. They were selected by stratified 2-stage cluster sampling. Percentile tables and curves by age, sex and ethnicity are presented. The body weight and BMI distributions were right skewed, while that of height was symmetrical. BMI distribution showed the expected increase with age, while that of height decrease with age. Differences in BMI between the 2 sexes and among the 4 ethnic groups were observed. Indian had the highest BMI, followed by Malay, Chinese and other indigenous ethnic group.
    Study name: National Health and Morbidity Survey (NHMS-1996)
    Matched MeSH terms: Body Mass Index*
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