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  1. The effect of disease activity on fat-free mass and resting energy expenditure in patients with rheumatoid arthritis versus noninflammatory arthropathies/soft tissue rheumatism
    Arshad A, Rashid R, Benjamin K
    Mod Rheumatol, 2007;17(6):470-5.
    PMID: 18084698 DOI: 10.1007/s10165-007-0628-1
    Rheumatoid arthritis (RA) is a chronic joint disease of undetermined cause that is associated with significant disability. Low-grade fever, anemia, and weight loss are recognized extra-articular features associated with increased disease activity. Weight loss and cachexia are well-established features of RA. The mechanism behind weight loss in RA is not known and may be multifactorial. Reduced energy intake and hypermetabolism are the major two factors frequently implicated in the etiology of RA cachexia. One would expect the effect of the above two factors to be highest during increased disease activity and lowest during remission. The purpose of this study was: (a) to establish whether in RA patients changes in body composition mirror changes in disease activity, (b) to investigate the relation between the energy expenditures and weight loss, (c) to examine the dietary energy intake and its role in weight loss in RA patients, and (d) to investigate the relation between the cytokine interleukin (IL)-6 and other variables including resting energy expenditure (REE), body composition, and acute phase reactants. Fourteen patients with RA were age-, sex-, and race-matched with 14 controls from patients with noninflammatory diseases/soft tissue rheumatism. The measurements included the following: disease activity assessment, anthropometric measurements, indirect calorimetry, and measurements of dietary intake. Blood was collected to measure the acute-phase reactants and IL-6 levels. We demonstrated that loss of fat-free mass (FFM) might accelerate during times of increased disease activity and is only partially restored during periods of reduced disease activity. This probably means that the extent of cachexia in RA patients is determined by the frequency and intensity of disease activity (flare) for a given disease duration. Hypermetabolism with increased REE was more evident during increased disease activity. Hypermetabolism in the face of increased energy intake continued to cause loss of the FFM. Interleukin-6 correlates with increased REE and erythrocyte sedimentation rate. There was no direct association between IL-6 level and low FFM. We conclude that loss of FFM is common in RA, cytokine production in RA is associated with altered energy metabolism, and preservation of FFM is important in maintaining good quality of life in patients with RA.
    Study site: Rheumatology clinic, Putra Specialist Centre, Kedah
    Matched MeSH terms: Interleukin-6/blood
  2. Peptide mimotopes of complex carbohydrates in Salmonella enterica serovar typhi which react with both carbohydrate-specific monoclonal antibody and polyclonal sera from typhoid patients
    Thong KL, Tang SS, Tan WS, Devi S
    Microbiol. Immunol., 2007;51(11):1045-52.
    PMID: 18037781
    Polyclonal sera from typhoid patients and a monoclonal antibody, mAb ATVi, which recognizes the capsular polysaccharide Vi antigen (ViCPS), were used to select for peptides that mimic the ViCPS by using a phage-displayed random 12-mer peptide library. Two major common mimotopes selected from the library carried the amino acid sequences TSHHDSHGLHRV and ENHSPVNIAHKL. Enzyme-linked immunosorbent assays (ELISAs) showed that these peptides carry mimotopes to ViCPS. Phage clones that contained the 12-mer peptides were also tested against pooled/individual typhoid patients' sera and found to have 3 to 5 times higher binding compared to normal sera. By using Phage-ELISA assays, the derived synthetic peptides, TSHHDSHGLHRV and ENHSPVNIAHKL, were tested against a monoclonal antibody mAb ATVi and over 2-fold difference in binding was found between these peptides and a control unrelated peptide, CTLTTKLYC. Inhibition of the mAb's binding to ViCPS indicated that the synthetic peptides successfully competed with the capsular polysaccharide for antibody binding.
    Matched MeSH terms: Antibodies, Bacterial/blood*
  3. Fulltext Effect of therapeutic lifestyle changes on insulin sensitivity of non-obese hyperlipidemic subjects: preliminary report
    Al-Mahmood AK, Ismail AA, Rashid FA, Azwany YN, Singh R, Gill G
    J Atheroscler Thromb, 2007 Jun;14(3):122-7.
    PMID: 17587763 DOI: 10.5551/jat.14.122
    AIM: To determine the effects of lipid lowering by TLC on insulin sensitivity and secretory status of non-obese normoglycemic hyperlipidemic subjects.
    METHODS: An intervention study was undertaken on 16 non-obese normoglycemic hyperlipidemic subjects. They underwent 6 months of a TLC regimen. Their insulin sensitivity and lipid status were assessed at baseline and after six months. A control group containing 16 age, sex and body mass index (BMI) matched normolipidemic subjects was also enrolled to compare the change in lipid levels and insulin sensitivity in the hyperlipidemic subjects.
    RESULTS: The intervention showed significant reductions in insulin resistance (HOMA-IR reduced from 3.8 to 1.4, p<0.001) and improvement of insulin sensitivity (HOMA%S increased from 50.1% to 121.2%, p=0.004) in hyperlipidemic subjects with associated reductions in lipid levels.
    CONCLUSION: Lipid lowering in non-obese hyperlipidemic subjects may be associated with improvement of insulin sensitivity.
    Study site: Staff of university and offices, Kelantan, Malaysia
    Matched MeSH terms: Blood Glucose/analysis
  4. Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: the role of risk factors and threshold value for the 50-g glucose challenge test
    Tan PC, Ling LP, Omar SZ
    Aust N Z J Obstet Gynaecol, 2007 Jun;47(3):191-7.
    PMID: 17550485 DOI: 10.1111/j.1479-828X.2007.00717.x
    Background: The best method of screening for gestational diabetes (GDM) remains unsettled. The 50-g glucose challenge test (GCT) is used in a two-stage screening process but its best threshold value can vary according to population.

    Aims: To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one-hour venous plasma glucose with the GCT.

    Method: In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT >or= 7.2 mmol/L underwent the 75-g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria.

    Result: Thirty-five per cent had GCT >or= 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was >or= 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT >or= 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM.

    Conclusions: Risk factors were not independent predictors of GDM in women with GCT >or= 7.2 mmol/L. GCT threshold value >or= 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.
    Matched MeSH terms: Blood Glucose/physiology*
  5. The effects of three factor VII polymorphisms on factor VII coagulant levels in healthy Singaporean Chinese, Malay and Indian newborns
    Quek SC, Low PS, Saha N, Heng CK
    Ann. Hum. Genet., 2006 Nov;70(Pt 6):951-7.
    PMID: 17044869
    Factor VII (FVII) is an independent risk factor for coronary artery disease. Three polymorphisms of the factor VII gene (F7) were studied in a group of healthy newborns comprising 561 Chinese, 398 Malays and 226 Asian Indians from Singapore. The allele frequencies of 3 polymorphisms (R353Q, Promoter 0/10bp Del/Ins and Intron 7) in the FVII gene were ascertained through genotyping by polymerase chain reaction and restriction digestion of amplified fragments. In Chinese the minor allele frequencies are Q: 0.04, Ins: 0.03, R7: 0.44; Malays, Q: 0.06, Ins: 0.10, R7: 0.41; and Indians, Q: 0.25, Ins: 0.23, R7: 0.43. Strong linkage disequilibrium (Delta > 0.7) is observed between the 0/10 bp and the R353Q sites in all ethnic groups. We conclude that: (i) the prevalence of the minor Q and Ins alleles of the R353Q and 0/10 bp polymorphisms are significantly higher in the Indian newborns than the Chinese and Malays; (ii) the Q allele is significantly associated (p = 0.01) with a lower plasma FVII coagulant level in the Indian and Malay neonates; and this polymorphism explains up to 3.8% of the variance in FVII coagulant levels; (iii) there is no significant difference in allele frequencies of the three polymorphisms between neonates with and without family histories of CAD.
    Matched MeSH terms: Antigens/blood*
  6. Fulltext Bilateral femoral neuropathy associated with disseminated intravascular coagulopathy: a case report
    Cheok CY, Merican A, Ng WM
    Med J Malaysia, 2006 Feb;61 Suppl A:97-9.
    PMID: 17042241
    We report a case of 20-year-old man who presented with bilateral femoral nerve palsy following resuscitation for traumatic massive blood loss and its consequence. A high suspicious index for this complication may lead to its early recognition. Its related pathoanatomy is discussed based on the described evidences in the literature. Nonoperative treatment remains as a recommended option for coagulopathy-related neuropathy.
    Matched MeSH terms: Blood Coagulation Disorders/complications
  7. Fulltext Repeated tourniquet testing as a diagnostic tool in dengue infection
    Norlijah O, Khamisah AN, Kamarul A, Mangalam S
    Med J Malaysia, 2006 Mar;61(1):22-7.
    PMID: 16708730 MyJurnal
    Prospective evaluation of repeated standard tourniquet testing as a diagnostic indicator of dengue infection was done. Included were patients admitted to a children's hospital in Kuala Lumpur on a clinical suspicion of dengue infection based on the World Health Organization (WHO) criteria. A standard method of tourniquet was performed on 79 patients on a daily basis following admission. subjects and negative in the remaining 14 subjects. Fifty-eight subjects were serologically confirmed cases, 4 indeterminate and the remaining 17 subjects had negative serology. For diagnostic classification, 13 had dengue fever, 49 with dengue haemmorhagic fever (DHF) while 17 had non-dengue infection. The sensitivity and specificity of the tourniquet test was 82.8% and 23.5% respectively. The positive predictive value (PPV) was 78.7% while the negative predictive value (NPV) was 28.6%. In addition, the tourniquet test aided in the diagnosis of one-fifth of patients with DHF, who presented with a positive tourniquet test as the only bleeding manifestation. It seems that in a hospital setting, the tourniquet test adds little to the diagnosis of dengue infection/DHF. A positive tourniquet test, repeatedly performed, was found clinically useful as a preliminary screening test in dengue infection as recommended by WHO. However, it was not very specific and had a high false positive rate.
    Matched MeSH terms: Severe Dengue/blood
  8. Time-level relationship between indicators of oxidative stress and Glasgow Coma Scale scores of severe head injury patients
    Nayak C, Nayak D, Raja A, Rao A
    Clin Chem Lab Med, 2006;44(4):460-3.
    PMID: 16599841
    Oxidative stress is said to strongly influence the neurological recovery of patients following a severe head injury. Estimation of the markers of oxidative stress in the blood of such patients can hence aid in predicting the prognosis of head injury.
    Matched MeSH terms: Biomarkers/blood
  9. Comparison of maternal-fetal outcomes in gestational diabetes and lesser degrees of glucose intolerance
    Nordin NM, Wei JW, Naing NN, Symonds EM
    J Obstet Gynaecol Res, 2006 Feb;32(1):107-14.
    PMID: 16445535 DOI: 10.1111/j.1447-0756.2006.00360.x
    AIM: To determine the relationships between maternal and fetal outcomes and gestational diabetes mellitus (GDM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), respectively.
    METHODS: A retrospective cohort study design was used with 149 patients with abnormal oral glucose tolerance test (OGTT) and 149 normal patients. Statistical analysis used was the chi-squared test, Fisher's exact test or the Student's t-test, as appropriate. P < 0.05 was considered significant.
    RESULTS: The level of hyperglycemia according to the OGTT (World Health Organization criteria) was associated with pre-eclampsia, polyhydramnios and macrosomia in GDM patients. There was no increase in the complications of preterm labor and premature rupture of membranes, despite the increased risk of polyhydramnios. Although treated with insulin, macrosomia still occurred in patients with GDM, but there was no shoulder dystocia as there was an increase in the incidence of cesarean section (CS). The IGT group was not associated with adverse fetal or maternal outcomes, but there was an increase in intervention and the incidence of CS. The IFG group was associated with a significantly increased risk of pre-eclampsia and macrosomia. These findings challenge the concept of IFG being a lesser pathology than GDM. Further prospective studies with a larger number of patients are needed to ascertain the significance of these findings.
    CONCLUSION: There was an increased risk of pre-eclampsia and macrosomia in both the GDM and IFG patients, but IGT was not associated with adverse fetal or maternal outcomes.
    Study site: Maternity Hospital Kuala Lumpur (MHKL), Kuala Lumpur, Malaysia
    Matched MeSH terms: Blood Glucose/metabolism
  10. Fulltext Rapid and cost-effective antenatal diagnosis of haemoglobin Bart's hydrops foetalis syndrome using a duplex-polymerase chain reaction
    Wee YC, Tan KL, Tan PC, Yap SF, Tan JAMA
    Med J Malaysia, 2005 Oct;60(4):447-53.
    PMID: 16570706
    Haemoglobin Bart's hydrops foetalis syndrome (--SEA/--SEA) is not compatible with life and contributes to a majority of the hydropic foetuses in the Malaysian Chinese alpha-thalassaemia carriers who possess the 2-alpha-gene deletion in cis (--SEA/alphaalpha). A duplex-PCR which simultaneously amplifies a normal 136 bp sequence between the psialpha-alpha2-globin genes and a 730 bp Southeast Asian deletion-specific sequence (--SEA) between the psialpha2-theta1-globin genes was established. The duplex-PCR which detects the --SEA deletion in both chromosomes serves as a rapid and cost-effective confirmatory test in the antenatal diagnosis of Haemoglobin Bart's hydrops foetalis syndrome in Malaysia. In addition, the duplex-PCR is simple to perform as both the normal and deletion-specific alpha-globin gene sequences are amplified in the same PCR reaction.
    Matched MeSH terms: Hydrops Fetalis/blood
  11. Factors associated with control of type I diabetes in Malaysian adolescents and young adults
    Tan SM, Shafiee Z, Wu LL, Rizal AM, Rey JM
    Int J Psychiatry Med, 2005;35(2):123-36.
    PMID: 16240970 DOI: 10.2190/EQ71-RMWV-6CEJ-1DGM
    Objectives: To examine the association between ethnicity, depression, quality of life, and diabetic control in Malaysian adolescents and young adults with type I diabetes mellitus.

    Methods: Fifty-two outpatients with type I diabetes (mean age 15.5 years) who attended a Diabetes Clinic were included. The level of HbA1c was the measure of diabetes control used (better control defined as HbA1c < 10%). Other variables were measured through questionnaires (e.g., depressive symptoms, quality of life), computerized diagnostic interviews (major depression), and medical records (e.g., demographic, family circumstances, compliance with treatment).

    Results: Ethnic Chinese youth showed better diabetic control than Malays and Indians (mean HbA1c 9.1%, 10.3%, and 11.0% respectively). Young people with better diabetic control (HbA1c < 10%) were more likely to have better quality of life and less likely to live in problematic families. When the cut-off for diabetic control was stricter (HbA1c < or = 8%), the young person's compliance was the main predictor of poor control. Family problems were also associated with poor control but to a lesser extent. The initial association between poorer diabetes control and depression became non-significant when quality of life was taken into account.

    Conclusions: There are ethnic differences in juvenile diabetic control in this Malaysian sample which need to be understood further. Previous findings of an association between quality of life and glycemic control were verified but different definitions of good control showed different associations with individual and environmental variables. Clinicians' awareness and early intervention for psychosocial problems (for example, inadequate family support) could improve diabetes control.
    Matched MeSH terms: Diabetes Mellitus, Type 1/blood
  12. Fulltext Laser versus dissection technique of tonsillectomy
    Wan Ishlah L, Fahmi AM, Srinovianti N
    Med J Malaysia, 2005 Mar;60(1):76-80.
    PMID: 16250284
    Tonsillectomy is the single most common operation performed in Ear Nose and Throat Department. Various methods of tonsillectomy have been practiced over the century aimed at reducing or eliminating intraoperative and postoperative morbidity. Due to various blood supplies received, intraoperative bleeding is the most difficult problem and securing it is time-consuming. The time taken to control the bleeding would invariably determine the length of operation. Common postoperative complications are bleeding and pain. This study evaluated the operative time, intraoperative blood loss, postoperative pain and other postoperative complications of tonsillectomy performed by laser as compared to conventional dissection technique. This is a prospective randomized study whereby sixty patients were divided into two groups of equal number. In one group, the tonsillectomy performed by laser and in the other group the tonsillectomy performed by conventional dissection technique. Operative time and amount of blood loss is significantly reduced in the laser group. Total postoperative pain and post operative complications were not significantly different between the two groups. Tonsillectomy by using laser have shown less intraoperative bleeding and shortened the operative time. In the hospital where laser machine and expertise are available, it is justifiable to use this technique as effective method of performing tonsillectomy.
    Matched MeSH terms: Blood Loss, Surgical/prevention & control
  13. Antigenicity and immunogenicity of the immunodominant region of hepatitis B surface antigen displayed on bacteriophage T7
    Tan GH, Yusoff K, Seow HF, Tan WS
    J Med Virol, 2005 Dec;77(4):475-80.
    PMID: 16254965
    The immunodominant region of hepatitis B virus (HBV) located in the viral small surface antigen (S-HBsAg) elicits virus-neutralizing and protective antibodies. In order to develop an easy and inexpensive method to produce this region without the need for extensive purification, amino acid residues 111-156 of S-HBsAg were fused to the C-terminal end of the 10B capsid protein of T7 phage. Western blotting and ELISA confirmed the expression of the recombinant protein on the surface of the phage particles. The recombinant phage exhibited the antigenic and immunogenic characteristics of HBsAg, illustrating its potential as an immunological reagent and vaccine.
    Matched MeSH terms: Hepatitis B Antibodies/blood
  14. Fulltext Specific, sensitive and rapid detection of human plasmodium knowlesi infection by loop-mediated isothermal amplification (LAMP) in blood samples
    Lau YL, Fong MY, Mahmud R, Chang PY, Palaeya V, Cheong FW, et al.
    Malar J, 2011;10:197.
    PMID: 21774805 DOI: 10.1186/1475-2875-10-197
    The emergence of Plasmodium knowlesi in humans, which is in many cases misdiagnosed by microscopy as Plasmodium malariae due to the morphological similarity has contributed to the needs of detection and differentiation of malaria parasites. At present, nested PCR targeted on Plasmodium ssrRNA genes has been described as the most sensitive and specific method for Plasmodium detection. However, this method is costly and requires trained personnel for its implementation. Loop-mediated isothermal amplification (LAMP), a novel nucleic acid amplification method was developed for the clinical detection of P. knowlesi. The sensitivity and specificity of LAMP was evaluated in comparison to the results obtained via microscopic examination and nested PCR.
    Matched MeSH terms: Blood/parasitology*
  15. Adverse effects of melatonin on rat pups of Wistar-Kyoto dams receiving melatonin supplementation during pregnancy
    Singh HJ, Keah LS, Kumar A, Sirajudeen KN
    Exp. Toxicol. Pathol., 2012 Nov;64(7-8):751-2.
    PMID: 21354772 DOI: 10.1016/j.etp.2011.01.011
    This report documents an incidental finding during a study investigating the effects of melatonin supplementation on the development of blood pressure in SHR. Administration of 10 mg/kg/day of melatonin in drinking water during pregnancy to Wistar-Kyoto (WKY) dams caused a loss of more than 50% of the pups by the age of three weeks and 95% by the age of 6 weeks. There was no maternal morbidity or mortality in the two strains or death of any of the SHR pups. No obvious physical defects were present but mean body weight was lower in the surviving WKY rats when compared to that of melatonin supplemented SHR or non-supplemented WKY pups. The reason for the high mortality in WKY pups is uncertain and appears to be strain if not batch specific. There is a need for caution in its use, particularly during pregnancy, and clearly necessitates more detailed studies.
    Matched MeSH terms: Blood Pressure/drug effects
  16. Fulltext Acute oral toxicity of methanolic seed extract of Cassia fistula in mice
    Jothy SL, Zakaria Z, Chen Y, Lau YL, Latha LY, Sasidharan S
    Molecules, 2011 Jun 23;16(6):5268-82.
    PMID: 21701437 DOI: 10.3390/molecules16065268
    BACKGROUND AND OBJECTIVE: Cassia fistula is widely used in traditional medicine to treat various types of ailments. The evaluation of toxic properties of C. fistula is crucial when considering public health protection because exposure to plant extracts can result in undesirable effects on consumers. Hence, in this study the acute oral toxicity of C. fistula seeds extract was investigated in mice.

    RESULTS: Oral administration of crude extract at the highest dose of 5000 mg/kg resulted in no mortalities or evidence of adverse effects, implying that C. fistula in nontoxic. Throughout 14 days of the treatment no changes in behavioural pattern, clinical sign and body weight of mice in both control and treatment groups. Also there were no any significant elevations observed in the biochemical analysis of the blood serum. Further, histopathological examination revealed normal architecture and no significant adverse effects observed on the kidney, heart, liver, lung and spleen.

    CONCLUSIONS: Overall, the results suggest that, the oral administration of C. fistula methanolic seeds extract did not produce any significant toxic effect in mice. Hence, the extract can be utilized for pharmaceutical formulations.

    Matched MeSH terms: Biomarkers/blood
  17. Fulltext Physiological responses of 3 chicken breeds to acute heat stress
    Soleimani AF, Zulkifli I, Omar AR, Raha AR
    Poult Sci, 2011 Jul;90(7):1435-40.
    PMID: 21673158 DOI: 10.3382/ps.2011-01381
    Domestic animals have been modified by selecting individuals exhibiting desirable traits and culling the others. To investigate the alterations introduced by domestication and selective breeding in heat stress response, 2 experiments were conducted using Red Jungle Fowl (RJF), village fowl (VF), and commercial broilers (CB). In experiment 1, RJF, VF, and CB of a common chronological age (30 d old) were exposed to 36 ± 1°C for 3 h. In experiment 2, RJF, VF, and CB of common BW (930 ± 15 g) were subjected to similar procedures as in experiment 1. Heat treatment significantly increased body temperature, heterophil:lymphocyte ratio, and plasma corticosterone concentration in CB but not in VF and RJF. In both experiments and irrespective of stage of heat treatment, RJF showed lower heterophil:lymphocyte ratio, higher plasma corticosterone concentration, and higher heat shock protein 70 expression than VF and CB. It can be concluded that selective breeding for phenotypic traits in the domestication process has resulted in alterations in the physiology of CB and concomitantly the ability to withstand high ambient temperature compared with RJF and VF. In other words, domestication and selective breeding are leading to individuals that are more susceptible to stress rather than resistant. It is also apparent that genetic differences in body size and age per se may not determine breed or strain variations in response to heat stress.
    Matched MeSH terms: Corticosterone/blood
  18. Efficacy evaluations of Mimosa pudica tannin isolate (MPT) for its anti-ophidian properties
    Ambikabothy J, Ibrahim H, Ambu S, Chakravarthi S, Awang K, Vejayan J
    J Ethnopharmacol, 2011 Sep 1;137(1):257-62.
    PMID: 21640180 DOI: 10.1016/j.jep.2011.05.013
    Evaluations of the anti-snake venom efficacy of Mimosa pudica tannin isolate (MPT) obtained from root of the plant.
    Matched MeSH terms: Snake Bites/blood
  19. Fulltext High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur, Malaysia
    Khor GL, Chee WS, Shariff ZM, Poh BK, Arumugam M, Rahman JA, et al.
    BMC Public Health, 2011;11:95.
    PMID: 21310082 DOI: 10.1186/1471-2458-11-95
    Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.
    Matched MeSH terms: Vitamin D Deficiency/blood
  20. Smoking is associated with an increased risk of developing ACPA-positive but not ACPA-negative rheumatoid arthritis in Asian populations: evidence from the Malaysian MyEIRA case-control study
    Yahya A, Bengtsson C, Lai TC, Larsson PT, Mustafa AN, Abdullah NA, et al.
    Mod Rheumatol, 2012 Aug;22(4):524-31.
    PMID: 22006120 DOI: 10.1007/s10165-011-0544-2
    We investigated the association between cigarette smoking and the risk of developing rheumatoid arthritis (RA) in the Malaysian population. A total of 1,056 RA patients and 1,416 matched controls aged 18-70 years within a defined area of Peninsular Malaysia were evaluated in a case-control study between August 2005 and December 2009. A case was defined as a person with early diagnosed RA using the 1987 American College of Rheumatology criteria for RA. Controls were randomly selected matched for sex, age, and residential area. Cases and controls answered a questionnaire on a broad range of issues, including lifestyle factors and smoking habits wherein current and former smoking was classified as ever-smoking. The presence of anti-citrullinated peptide antibodies (ACPA) was determined for cases and controls. We found that ever-smokers had an increased risk of developing ACPA-positive RA [odds ratio (OR) = 4.1, 95% confidence interval (CI) 1.9-9.2] but not ACPA-negative RA (OR = 0.7, 95% CI 0.3-2.0), compared with never-smokers. A significant dose-response relationship between cumulative dose of smoking and risk of ACPA-positive RA was observed (<20 pack-years OR = 3.3, 95% CI 1.1-9.8; at least 20 pack-years OR = 5.2, 95% CI 1.6-17.6). Hence, smoking is associated with an increased risk of ACPA-positive RA in the Malaysian population, in which the genetic context is similar to several other Asian countries.
    Matched MeSH terms: Autoantibodies/blood*
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