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Fulltext Clinical profile, risk factors and aetiology of young ischaemic stroke patients in Asia: A prospective, multicentre, observational, hospital-based study in eight cities

Kay, Sin Tan, Navarro, Jose C, Ka, Sing Wong, Yi, Ning Huang, Hou, Chang Chiu, Poungvarin, Niphon, et al.

Neurology Asia, 2014;19(2):117-127.
MyJurnal

Background and Objective: There is a lack of international collaborative studies on young adults with ischaemic stroke in Asia. The aim of this study was to investigate risk factors, aetiology and outcome at hospital discharge of these patients across 8 participating countries in Asia. Methods: This was a prospective, observational, multicentre, hospital based cohort study. Consecutive young stroke patients with confirmed cerebral infarction between the ages of 18-49 were recruited from December 2011 to May 2012. Data was collected for patient demography, risk factors, investigations, clinical profile and TOAST classification. Outcome measures were death and independence (modified Rankin score≤ 2) at hospital discharge. Results: Two hundred and eighteen patients with the mean age was 40.8±6.7 years were recruited. There was a larger proportion of male patients with a ratio of 1.9:1. Traditional risk factors observed were hypertension (n=103; 47.3%), dyslipidaemia (n=93; 42.4%), smoking (n=85; 38.8%), diabetes (n=53; 24.3%), alcohol use (n=33; 15.0%), a previous history of stroke and transient ischaemic attacks (6.4%), family history (n=12; 5.5%), migraine (n=6;2.8%), pregnancy related (n=5; 2.3%) and numerous cardiac risk factors (0.9-5.5%). The majority suffered arterial infarction; n=216 (99.4%) while n=2 (0.6%) had venous strokes. The predominant stroke subtypes were large artery atherosclerosis (LAA); 29.8% and small vessel occlusion (SVO); 20.2%. LAA and SVO accounted for 37.5% of all stroke subtypes in the ≤36 year age-group. Cardioembolism (15.1%) and stroke of determined aetiology (14.7%) contributed to the other categories of identified stroke subtypes. Mortality on hospital discharge was 3.1% while 65.1% of patients were independent on discharge. Conclusion: This study demonstrated the substantial presence of premature atherosclerosis and conventional risk factors in young ischaemic stroke patients from 8 Asian cities. Venous infarction from cerebral venous thrombosis was rare in this study. Outcome on hospital discharge was poorer compared to Western studies. Detection of vascular risk factors and primary prevention measures should be initiated during late adolescence or early adulthood in urban Asia.

Matched MeSH terms: Dyslipidemias
Fulltext Metabolic control and cardiovascular risk factors among type 2 diabetes in a primary care clinic

Cheong AT, Ahmad Z, Chew BH

Malaysian Journal of Medicine and Health Sciences, 2012;8(1):5-12.
MyJurnal

Prevalence of diabetes is escalating both globally as well as in Malaysia. With the epidemic of diabetes and its related morbidities and mortalities, health care professionals are facing an unprecedented challenges in controlling the disease. Objective: To determine the metabolic control and the cardiovascular risk factors among type 2 diabetic patients in a primary care setting. Method: This was a cross sectional study conducted in a primary care clinic in Selangor, Malaysia. Inclusion criteria were all type 2 diabetic patients aged 18 and above and were being followed-up for more than six months prior to the recruiting period in May 2009. The demographic data were obtained through face- to-face interview. Height, weight and blood pressure of the patients were taken during the day of data collection. The co-morbidities and laboratory results were obtained from the medical records. Results: Two-hundred patients were recruited. The mean age was 58.6 (SD=10.5) with 79.0% of the patients aged more than 50 years old. The majority of the patients were female (62.5%). One-tenth (11.5%) were smokers. More than half of the patients (64.0%) had co-morbid of hypertension and half of them (50.5%) had dyslipidaemia. A total of 72.5% of the patients had 3 or more cardiovascular risk factors. Less than one fifth of the patients had achieved the target of control for glycaemia, blood pressure, LDL and BMI. Those age 60 and above had significantly higher proportion of patients achieving fasting blood glucose control (p=0.033). Conclusion: The majority of type 2 diabetic patients had multiple cardiovascular risk factors (3 or more risk factors) and had not achieved the recommended goals in
metabolic control.

Matched MeSH terms: Dyslipidemias
Fulltext Cognitive health of older persons in longitudinal ageing cohort studies

Ng TP

Sains Malaysiana, 2016;45:1351-1355.

Dementia poses a major global burden of care to society and health systems in ageing populations. The majority (over 60%) of persons with dementia in the world are found in Asia and developing countries with rapid rates of population ageing. Improving and maintaining the cognitive health of older persons is vital to national strategies for dementia prevention. Increasing numbers of population-based ageing cohort studies in the past decade have provided a better understanding of the factors that contribute to cognitive function and decline in old age. The roles of major demographic, psychosocial, lifestyle, behavioral and cardiovascular risk factors contributing to cognitive health were discussed using examples from the Singapore Longitudinal Ageing Studies. They include socio-demographic factors, particularly education and marital status, leisure time activity such as physical activity, social engagement and mental activities, psychological factors such as depression, cardiovascular and metabolic risk factors: obesity, diabetes, hypertension and dyslipidemia, and the metabolic syndrome, under-nutrition, low albumin, low hemoglobin, nutritional factors such as blood folate, B12 and homocysteine, omega-3 poly-unsaturated fatty acids, tea drinking and curcumin-rich turmeric in curry meals. These factors are found to be associated variously with cognitive functions (memory and learning, language, visuospatial, attention and information processing speed), rates of cognitive impairment and cognitive decline, or increased risk of developing MCI and progression to dementia.

Matched MeSH terms: Dyslipidemias
Sargassum polycystum reduces hyperglycaemia, dyslipidaemia and oxidative stress via increasing insulin sensitivity in a rat model of type 2 diabetes

Motshakeri M, Ebrahimi M, Goh YM, Matanjun P, Mohamed S

J Sci Food Agric, 2013 May;93(7):1772-8.
PMID: 23208488 DOI: 10.1002/jsfa.5971

BACKGROUND: Sargassum polycystum, a brown seaweed, contains various nutrients and bioactive compounds that have antioxidant and healing properties. The research hypothesises that antioxidants and pigments in dietary S. polycystum extracts can improve insulin sensitivity, blood sugar levels and blood lipid levels in a rat model of type 2 diabetes. The diabetes was induced by a high-sugar, high-fat diet for 16 weeks to enhance insulin resistance, followed by a low-dose intraperitoneal injection of streptozotocin (35 mg kg(-1) body weight). The doses of S. polycystum tested on diabetic rats were 150 and 300 mg kg(-1) body weight for the ethanolic extract or 150 and 300 mg kg(-1) for the water extract. Normal rats, untreated diabetic and metformin-treated diabetic rats (n = 6) were used as control.
RESULTS: Both doses of the alcohol extract of S. polycystum and the 300 mg kg(-1) water extract, significantly reduced blood glucose and glycosylated haemoglobin (HbA1C ) levels. Serum total cholesterol, triglyceride levels and plasma atherogenic index were significantly decreased after 22 days treatment in all seaweed groups. Unlike metformin, S. polycystum did not significantly change plasma insulin in the rats, but increased the response to insulin.
CONCLUSION: The consumption of either ethanolic or water extracts of S. polycystum dose dependently reduced dyslipidaemia in type 2 diabetic rats. S. polycystum is a potential insulin sensitiser, for a comestible complementary therapy in the management of type 2 diabetes which can help reduce atherogenic risk.

Matched MeSH terms: Dyslipidemias/blood; Dyslipidemias/drug therapy
Fulltext Amelioration of high-fat diet-induced obesity and its associated complications by a myricetin derivative-rich fraction from Syzygium malaccense in C57BL/6J mice

Nallappan D, Chua KH, Ong KC, Chong CW, Teh CSJ, Palanisamy UD, et al.

Food Funct, 2021 Jul 05;12(13):5876-5891.
PMID: 34019055 DOI: 10.1039/d1fo00539a

Obesity is a driving factor in the onset of metabolic disorders. This study aims to investigate the effects of the myricetin derivative-rich fraction (MD) from Syzygium malaccense leaf extract on high-fat diet (HFD)-induced obesity and its associated complications and its influence on uncoupling protein-1 (UCP-1) and gut microbiota in C57BL/6J mice. Mice were randomly assigned into four groups (n = 6) and given a normal diet (ND) or high-fat diet (HFD) for 10 weeks to induce obesity. The HFD groups (continued with HFD) were administered 50 mg kg-1 MD (treatment), 50 mg kg-1 metformin (positive control) and normal saline (HFD and ND controls) daily for four weeks via oral gavage. The ten-week HFD-feeding resulted in hyperglycemia and elevated urinary oxidative indices. The subsequent MD administration caused significant weight reduction without appetite suppression and amelioration of insulin resistance, steatosis and dyslipidemia. Besides, MD significantly reduced lipid hydroperoxides and protein carbonyls in tissue homogenates and urine and elevated Trolox equivalent antioxidant capacity (TEAC), ferric reducing antioxidant power (FRAP) and reduced glutathione (GSH) and thus, alleviated oxidative stress. The weight reduction was correlated with downregulation of inflammatory markers and the increased UCP-1 level, suggesting weight loss plausibly through thermogenesis. The Akkermansia genus (reflects improved metabolic status) in the HFD50 group was more abundant than that in the HFD group while the non-enzymatic antioxidant markers were strongly associated with UCP-1. In conclusion, MD ameliorates obesity and its related complications possibly via the upregulation of UCP-1 and increased abundance of Akkermansia genus and is promising as a therapeutic agent in the treatment of obesity and its associated metabolic disorders.

Matched MeSH terms: Dyslipidemias