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  1. Diabetes mellitus in peninsular Malaysia: ethnic differences in prevalence and complications
    Mustaffa BE
    Ann Acad Med Singap, 1985 Apr;14(2):272-6.
    PMID: 4037685
    Estimated prevalence of diabetes mellitus in Malaysia was about 2%. Diabetes was most common in Indians especially males and least common in Chinese. There was a slight male preponderance seen in Malays and Indians. Positive family history was obtained in 14% of cases most commonly in Malays, almost 1/3 of whom had more than one family member with diabetes. Familial association was uncommon in Chinese. Over 50% of patients were overweight. Obesity was noted in nearly 70% of female Malays and Indians while the majority of Chinese were not overweight. More than 80% of patients were non insulin requiring. Youth onset diabetes was considered rare; those 10 years and below were estimated to be only 0.4% and below 20 years of age between 2%-4% of the diabetic population. Females were twice as common than males in this type of diabetes and familial association was greater. Malnutrition-related diabetes and pancreatic calcification were not well-documented but youth-onset non insulin requiring diabetics with mild symptoms but strong family history of diabetes were observed. More than half of hospital-based patients had evidence of complications, mainly amongst Malays and Indians. Hypertension was the most frequent associated disease followed by foot ulcers and ischaemic heart disease. Hypertension usually associated with chronic renal failure was most common amongst Malays while gangrenic ulcers and heart diseases were seen mainly in Indians. The major causes of death were chronic renal failure, myocardial infarction, ketoacidosis, stroke and septicaemia related to gangrene.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: China/ethnology
  2. Insulin-dependent diabetes mellitus: strategy for prevention and management
    Wong HB
    Ann Acad Med Singap, 1985 Apr;14(2):334-42.
    PMID: 4037695
    Insulin-dependent diabetes mellitus (IDDM) is inherited in a multifactorial manner with polygenes and environmental factors contributing to its emergence in a particular individual. The evidence for such a mode of inheritance is reviewed. One of the most important genetic roles is that played by the HLA genes on chromosome 6 and the different alleles which increase or decrease susceptibility in Caucasians, Japanese, Singapore Chinese and Shanghai Chinese are described. It is inferred that these alleles are different in different ethnic groups. The other genes which are important are unknown. The environmental influences are less well known although viral infections may act as triggers. Because the morbidity and mortality are still extremely serious in IDDM patients in spite of insulin therapy, it is proposed that preventive measures should be instituted in families prone to IDDM. The role of prenatal diagnosis is discussed especially in those families with multiple HLA susceptibility genes present. Great care paid to management of hyperglycemia from onset of the disease may reduce future morbidity and mortality.
    Matched MeSH terms: China/ethnology
  3. The influence of sex, race and dialect on peptic ulcer and non-ulcer dyspepsia in Singapore
    Kang JY, Guan R, LaBrooy SJ, Lim KP, Yap I
    Ann Acad Med Singap, 1983 Oct;12(4):527-31.
    PMID: 6611105
    A consecutive series of 2,277 patients presenting for upper gastrointestinal endoscopy was analysed. The following groups of patients were studied with reference to sex, race and dialect groups: those presenting with dyspepsia but no haemorrhage, those presenting with upper gastrointestinal haemorrhage, those with non-ulcer dyspepsia, gastric ulcer and duodenal ulcer. Males out-numbered females in all diagnostic groups. Male and female Malays were under-represented in all diagnostic groups when compared to the Singapore population. Amongst female Chinese, there was an excess of Cantonese patients and an under-representation of Teochew patients in most diagnostic groups. These dialect differences were not remarkable amongst male Chinese. The possible reasons for these differences and their significance are discussed.
    Matched MeSH terms: China/ethnology
  4. Fulltext Can dietary factors explain differences in serum cholesterol profiles among different ethnic groups (Chinese, Malays and Indians) in Singapore?
    Deurenberg-Yap M, Li T, Tan WL, van Staveren WA, Chew SK, Deurenberg P
    Asia Pac J Clin Nutr, 2001;10(1):39-45.
    PMID: 11708607
    In Singapore. there exists differences in risk factors for coronary heart disease among the three main ethnic groups: Chinese, Malays and Indians. This study aimed to investigate if differences in dietary intakes of fat, types of fat, cholesterol, fruits, vegetables and grain foods could explain the differences in serum cholesterol levels between the ethnic groups. A total of 2408 adult subjects (61.0% Chinese, 21.4% Malays and 17.6% Indians) were selected systematically from the subjects who took part in the National Health Survey in 1998. The design of the study was based on a cross-sectional study. A food frequency questionnaire was used to assess intakes of energy, total fat, saturated fat, polyunsaturated fat, monounsaturated fat, cholesterol, fruits, vegetables and cereal-based foods. The Hegsted score was calculated. Serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol were analysed and the ratio of total cholesterol to high density lipoprotein cholesterol was computed. The results showed that on a group level (six sex-ethnic groups), Hegsted score, dietary intakes of fat, satutrated fat, cholesterol, vegetables and grain foods were found to be correlated to serum cholesterol levels. However, selected dietary factors did not explain the differences in serum cholesterol levels between ethnic groups when multivariate regression analysis was performed, with adjustment for age, body mass index, waist-hip ratio, cigarette smoking, occupation, education level and physical activity level. This cross-sectional study shows that while selected dietary factors are correlated to serum cholesterol at a group level, they do not explain the differences in serum cholesterol levels between ethnic groups independently of age, obesity, occupation, educational level and other lifestyle risk factors.
    Matched MeSH terms: China/ethnology
  5. Fulltext Vitamin D status among postmenopausal Malaysian women
    Rahman SA, Chee WS, Yassin Z, Chan SP
    Asia Pac J Clin Nutr, 2004;13(3):255-60.
    PMID: 15331337
    Serum levels of 25-hydroxyvitamin D (25 (OH) D) were determined in 276 (103 Malays and 173 Chinese) postmenopausal women, aged 50 to 65 years. The level of 25 (OH) D was significantly lower in the postmenopausal Malay women (44.4 +/-10.6 nmol/L) compared to the Chinese women (68.8 +/- 15.7 nmol/L) (P<0.05). There were 27% Malay women with serum 25 (OH) D in the range of 50 - 100 nmol/L (defined as lowered vitamin D status, or hypovitaminosis D) and 71% with levels in the range of 25 - 50 nmol/L (defined as vitamin D insufficiency) compared to 87% and 11% Chinese women respectively. Serum 25 (OH) D was found to significantly correlate with BMI, fat mass and PTH level. Multivariate analyses showed that race has a strong association with vitamin D status. The high prevalence of inadequate levels of serum vitamin D found in our study may have important public health consequences and warrants the development of a strategy to correct this problem in the older adult Malaysian population.
    Matched MeSH terms: China/ethnology
  6. Fulltext Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia
    Mohd Zaher ZM, Zambari R, Chan SP, Muruga V, Ng B, Appannah G, et al.
    Asia Pac J Clin Nutr, 2009;18(2):209-16.
    PMID: 19713180
    Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.
    Study site: 93 primary care clinics (klinik kesihatan and general practice clinics) in Malaysia
    Matched MeSH terms: China/ethnology
  7. Fulltext Red cell folate and predicted neural tube defect rate in three Asian cities
    Green TJ, Skeaff CM, Venn BJ, Rockell JE, Todd JM, Khor GL, et al.
    Asia Pac J Clin Nutr, 2007;16(2):269-73.
    PMID: 17468082
    Periconceptional folic acid reduces neural tube defect (NTD) risk. Red blood cell folate concentration is inversely associated with NTD risk. In many countries there is a lack of information on NTD rates. Red cell folate status in women of childbearing age may be a surrogate for NTD rates and may be helpful in identifying countries or regions most likely to benefit from improved folate status.
    Matched MeSH terms: China/epidemiology
  8. Fulltext Anemia in pregnancy in Malaysia: a cross-sectional survey
    Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al.
    Asia Pac J Clin Nutr, 2007;16(3):527-36.
    PMID: 17704035
    Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.
    Matched MeSH terms: China/ethnology
  9. TT genotype of the methylenetetrahydrofolate reductase C677T polymorphism is an important determinant for homocysteine levels in multi-ethnic Malaysian ischaemic stroke patients
    Mejia Mohamed EH, Tan KS, Ali JM, Mohamed Z
    Ann Acad Med Singap, 2011 Apr;40(4):186-91.
    PMID: 21678004
    INTRODUCTION: The functional point mutation C677T in the methylenetetrahydrofolate reductase (MTHFR) gene, has been reported to contribute to hyperhomocysteinaemia which is a risk factor for atherothrombotic ischaemic strokes. This study evaluated the prevalence of the C677T polymorphism of the gene in Malaysian ischaemic stroke subjects of Malay, Chinese and Indian ethnicities, and its association with homocysteine levels (tHcy).

    MATERIALS AND METHODS: A total of 292 subjects were recruited, comprising 150 ischaemic stroke patients and 142 control subjects who were age and sex matched. Plasma homocysteine, serum folate and vitamin B12 were measured in all subjects. Genotyping was carried out using PCR-RFLP.

    RESULTS: The homocysteine levels were significantly higher (P = 0.001) in the stroke group (11.35 ± 2.75 μmol/L) compared to the control group (10.38 ± 2.79 μmol/L). The MTHFR C677T genotype distribution for the stroke group was 46%, 40% and 14%, respectively for CC, CT and TT genotypes and 59.9%, 33.8% and 6.3%, respectively for the control group. The genotype and allelic frequencies were significantly different between the 2 groups, with P = 0.02 and P = 0.004 respectively. No significant difference was seen in the genotype distribution inter-ethnically. An increasing tHcy was seen with every additional T allele, and the differences in the tHcy for the different genotypes were significant in both the control (P <0.001) and stroke groups (P <0.001).

    CONCLUSION: This study shows that TT genotype of the methylenetetrahydrofolate reductase C677T polymorphic gene is an important determinant for homocysteine levels in Malaysian ischaemic stroke patients.

    Matched MeSH terms: China/ethnology
  10. Lack of association between the LRRK2 A419V variant and Asian Parkinson's disease
    Gopalai AA, Lim SY, Aziz ZA, Lim SK, Tan LP, Chong YB, et al.
    Ann Acad Med Singap, 2013 May;42(5):237-40.
    PMID: 23771111
    INTRODUCTION: The G2385R and R1628P LRRK2 gene variants have been associated with an increased risk of Parkinson's disease (PD) in the Asian population. Recently, a new LRRK2 gene variant, A419V, was reported to be a third risk variant for PD in Asian patients. Our objective was to investigate this finding in our cohort of Asian subjects.

    MATERIALS AND METHODS: Eight hundred and twenty-eight subjects (404 PD patients, and 424 age and gender-matched control subjects without neurological disorders) were recruited. Genotyping was done by Taqman® allelic discrimination assay on an Applied Biosystems 7500 Fast Real-Time PCR machine.

    RESULTS: The heterozygous A419V genotype was found in only 1 patient with PD, compared to 3 in the control group (0.4% vs 1.3%), giving an odds ratio of 0.35 (95% confidence interval (CI), 0.01 to 3.79; P = 0.624).

    CONCLUSION: A419V is not an important LRRK2 risk variant in our Asian cohort of patients with PD. Our data are further supported by a literature review which showed that 4 out of 6 published studies reported a negative association of this variant in PD.

    Matched MeSH terms: China/ethnology
  11. Smoking and nicotine dependence in Singapore: findings from a cross-sectional epidemiological study
    Picco L, Subramaniam M, Abdin E, Vaingankar JA, Chong SA
    Ann Acad Med Singap, 2012 Aug;41(8):325-34.
    PMID: 23010809
    INTRODUCTION: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.

    MATERIAL AND METHODS: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.

    RESULTS: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.

    CONCLUSION: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.

    Matched MeSH terms: China/ethnology
  12. Fulltext Association and interaction between dietary pattern and VEGF receptor-2 (VEGFR2) gene polymorphisms on blood lipids in Chinese Malaysian and Japanese adults
    Yap RW, Shidoji Y, Hon WM, Masaki M
    Asia Pac J Clin Nutr, 2012;21(2):302-11.
    PMID: 22507619
    Dietary pattern and genetic predisposition of each population have different impacts on lifestyle-related chronic diseases. This study was conducted to evaluate the association and interaction between dietary patterns and VEGFR2 or KDR gene polymorphisms on physical and biochemical risk factors of cardiovascular disease in two Asian populations (179 Chinese Malaysian and 136 Japanese adults).
    Matched MeSH terms: China/ethnology
  13. Origins of suspended particulate matter based on sterol distribution in low salinity water mass observed in the offshore East China Sea
    Kim M, Jung JH, Jin Y, Han GM, Lee T, Hong SH, et al.
    Mar Pollut Bull, 2016 Jul 15;108(1-2):281-8.
    PMID: 27167134 DOI: 10.1016/j.marpolbul.2016.04.049
    The molecular composition and distribution of sterols were investigated in the East China Sea to identify the origins of suspended particulate matter (SPM) in offshore waters influenced by Changjiang River Diluted Water (CRDW). Total sterol concentrations ranged from 3200 to 31,900pgL(-1) and 663 to 5690pgL(-1) in the particulate and dissolved phases, respectively. Marine sterols dominated representing 71% and 66% in the particulate and dissolved phases, respectively. Typical sewage markers, such as coprostanol, were usually absent at ~250km offshore. However, sterols from allochthonous terrestrial plants were still detected at these sites. A negative relationship was observed between salinity and concentrations of terrestrial sterols in SPM, suggesting that significant amounts of terrestrial particulate matter traveled long distance offshore in the East China Sea, and the Changjiang River Diluted Water (CRDW) was an effective carrier of land-derived particulate organic matter to the offshore East China Sea.
    Matched MeSH terms: China
  14. A multilevel approach to assessing temporal change of CD4 recovery following HAART initiation in a cohort of Chinese HIV positive patients
    Wong NS, Reidpath DD, Wong KH, Lee SS
    J Infect, 2015 Jun;70(6):676-8.
    PMID: 25452038 DOI: 10.1016/j.jinf.2014.10.012
    Matched MeSH terms: China
  15. Patterns of linkage disequilibrium at PARK16 may explain variances in genetic association studies
    Li H, Teo YY, Tan EK
    Mov Disord, 2015 Sep;30(10):1335-42.
    PMID: 25758099 DOI: 10.1002/mds.26176
    Reproducing genomewide association studies findings in different populations is challenging, because the reproducibility fundamentally relies on the similar patterns of linkage disequilibrium between the unknown causal variants and the genotyped single-nucleotide polymorphisms (SNPs).
    Matched MeSH terms: China
  16. Revision of the leafhopper genus Dusuna Distant (Hemiptera: Cicadellidae: Ledrinae), with description of one new species from China
    Sun J, Webb M, Zhang Y
    Zootaxa, 2014;3821(5):575-82.
    PMID: 24989768 DOI: 10.11646/zootaxa.3821.5.5
    The leafhopper genus Dusuna Distant is revised to include seven species including one new species D. anacantha sp. nov. from China and one new combination D. distanti (Schmidt) n. comb. All species are described and illustrated. A checklist to species of the genus is provided together with a key to separate the two species known from the male. Figures of an unknown species from Malaysia (possibly new) are also included.
    Matched MeSH terms: China
  17. A cross-cultural study investigating body features associated with male adolescents' body dissatisfaction in Australia, China, and Malaysia
    Mellor D, Hucker A, Waterhouse M, binti Mamat NH, Xu X, Cochrane J, et al.
    Am J Mens Health, 2014 Nov;8(6):521-31.
    PMID: 24707036 DOI: 10.1177/1557988314528370
    This study investigated how dissatisfaction with particular aspects of the body was associated with overall body dissatisfaction among male adolescents in Western and Asian cultures. One hundred and six Malaysian Malays, 55 Malaysian Chinese, 195 Chinese from China, and 45 non-Asian Australians aged 12 to 19 years completed a questionnaire assessing dissatisfaction with their overall body and dissatisfaction with varying aspects of their body. Dissatisfaction with the face, height, and hair was positively correlated with overall body dissatisfaction among Malaysian Malays after body mass index, age and dissatisfaction with body areas typically included in measures (weight/shape, upper, middle, and lower body, and muscles) had been controlled for. Dissatisfaction with the face was positively correlated with overall body dissatisfaction among Malaysian Chinese. These findings demonstrate the differences in body focus for males from different cultures and the importance of using assessment measures that address all possible areas of body focus.
    Matched MeSH terms: China
  18. Conspectus of the Phlaeothripinae genera from China and Southeast Asia (Thysanoptera, Phlaeothripidae)
    Dang LH, Mound LA, Qiao GX
    Zootaxa, 2014;3807:1-82.
    PMID: 24871154 DOI: 10.11646/zootaxa.3807.1.1
    An illustrated identification key is provided to 100 genera of Phlaeothripinae from China and Southeast Asia, together with a diagnosis for each genus, and comments on the species diversity. One new genus with a new species, Akarethrips iotus gen.n. & sp.n., and two new species, Heliothripoides boltoni sp.n. and Terthrothrips strasseni sp.n., are described from specimens collected in Peninsular Malaysia and Java respectively. Three Phlaeothripinae genera are synonymised, Mychiothrips Haga & Okajima syn.n. of Veerabahuthrips Ramakrishna, Syringothrips Priesner syn.n. of GigantothripsZimmermann, and Sauridothrips Priesner syn.n. of Gynaikothrips Zimmermann. In addition, four nomenclatural changes are included, Adelphothrips ignotus (Reyes) comb.n. transferred from Mesothrips, Karnyothrips palmerae (Chen) comb.n from Xylaplothrips, Xylaplothrips bogoriensis (Karny) comb.n from Brachythrips, and Oidanothrips notabilisFeng, Guo & Duan considered as a new synonym of Oidanothrips frontalis (Bagnall).
    Matched MeSH terms: China
  19. Fulltext Shifting baselines on a tropical forest frontier: extirpations drive declines in local ecological knowledge
    Kai Z, Woan TS, Jie L, Goodale E, Kitajima K, Bagchi R, et al.
    PLoS One, 2014;9(1):e86598.
    PMID: 24466163 DOI: 10.1371/journal.pone.0086598
    The value of local ecological knowledge (LEK) to conservation is increasingly recognised, but LEK is being rapidly lost as indigenous livelihoods change. Biodiversity loss is also a driver of the loss of LEK, but quantitative study is lacking. In our study landscape in SW China, a large proportion of species have been extirpated. Hence, we were interested to understand whether species extirpation might have led to an erosion of LEK and the implications this might have for conservation. So we investigated peoples' ability to name a selection of birds and mammals in their local language from pictures. Age was correlated to frequency of forest visits as a teenager and is likely to be closely correlated to other known drivers of the loss of LEK, such as declining forest dependence. We found men were better at identifying birds overall and that older people were better able to identify birds to the species as compared to group levels (approximately equivalent to genus). The effect of age was also stronger among women. However, after controlling for these factors, species abundance was by far the most important parameter in determining peoples' ability to name birds. People were unable to name any locally extirpated birds at the species level. However, contrary to expectations, people were better able to identify extirpated mammals at the species level than extant ones. However, extirpated mammals tend to be more charismatic species and several respondents indicated they were only familiar with them through TV documentaries. Younger people today cannot experience the sights and sounds of forest animals that their parents grew up with and, consequently, knowledge of these species is passing from cultural memory. We suggest that engaging older members of the community and linking the preservation of LEK to biodiversity conservation may help generate support for conservation.
    Matched MeSH terms: China
  20. Spatial effect of new municipal solid waste landfill siting using different guidelines
    Ahmad SZ, Ahamad MS, Yusoff MS
    Waste Manag Res, 2014 Jan;32(1):24-33.
    PMID: 24241167 DOI: 10.1177/0734242X13507313
    Proper implementation of landfill siting with the right regulations and constraints can prevent undesirable long-term effects. Different countries have respective guidelines on criteria for new landfill sites. In this article, we perform a comparative study of municipal solid waste landfill siting criteria stated in the policies and guidelines of eight different constitutional bodies from Malaysia, Australia, India, U.S.A., Europe, China and the Middle East, and the World Bank. Subsequently, a geographic information system (GIS) multi-criteria evaluation model was applied to determine new suitable landfill sites using different criterion parameters using a constraint mapping technique and weighted linear combination. Application of Macro Modeler provided in the GIS-IDRISI Andes software helps in building and executing multi-step models. In addition, the analytic hierarchy process technique was included to determine the criterion weight of the decision maker's preferences as part of the weighted linear combination procedure. The differences in spatial results of suitable sites obtained signifies that dissimilarity in guideline specifications and requirements will have an effect on the decision-making process.
    Matched MeSH terms: China
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