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Association of metabolic syndrome with testosterone and inflammation in men

Wickramatilake CM, Mohideen MR, Pathirana C

Ann Endocrinol (Paris), 2015 Jul;76(3):260-3.
PMID: 26142486 DOI: 10.1016/j.ando.2015.04.008

OBJECTIVE: There is limited data on the assessment of relationship between sex hormones, metabolic syndrome (MS) and inflammation. Therefore, our objective was to examine the relationship between metabolic syndrome, testosterone and inflammation.
PATIENTS AND METHODS: It was a cross-sectional study which included 309 subjects in the age range of 30-70years. Blood was analyzed for plasma glucose, serum lipids, total testosterone (TT) and high-sensitivity C-reactive protein (hs-CRP).
RESULTS: There were 153 patients with metabolic syndrome and 156 without MS according to modified NCEP guidelines. Age, BMI, obesity, dyslipidaemia, smoking (OR=2.35, CI=1.35-4.09), LDL-Ch, low TT (OR=0.76, CI=0.38-1.52) and elevated hs-CRP (OR=1.56, CI=0.87-2.80) were significant independent predictors of MS (all P<0.05).
CONCLUSIONS: The low testosterone and high hs-CRP levels are independent predictors of metabolic syndrome.
KEYWORDS: Hommes; Inflammation; Men; Metabolic syndrome; Syndrome métabolique; Testosterone; Testostérone
Fulltext Effects of Mg and Cu dopants on the properties of zinc oxide nanorod arrays

Malek, M.F., Mamat, M.H., Ismail, A.S., Mohamed, R., Salifairus, M.J., Khusaimi, Z., et al.

Science Letters, 2016;11(2):36-40.
MyJurnal

We had successfully synthesised Mg-doped zinc oxide (MZO) and Cudoped zinc oxide (CZO) nanorod arrays (NRAs) on Al-doped ZnO (ZAO)-coated glass substrates using immersion method and investigated their structural properties. With the incorporation of the Mg dopant, the length and crystallinity of MZO NRAs is higher compared to that of the CZO NRAs. The average optical transmittance of MZO NRAs was slightly lower than that of the CZO NRAs over the visible wavelength region. With the incorporation of the Cu dopant, the morphology of the CZO sample was slightly different from that of the MZO NRAs. The CZO NRAs present granular with small sphere shape. On the other hand, the MZO NRAs exhibit a hexagonal shape structure with a flat-top facet. Rods with a diameter of 58.9-96.7 nm were uniformly grown on the ZAO-coated glass substrate. This paper presents the growth behaviors of the MZO and CZO NRAs.
An ELISA-disc procedure for antibodies toPseudomonas pseudomallei: application for a serological study of melioidosis in an endemic area

Embi N, Devarajoo D, Mohamed R, Ismail G

World J Microbiol Biotechnol, 1993 Jan;9(1):91-6.
PMID: 24419848 DOI: 10.1007/BF00656525

The optimization and development of an ELISA-disc procedure for the detection of antibodies to whole cell surface antigens and purified exotoxin ofPseudomonas pseudomallei is described. Comparison of the serum agglutination test (SAT), the serum based enzyme-linked immunosorbent assay (ELISA) and the ELISA-disc procedures used on goat and human sera demonstrated a high correlation in their ability to detect antibodies specific forP. pseudomallei antigens. A serological survey using the ELISA-disc method was carried out on a normal human population in Sabah, Malaysia, an area known to be endemic for melioidosis. The prevalances of antibodies towards cell surface antigens and exotoxin ofP. pseudomallei were 28% and 8%, respectively. As a procedure, the ELISA-disc technique reported here is technically simple and provides savings in costs and is thus deemed suitable for seroepidemiological surveillance of melioidosis in remote areas of South-East Asia.
Abnormality in DNA-protein binding in ataxia-telangiectasia nuclear extracts

Mohamed R, Lavin MF

Biochem Biophys Res Commun, 1989 Feb 15;158(3):749-54.
PMID: 2537634

Anomalies in DNA replication, repair and recombination in ataxia-telangiectasia (A-T) point to a defect in structure or function of chromatin. In this study we have compared DNA-protein binding in nuclear extracts from control and A-T cells using two assay systems, filter-binding and DNA-accessibility. Interestingly, the extent of DNA protein binding over a range of protein concentration was significantly lower in A-T extracts. In addition the accessibility of the restriction enzyme Eco R1 to protein-bound plasmid was greater when A-T extracts were used. This is in keeping with the reduced binding observed in the filter-binding assay.
Prevalence of antibodies to Pseudomonas pseudomallei exotoxin and whole cell antigens in military personnel in Sabah and Sarawak, Malaysia

Embi N, Suhaimi A, Mohamed R, Ismail G

Microbiol. Immunol., 1992;36(8):899-904.
PMID: 1474938

Sera from 420 military personnel serving in Sabah and Sarawk, Malaysia, were tested for antibodies to Pseudomonas pseudomallei exotoxin and whole cell antigens by enzyme-linked immunosorbent assay procedure (ELISA). Data showed that 54.4% of serum samples were positive for antibodies to P. pseudomallei exotoxin and 65.7% were positive for antibodies to the whole cell antigens. Samples gave much lower titers for anti-exotoxin antibodies compared to titers against crude whole cell antigens. The incidence of antibody to exotoxin was highest in the age groups ranging from 26 to 32 years, where the positive rates were higher than 40% and 30% for military personnel serving in Sarawak and Sabah, respectively.
Group B streptococci in a maternity unit

Jamal F, Mohamed R, Zainal Z, Arshat H

Med J Malaysia, 1979 Jun;33(4):349-51.
PMID: 574917
Plant cytochrome P450s: nomenclature and involvement in natural product biosynthesis

Rasool S, Mohamed R

Protoplasma, 2016 Sep;253(5):1197-209.
PMID: 26364028 DOI: 10.1007/s00709-015-0884-4

Cytochrome P450s constitute the largest family of enzymatic proteins in plants acting on various endogenous and xenobiotic molecules. They are monooxygenases that insert one oxygen atom into inert hydrophobic molecules to make them more reactive and hydro-soluble. Besides for physiological functions, the extremely versatile cytochrome P450 biocatalysts are highly demanded in the fields of biotechnology, medicine, and phytoremediation. The nature of reactions catalyzed by P450s is irreversible, which makes these enzymes attractions in the evolution of plant metabolic pathways. P450s are prime targets in metabolic engineering approaches for improving plant defense against insects and pathogens and for production of secondary metabolites such as the anti-neoplastic drugs taxol or indole alkaloids. The emerging examples of P450 involvement in natural product synthesis in traditional medicinal plant species are becoming increasingly interesting, as they provide new alternatives to modern medicines. In view of the divergent roles of P450s, we review their classification and nomenclature, functions and evolution, role in biosynthesis of secondary metabolites, and use as tools in pharmacology.
Short-term effect of atorvastatin on endothelial function in healthy offspring of parents with type 2 diabetes mellitus

Amudha K, Choy AM, Mustafa MR, Lang CC

Cardiovasc Ther, 2008;26(4):253-61.
PMID: 19035876 DOI: 10.1111/j.1755-5922.2008.00064.x

Endothelial function is impaired in healthy subjects at risk of type 2 diabetes mellitus (DM). We investigated whether endothelial dysfunction can be normalized by statin therapy in this potentially predisposed population. Flow-mediated dilation (FMD) was measured in 56 first-degree relatives (FDRs) (normotensive, normal glucose tolerance) and 20 age-, sex-, and BMI-matched controls with no family history of DM. Other measurements included insulin resistance index using the homeostasis model of insulin resistance (HOMA(IR)), plasma lipids, and markers of inflammation. The FDRs were then randomized and treated with atorvastatin (80 mg) or placebo daily in a 4-week double-blind, placebo-controlled trial. The FDRs had significantly impaired FMD (4.4 +/- 8.1% vs. 13.0 +/- 4.2%; P < 0.001), higher HOMA(IR) (1.72 +/- 1.45 vs. 1.25 +/- 0.43; P = 0.002), and elevated levels of plasma markers of inflammation-highly sensitive C-reactive protein (hsCRP) (2.6 +/- 3.8 mg/L vs. 0.7 +/- 1.0 mg/L; P = 0.06), interleukin (IL)-6 (0.07 +/- 0.13 ng/mL vs. 0.03 +/- 0.01 ng/mL; P < 0.001), and soluble intercellular adhesion molecule (sICAM) (267.7 +/- 30.7 ng/mL vs. 238.2 +/- 20.4 ng/mL; P < 0.001). FMD improved in the atorvastatin-treated subjects when compared with the placebo-treated subjects (atorvastatin, from 3.7 +/- 8.5% to 9.8 +/- 7.3%; placebo, from 3.9 +/- 5.6% to 4.7 +/- 4.2%; P = 0.001). There were also reductions in the levels of IL-6 (0.08 +/- 0.02 ng/mL vs. 0.04 +/- 0.01 ng/mL; P < 0.001) and hsCRP (3.0 +/- 3.9 mg/L vs. 1.0 +/- 1.3 mg/L; P = 0.006). Our study suggests that treatment with atorvastatin may improve endothelial function and decrease levels of inflammatory markers in FDRs of type 2 DM patients.
Removal of caffeine from aqueous solution by indirect electrochemical oxidation using a graphite-PVC composite electrode: A role of hypochlorite ion as an oxidising agent

Al-Qaim FF, Mussa ZH, Othman MR, Abdullah MP

J Hazard Mater, 2015 Dec 30;300:387-397.
PMID: 26218306 DOI: 10.1016/j.jhazmat.2015.07.007

The electrochemical oxidation of caffeine, a widely over-the-counter stimulant drug, has been investigated in effluent wastewater and deionized water (DIW) using graphite-poly vinyl chloride (PVC) composite electrode as anode. Effects of initial concentration of caffeine, chloride ion (Cl(-)) loading, presence of hydrogen peroxide (H2O2), sample volume, type of sample and applied voltage were determined to test and to validate a kinetic model for the oxidation of caffeine by the electrochemical oxidation process. The results revealed that the electrochemical oxidation rates of caffeine followed pseudo first-order kinetics, with rate constant values ranged from 0.006 to 0.23 min(-1) depending on the operating parameters. The removal efficiency of caffeine increases with applied voltage very significantly, suggesting a very important role of mediated oxidation process. However, the consumption energy was considered during electrochemical oxidation process. In chloride media, removal of caffeine is faster and more efficiently, although occurrence of more intermediates takes place. The study found that the adding H2O2 to the NaCl solution will inhibit slightly the electrochemical oxidation rate in comparison with only NaCl in solution. Liquid chromatography-time of flight-mass spectrometry (LC-TOF-MS) technique was applied to the identification of the by-products generated during electrochemical oxidation, which allowed to construct the proposed structure of by-products.
Inhibition of macromolecular synthesis in cultured macrophages by Pseudomonas pseudomallei exotoxin

Mohamed R, Nathan S, Embi N, Razak N, Ismail G

Microbiol. Immunol., 1989;33(10):811-20.
PMID: 2615673

Pseudomonas pseudomallei exotoxin was found to be a potent inhibitor of protein and DNA synthesis in cultured macrophages. Inhibition of DNA synthesis occurred at toxin concentrations as low as 1-2 micrograms/ml and inhibition of 3H-thymidine uptake was almost complete at concentrations of 8 micrograms/ml or more. A close correlation between cell damage and inhibition by DNA synthesis was observed. For protein synthesis, inhibition was obtained at much lower doses (0.06-2.0 micrograms/ml) of the toxin. At similar toxin concentrations, DNA synthesis was marginally affected. Further, it was shown that protein synthesis inhibition occurred almost immediately after incubation, reaching its maximal inhibitory effect of 70% after 6 hr. DNA synthesis, however, was minimally affected by a similar toxin concentration even after 10 hr of incubation. The inhibition of macromolecular synthesis in macrophages by P. pseudomallei exotoxin may be relevant to its modulatory effect on the host defense mechanism.
Resistance of Pseudomonas pseudomallei to normal human serum bactericidal action

Ismail G, Razak N, Mohamed R, Embi N, Omar O

Microbiol. Immunol., 1988;32(7):645-52.
PMID: 3193910

The effect of human normal serum (HNS) on Pseudomonas pseudomallei was determined. It is apparent from our data that the organism is resistant to the normal serum bactericidal mechanism. Ancillary experiments to confirm this serum-resistant property of P. pseudomallei were done by examining the effects of growth phase conditions of the bacteria (i.e., logarithmic and stationary phases) and different buffered systems used as diluent in our bactericidal assay. Results obtained showed similar degree of resistance to serum bactericidal killing by 5 strains of the organisms tested. The possible survival advantage of serum-resistance property to P. pseudomallei as bacterial pathogens known to invade the blood stream is discussed.
Sexual education in malaysia: accepted or rejected?

Mohd Mutalip SS, Mohamed R

Iran J Public Health, 2012;41(7):34-9.
PMID: 23113207

BACKGROUND: Introduction to sexual education in schools was suggested by the Malaysian government as one of the effort taken in the aim to reduce the sexual-related social problems among Malaysian teenagers nowadays. This study was proposed in the aim to determine the rate of acceptance among adolescents on the implementation of sexual education in schools.
METHODS: This study was conducted using questionnaires distributed to 152 pre-degree students in Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Kampus Puncak Alam, Selangor, Malaysia. Obtained data were statistically analyzed.
RESULTS: Almost half (49.3%) of the respondents agreed that sexual education might help to overcome the social illness among school teenagers. Besides, a large number (77.6%) of respondents also agreed that this module should be incorporated with other core subjects compare to the feedback received on the implementation of this module on its own (28.9%).
CONCLUSION: These results have provided some insight towards the perception of sexual education among the teenagers. Since most of the respondents agreed with this idea, so it might be a sign that the implementation of sexual education is almost accepted by the adolescents.
Transcriptome analysis of Burkholderia pseudomallei T6SS identifies Hcp1 as a potential serodiagnostic marker

Chieng S, Mohamed R, Nathan S

Microb Pathog, 2015 Feb;79:47-56.
PMID: 25616255 DOI: 10.1016/j.micpath.2015.01.006

Burkholderia pseudomallei, the causative agent of melioidosis, is able to survive extreme environments and utilizes various virulence factors for survival and pathogenicity. To compete and survive within these different ecological niches, B. pseudomallei has evolved specialized pathways, including the Type VI secretion systems (T6SSs), that have a role in pathogenesis as well as interbacterial interactions. We examined the expression profile of B. pseudomallei T6SS six gene clusters during infection of U937 macrophage cells. T6SS-5 was robustly transcribed while the other five clusters were not significantly regulated proposing the utility of T6SS-5 as a potential biomarker of exposure to B. pseudomallei. Transcription of T6SS regulators VirAG and BprB was also not significant during infection when compared to bacteria grown in culture. Guided by these findings, three highly expressed T6SS genes, tssJ-4, hcp1 and tssE-5, were expressed as recombinant proteins and screened against melioidosis patient sera by western analysis and ELISA. Only Hcp1 was reactive by both types of analysis. The recombinant Hcp1 protein was further evaluated against a cohort of melioidosis patients (n = 32) and non-melioidosis individuals (n = 20) sera and the data clearly indicates a higher sensitivity (93.7%) and specificity (100%) for Hcp1 compared to bacterial lysate. The detection of anti-Hcp1 antibodies in patients' sera indicating the presence of B. pseudomallei highlights the potential of Hcp1 to be further developed as a serodiagnostic marker for melioidosis.
Fulltext Stimulatory Secretions of Airway Epithelial Cells Accelerate Early Repair of Tracheal Epithelium

Kardia E, Mohamed R, Yahaya BH

Sci Rep, 2017 09 15;7(1):11732.
PMID: 28916766 DOI: 10.1038/s41598-017-11992-6

Airway stem/progenitor epithelial cells (AECs) are notable for their differentiation capacities in response to lung injury. Our previous finding highlighted the regenerative capacity of AECs following transplantation in repairing tracheal injury and reducing the severity of alveolar damage associated acute lung injury in a rabbit model. The goal of this study is to further investigate the potential of AECs to re-populate the tracheal epithelium and to study their stimulatory effect on inhibiting pro-inflammatory cytokines, epithelial cell migration and proliferation, and epithelial-to-mesenchymal transition (EMT) process following tracheal injury. Two in vitro culture assays were applied in this study; the direct co-culture assay that involved a culture of decellularised tracheal epithelium explants and AECs in a rotating tube, and indirect co-culture assay that utilized microporous membrane-well chamber system to separate the partially decellularised tracheal epithelium explants and AEC culture. The co-culture assays provided evidence of the stimulatory behaviour of AECs to enhance tracheal epithelial cell proliferation and migration during early wound repair. Factors that were secreted by AECs also markedly suppressed the production of IL-1β and IL-6 and initiated the EMT process during tracheal remodelling.
Fulltext Perception of family satisfaction with care at critical care setting Hospital University Sains Malaysia: a pilot study

Mahyiddin NS, Mohamed R, Jan Mohamed HJ

The Malaysian Journal of Nursing, 2015;7(1):32-37.
MyJurnal

Family members' satisfaction has become an important measurement in determining the quality of care of patients in the critical care setting. The aims of the study were to determine the satisfaction level of family members, to determine the reliability of family satisfaction and its subscales, to identify mean of each question and their subscales. A cross-sectional study was conducted on 30 family members who accompanied patients during intensive care admission. The study was conducted in a critical care setting in
a high dependency unit (HDU) and cardiac intensive care unit (CCU), Hospital University Sains Malaysia (Hospital USM). The data was collected from October 2012 to January 2013. The Critical Care Family Satisfaction Survey (CCFSS) Malay version was used to measure family satisfaction in addition to the collection of demographic data. The statistical analysis used a descriptive approach. Ethical approval was obtained prior to data collection. Majority of the respondents were female: 23 (76.7%). Mean age was 35.67 years (SD=12.83) and the score of overall satisfaction level was 78.80 (SD=13.88). The Cronbach's alpha was 0.96. A majority of the respondents, 19 (63.3%) were satisfied with the care provided. This study showed that a majority of family members were slightly satisfied with the care that was provided in a critical
care setting at HUSM. It also showed that families play an important role in giving support and hope to patients.
Study site: HDU and CCU, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Fulltext A New Method for a Piezoelectric Energy Harvesting System Using a Backtracking Search Algorithm-Based PI Voltage Controller

Sarker MR, Mohamed A, Mohamed R

Micromachines (Basel), 2016 Sep 23;7(10).
PMID: 30404344 DOI: 10.3390/mi7100171

This paper presents a new method for a vibration-based piezoelectric energy harvesting system using a backtracking search algorithm (BSA)-based proportional-integral (PI) voltage controller. This technique eliminates the exhaustive conventional trial-and-error procedure for obtaining optimized parameter values of proportional gain (Kp), and integral gain (Ki) for PI voltage controllers. The generated estimate values of Kp and Ki are executed in the PI voltage controller that is developed through the BSA optimization technique. In this study, mean absolute error (MAE) is used as an objective function to minimize output error for a piezoelectric energy harvesting system (PEHS). The model for the PEHS is designed and analyzed using the BSA optimization technique. The BSA-based PI voltage controller of the PEHS produces a significant improvement in minimizing the output error of the converter and a robust, regulated pulse-width modulation (PWM) signal to convert a MOSFET switch, with the best response in terms of rise time and settling time under various load conditions.
Fulltext Phylogenetic Relatedness of Several Agarwood-Producing Taxa (Thymelaeaceae) from Indonesia

Lee SY, Turjaman M, Mohamed R

Trop Life Sci Res, 2018 Jul;29(2):13-28.
PMID: 30112138 MyJurnal DOI: 10.21315/tlsr2018.29.2.2

Indonesia is home to several tree taxa that are harvested for agarwood. This highly valuable oleoresin ironically was the cause for some species to become vulnerable due to gluttonous human activity. However, information on the genetic diversity of these endangered trees is limited. In this study, 28 specimens representing eight species from two genera, Aquilaria and Gyrinops, were collected from ex-situ and in-situ populations in Indonesia. Phylogenetic analysis conducted on DNA sequences of the nuclear ribosomal internal transcribed spacer (ITS) and the trnL-trnF intergenic spacer regions, revealed that Aquilaria and Gyrinops are paraphyletic when Aquilaria cumingiana is excluded. The phylogenetic analysis for ITS and trnL-trnF showed capability to categorise agarwood-producing species based on their regions: East Indonesia and West Indonesia, using Wallace's Line as the divider. In addition, we discuss challenges in species identification and taxonomy of agarwood-producing genera, and their conservation efforts in Indonesia.
Method validation and determination of heavy metals in cocoa beans and cocoa products by microwave assisted digestion technique with inductively coupled plasma mass spectrometry

Mohamed R, Zainudin BH, Yaakob AS

Food Chem, 2020 Jan 15;303:125392.
PMID: 31446362 DOI: 10.1016/j.foodchem.2019.125392

In this article, an easy and quick method based on microwave assisted acid digestion technique prior to quantification using inductively coupled plasma mass spectrometry for the analysis of heavy metals in cocoa beans, cocoa powder and chocolate was established and validated for arsenic (As), cadmium (Cd), lead (Pb), and antimony (Sb). Limit of quantification for all elements were product dependent and varies from 7.84 to 194.52 µg/kg. The recoveries of the heavy metals at 250 and 1000 µg/kg spiking levels were ranged between 96.27-108.75%, 90.43-101.97% and 89.72-106.26% for cocoa beans, cocoa powder, and chocolate, respectively. Relative standard deviation values obtained were all below 20% and the expanded uncertainty measurements for the elements were less than 25%. The analysis of real samples found that the concentration level is far from the national alarming level except for cadmium in cocoa beans.
Gynura procumbens ethanol extract and its fractions inhibit macrophage derived foam cell formation

Manogaran M, Vuanghao L, Mohamed R

J Ethnopharmacol, 2020 Mar 01;249:112410.
PMID: 31747560 DOI: 10.1016/j.jep.2019.112410

ETHNOPHARMACOLOGY RELEVANCE: Gynura procumbens (Lour.) Merr. displayed cardio-protective effect that may prevent atherogenesis. The primary underlying pathological process of cardiovascular disease is atherosclerosis. Atherosclerotic lesion composed of macrophages, T cells and other immune cells which incorporated with cholesterol that infiltrates from the blood.
AIM OF THE STUDY: The present study was performed to determine underlying mechanism of G. procumbens ethanol extract and its fractions such as aqueous, chloroform, ethyl acetate and hexane affect macrophage derived foam cell formation.
MATERIALS AND METHODS: Lipid droplets accumulation in treated macrophages were visualized by Oil Red O staining while the total cholesterol present in the treated macrophages were measured using Cholestryl Ester quantification assay kit. Enzyme-Linked Immunosorbent Assay (ELISA) were used to detect TNF-α and IL-1β secretion in the supernatant of treated macrophages. Gene expression of Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and ATP-binding cassette transporter A-1 (ABCA-1) in treated macrophages were analyzed using Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR).
RESULTS: G. procumbens ethanol extract and its fractions reduced lipid droplet accumulation and total cholesterol in oxLDL-treated macrophages together with significantly reduction of TNF-α and IL-1β secretions in supernatant oxLDL-treated macrophages. LOX-1 gene expression was significantly reduced when G. procumbens ethanol extract and its fractions were added in oxDL-treated macrophages. In contrast, G. procumbens ethanol extract and its fractions significantly increased the expression of ABCA-1 gene in oxLDL-treated macrophages.
CONCLUSION: In conclusion, G. procumbens ethanol extract and its fractions inhibit the formation of macrophage derived foam cell by reducing TNF-α and IL-1β expression, which usually highly expressed in atherosclerotic plaques, suppressing scavenger receptor LOX-1 gene that binds oxLDL but induced ABCA-1 gene that mediate lipid efflux from macrophages.
Fatty liver is associated with advanced fibrosis but does not predict adverse outcomes in patients with chronic hepatitis B

Wong SW, Chan WK, Mohamed R

J Viral Hepat, 2020 12;27(12):1297-1305.
PMID: 32668489 DOI: 10.1111/jvh.13361

Hepatic steatosis is increasingly common and has been implicated in progression of liver fibrosis in chronic hepatitis B (CHB) patients. We aimed to investigate the impact of hepatic steatosis on liver fibrosis and clinical outcomes in CHB patients. Consecutive CHB patients who underwent transient elastography between 2013 and 2017 at a tertiary hospital were included in this longitudinal cohort study. Presence of hepatic steatosis was defined as controlled attenuation parameter, CAP ≥ 248 dB/m, while advanced liver fibrosis was defined as liver stiffness measurement, LSM ≥ 9.4 kPa. Cardiovascular events, liver-related complications, malignancy and mortality and a composite of these outcomes were evaluated with Kaplan-Meier analysis and Cox proportional hazards regression. Our study cohort included 614 patients with median follow-up of 45 (32-63) months. Hepatic steatosis was present in 294 patients (47.9%), and advanced liver fibrosis was present in 127 patients (21.0%). Presence of hepatic steatosis (OR: 1.956, 95% CI: 1.250-3.060) and diabetes mellitus (OR: 3.507, 95% CI: 2.069-5.944) was independently associated with advanced fibrosis. Advanced fibrosis was independently associated with composite outcome (HR: 2.496, 95% CI: 1.352-4.606), liver-related complications (HR: 3.765, 95% CI: 1.380-10.271) and mortality (HR: 3.632, 95% CI: 1.342-9.826), but not cardiovascular events and malignancy. Hepatic steatosis was not associated with any adverse outcomes. We conclude that hepatic steatosis is common and associated with advanced fibrosis in CHB patients. Unlike advanced fibrosis, hepatic steatosis does not predict adverse outcomes in CHB patients.

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