Women are at a higher risk of metabolic syndrome in rural Malaysia

Effects of sociodemographic and socioeconomic factors on stroke development in Lebanese patients with atrial fibrillation: a cross-sectional study

Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4 to 5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic and socioeconomic factors on stroke development in patients with AF.

Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA ₂DS ₂-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Data was collected through a survey that was distributed to all eligible patients.

Results: A total of 524 patients were enrolled in the study with a mean age (± SD) of 58.75 ± 13.59 years with hypertension (78.4%) being the most predominant disease. The results showed that obesity (Beta=0.61, p-value =0.011), retirement and unemployment compared to employment (Beta=1.44 and 1.44, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.38, p-value =0.001) were significantly associated with higher CHA ₂DS ₂-VASc scores whereas high versus low socio-economic status (Beta=-1.03, p=0.009) and high school education versus primary education level (Beta=-0.49, p-value=0.025) were significantly associated with lower CHA ₂DS ₂-VASc scores.

Conclusions: The study highlights that the CHA ₂DS ₂-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.

Effects of sociodemographic and socioeconomic factors on stroke development in Lebanese patients with atrial fibrillation: a cross-sectional study

Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4-5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic factors on stroke development in patients with AF. Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA ₂DS ₂-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Results: A total of 524 patients were enrolled in the study with a mean age of 58.75 (± SD) ± 13.59 years with hypertension (78.38%) being the most predominant disease. The results showed that obesity (Beta=0.610, p-value =0.011), retirement and unemployment compared to employment (Beta=1.440 and 1.440, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.380, p-value =0.001) were significantly associated with higher CHA ₂DS ₂-VASc scores whereas high versus low socio-economic status (Beta=-1.030, p=0.009) and high school education versus primary education level (Beta=-0.490, p-value=0.025) were significantly associated with lower CHA ₂DS ₂-VASc scores. Conclusions: The study highlights that the CHA ₂DS ₂-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.

Socioeconomic inequalities in abdominal obesity among Peruvian adults

Objectives

Abdominal obesity (AO) has become a public health issue due to its impact on health, society and the economy. The relationship between socioeconomic disparities and the prevalence of AO has yet to be studied in Peru. Thus, our aim was to analyze the socioeconomic inequalities in AO distribution defined using the International Diabetes Federation (IDF) cut-off points in Peruvian adults in 2018–2019.

Methods

This was a cross-sectional study using data from the 2018–2019 Demographic and Family Health Survey (ENDES) of Peru. We analyzed a representative sample of 62,138 adults over 18 years of age of both sexes from urban and rural areas. Subjects were grouped into quintiles of the wealth to calculate a concentration curve and the Erreygers Concentration Index (ECI) in order to measure the inequality of AO distribution. Finally, we performed a decomposition analysis to evaluate the major determinants of inequalities.

Results

The prevalence of AO among Peruvian adults was 73.8%, being higher among women than men (85.1% and 61.1% respectively, p < 0.001). Socioeconomic inequality in AO was more prominent among men (ECI = 0.342, standard error (SE) = 0.0065 vs. ECI = 0.082, SE = 0.0043). The factors that contributed most to inequality in the prevalence of AO for both sexes were having the highest wealth index (men 37.2%, women 45.6%, p < 0.001), a higher education (men 34.4%, women 41.4%, p < 0.001) and living in an urban setting (men 22.0%, women 57.5%, p < 0.001).

Conclusions

In Peru the wealthy concentrate a greater percentage of AO. The inequality gap is greater among men, although AO is more prevalent among women. The variables that most contributed to inequality were the wealth index, educational level and area of residence. There is a need for effective individual and community interventions to reduce these inequalities.

Prevalence of metabolic syndrome among breast cancer survivors in East Coast of Peninsular Malaysia

Background

To date, limited data are available on metabolic syndrome prevalence among breast cancer survivors in Malaysia. Therefore, this study was conducted to determine the prevalence of metabolic syndrome and abnormal metabolic syndrome components among breast cancer survivors in East Coast of Peninsular Malaysia.

Methods

This cross-sectional study included 95 breast cancer survivors (age 53.7 ± 7.6 years) who have completed main cancer treatments for ≥6 months. Cancer survivors were recruited from two main government hospitals in Kelantan and Terengganu using a purposive sampling method.

Results

According to the Harmonized criteria, the metabolic syndrome prevalence was 50.5%. Among those with metabolic syndrome, the most prevalent abnormal metabolic components were triglycerides (91.2%), fasting blood glucose (79.6%) and HDL-c level (78.4%). Except for total cholesterol and LDL-c, all other metabolic syndrome components were significantly different (p < 0.05) between those with and without metabolic syndrome. Significant differences between metabolic syndrome and non-metabolic syndrome groups were found for weight, BMI, waist circumference, body fat percentage and cancer stages (p < 0.05). However, no significant relationship was reported between sociodemographic, clinical parameters and metabolic syndrome among breast cancer survivors in this study.

Conclusions

Metabolic syndrome was highly prevalent among breast cancer survivors. It is recommended for health care professionals to closely monitor and improve the triglycerides, blood glucose and HDL-c level of the breast cancer survivors under their care to control the detrimental effect of metabolic syndrome.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10288-9.

Association of job sectors with type 2 diabetes mellitus, hypercholesterolemia and obesity: a cross-sectional study from the Malaysian Cohort (TMC) project

Background

The investigation of risk factors of cardiovascular disease (e.g., major endocrine, nutritional and metabolic diseases) across job sectors is useful for targeted public health intervention. This study examined the occurrence of type 2 diabetes mellitus (T2DM), hypercholesterolemia and obesity in 21 job sectors in the general population.

Methods

A baseline cross-sectional analysis of the Malaysian Cohort was conducted, which included 105 391 adults. Multiple logistic regression analyses were conducted for these three diseases across 20 job sectors compared with the unemployed/homemaker sector.

Results

The prevalence of T2DM, hypercholesterolemia and obesity was 16.7%, 38.8% and 33.3%, respectively. The Accommodation & Food Service Activities and Transportation & Storage sectors had significantly higher odds for T2DM (adjusted [adj.] prevalence odds ratio [POR] 1.18, p=0.007 and adj. POR 1.15, p=0.008, respectively). No job sector had significantly higher odds for hypercholesterolemia compared with the unemployed/homemaker sector. Only the Accommodation & Food Service Activities sector had significantly higher odds for obesity (adj. POR 1.17, p≤0.001).

Conclusions

Many job sectors were significantly associated with lower odds of having these three diseases when compared with the unemployed/homemaker sector. These differing associations between diverse job sectors and these diseases are important for public health intervention initiatives and prioritization.

Is within-normal range liver enzymes associated with metabolic syndrome in adults?

BACKGROUND

Considering the clear association between metabolic syndrome and future cardiovascular disease, early detection of metabolic syndrome is important. This study was conducted to assess the correlation between metabolic syndrome components and within-normal-range of liver enzymes in Iranian adults.

METHODS

This cross-sectional study was comprised of 700 Iranian adults in the districts of East Azerbaijan-Iran in 2015. The levels of lipid profile and glucose were measured by enzymatic colorimetric methods. Weight, height, waist circumferences were measured with standard protocols. Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) were assessed using the ultraviolet method. The Pearson correlation and Logistic regression were used to for statistical analysis.

RESULTS

With increasing the number of metabolic abnormalities, the mean ALT level was increased significantly (P_trend=0.04). In women, the increase in AST and ALT with increasing the number of metabolic abnormalities was statistically significant (P_AST=0.01; P_ALT<0.001). In men, ALT level had significantly positive correlation with waist circumference (r=0.14, P<0.05), serum TG (r=0.16, P<0.05) and fasting plasma glucose (r=0.17, P<0.01). In women, there was a significant correlation between AST level and serum TG (r=0.15, P<0.05). A significant positive and negative correlation were found respectively between serum ALT and AST/ALT ratio and waist circumference, serum TG and fasting blood glucose. Women in the 4th quartile of ALT were 4.43 fold at an increased risk for metabolic syndrome outcome when compared to those in the first quartile [OR (95% CI): 4.43 (1.69, 11.63)]. In women, with increasing the quartiles of ALT within normal limits, the percent of participants with metabolic syndrome also increased significantly (P_trend=0.04).

CONCLUSIONS

Based on the results, the use of ALT and AST:ALT ratio as continuous biomarkers for early signaling of dysmetabolism especially in women could be encouraged.

Prevalence of Cancers of Female Organs among Patients with Diabetes Type 2 in Kelantan, Malaysia: Observations over an 11 Year Period and Strategies to Reduce the Incidence

INTRODUCTION

Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2). Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known.

OBJECTIVE

To determine the proportion of breast, cervical, ovarian and endometrial cancers among females with DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period.

MATERIALS AND METHODS

All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admitted to the Hospital were included in the study. The patient diabetic status was traced from the hospital medical records.

RESULTS

There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas over this period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860 (18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%) were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1% (51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer 23.3% (37/159).

CONCLUSIONS

There is a significant proportion of DM2 among women with these four cancers, endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend of these four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetes is prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening for these cancers among their female patients and gynecology clinics should screen the women they treat for their diabetes status.

Sociodemographic factors associated with multiple cardiovascular risk factors among Malaysian adults

BACKGROUND

To determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults.

METHODS

We analysed data on 1044 men and 1528 women, aged 24-64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors.

RESULTS

The response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors.

CONCLUSION

The prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.