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  1. Fulltext Tocotrienol rich fraction supplement reduces oxidative stress in non Familial Hypercholesterolaemia: beyond the lipid lowering capability
    Muid, S., Hamid, Z., Nawawi, H.
    International Food Research Journal, 2018;25(4):1410-1418.
    MyJurnal
    The beneficial effects of Palm Tocotrienol Rich Fraction (TRF) in the reduction of cholesterol and oxidative stress in human especially in Non-Familial Hypercholesterolaemia (NFH) patients are still lacking and need to be further investigated. In this clinical trial, 37 NFH patients were recruited and randomized to either Palmvitee (60 mg/day TRF) [NFHe; n= 12) and atorvastatin 10 mg/day (NFHs; n=25). Fasting serum lipids, F2 -isoprostanes, oxidized LDL (ox-LDL) and malondialdehyde (MDA) were measured at baseline (BL), 2 weeks and 12 weeks. NFHe group showed significant reduction in Total cholesterol, TC, LDL, MDA, F2 – isoprostanes and ox-LDL at 12 weeks compared to BL. NFHs group showed a reduction in TC, LDL and TG, MDA and F2 – isoprostanes in 12 weeks compared to the BL. NFHs had greater % change reduction of TC, LDL, TG and MDA than NFHe in 12 weeks. Despite that, NFHe and NFHs had comparable % reduction of F2–isoprostanes in 12 weeks. NFHe had greater % change reduction of ox-LDL than NFHs. In conclusion, TRF reduces cholesterol level in NFH patients even though it is not as efficient as statins. The ability of TRF in the reduction of oxidative stress especially F2-isoprostanes is comparable with statins. TRF has a great potential in the prevention of atherosclerosis in part not only due to its cholesterol lowering activity, but perhaps more effective as a potent antioxidant.
  2. Fulltext Low dose palm Tocotrienol-rich fraction reduces Aortic tissue endothelial activation in severely atherosclerotic rabbits
    Razak, A.A., Omar, E., Muid, S., Nawawi, H.
    Pertanika Journal of Science & Technology, 2017;25(108):63-72.
    MyJurnal
    Chronic inflammation plays a pivotal role in atherogenesis. Antioxidants have a potential role in the prevention and treatment of atherosclerosis. The effects of palm oil-derived tocotrienol-rich fraction (TRF) supplementation on inflammation are not well established. This study aims to investigate the effects of TRF supplementation on the inflammatory biomarkers and adhesion molecules in severe atherosclerosis. A total of 28 New Zealand white rabbits were given 1% high-cholesterol diet (HCD) for five months and randomised from the second month onwards into one of five intervention groups: Placebo, TRF 15, 30, 60 and 90 mg/kg/day. Treatment was given for three months and the animals were fed HCD throughout the duration. At the end of the study, the aortas were obtained, stained with Sudan IV, fixed in formalin, embedded in paraffin and immunostained for tissue intracellular adhesion molecule-1 (ICAM-1), interleukin-6 (IL-6), E-selectin, smooth muscle actin (SMA), and nuclear factor-κB (NF-κB). The amount of atherosclerotic lesions was not significantly different between the groups and compared to placebo. Qualitative analysis showed lower trend of ICAM-1, IL-6, E-selectin and NF-κB but higher trend of SMA tissue expression in TRF-treated groups especially at low dose of TRF (TRF-15) compared to placebo. Quantitative analysis showed lower ICAM-1 and E-select in positivity in TRF-15 compared to placebo group (25.1 ± 7.4 % vs. 3.8 ± 2.0 %, 23.2 ±6.5 % vs. 4.2± 2.1 %, respectively, p
  3. Fulltext Tocotrienols reduce monocytes adhesion to stimulated human endothelial cells
    Muid, S., Froemming, G.R.A., Rahman, T.H., Ali, A.M., Nawawi, H.
    International Food Research Journal, 2017;24(6):2580-2585.
    MyJurnal
    The anti-atherosclerotics activity of tocotrienols (TCT) compared to alpha-Tocopherol (α-TOC) in in vitro study is not much being reported especially in human endothelial cells. The aim of the present study was to study the effects of TTMF, TCT and α-TOC on monocytes adherence to stimulated endothelial cells and to investigate the correlation between monocytes adherence and adhesion molecules in endothelial cells treated with TTMF, pure TCT isomers and α-TOC. Human umbilical vein endothelial cells (HUVECs) were incubated with TTMF, TCT isomers and α-TOC (0.3-10 µM) together with lipopolysaccharide, LPS (1 μg/ml). Monocytes adherence was measured by Rose Bengal staining. Soluble ICAM-1, VCAM-1 and e-selectin and NFκB binding were measured by ELISA. TTMF and TCT isomers inhibit monocytes adhesion to LPS-stimulated HUVECs but not α-TOC. δ-TCT exhibit the highest % inhibition of monocytes adhesion compared to the other TCT isomers. Only TCT isomers show positive correlation of monocytes adhesion with certain adhesion molecules and NFκB but not TTMF and α-TOC. In conclusion, TTMF and TCT isomers exhibit reduction of adhesion of monocytes to LPS stimulated endothelial cells. The reduction of monocytes adhesion by TCT isomers especially δ-TCT are positively correlated with reduction of adhesion molecules and NFκB deactivation. It can be suggested that TCT especially the δ-TCT isomers is beneficial in the prevention of early atherogenesis in human.
  4. Fulltext Impact of container, temperature and microcarriers on inflammation and Endothelial activation in human Endothelial cells
    Muid, S., Froemming, G.R.A., Ali, A.M., Nawawi, H.
    Pertanika Journal of Science & Technology, 2017;25(107):263-274.
    MyJurnal
    Human umbilical vein endothelial cells (HUVECs) were cultured on microcarrier beads to accommodate different experiment apparatus such as rotating wall vessel. In this study, fluid operating apparatus (FPA) was used. However, the effect of inflammation and endothelial activation biomarkers in HUVECs cultured on different culture surface and containers are not well established. The effects of temperature changes on these biomarkers in HUVECs grown in FPA, a spaceflight hardware, are still unclear. The objective of this study was to compare the protein and gene expression of inflammation and endothelial activation biomarkers in (i) HUVECs cultured on microcarrier beads in conventional culture flask (CCFMC) vs. conventional culture flask (CCF) (ii) HUVECs cultured on microcarrier in FPA (FPAMC) vs. CCFMC and (iii) HUVEC cultured in FPAMC with ideal temperature (37°C) (FPAMC) vs. simulated space travel temperature(25-37°C), (FPAMC-ST). sICAM-1 and sVCAM-1protein expression in HUVECs grown in CCFMC were higher than CCF. FPAMC had higher IL-6, TNF-α, ICAM-1, VCAM-1, e-selectin, NFκB and eNOS gene expression than in CCFMC. FPAMC-ST had higher ICAM-1 and e-selectin protein expression than FPAMC- in ideal temperature. HUVECs are cultured onto microcarrier in simulated space flight temperature compared with ideal temperature had higher protein expression of sICAM-1 and e-selectin but the protein and gene expression of other biomarkers of inflammation and endothelial activation are comparable. This suggests that differences in culture surface and container are have an impact on the expression of inflammation and adhesion molecule by HUVECs.
  5. Fulltext Prevalence of coronary artery disease in young sudden death cases and correlation with post-mortem computed tomography calcium score
    Omar, E., Faizuddin, R., Mansharan, K., Razuin, R., Mahmood, M.S., Nurliza, A., et al.
    Journal of Clinical and Health Sciences, 2018;3(1):27-32.
    MyJurnal
    Introduction: Data on prevalence of coronary atherosclerosis and coronary artery disease (CAD) in young sudden death autopsy cases in Malaysia are still scarce. Calcium scoring (CS) on Computed Tomography (CT) was suggested to be predictive for CAD; however the reports have been conflicting. Objectives: to investigate (i) the prevalence of young CAD in sudden death cases in a Malaysian population; (ii) the association between CT CS and CAD in such cases and correlation with age. Methods: Sudden death cases received at the National Institute of Forensic Medicine, Kuala Lumpur between September 2012 and December 2013 were recruited. The cases were divided into young [≤40] and old [>40 years old] age groups. Presence of CAD was recorded during autopsy. Results: A total of 155 cases was included; 64.5% of the subjects were below 40 years old. CAD was the cause of death of 34 [21.9%] cases; of these, young individuals comprise 47.1% of cases [n=16; 10.3% of total cases, 16% of young sudden death cases]. Both young and old subjects with CAD had lower CS compared to those without CAD [p
  6. Serum levels of bone-specific alkaline phosphatase and procollagen type I carboxyterminal peptide in vitamin D deficiency
    Nawawi H, Girgis SI
    Southeast Asian J Trop Med Public Health, 2002;33 Suppl 2:124-30.
    PMID: 12755282
    Vitamin D deficiency in adults causes osteomalacia where there is a defect in bone mineralization resulting in an excess of unmineralised osteoid in the bone matrix. The aim of this study was to evaluate the markers of bone formation: total (TALP), bone-specific alkaline phosphatase (BSALP) and procollagen type I carboxyterminal peptide (PICP) in vitamin D deficiency. We studied 100 vitamin D deficient subjects and 82 gender-matched controls. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D level of less than 7 ng/ml, and greater than 10 ng/ml for normal controls. Serum TALP assay was performed by a standard automated method, BSALP and PICP were measured by enzyme immunoassays (Metra Biosystems) and vitamin D by radioimmunoassay. There was significant difference in the TALP between female vitamin D deficient and control subjects (mean +/- sem = 99.8 +/- 8.2 vs 70.5 +/- 2.8 iu/l, p<0.001). Elevated serum TALP (>130 iu/l) was found in 20% (20/100) of the vitamin D deficient patients. There were no significant differences in BSALP or PICP between vitamin D deficient patients and gender-matched control subjects. There was no correlation between vitamin D and PICP in patients but in control subjects, a significant negative correlation (r= -0.431, p<0.0001) was found. In conclusion, although elevated TALP was observed in a minority of vitamin D deficient patients, it is a better marker than PICP. The lack of PICP response in vitamin D deficient subjects suggests the possibility of vitamin D deficiency leading to a block in osteoblast differentiation.
  7. Fulltext Effects of water-based contrast media on experimentally induced established atherosclerotic plaques in rabbits.
    Isa MR, Mohd Noor N, Nawawi H, Kaur M., Rahman T, Mohd Kornain NK, et al.
    IIUM Medical Journal Malaysia, 2020;19(2):21-28.
    MyJurnal
    Imaging techniques involving optical coherence tomography, computed tomography (CT) and high-resolution magnetic resonance imaging (MRI) are used as tools to identify atherosclerotic plaques. However, the effects of water-based contrast media used in Post Mortem Computed Tomography Angiography (PMCTA) on the histopathology of atherosclerotic plaques have not been widely explored. The objective of this study is to determine the effects of water-based contrast media used in PMCTA on the histopathology of atherosclerotic plaques and biomarkers of atherosclerosis in experimentally induced established atherosclerotic rabbits. MATERIALS AND METHODS: Twenty male New Zealand white rabbits were divided into 2 groups. One group was given a high cholesterol diet (HCD) for 12 weeks to establish atherosclerosis and the control group normal diet (ND). Five rabbits from each group were then given intravenous water-based contrast media before being sacrificed. The entire length of aorta was dissected and submitted for histopathological examination and determination of tissue biomarkers α-SMA and MMP-9. RESULTS:Histopathological examination of the aorta including percentage of area covered by plaque and foam cell formation showed no significant difference in atheromatous plaque formation in both groups of HCD rabbits with or without intravenous contrast media injection (plaque: 55±41 vs. 63±15, p=0.731; foam cells: 124±83 vs. 171±55, p=0.325). Similarly, α-SMA and MMP-9 protein expression also showed no significant difference in both groups (α-SMA: 70±20 vs. 67±26, p=0.807; MMP-9: 60±12 vs. 57±17, p=0.785). CONCLUSION:Water-based contrast media used in PMCTA does not affect the morphology or the immunohistochemistry staining of SMA and MMP-9 in atherosclerotic plaques.
  8. External quality assurance in Malaysia
    Nawawi H, Lim HH, Zakiah I
    Southeast Asian J Trop Med Public Health, 1999;30 Suppl 3:39-45.
    PMID: 10926257
    An activity supportive of the MOH QA Programme, the National EQAS for clinical chemistry monitors for analytical performance in core routine biochemical testing by the pathology laboratories, with unsatisfactory performance scores serving to alert against deficiencies or problems and the scores in subsequent challenges providing the feedback of effectiveness of remedial actions taken. While unacceptable individual analyte performance score (variance index score, VIS) indicated problems in instruments, reagent and calibrators, or the use of inherently poorer methods, repeated occurrence of unsatisfactory OMRVIS was traceable to generally poor laboratory management of usually inadequately-equipment small laboratories. The outcome has been one of slow but gradual improvement in the overall performance of participating laboratories, with a move towards methods upgrading and standardization to achieve greater concordance of results. Presently, the programme is limited to 61 government and 4 private hospital laboratories in the country for 12 commonly assayed clinical biochemistry analytes. It is hoped that the NEQAS could be extended to the other private laboratories and that of academic institutions. However, this is dependent to a large extent on the manpower and financial support obtainable by the organizing body of the programme in the future. Belk and Sunderman, 1947 demonstrated that laboratories participating in an quality assessment scheme could rapidly and dramatically improve their analytical performance. In some countries, participation has become mandatory, and acceptable performance is a requirement in laboratory accreditation. The need and value of the NEQAP is, therefore, evident. While there may be limitations in the national programme. efforts are being made at improving the programme within the means and resources of the organising body. The goals of the NEQAP are not just to monitor performance but also to educate. On this, matters related to and supportive of these goals have also been pursued. The annual workshop/forum on quality controls had allowed exchange of information between representatives of participating laboratories and the organising body. Recently in the 1997 MOH Quality Improvement evaluation, Quality Control has been evaluated together with the other 17 such activities. The study on knowledge, attitude and practice has provided the necessary feedback and will be used for future planning in making efforts at increasing the effectiveness and benefits of the all QC activities including this NEQAP for clinical chemistry. In addition, there is a need to look into areas such as selection of methods and test systems, and improvement of continuing education, training as well as research in quality improvement as suggested by the Quality Improvement evaluation.
  9. Fulltext Interleukin-6 and intercellular cell adhesion molecule-1 expression remains elevated in revived live endothelial cells following spaceflight
    Muid S, Froemming GR, Ali AM, Nawawi H
    Malays J Pathol, 2013 Dec;35(2):165-76.
    PMID: 24362480 MyJurnal
    The effects of spaceflight on cardiovascular health are not necessarily seen immediately after astronauts have returned but can be delayed. It is important to investigate the long term effects of spaceflight on protein and gene expression of inflammation and endothelial activation as a predictor for the development of atherosclerosis and potential cardiovascular problems. The objectives of this study were to investigate the (a) protein and gene expression of inflammation and endothelial activation, (b) expression of nuclear factor kappa B (NFκB), signal transducer and activator of transcription-3 (STAT-3) and endothelial nitric oxide synthase (eNOS) in human umbilical vein endothelial cells (HUVEC) 3 months post-space flight travel compared to ground controls. HUVEC cultured on microcarriers in fluid processing apparatus were flown to the International Space Station (ISS) by the Soyuz TMA-11 rocket. After landing, the cells were detached from microcarriers and recultured in T-25 cm(2) culture flasks (Revived HUVEC). Soluble protein expression of IL-6, TNF-α, ICAM-1, VCAM-1 and e-selectin were measured by ELISA. Gene expression of these markers and in addition NFκB, STAT-3 and eNOS were measured. Spaceflight induced IL-6 and ICAM-1 remain elevated even after 3 months post spaceflight travel and this is mediated via STAT-3 pathway. The downregulation of eNOS expression in revived HUVEC cells suggests a reduced protection of the cells and the surrounding vessels against future insults that may lead to atherosclerosis. It would be crucial to explore preventive measures, in relation to atherosclerosis and its related complications.
  10. Fulltext The prognostic value of C-reactive protein (CRP) levels in patients with acute ischaemic stroke
    Hamidon BB, Sapiah S, Nawawi H, Raymond AA
    Med J Malaysia, 2004 Dec;59(5):631-7.
    PMID: 15889566 MyJurnal
    Increasing evidence suggests that inflammation plays an important role in the development of both cardiovascular and cerebrovascular events. Recently C-reactive protein (CRP) levels have been reported to be a prognostic factor for cerebrovascular and cardiovascular events. The main objective of the study was to evaluate the prognostic value of CRP levels in a first ever ischaemic stroke at one month. All ischaemic stroke patients who were admitted to Hospital Universiti Kebangsaan Malaysia (HUKM) between May 2002 and July 2002 were eligible for the study. CRP levels were taken within 72 hours after an acute ischaemic stroke. The functional ability was assessed using the Barthel Index (BI) after one month of stroke. During the study period 84 patients were admitted to HUKM with the diagnosis of ischaemic stroke; 49 patients were enrolled and 35 were excluded. Twenty-nine patients (59.2%) had elevated CRP levels (median 1.64+/-3.07 mg/dL, range 0.06 to 16.21 mg/dL). Elevated CRP levels were found to be a predictor of severe functional disability (BI<5) and were also associated with larger infarcts. In conclusion, elevated CRP levels are associated with poorer functional outcome and predict a larger infarct size.
  11. Reduction in serum levels of adhesion molecules, interleukin-6 and C-reactive protein following short-term low-dose atorvastatin treatment in patients with non-familial hypercholesterolemia
    Nawawi H, Osman NS, Yusoff K, Khalid BA
    Horm. Metab. Res., 2003 Aug;35(8):479-85.
    PMID: 12953165 DOI: 10.1055/s-2003-41805
    Hypercholesterolemia causes endothelial dysfunction, an early feature of atherosclerosis, leading to increased production of adhesion molecules and cytokines. The aim of this study was to investigate the effects of three months of treatment with low dose atorvastatin on serum levels of adhesion molecules, interleukin-6 (IL-6) and highly sensitive C-reactive protein (hs-CRP) in patients with non-familial hypercholesterolemia. Fifty-five patients with non-familial hypercholesterolemia were randomized to treatment with atorvastatin 10 mg/day or placebo for 3 months. Soluble intercellular adhesion molecules-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, IL-6 and hs-CRP levels were measured to assess the inflammatory activity of the endothelium. There was a significant reduction in ICAM-1 at 2 weeks (p<0.0001) with further reduction at 3 months (p<0.0001). At 3 months, there were significant reductions in VCAM-1 (p<0.02), IL-6 (p<0.0001) and hs-CRP (p<0.01), but an increase in E-selectin levels (p<0.002). Treatment with statin was an independent determinant of change in ICAM-1 (p<0.05) and IL-6 levels (p<0.05) after correcting for anthropometric indices, blood pressure and lipid profile. Low-dose atorvastatin treatment leads to reduction in proinflammatory markers of endothelial function, suggesting an attenuation of endothelial activation and improvement in endothelial function, independent of lipid lowering. This may lead to a reduction in the progression of atherosclerosis.
  12. Soluble intercellular adhesion molecule-1 and interleukin-6 levels reflect endothelial dysfunction in patients with primary hypercholesterolaemia treated with atorvastatin
    Nawawi H, Osman NS, Annuar R, Khalid BA, Yusoff K
    Atherosclerosis, 2003 Aug;169(2):283-91.
    PMID: 12921980
    Adhesion molecules and cytokines are involved in the pathogenesis of intimal injury in atherosclerosis but their relationship with endothelial function remains unclear. The objectives of this study were to examine the effects of atorvastatin on soluble adhesion molecules, interleukin-6 (IL-6) and brachial artery endothelial-dependent flow mediated dilatation (FMD) in patients with familial (FH) and non-familial hypercholesterolaemia (NFH). A total of 74 patients (27 FH and 47 NFH) were recruited. Fasting lipid profiles, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular-cellular adhesion molecule-1 (sVCAM-1), E-selectin, IL-6 and FMD were measured at baseline, 2 weeks, 3 and 9 months post-atorvastatin treatment (FH--80 mg/day, NFH--10 mg/day). In both groups, compared to baseline, sICAM-1 levels were significantly reduced at 2 weeks, further reduced at 3 months and maintained at 9 months (P<0.0001). The IL-6 levels were significantly reduced at 3 months and 9 months compared to baseline for FH (P<0.005) and NFH (P<0.0001). In both groups, the FMD at 2 weeks was higher than baseline (P<0.005), with progressive improvement up to 9 months. FMD was negatively correlated with sICAM-1 and IL-6. In conclusion, both low and high doses of atorvastatin lead to early progressive improvement in endothelial function in patients with primary hypercholesterolaemia. sICAM-1 and IL-6 levels reflect endothelial dysfunction in these patients.
  13. Fulltext Measurement of intima-media thickness of common carotid arteries using ultrasound in patients with familial and non-familial hypercholesterolaemia and correlation of intima-media thickness to obesity
    Nafikudin M, Nawawi H, Muid S, Annuar R, Yusoff K, Khalid BAK
    Med J Malaysia, 2003 Dec;58(5):647-52.
    PMID: 15190648
    Ultrasonographic measurements of the intima-media thickness (IMT) of common carotid arteries (CCA) were taken in 50 patients with familial hypercholesterolaemia (FH) and 57 patients with non-familial hypercholesterolemia (NFH). The lipid profile, body mass index (BMI) and waist-hip ratio (WHR) of each patient were recorded. In FH patients, the IMT was significantly higher in overweight and elevated WHR subgroups compared to the normal with significant correlations between BMI and WHR to the IMT. In NFH patients, the IMT was significantly higher in the elevated WHR compared to the normal subgroup but the correlations between either BMI or WHR to IMT were insignificant. These suggest that the environmentally modified anthropometric indices may have an effect on atherosclerosis in genetically determined hypercholesterolaemia in FH patients.
  14. Fulltext The 2019 Universiti Teknologi MARA, Malaysia Staff Survey: Determining the Level and Predictors of Quality of Life
    Nazali MIM, Razali S, Ariaratnam S, Ahmad Y, Nawawi H
    Front Psychiatry, 2021;12:705018.
    PMID: 34434129 DOI: 10.3389/fpsyt.2021.705018
    Experiencing good quality of life (QOL) among university staff is extremely crucial to ensuring academic excellence; however, there are limited data on factors that contribute to QOL among university staff. This study aims to determine the level and the predictors for good QOL among university staff. The consenting participants were selected using a stratified sampling method. Participants who had fulfilled the selection criteria were provided with socio-demographic, medical illness, job factor, and family background questionnaires. QOL and psychological well-being (depression, anxiety, and stress) were assessed using the World Health Organization Quality of Life brief version (WHOQOL-BREF) and Depression, Anxiety, and Stress Scale (DASS-21) questionnaires, respectively. A total of 278 staff (mean ± SD age: 38.84 ± 7.85 years, 44.2% males, 82.7% married) had participated in this study. This study found that participants had low QOL in the domains of physical health [P-QOL] (11.2%), psychological health [PSY-QOL] (9.7%), social relationships [SR-QOL] (19.1%), and environment [E-QOL] (14.4%). The predictors of P-QOL were depression, medical illness, and number of dependents, while those of PSY-QOL were work promotion, depression, medical illness, and number of dependents. Additionally, the predictors of SR-QOL were campus location, depression, and work promotion, while those of E-QOL were age, level of education, depression, work promotion, and medical illness. Depression significantly affected all domains of QOL. Younger participants without medical illness and those with tertiary level of education had increased odds of having good QOL. Participants having dependents without work promotion and employed in suburban areas had decreased odds of having good QOL. The relevant authority should be identified and then assist staff with difficulties to ensure the staff benefited from having a good QOL.
  15. Fulltext Obesity and its associated factors among older adults: MyHEBAT (Malaysian HEalth and Well-Being AssessmenT) study
    Kyaw TM, Ismail Z, Selamat MI, Nawawi H, MyHEBAT investigators
    Health Sci Rep, 2022 Jul;5(4):e668.
    PMID: 35866050 DOI: 10.1002/hsr2.668
    BACKGROUND: Despite being a preventable disease, the prevalence of obesity is rising progressively worldwide. However, the prevalence of obesity and its associated factors among older adults remains unclear in Malaysia. The aim of this study was to determine the prevalence of obesity and its associated factors among older adults who voluntarily attended the health screening programs, which were part of the Malaysian HEalth and Well-Being AssessmenT (My-HEBAT) Study.

    METHODS: Cross-sectional study was conducted among Malaysian adults, aged ≥60 years. A standardized self-administered questionnaire was used to gather information regarding socio-demographic status, personal, family and medical history. Anthropometric indices, blood pressure and physical examinations were conducted on site. Venous blood samples were collected for lipid profile and blood glucose analysis. Participants with BMI of ≥30 kg/m2 or < 30kg/m2 were classified as obese or non-obese respectively. Age was categorized into three subgroups: 60-69, 70-79, and ≥80 years old. The factors associated with obesity among older adults were then identified using multiple logistic regression.

    RESULTS: A total of 716 older adults aged ≥60 years (mean ± SD: 66.6 ± 6.0 years) were recruited. The prevalence of obesity among older adults was 15.8%, while higher prevalence was found among females (42.9%) compared to males (38.3%). The prevalence of obesity decreased with increasing age (48.5% in 60-69 years, 20.8% in 70-79 years, and 11.8% in ≥80 years).

    CONCLUSION: The prevalence of obesity among Malaysian population is higher than that of worldwide prevalence. Current national health promotion and educational programs should focus on identifying factors associated with obesity, and promotion of healthy lifestyle with obesity should be improved and modified, particularly for older adults in Malaysia.

  16. Fulltext Acute effects of acarbose on post-prandial glucose and triglycerides in type 2 diabetics following intake of different Malaysian foods
    Nawawi HM, Yazid TN, Ismail F, Khalid BA
    Asia Pac J Clin Nutr, 2000 Mar;9(1):41-5.
    PMID: 24394314
    Acarbose inhibits intestinal alpha-glucosidases resulting in diminished and delayed postprandial hyperglycaemia (PPH). Studies on effects of acarbose on postprandial lipaemia (PPL) have been inconclusive. Little is known about the effects of acarbose on PPH and PPL following intake of a polysaccharide diet. We studied 30 type 2 diabetic patients on dietary and/or oral hypoglycaemic agent(s). Thirty patients were recruited for food A (nasi lemak), 28 for food B (mee goreng) and 28 for food C (roti telur), which represent the typical diets of the three main races in Malaysia. Serial blood samples were taken at 15 min before and up to 240 min after each food intake, without acarbose. Subsequently, three doses of 50 mg acarbose were given orally and the same procedure was repeated the following day. There were significantly lower mean increments in plasma glucose levels after compared to before acarbose treatment 30, 45 and 60 min for food A and at 30, 45, 60, 120, 180 and 240 min for food C, but no significant difference was noted for food B. There was a significantly lower mean fasting glucose level after compared with before acarbose treatment following intake of food A and C but not food B. Short-term treatment with acarbose caused significant diminished and delayed PPH response with food A and C but not with food B. Acarbose was more effective in reducing PPH response in polysaccharide foods with a higher and earlier postprandial glucose peak than in those with a lower and lagged peak. There were no significant differences in the mean fasting or postprandial triglyceride levels before and after acarbose treatment, following intake of all three foods for up to 4 hours. Depending on the food absorption pattern, overnight low dose treatment with acarbose leads to diminished fasting and peak plasma glucose levels, and delayed PPH but insignificant reduction in postprandial lipaemia in poorly controlled type 2 diabetics following intake of racially different Malaysian food.
  17. Fulltext Homozygous familial hypercholesterolemia
    Alicezah MK, Razali R, Rahman T, Hoh BP, Suhana NH, Muid S, et al.
    Malays J Pathol, 2014 Aug;36(2):131-7.
    PMID: 25194536 MyJurnal
    We report a rare case of homozygous familial hypercholesterolemia (HoFH), a 22-year-old Malay woman who presented initially with minor soft tissue injury due to a cycling accident. She was then incidentally found to have severe xanthelasma and hypercholesterolemia (serum TC 15.3 mmol/L and LDL-C 13.9 mmol/L). She was referred to the Specialized Lipid Clinic and was diagnosed with familial hypercholesterolemia (FH) based on the Simon Broome (SB) diagnostic criteria. There was a family history of premature coronary heart disease (CHD) in that three siblings had sudden cardiac death, and of consanguineous marriage in that her parents are cousins. DNA screening of LDLR and APOB genes was done by Polymerase Chain Reaction (PCR), followed by Denaturing High Performance Liquid Chromatography (DHPLC). Homozygous mutation C255S in Exon 5 of her LDLR gene was found. There was no mutation was found in Exon 26 and Exon 29 of the APOB gene. This report is to emphasize the importance of identifying patients with FH and cascade screening through established diagnostic criteria and genetic studies in order to ensure early detection and early treatment intervention to minimize the risk of developing CHD and related complications.
  18. Fulltext Alteration of cell cytoskeleton and functions of cell recovery of normal human osteoblast cells caused by factors associated with real space flight
    Kapitonova MY, Salim N, Othman S, Muhd Kamauzaman TM, Ali AM, Nawawi HM, et al.
    Malays J Pathol, 2013 Dec;35(2):153-63.
    PMID: 24362479 MyJurnal
    Experiments involving short-term space flight have shown an adverse effect on the physiology, morphology and functions of cells investigated. The causes for this effect on cells are: microgravity, temperature fluctuations, mechanical stress, hypergravity, nutrient restriction and others. However, the extent to which these adverse effects can be repaired by short-term space flown cells when recultured in conditions of normal gravity remains unclear. Therefore this study aimed to investigate the effect of short-term spaceflight on cytoskeleton distribution and recovery of cell functions of normal human osteoblast cells. The ultrastructure was evaluated using ESEM. Fluorescent staining was done using Hoechst, Mito Tracker CMXRos and Tubulin Tracker Green for cytoskeleton. Gene expression of cell functions was quantified using qPCR. As a result, recovered cells did not show any apoptotic markers when compared with control. Tubulin volume density (p<0.001) was decreased significantly when compared to control, while mitochondria volume density was insignificantly elevated. Gene expression for IL-6 (p<0.05) and sVCAM-1 (p<0.001) was significantly decreased while alkaline phosphatase (p<0.001), osteocalcin and sICAM (p<0.05) were significantly increased in the recovered cells compared to the control ones. The changes in gene and protein expression of collagen 1A, osteonectin, osteoprotegerin and beta-actin, caused by short-term spaceflight, were statistically not significant. These data indicate that short term space flight causes morphological changes in osteoblast cells which are consistent with hypertrophy, reduced cell differentiation and increased release of monocyte attracting proteins. The long-term effect of these changes on bone density and remodeling requires more detailed studies.
  19. In-vitro expression of adhesion molecules and bone specific markers are depending on the cell culture material
    Salin N, Ishak AK, Abdul Rahman S, Ali M, Nawawi HM, Said MS, et al.
    Med J Malaysia, 2008 Jul;63 Suppl A:67-8.
    PMID: 19024987
    Bone formation is an active process whereby osteoblasts are found on the surface of the newly formed bone. Adhesion to extracellular matrix is essential for the development of bone however not all surfaces are suitable for osteoblast adhesion and don't support osteoblastic functions. The objective of this study was to test the suitability of a collagen based microcarrier which would support osteoblastic functions.
  20. Fulltext Real space flight travel is associated with ultrastructural changes, cytoskeletal disruption and premature senescence of HUVEC
    Kapitonova MY, Muid S, Froemming GR, Yusoff WN, Othman S, Ali AM, et al.
    Malays J Pathol, 2012 Dec;34(2):103-13.
    PMID: 23424772 MyJurnal
    Microgravity, hypergravity, vibration, ionizing radiation and temperature fluctuations are major factors of outer space flight affecting human organs and tissues. There are several reports on the effect of space flight on different human cell types of mesenchymal origin while information regarding changes to vascular endothelial cells is scarce. Ultrastructural and cytophysiological features of macrovascular endothelial cells in outer space flight and their persistence during subsequent culturing were demonstrated in the present investigation. At the end of the space flight, endothelial cells displayed profound changes indicating cytoskeletal lesions and increased cell membrane permeability. Readapted cells of subsequent passages exhibited persisting cytoskeletal changes, decreased metabolism and cell growth indicating cellular senescence.
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