MyMedR

Displaying all 6 publications

Abstract:

Sort:

Sensitivity and specificity of visual clinical assessment as compared to WHO 2006 standard and NCHS 1977 reference in measuring the growth status of Malaysian infants

Selamat R, Zain F, Raib J, Zakaria R, Marzuki MS, Ibrahim TF

J Am Coll Nutr, 2011 Dec;30(6):522-8.
PMID: 22331687

OBJECTIVE: To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year.
MATERIALS AND METHODS: A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software.
RESULTS: The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference.
CONCLUSION: The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.
Lifestyle intervention improves cardiometabolic profiles among children with metabolically healthy and metabolically unhealthy obesity

Wan Mohd Zin RM, Jalaludin MY, Md Zain F, Hong JYH, Ahmad Kamil NZI, Mokhtar AH, et al.

Diabetol Metab Syndr, 2024 Nov 11;16(1):268.
PMID: 39523406 DOI: 10.1186/s13098-024-01493-8

BACKGROUND: In recent years, there has been a surge of interest in the metabolic phenotype among children with obesity characterized by the absence of associated cardiometabolic risk factors (CRFs), known as metabolically healthy obesity (MHO), as opposed to those with metabolically unhealthy obesity (MUO). This study investigated the effect of lifestyle intervention on CRFs among children with MHO and MUO.
METHODS: A total of 102 school-aged children with obesity (54 girls and 48 boys) aged 8-16 years completed a 16-week school-based lifestyle modification intervention program, MyBFF@school Phase I. The intervention consisted of physical activity, healthy eating promotion, and psychological empowerment. MHO and MUO statuses were defined based on the 2018 consensus-based criteria. Fasting venous blood collection, body composition measurement, clinical assessment and physical fitness testing were conducted at baseline and at the end of week 16.
RESULTS: After the intervention, the CRFs of the children with MUO improved with significant decreases in systolic (p
Fulltext Tobacco Denormalization Indicator in the Prevalence of Positive Smoker Identity and Its Associated Factors

Ahmad MH, Ibrahim MI, Ab Rahman A, Musa KI, Mohd Zain F, Mohd Zain R, et al.

Int J Environ Res Public Health, 2020 Mar 31;17(7).
PMID: 32244417 DOI: 10.3390/ijerph17072363

Positive smoker identity (PSI) is a construct that evaluates the degree of smokers' positive thoughts, images and feeling about smoking behavior and culture. PSI encompasses the indicators related to tobacco denormalization strategy, which is one of the four WHO tobacco endgame strategies. PSmoQi is a newly validated instrument which could reliably assess PSI. This study's objectives were to determine the prevalence of positive smoker identity and its associated factors using PSmoQi. A sample of 253 smokers from government agencies in Kota Bharu City, Malaysia were recruited using invitation letters sent to their head of agencies. Data collection was done in a briefing session voluntary attended by the smokers. Factors associated with PSI were analyzed using Multiple Logistic Regression. The prevalence of smokers with positive smoker identity was 72.3%. Factors associated with positive smoker identity were older age (Adjusted Odds ratio; AOR: 1.042; 95% confident interval; CI: 1.004, 1.081); p = 0.028), higher smoking self-concept scale Malay version (SSCS-M) score (AOR: 1.216; 95% CI: 1.112, 1.329; p < 0.001), higher heaviness index (AOR: 1.002; 95% CI: 1.001, 1.004; p = 0.011) and lower educational attainment (AOR: 0.458; 95% CI: 0.233, 0.900; p = 0.024). This study shows a high prevalence of PSI among smokers from government agencies in Kota Bharu City. Factors such as age, SSCS-M score, heaviness index and educational attainment influenced the level of positive smoker identity in a smoker. The finding would contribute an evidentiary guideline in screening smokers for smoking cessation clinic enrollment to achieve the best interventional outcome, as well as it would provide an objective indicator for tobacco denormalization status in a population.
Fulltext Preserved glucagon-like peptide-1 responses to oral glucose, but reduced incretin effect, insulin secretion and sensitivity in young Asians with type 2 diabetes mellitus

Yeow TP, Pacini G, Tura A, Hor CP, Lim SL, Tan FH, et al.

BMJ Open Diabetes Res Care, 2017;5(1):e000352.
PMID: 28321312 DOI: 10.1136/bmjdrc-2016-000352

OBJECTIVE: Youth onset type 2 diabetes mellitus (YT2DM) is a globally rising phenomenon with substantial Asians representation. The understanding of its pathophysiology is derived largely from studies in the obese African-American and Caucasian populations, while studies on incretin effect are scarce. We examined the insulin resistance, β-cell function (BC), glucagon-like peptide (GLP)-1 hormone and incretin effect in Asian YT2DM.

RESEARCH DESIGN AND METHODS: This case-control study recruited 25 Asian YT2DM and 15 healthy controls, matched for gender, ethnicity and body mass index. Serum glucose, insulin, C peptide and GLP-1 were sampled during 2-hour oral glucose tolerance tests (OGTTs) and 1-hour intravenous glucose tolerance tests (IVGTTs). Insulin sensitivity was derived from the Quantitative Insulin Sensitivity Check Index (QUICKI), Oral Glucose Insulin Sensitivity Index (OGIS) in OGTT and surrogate index of SI from the minimal model (calculated SI, CSI). Acute insulin response (AIR) was obtained from IVGTT. Total BC was computed as incremental area under the curve of insulin/incremental area under the curve of glucose, during OGTT (BCOG) and IVGTT (BCIV), respectively. Disposition index (DI) was calculated using the product of insulin sensitivity and insulin secretion. GLP-1 response to oral glucose was calculated as incremental area under the curve of GLP-1 (ΔAUCGLP-1). Per cent incretin effect was estimated as 100×(BCOG-BCIV)/BCOG).

RESULTS: The YT2DM had marked impairment in BC (>80% reduction in AIR and BCOG, p<0.001) and lower QUICKI (p<0.001), OGIS (p<0.001) and CSI (p=0.015) compared with controls. There was no difference in GLP-1 at all time points and ΔAUCGLP-1 but the per cent incretin effect was reduced in the YT2DM compared with controls (12.1±8.93 vs 70.0±4.03, p<0.001).

CONCLUSIONS: Asian YT2DM showed similar GLP-1 response to oral glucose as controls but reduced incretin effect, BC and insulin sensitivity. The lack of compensatory mechanisms, as shown by the DI may be partly ascribed to the impaired incretin effect, similar to that of adult T2DM.

TRIAL REGISTRATION NUMBER: NMRR-12-1042-13254.
Dietary Practices and Meal Patterns among Overweight and Obese School Children in Malaysia: Baseline Data from a School-Based Intervention Study

Selamat R, Raib J, Abdul Aziz NA, Zulkafly N, Ismail AN, W Mohamad WNA, et al.

Ecol Food Nutr, 2019 11 22;59(3):263-278.
PMID: 31755310 DOI: 10.1080/03670244.2019.1694922

This study aimed to determine dietary practices and meal patterns among Malaysian overweight and obese school children at baseline. This study was part of a school-based obesity intervention study, My Body is Fit and Fabulous at School (MyBFF@school). It involved 1045 primary and 1041 secondary overweight and obese school children from a randomly selected 23 out of 1196 primary and 15 out of 416 secondary government schools in central Peninsular Malaysia. The results showed a significantly higher of adequate intake (4-8 servings/day) of cereals and grains among primary (54.7%) than secondary school children (48.2%). About 28.2% of primary and 32.6% of secondary school children had consumed adequate fruit (2 servings/day), while a very low percentage of both primary (5.0%) and secondary (3.6%) school children consumed adequate vegetables (3 servings/day). As for the meal patterns, school children in both primary and secondary were not taking breakfast regularly (mean±SD for primary: 3.16 ± 2.61 days/week vs secondary: 2.97 ± 2.52 days/week). There was also a significantly higher mean frequency of primary school children brought plain water to school than the secondary school children. In conclusion, urgent actions to address improper dietary practices and meal patterns of overweight and obese school children in Malaysia are warranted.
Fulltext Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity

Nur Zati Iwani AK, Jalaludin MY, Roslan FA, Mansor F, Md Zain F, Hong JYH, et al.

Front Public Health, 2023;11:1097675.
PMID: 37181686 DOI: 10.3389/fpubh.2023.1097675

BACKGROUND: The increasing severity of obesity is expected to lead to more serious health effects. However, there is limited information on the prevalence and clinical characteristics of cardiometabolic risk factors in severely children affected by obesity in Malaysia. This baseline study aimed to investigate the prevalence of these factors and their association with obesity status among young children.
METHODS: In this study, a cross-sectional design was employed using the baseline data obtained from the My Body Is Fit and Fabulous at school (MyBFF@school) intervention program involving obese school children. Obesity status was defined using the body mass index (BMI) z-score from the World Health Organization (WHO) growth chart. Cardiometabolic risk factors presented in this study included fasting plasma glucose (FPG), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood pressure, acanthosis nigricans, insulin resistance (IR), and MetS. MetS was defined using the International Diabetes Federation (IDF) 2007 criteria. Descriptive data were presented accordingly. The association between cardiometabolic risk factors, such as obesity status, and acanthosis nigricans with MetS was measured using multivariate logistic regression, which was adjusted for gender, ethnicity, and strata.
RESULTS: Out of 924 children, 38.4% (n = 355) were overweight, 43.6% (n = 403) were obese, and 18% (n = 166) were severely obese. The overall mean age was 9.9 ± 0.8 years. The prevalence of hypertension, high FPG, hypertriglyceridemia, low HDL-C, and the presence of acanthosis nigricans among severely children affected by obesity was 1.8%, 5.4%, 10.2%, 42.8%, and 83.7%, respectively. The prevalence of children affected by obesity who were at risk of MetS in <10-year-old and MetS >10-year-old was observed to be similar at 4.8%. Severely children affected by obesity had higher odds of high FPG [odds ratio (OR) = 3.27; 95% confdence interval (CI) 1.12, 9.55], hypertriglyceridemia (OR = 3.50; 95%CI 1.61, 7.64), low HDL-C (OR = 2.65; 95%CI 1.77, 3.98), acanthosis nigricans (OR = 13.49; 95%CI 8.26, 22.04), IR (OR = 14.35; 95%CI 8.84, 23.30), and MetS (OR = 14.03; 95%CI 3.97, 49.54) compared to overweight and children affected by obesity. The BMI z-score, waist circumference (WC), and percentage body fat showed a significant correlation with triglycerides, HDL-C, the TG: HDL-C ratio, and the homeostatic model assessment for IR (HOMA-IR) index.
CONCLUSIONS: Severely children affected by obesity exhibit a higher prevalence of and are more likely to develop cardiometabolic risk factors compared to overweight and children affected by obesity. This group of children should be monitored closely and screened periodically for obesity-related health problems to institute early and comprehensive intervention.