Prevalence of overweight and its associated factors among Malaysian adults: Findings from a nationally representative survey

A Study of Antioxidant, Antihyperlipidemic, and Anti-Glycation Effects of Alkylsulfonic Acids with Quinobenzothiazinyl Substituents: In Vitro and In Silico Investigations

Hyperlipidemia, marked by high levels of fats in the blood, is a major risk factor for non-communicable diseases such as type 2 diabetes, cardiovascular diseases, and cancer. It has been linked to the action of reactive oxygen species and the formation of advanced glycation end products. Current treatments for hyperlipidemia, like orlistat, simvastatin, and atorvastatin, often present undesirable side effects, prompting the need for new therapeutic agents that are safer, more effective, cost-efficient, and have fewer side effects. In this context, new compounds, specifically propano- and butanosulfonic acids with 9-substituted quinobenzothiazinyl substituents, were synthesized through reactions with 9-substituted quinobenzothiazines and propane sultone or butane sultone. These novel quinobenzothiazine derivatives were verified using 1H NMR, 13C NMR, and HR-MS techniques. The research focused on assessing these compounds for their toxicity, ability to prevent glycation, antioxidant properties, and their potential to combat hyperlipidemia. Toxicity was evaluated on the 3T3 L1 fibroblast cell line using the MTT assay. The capacity to prevent glycation was tested with bovine serum albumin-methylglyoxal and bovine serum albumin-glucose systems. This study measured total reactive oxygen species in the 3T3 L1 cell line using 2',7'-dichlorodihydrofluorescein diacetate staining, and antioxidant capacity was assessed through DPPH scavenging and metal ion chelation tests. The effectiveness against hyperlipidemia was determined by targeting cholesterol esterase and pancreatic lipase activities, with concentrations of the compounds 5 to 12 ranging from 0.0245 to 0.268 μM. Standard drugs such as orlistat, simvastatin, statins, and aminoguanidine were used as positive controls in various assays. Additionally, computational docking studies with AutoDock Vina were performed. The resulting findings indicated that the compounds were non-toxic to cells, effectively inhibited key enzymes related to hyperlipidemia, and showed significant antioxidant properties, including the prevention of advanced glycation end-product formation. Compounds 11 and 12 demonstrated the highest activity levels. These promising results highlight the potential of new quinobenzothiazine derivatives as lead compounds for the development of antihyperlipidemic drugs, although further research is necessary to confirm their efficacy and safety.

Cardiovascular disease incidence and its predictors among school teachers in Peninsular Malaysia: a prospective cohort study

Cardiovascular disease (CVD) caused substantial morbidity among occupationally active populations. However, data regarding the longitudinal burden of CVD were limited, particularly among school teachers. The objectives of our study were to estimate the incidence rate of CVD and determine its predictors among school teachers in Peninsular Malaysia through a prospective cohort study. We followed 14,046 eligible school teachers recruited between 2013 and 2014 until 31st December 2021. We accessed three computerised, country-level registries to determine incident CVD cases during the study period from 2013 to 2021. Baseline sociodemographic, lifestyle, work-related and clinical characteristics were recorded. Cox proportional hazard regression models with adjusted hazard ratio and 95% confidence interval were reported. With a median follow-up of 7.71 yr, we observed 209 incident CVD cases (or 195.7 CVD cases per 100,000 person-years). Male gender, age ≥40 yr old, Indian or others ethnicity (as compared to Chinese), family history of CVD, laboratory-confirmed diabetes mellitus, self-reported hypertension, high low-density lipoprotein cholesterol and high triglyceride were predictors for incident CVD among school teachers. Neither work-related nor lifestyle factors were significantly associated with incident CVD. Screening at-risk teachers for diabetes mellitus, hypertension or dyslipidemia is recommended to delay the onset or progression of CVD.

Factors associated with thrombosis among solid organ cancer patients in Kuala Lumpur, Malaysia

BACKGROUND

Patients with solid organ cancers are at increased risk of developing cancer-associated thrombosis (CAT), a complication driven by a complex interplay of patient-specific factors, cancer characteristics, and treatment modalities. Data on CAT and its associated risk factors within diverse ethnic groups, such as the Malaysian population, remains limited. This observational, cohort study aimed to address this gap by determining the incidence of CAT and identifying associated risk factors among multi-ethnic Malaysian patients with solid organ cancers.

METHODS

This study included solid organ cancer patients aged ≥ 18 who attended HCTM and HKL from May 2022 to August 2023. The baseline demographics, and clinical characteristics, were acquired at the cancer diagnosis. Data on cancer treatment, thrombotic events and anticoagulation therapy during the study and its treatment were documented. Multivariable logistic regression analysis was performed to determine the independent factors associated with CAT in solid organ cancer.

RESULTS

A total of 250 solid organ cancer patients were included, with a mean age of 57.7 (13.7) years. This multi-ethnic cohort consisted of mostly Malay patients (55.2%), followed by Chinese (33.2%) and Indian & others (11.6%). The prevalence of CAT at baseline was 4.8%, while the incidence of CAT during follow-up was 12%. Poor performance status and obesity were associated with CAT at baseline. Univariable logistic regression showed platelets ≥ 450 × 109/L and Khorana score ≥ 3 had significantly higher risks of CAT at baseline. Stage IV disease, radiotherapy and chemotherapy, namely platinum-based chemotherapy and antimetabolites were associated with CAT during follow-up. The ROC analysis showed that the KRS significantly predicted CAT (area under the curve, 0.701 (95%CI: 0.594-0.808, p = 0.001).

CONCLUSIONS

This study highlights the prevalence of CAT at baseline and the incidence of CAT during follow-up, similar to other studies. Patients' clinical characteristics were associated with CAT at baseline while disease and treatment factors were associated with CAT at follow-up. These findings emphasise the need for targeted thromboprophylaxis in high-risk populations and highlight the importance of risk stratification tools such as the Khorana score for optimal patient management. Future studies involving larger patient cohorts and longer study duration would be beneficial. These findings provide valuable insights to inform clinical decision-making, optimise patient outcomes, and minimise potential risks.

Who drives weight stigma? A multinational exploration of clustering characteristics behind weight bias against preconception, pregnant, and postpartum women

BACKGROUND

Weight bias is a global health challenge and community members are endorsed as the most common source of weight bias. The nature of weight biases specifically against preconception, pregnant, and postpartum (PPP) women from the perspective of community members is not known, especially in terms of cross-cultural trends. We investigated the magnitude of explicit and implicit weight bias and profiles of characteristics associated with harbouring weight bias.

METHODS

We conducted a multinational investigation of clusters of factors associated with weight bias against PPP women (May-July 2023). Community members from Australia, Canada, United States (US), United Kingdom (UK), Malaysia, and India completed a cross-sectional survey measuring explicit and implicit weight biases, beliefs about weight controllability, and awareness of sociocultural body ideals. Hierarchical multiple regression and latent profile analyses identified clusters of factors associated with weight bias.

RESULTS

Participants from India reported the lowest explicit weight bias (B = -0.45, p = 0.02). Participants from Australia (B = -0.14, p = 0.04) and the UK (B = -0.16, p = 0.02) (vs. US) reported the lowest implicit weight bias. Three distinct profiles were identified clustering on body mass index (BMI) and weight-controllability beliefs: low-BMI/moderate-beliefs, high-BMI/more biased beliefs, and high-BMI/less biased beliefs. Profile membership varied by country of residence and weight bias outcomes with low-BMI/moderate-beliefs profiles containing more people from non-Western countries and with low explicit weight bias.

CONCLUSIONS

Explicit and implicit weight bias was harboured by participants across all included nations, although less pronounced in non-Western countries. Our profiles highlight that individuals who held a stronger belief that weight is controllable, regardless of their body weight, should be targeted for interventions to eliminate weight stigma.

Post bariatric surgery complications, nutritional and psychological status

BACKGROUND AND OBJECTIVES

Bariatric surgery becomes the final option for managing severe obesity. This study aims to identify the complications, changes in anthropometry, adherence to dietary recommendations, and psychological well-being of post-bariatric surgery patients.

METHODS AND STUDY DESIGN

An observational study was conducted on 63 post-bariatric surgery patients who had undergone bariatric surgery between two weeks and five years after surgery. The participants were assessed for the complications experienced, current comorbidities, anthropometric changes, dietary intake, and psychological well-being. A three-day, 24-hour diet recall was done to assess the dietary intake of the patients. The mean macronutrient and micronutrient intakes were compared to several available recommendations. The DASS-21 questionnaire was administered to determine the psychological well-being of the participants.

RESULTS

The most common complications experienced by patients after bariatric surgery were hair loss (50.8%), gastroesophageal reflux disease (GERD) (49.2%), and vomiting (41.3%). There were significant differences in mean weight before (129.5 (33.0) kg/m2) and after (85.0 (32.0) kg/m2) bariatric surgery (p<0.001). The prevalence of clinically severe obesity declined by 55%. Overall, patients had insufficient intake of some nutrients such as protein, fat, calcium, and iron. Majority of the patients experienced a normal level of stress, anxiety, and depression, but some had mild (3.2%), moderate (4.8%), and severe anxiety (1.6%).

CONCLUSIONS

There were drastic improvements in patients' weight following bariatric surgery. However, there were several complications including nutrient deficiencies. Due to the anatomical changes in the gastrointestinal tract, patients must comply with the dietary and lifestyle changes and follow up with the healthcare professional. A nutrition module will be helpful for patients to prepare for and adapt to the changes after bariatric surgery.

Green honey of Banggi Island: A preliminary anti-diabetic study on zebrafish model

Zebrafish is a developing vertebrate model with several advantages, including its small size, and high experimental efficiency. Malaysia exhibit one of the highest diabetes rates in the Western Pacific and incurring an annual cost of 600 million US dollars. The objective of the study is to determine the antidiabetic properties of green honey (GH) using a zebrafish model. Adult zebrafish, aged 3-4 months, were subjected to overfeeding and treated with streptozotocin (STZ) through intraperitoneal injection (IP) on days 7 and 9. The study assessed the oral sucrose tolerance test (OSTT) and the anti-diabetic effects of green honey. The evaluation was conducted at three time points: 30, 60, and 120 min after treatment and sucrose administration. The study utilised a model with a sample size of 5. The study was performed in six groups. These groups are (1) Normal control (non-diabetic, no intervention), (2) Normal control + GH (non-diabetic, supplemented with GH 3 μl), (3) DM control (diabetic, no intervention), (4) DM Gp1 (diabetic, 3 μL GH), (5) DM Gp2 (diabetic, 6 μ L GH), (6) DM Acarbose (diabetic, treated with acarbose). Fasting blood glucose levels for non-diabetic (non-DM) and diabetic (DM) groups were evaluated before and after the 10 days of diabetic induction. DM groups (excess of food and two injections of STZ) have caused a significant increment in the fasting blood glucose to 11.55 mmol/l (p < 0.0001). Both GH treatments effectively decreased postprandial blood glucose levels and the area under the curve in the oral glucose tolerance test (OSTT). Based on these results, it is concluded that green honey could play a role in hyperglycemia management and show potential as a natural alternative to conventional diabetes therapy. The underlying mechanisms need to be clarified, and their potential use in human diabetes therapy needs to be investigated.