Variation in the Prevalence, Awareness, and Control of Diabetes in a Multiethnic Population: A Nationwide Population Study in Malaysia

Rampal, Sanjay; Rampal, Lekhraj Rampal Gyanchand; Rahmat, Ramlee; Zain, Azhar Md.; Yap, Yee Guan; Mohamed, Mafauzy; Taha, Mohamad

doi:10.1177/1010539509334816

Cited by 41 publications

(40 citation statements)

References 18 publications

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“…The Malaysian Statistics Department sampled the population using a stratified two-stage cluster sampling design. A detailed description of the sampling and data collection techniques has been previously reported [17]–[19]. A total of 18,805 subjects were interviewed giving an overall response rate of 93.2%.…”

Section: Methodsmentioning

confidence: 99%

Ethnic Differences in the Prevalence of Metabolic Syndrome: Results from a Multi-Ethnic Population-Based Survey in Malaysia

et al. 2012

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IntroductionThe prevalence of metabolic syndrome is increasing disproportionately among the different ethnicities in Asia compared to the rest of the world. This study aims to determine the differences in the prevalence of metabolic syndrome across ethnicities in Malaysia, a multi-ethnic country.MethodsIn 2004, we conducted a national cross-sectional population-based study using a stratified two-stage cluster sampling design (N = 17,211). Metabolic syndrome was defined according to the International Diabetes Federation/National Heart, Lung and Blood Institute/American Heart Association (IDF/NHLBI/AHA-2009) criteria. Multivariate models were used to study the independent association between ethnicity and the prevalence of the metabolic syndrome.ResultsThe overall mean age was 36.9 years, and 50.0% participants were female. The ethnic distribution was 57.0% Malay, 28.5% Chinese, 8.9% Indian and 5.0% Indigenous Sarawakians. The overall prevalence of the metabolic syndrome was 27.5%, with a prevalence of central obesity, raised triglycerides, low high density lipoprotein cholesterol, raised blood pressure and raised fasting glucose of 36.9%, 29.3%, 37.2%, 38.0% and 29.1%, respectively. Among those <40 years, the adjusted prevalence ratios for metabolic syndrome for ethnic Chinese, Indians, and Indigenous Sarawakians compared to ethnic Malay were 0.81 (95% CI 0.67 to 0.96), 1.42 (95% CI 1.19 to 1.69) and 1.37 (95% CI 1.08 to 1.73), respectively. Among those aged ≥40 years, the corresponding prevalence ratios were 0.86 (95% CI 0.79 to 0.92), 1.25 (95% CI 1.15 to 1.36), and 0.94 (95% CI 0.80, 1.11). The P-value for the interaction of ethnicity by age was 0.001.ConclusionsThe overall prevalence of metabolic syndrome in Malaysia was high, with marked differences across ethnicities. Ethnic Chinese had the lowest prevalence of metabolic syndrome, while ethnic Indians had the highest. Indigenous Sarawakians showed a marked increase in metabolic syndrome at young ages.

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Section: Methodsmentioning

confidence: 99%

Ethnic Differences in the Prevalence of Metabolic Syndrome: Results from a Multi-Ethnic Population-Based Survey in Malaysia

et al. 2012

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“…Thus, ''Other-Bumiputera'' refers to other native ethnic groups, not including the Malays). [14][15][16][17] Ethnic-based disparities in metabolic syndrome prevalence have been noted in previous studies for developed countries, [18][19][20] and reducing inequality among citizens of different ethnic groups has been a long-standing goal of policy makers in Malaysia. Therefore, this study uses data from a nationally representative sample of Malaysians to study differences in metabolic syndrome prevalence, as well as differences in the underlying conditions that comprise metabolic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Ethnic Disparities in Metabolic Syndrome in Malaysia: An Analysis by Risk Factors

Tan

Dunn

Yen

2011

Metabolic Syndrome and Related Disorders

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Background: This study investigates ethnic disparities in metabolic syndrome in Malaysia. Methods: Data were obtained from the Malaysia Non-Communicable Disease Surveillance-1 (2005Surveillance-1 ( /2006. Logistic regressions of metabolic syndrome health risks on sociodemographic and health-lifestyle factors were conducted using a multiracial (Malay, Chinese, and Indian and other ethnic groups) sample of 2,366 individuals. Results: Among both males and females, the prevalence of metabolic syndrome amongst Indians was larger compared to both Malays and Chinese because Indians are more likely to exhibit central obesity, elevated fasting blood glucose, and low high-density lipoprotein cholesterol. We also found that Indians tend to engage in less physical activity and consume fewer fruits and vegetables than Malays and Chinese. Although education and family history of chronic disease are associated with metabolic syndrome status, differences in socioeconomic attributes do not explain ethnic disparities in metabolic syndrome incidence. The difference in metabolic syndrome prevalence between Chinese and Malays was not statistically significant. Whereas both groups exhibited similar obesity rates, ethnic Chinese were less likely to suffer from high fasting blood glucose. Conclusions: Metabolic syndrome disproportionately affects Indians in Malaysia. Additionally, fasting blood glucose rates differ dramatically amongst ethnic groups. Attempts to decrease health disparities among ethnic groups in Malaysia will require greater attention to improving the metabolic health of Malays, especially Indians, by encouraging healthful lifestyle changes.

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“…2 Most (90%-95%) hypertension is idiopathic and apparently primary or essential hypertension (EHT), and the remainder are said to be secondary hypertension that leads to renal and adrenal diseases. 3 Evidence suggests that genes may contribute to 30% of the variation of BP; however, the gene-gene and gene-environment interactions are still remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Association of insertion/deletion polymorphism of angiotensin-converting enzyme gene among Malay male hypertensive subjects in response to ACE inhibitors

Heidari

Ramachandran

Ali³

et al. 2014

J Renin Angiotensin Aldosterone Syst

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Introduction: Several studies show that the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been associated with hypertension in various populations. The present study sought to determine the association of the I/D gene polymorphism among Malay male essential hypertensive subjects in response to ACE inhibitors (enalapril and lisinopril). Materials and methods: A total of 72 patients with newly diagnosed hypertension and 72 healthy subjects were recruited in this study. Blood pressure was recorded from 0 to 24 weeks of treatment with enalapril or lisinopril. Genotyping of the I/D polymorphism was carried out using a standard PCR method. Results: Statistically significant association of the D allele of the ACE gene was observed between the case and control subjects (p < 0.01). There was a decrease in blood pressure in the patients carrying the DD genotype (SBP=18.5±8.1 mmHg, DBP=15.29±7.1 mmHg) rather than the ID (SBP=4.1±3.3 mmHg, DBP=9.1±3.5 mmHg) and II genotypes (SBP= 3.0±0.2 mmHg, DBP 0.11±6.1 mmHg) of the ACE gene. Conclusion: Patients carrying the DD genotype had higher blood pressure-lowering response when treated with ACE inhibitors enalapril or lisinopril than those carrying ID and II genotypes, suggesting that the D allele may be a possible genetic marker for essential hypertension among Malay male subjects.

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Variation in the Prevalence, Awareness, and Control of Diabetes in a Multiethnic Population: A Nationwide Population Study in Malaysia

Cited by 41 publications

References 18 publications

Ethnic Differences in the Prevalence of Metabolic Syndrome: Results from a Multi-Ethnic Population-Based Survey in Malaysia

Ethnic Differences in the Prevalence of Metabolic Syndrome: Results from a Multi-Ethnic Population-Based Survey in Malaysia

Ethnic Disparities in Metabolic Syndrome in Malaysia: An Analysis by Risk Factors

Association of insertion/deletion polymorphism of angiotensin-converting enzyme gene among Malay male hypertensive subjects in response to ACE inhibitors

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