exudates and Hypertriglyceridemia

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE.. A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM.. Thirteen of them (13%) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05).. The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.

Topics: Adrenal Cortex Hormones; Adult; Antirheumatic Agents; China; Cohort Studies; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Hydroxychloroquine; Hypertriglyceridemia; India; Lupus Erythematosus, Systemic; Malaysia; Male; Middle Aged; Multivariate Analysis; Obesity, Abdominal; Prednisolone; Prevalence; Racial Groups; Risk Factors

To determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine its associations with cardiometabolic risks and lifestyle behaviours.. This was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia. Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration.. Body mass index, %BF, cardiometabolic risk factors, lifestyle behaviours.. A total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3-22.5). NWO was more prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73-4.04), hypertriglyceridemia (2.51, 1.47-4.29) and hypertension (1.63, 1.15-2.31) compared to women with lower % body fat after adjusted for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0-9.8). None of the lifestyle behaviours were significantly associated with NWO.. Women with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidaemia and increased blood pressure. Health promotion efforts should include NWO women who may be oblivious of their deleterious health risks.

Topics: Adiposity; Adult; Aged; Body Mass Index; Body Weight; Cross-Sectional Studies; Developing Countries; Female; Health Behavior; Humans; Hypertension; Hypertriglyceridemia; Life Style; Malaysia; Metabolic Syndrome; Middle Aged; Obesity; Obesity, Abdominal; Prevalence; Risk Factors

The effectiveness of the Nutrition Support Team (NST) at Hospital Sungai Buloh, a large public hospital in Kuala Lumpur, Malaysia, in optimising parenteral nutrition (PN) has not been evaluated. To evaluate the effects of this NST in optimising patient outcomes, treatment outcomes, and adherence to biochemical monitoring guidelines, two groups of patients, those given PN before (n = 106) NST intervention and those given PN after (n=106) NST intervention, were retrospectively compared. Intervention by the NST significantly reduced metabolic abnormalities, reducing sodium abnormalities from 67% to 44% (p<0.01); potassium abnormalities from 42% to 15% (p<0.01); magnesium abnormalities from 13% to 3% (p<0.05) and phosphate abnormalities from 21% to 9% (p=0.01). Intervention by the NST also significantly reduced the incidence of hypertriglyceridemia from 68% to 45% (p=0.002) and significantly improved adherence to biochemical monitoring guidelines from 46% to 72% (p<0.01). However, the length of hospital stay, patient mortality, and duration of PN were similar in both groups. This study failed to demonstrate that the establishment of a NST gave better outcomes in terms of the common measures of effectiveness. In conclusion, although management by an NST significantly reduced metabolic abnormalities and improved adherence to biochemical monitoring guidelines, the NST did not improve patient mortality rates and length of hospital stay.. 位於馬來西亞吉隆坡的一所大型公立醫院-Sungai Buloh 醫院，其營養支持小組 (NST)對於優化靜脈營養(PN)的效益尚未被評估。兩組病人，一組為NST 介入 前給予PN (106 位)，另一組則在NST 介入後給予PN (106 位)。回溯性比較以 評估NST 對於病人的治療結果及生化監測指南的遵從性之優化效果。NST 介入 顯著降低代謝性異常，降低鈉異常由67%至44% (p<0.01)；鉀異常從42%至 15% (p<0.01) ； 鎂異常從13%至3% (p<0.05) 及磷酸鹽異常從21%至8% (p=0.01)。NST 介入也顯著降低高三酸甘油酯血症發生率從68% 至45% (p=0.002)及改善生化監測指南的遵從性由46%到72% (p<0.01)。然而，兩組的 住院天數、病人死亡率及接受PN 期間則相似。以常用的效益測量為指標來 看，這個研究無法證明NST 有較好的結果。總之，雖然NST 的管理顯著地降 低代謝性異常及改善生化監測指南遵從性，但並未改善病人死亡率及住院天 數。

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Hypertriglyceridemia; Length of Stay; Malaysia; Male; Metabolic Diseases; Middle Aged; Parenteral Nutrition; Patient Care Team; Retrospective Studies; Treatment Outcome; Water-Electrolyte Imbalance