Introduction: Metabolic syndrome (MetS) had been known as clustering of risk factors for cardiovascular disease and diabetes. Over the years, clinical criteria had been revised to highlight importance of various risk factors in defining MetS. Studies had reported different clustering of factors based on different population characteristics. Objective: Our study aimed to identify the clustering factors among our Malaysian population based on sexes and 4 major ethnic groups namely Malay, Chinese, Indian and other minor ethnic Methods: A national cross sectional study was done covering both Peninsular and East Malaysia. Subjects’ sociodemographic, body mass index (BMI), waist, hip and neck circumference, blood pressure, fasting triglycerides (TG) and HDL-cholesterol and glucose, urine microalbumin and serum insulin were taken. Principal component factor analysis with Varimax rotation was done to identify the clustering based on sex and ethnic groups. Results: One thousand two hundred and sixty eight male and 2355 female subjects were recruited. Majority of subjects were Malays (63.0%) followed by Chinese (13.3%), Indian (7.4%) and other ethnic groups (13.8%) which followed the population composition in Malaysia. Four factors were identified for both men and women. The factors were anthropometry, glycemia, blood pressure and dyslipidemia given the cumulative percent of variance of 69.4 and 65.9 respectively. There are 4 factors identified for Malay, Chinese and Aborigines but 5 factors for Indian ethnic groups given cumulative percent of variance explained ranged from 65.1 to 77.7. Discussion and Conclusion: BMI, neck circumference, blood pressure, Fasting TG and HDL had a high factor loading in both sexes suggesting that for field screening, diagnostic criteria would be adequate criteria. These factors also showed a similar pattern of loading by different ethnic groups. In conclusion, in Malaysian population, at least one measurement from each components namely anthropometric, blood pressure, glycemia and dyslipidemia is adequate to diagnose MetS.

Aim: To report the national prevalence of metabolic syndrome (MetS) and its risk factors among adult Malaysians (>18 years old) based on World Health Organization (WHO), the National Cholesterol Education Program Expert Panel III (ATP III)(,) International Diabetes Federation (IDF) and the 'Harmonized' criteria. Methods: A multi-stage stratified sampling method was used to select 4341 subjects from Peninsular and East Malaysia. Subjects underwent physical and clinical examinations. Results: Based on the WHO, ATP III, IDF and Harmonized definitions, the overall crude prevalences of MetS were 32.1, 34.3, 37.1 and 42.5%, respectively. Regardless of the criteria used, MetS was higher in urban areas, in females, in the Indian population and increased significantly with age. Risk factors also increased with age; abdominal obesity was most prevalent (57.4%), was higher in females (64.2%) and was highest in Indians (68.8%). Hypertension was higher in males (56.5%) and highest among Malaysians (52.2%). In contrast, the Chinese had the highest prevalence of hypertriglyceridaemia (47.4%). Conclusions: Malaysia has a much higher prevalence of MetS compared with other Asian countries and, unless there is immediate intervention to reduce risk factors, this may pose serious implications on the country's healthcare costs and services.

Aim: To report the national prevalence of metabolic syndrome (MetS) and its risk factors among adult Malaysians (>18 years old) based on World Health Organization (WHO), the National Cholesterol Education Program Expert Panel III (ATP III), International Diabetes Federation (IDF) and the ‘Harmonized’ criteria. Methods: A multi-stage stratified sampling method was used to select 4341 subjects from Peninsular and East Malaysia. Subjects underwent physical and clinical examinations. Results: Based on the WHO, ATP III, IDF and Harmonized definitions, the overall crude prevalences of MetS were 32.1, 34.3, 37.1 and 42.5%, respectively. Regardless of the criteria used, MetS was higher in urban areas, in females, in the Indian population and increased significantly with age. Risk factors also increased with age; abdominal obesity was most prevalent (57.4%), was higher in females (64.2%) and was highest in Indians (68.8%). Hypertension was higher in males (56.5%) and highest among Malays (52.2%). In contrast, the Chinese had the highest prevalence of hypertriglyceridemia (47.4%). Conclusions: Malaysia has a much higher prevalence of MetS compared with other Asian countries and, unless there is immediate intervention to reduce risk factors, this may pose serious implications on the country’s healthcare costs and services.

OBJECTIVE: To determine the prevalence of prediabetes and diabetes among rural and urban Malaysians. RESEARCH DESIGN AND METHODS: This cross-sectional survey was conducted among 3,879 Malaysian adults (1,335 men and 2,544 women). All subjects underwent the 75-g oral glucose tolerance test (OGTT). RESULTS: The overall prevalence of prediabetes was 22.1% (30.2% in men and 69.8% in women). Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were found in 3.4 and 16.1% of the study population, respectively, whereas 2.6% of the subjects had both IFG and IGT. Based on an OGTT, the prevalence of newly diagnosed type 2 diabetes was 12.6% (31.0% in men and 69.0% in women). The prediabetic subjects also had an increased prevalence of cardiovascular disease risk factors. CONCLUSIONS: The large proportion of undiagnosed cases of prediabetes and diabetes reflects the lack of public awareness of the disease.

Background Type 2 diabetes is associated with early development of endothelial dysfunction. Patients present with typical dyslipidemia (predominantly high levels of triglycerides [TG] and low levels of high-density lipoprotein cholesterol [HDL-C]) or mixed hypercholesterolemia (high levels of low-density lipoprotein cholesterol [LDL-C] and TG with low HDL-C). Normal levels include LDL-C < 100 mg/dL, TG < 135 mg/dL, and HDL-C > 40 mg/dL for men and >50 mg/dL for women. Objective To determine the effects of 8 weeks’ administration of fenofibrate on inflammatory markers, metabolic parameters, and endothelial dysfunction. Methods We administered micronized fenofibrate (Laboratories Fourneir S.A Dijon, France) daily for 8 weeks to 40 dyslipidemic, type 2 diabetes patients with equal numbers in each arm of the typical or mixed dyslipidemia groups. Noninvasive endothelial function assessments were performed and serum inflammatory markers obtained before and after treatment. Results The typical group demonstrated significantly greater TG reduction and HDL-C increment, ie, 56% vs, 21.3% (P < .005) and 21% vs. 7.6% (P = .001), respectively, compared with the mixed group. There was greater LDL-C reduction within the mixed group compared with the typical group 21.0% vs. 2.2% (P < .05). Endothelial dysfunction was present in both groups at baseline. After treatment, the typical group demonstrated significant improvement in resting brachial diameter (3.9 mm [interquartile range {IQR} 3.3-4.7] to 4.2 mm [IQR 3.4-4.8], P = .001) compared with no change within the mixed group (3.6 mm [IQR 3.1-5.4] to 3.7 mm [IQR 3.1-5.3], P = .26). Flow-mediated diameter improved significantly in both groups. The mixed group had significantly greater levels of hs-CRP at baseline but no changes throughout the study. The mixed group demonstrated an increase in vascular adhesion molecule-1 from 706 ng/mL (IQR 566-1195) to 845 ng/mL (637-1653; P = .01), a reduction of tumor necrosis factor-α from 7.0 pg/mL (IQR 1.0-43.5) to 2.5 pg/mL (IQR 1.5-13.5; P = .04) throughout the study. Conclusions We effectively compared 8 weeks of fenofibrate therapy in type 2 diabetics with contrasting lipid abnormalities. The typical dyslipidemia group showed significantly greater lipid improvements compared with the mixed dyslipidemia group. Both groups had improvements in endothelial functions that were independent of the lipid levels. We concluded that fibrate therapy in type 2 diabetics is beneficial, especially those with typical dyslipidemia and extends beyond its lipid lowering properties.