 |
 |
 |
 |
 |
 |
Metabolic Risk Factors among Government Employees in Putrajaya, Malaysia (Faktor Risiko Metabolik dalam Kalangan Kakitangan Kerajaan di Putrajaya,
Malaysia)
CHEE, H.P1., HAZIZI, A.S.1,2*, BARAKATUN NISAK, M.Y.1 & MOHD NASIR, M.T.1
1Department of
Nutrition and Dietetics, Faculty of Medicine and Health Sciences
Universiti Putra Malaysia, 43400 Serdang, Selangor Darul
Ehsan, Malaysia
2Sports Academy, Universiti
Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan
Malaysia
Diserahkan: 28 Oktober 2013/Diterima: 10 Disember 2013
ABSTRACT
This study aimed to assess the metabolic risk factors among government
employees in Putrajaya, Malaysia. Government employees (n=675) were recruited from five government agencies
in Putrajaya using a multi-stage random sampling method. Data on
socio demographic characteristics, stages of change for physical
activity, anthropometric and biochemical and clinical examinations
were collected. A total of 154 (23.4%) men and 505 (76.6%) women
with the mean age of 34.49±8.80 years participated in this
study. The number of government employees that met the metabolic
syndrome criteria based on a 'Harmonized' definition (48.9%) was
higher than that in the general Malaysian population. High blood
pressure was higher in men (56.5%) compared to women (39.8%). The
male participants had a significantly higher mean ± standard
deviation in all the metabolic risk factors except HDL-cholesterol, compared to a significance
level of 0.05 in the female participants. A high proportion of government
employees (84.5%) had at least one metabolic risk factor. Men were
54% more likely to have metabolic syndrome than women based on 'Harmonized'
definition. Participants in the pre- contemplation stage for physical
activity were approximately 17 times more likely to have metabolic
syndrome compared to participants in the maintenance stage according
to 'Harmonized' definition. In general, this study suggested that
a high proportion of government employees (84.5%) had at least one
metabolic risk factor. There is a pressing need to commence intervention
programs in the workplace to identify and manage government employees
at high risk for cardiovascular disease and diabetes.
Keywords: Government employees; metabolic risk factors; workplace
ABSTRAK
Kajian ini bertujuan untuk menilai faktor risiko
metabolik dalam kalangan kakitangan kerajaan di Putrajaya, Malaysia. Kakitangan kerajaan (n=675) daripada lima
agensi kerajaan di Putrajaya telah dipilih dengan menggunakan kaedah
persampelan rawak berperingkat. Pengumpulan
data melibatkan data sosio demografi, peringkat perubahan terhadap
aktiviti fizikal, pengukuran data antropometri, biokimia dan pemeriksaan
klinikal. Seramai 154 (23.4%) lelaki
dan 505 (76.6%) wanita telah mengambil bahagian dalam kajian ini
dengan min umur 34.49±8.80 tahun. Prevalens bagi kakitangan
kerajaan yang memenuhi kriteria sindrom metabolik (48.9%) dalam
kajian ini berdasarkan definisi 'Harmonized' adalah lebih tinggi
berbanding penduduk Malaysia secara keseluruhan. Tekanan
darah tinggi adalah lebih tinggi dalam kalangan lelaki (56.5%) berbanding
dengan wanita (39.8%). Lelaki mempunyai lebih tinggi min ± sisihan piawai bagi semua
faktor risiko metabolik kecuali kolesterol HDL berbanding
dengan wanita pada tahap kesignifikanan 0.05. Sebahagian
besar daripada kakitangan kerajaan (84.5%) mempunyai sekurang-kurangnya
satu faktor risiko metabolik. Lelaki adalah 54% lebih cenderung
untuk mempunyai sindrom metabolik berbanding dengan wanita berdasarkan
definisi 'Harmonized'. Peserta dalam peringkat pra- pertimbangan
untuk aktiviti fizikal adalah kira- kira 17 kali ganda lebih cenderung
untuk mempunyai sindrom metabolik berbanding dengan peserta di peringkat
berterusan mengikut definisi 'Harmonized'. Secara
umumnya, kajian ini mencadangkan bahawa sebahagian besar daripada
kakitangan kerajaan (84.5%) mempunyai sekurang-kurangnya satu faktor
risiko metabolik. Terdapat keperluan yang mendesak untuk
memulakan program intervensi di tempat kerja untuk mengenal pasti
serta menguruskan kakitangan kerajaan yang berisiko tinggi untuk
penyakit kardiovaskular dan diabetes pada masa akan
datang.
Kata kunci: Faktor risiko metabolik; kakitangan
kerajaan; tempat kerja RUJUKAN
Alberti, K.G.M.M., Eckel, R.H., Grundy, S.M., Zimmet, P.Z.,
Cleeman, J.I., Donato, K.A., Fruchart, J.C., James, W.P.T., Loria, C.M. &
Smith, S.C. 2009. Harmonizing the metabolic syndrome. A joint interim statement
of the International Diabetes Federation Task Force on Epidemiology and
Prevention; National Heart, Lung and Blood Institute; American Heart
Association; World Heart Federation; International Diabetes Atherosclerosis
Society; and International Association for the Study of Obesity. Circulation 120: 1640-1645.
Alberti, K.G., Zimmet, P., Shaw, J. & IDF Epidemiology
Task Force Consensus Group. 2005. The metabolic syndrome: A new worldwide
definition. Lancet. 366: 1059-1062.
Alberti, K.G. & Zimmet, P.Z. 1998. Definition, diagnosis
and classification of diabetes mellitus, and its complications, part I:
diagnosis and classification of diabetes mellitus provisional report of a WHO
consultation. Diabet. Med. 15: 539-553.
Alegria, E., Cordero, A., Laclaustra, M., Grima, A., Leon,
M., Casasnovoas, J.A., Luengo, E., del Rio, A.,
Ferreira, I. & Investigadores del registro MESYAS. 2005. Prevalence of
metabolic syndrome in the Spanish working population: MESYAS Registry. Rev.
Esp. Cadriol. 58: 797-806.
Bayan, A.O., Eslam, K.A.A., Khalid, K.A. & Yousef, S.K.
2012. Predictors of metabolic syndrome among employees: A study from Jordan. Food
and Nutrition Sciences 3: 669- 677.
Dallongeville, J., Cottel, D., Ferrieres, J., Arveiler, D.,
Bingham, A., Ruidavets, J.B., Hass, B., Ducimetiere, P. & Amouyel, P. 2005.
Household income is associated with the risk of metabolic syndrome in a sex-
specific manner. Diabetes Care 28: 409-415.
D' Agostino Sr, R.B., Vasan, R.S., Pencina,
M.J., Wof, P.A., Cobain, M., Massaro, J. & Kannel, W.B. 2008. General cardiovascular risk profile for use in primary care:
The Framingham heart study. Circulation 117: 743-753. Davila, E.P., Florez, H., Fleming, L.E., Lee, D.J., Goodman,
E., LeBlanc, G., Caban- Martinez, A.J., Arheart, K.L., McCollister, K.E.,
Christ, S.L., Clark III, J.C. & Clarke, T. 2010. Prevalence
of the metabolic syndrome among US workers. Diabetes Care 33(11):
2390-2395.
Department of Statistics. Labour Force Statistics, Malaysia, December 2012. Malaysia:
Department of Statistics, 2013.
Freak-Poli, R., Wolfe, R. &
Peeters, A. 2010. Risk of
cardiovascular disease and diabetes in a working population with sedentary
occupations. American College of Occupational and Environmental
Medicine 52: 1132-1137.
Gami, A.S., Witt, B.J., Howard, D.E.,
Erwin, P.J., Gami, L.A., Somers, V.K. & Montori, V.M. 2007. Metabolic syndrome and risk of incident cardiovascular
events and death: A systematic review and meta-analysis of longitudinal
studies. J. Am. Coll. Cardiol. 49: 403-414.
Grundy, S.M. 2007. Metabolic syndrome: A multiplex
cardiovascular risk factor. J. Clin. Endocrinol. Metab. 92: 399-404.
Grundy, S.M., Hansen, B., Smith Jr,
S.C., Cleeman, J.I. & Kahn, R.A. 2004. Clinical management of metabolic syndrome: Report of the American Heart
Association/ National Heart, Lung and Blood Institute/ American Diabetes
Association conference on scientific issues related to management. Arterioscler
Thromb. Vasc. Biol. 24: e19-e24.
Institute for Public Health. The Third National Health and
Morbidity Survey 2011. Malaysia: Ministry of Health, 2011.
Institute for Public Health. The Third National Health and
Morbidity Survey 2006. Malaysia: Ministry of Health, 2008.
Johnson, L.W. & Weinstock, R.S. 2006. The metabolic
syndrome: Concepts and controversy. Mayo Clin. Proc. 81: 1615-1620.
Johnson, R.R. & Kuby, P. 2008. Chapter 9. Inferences involving one population. In Elementary
Statistics. USA: Thomson Learning Inc. pp. 472-542.
Khunti, K. & Davies, M. 2005. Metabolic syndrome. British Medical Journal 331(7526): 1153-1154.
Li, C.Y. & Sung,
F.C. 1999. A review of the healthy worker effect in occupational
epidemiology. Occup. Med. (London) 49: 225-229.
Lin, Y.C., Hsiao, T.J. & Chen, P.C.
2009. Persistent rotating shift- work
exposure accelerates development of metabolic syndrome among middle-aged female
employees: A five-year follow-up. Chronobiology International 26(4):
740-755.
Marcus, B.H., Rossi, J.S., Selby, V.C.,
Niaura, R.S. & Abrams, D.B. 1992. The
stages and processes of exercise adoption and maintenance in a worksite sample. Health Psychology 11: 386-395.
Ministry of Health. 2011. Country Health Plan. 10th Malaysia
Plan 2011- 2015. Putrajaya: Ministry of Health.
Ministry of Health. 2010. National Strategic Plan for Non- Communicable
Disease. Medium Term Strategic Plan to Further Strengthen the Cardiovascular
Diseases & Diabetes Prevention & Control Program in Malaysia (2010-
2014). Putrajaya: Ministry of Health.
Ministry of Health. 2006a. MyNCDS-1 Malaysia NCD
Surveillance- 1 2005/ 2006. NCD Risk Factors in Malaysia.
Putrajaya: Ministry of Health, Disease Control Division, Non-communicable
Disease Section.
Ministry of Health. 2006. Malaysia’s Health. Putrajaya: Ministry of
Health.
Murphy, M.H., Murtagh, E.M., Breham,
C.A.G., Hare, L.G. & Nevill, A.M. 2006. The effect of a worksite based walking programme on
cardiovascular risk in previously sedentary civil servants. BMC Public
Health 6: 136-143.
Nair, C.V. 2010. Metabolic syndrome: An occupational
perspective. Indian Journal of Community Medicine 35(1): 122-124.
National Cholesterol Education Program (NCEP). 2002. Third
report of the National Cholesterol Education Program (NCEP) expert panel on
detection, evaluation and treatment of high blood cholesterol in adults (Adult
Treatment Panel III) final report. Circulation 106: 3143- 3421.
Nestel, P., Lyu, R., Low, L.P., Sheu, W.H., Nitiyanant, W.,
Saito, I. & Tan, C.E. 2007. Metabolic syndrome: Recent prevalence in East
and Southeast Asian populations. Asia Pac. J. Clin. Nutr. 16: 362- 367.
Puig- Ribera, A., McKenna, J., Gilson,
N. & Brown, W.J. 2008. Change
in work day step counts, wellbeing and job performance in Catalan university
employees: A randomized controlled trial. Promotion & Education 15:
11-16.
Rakugi, H. & Ogihara, T. 2005. The metabolic syndrome in the Asian
population. Curr. Hypertens. Rep. 7: 103-109.
Salsberry, P.J., Corwin, E. & Reagan, P.B. 2007. A
complex web of risks for metabolic syndrome: Race/ ethnicity, economics and
gender. Am. J. Prev. Med. 33: 114-120.
Sanchez-Chapparo, M.A., Calvo-Bonacho, E., Gonzalez-
Quintela, A., Fernandez-Labandera, C., Cabrera, M., Sainz, J.C.,
Fernandez-Meseguer, A., Banegas, J.R., Ruilope, L.M., Valdivielso, P. &
Roman-Garcia, J. 2008. Occupational-related differences in
the prevalence of metabolic syndrome. Diabetes Care 31:
1884-1885.
Sundstrom, J., Riserus, U., Byberg, L.,
Zethelius, B., Lithell, H. & Lind, L. 2006. Clinical values of the metabolic syndrome for long term
prediction of total and cardiovascular mortality: Prospective, population based
cohort study. BMJ 332: 878- 882.
Tan, B.Y., Kumar, K.H. & Rajbans, S. 2008. Prevalence of
metabolic syndrome among Malaysians using the International Diabetes
Federation, National Cholesterol Education Program and modified World Health
Organization definitions. Mal. J. Nutr. 14(1): 65-77.
Wan Nazaimoon, W.W., Aziz, A.I., Amir, S., Ikram, S.I.,
Kamarul, I.M., Khalid, A.K., Nor Azmi, K., Nor Azwany, Y., Norlaila, M., Osman,
A., Siti, H. & Wan Mohamad, W.B. 2011. Prevalence of metabolic syndrome and
its risk factors in adult Malaysians: Results of a nationwide survey. Diabetes
Research and Clinical Practice 91(2): 239-245.
Wilson, P.W.F., D’Agostino, R.B., Parise, H., Sullivan, L.
& Meigs, J.B. 2005. Metabolic syndrome as a precursor of
cardiovascular disease and type 2 diabetes mellitus. Circulation 112:
3066-3072.
World Health Organization (WHO). 2009. Global health risks: Mortality and burden of disease
attributable to selected major risks. Geneva: WHO Press.
World Health Organization and World Economic Forum. 2008.
Preventing non- communicable diseases in the workplace through diet and
physical activity: WHO/ World economic forum report of a joint event. Geneva,
Switzerland: World Health Organization.
WHO/IASO/IOTF. 2000. The Asia- pacific perspective:
Redefining obesity and its treatment. Melbourne: Health Communications Australia.
World Health Organization (WHO). 1997. MONICA Manual. Part III: Population Survey. Section
1: Population survey data component by WHO MONICA Project, http://www.thl.
fi/publications/monica/manual/part3/iii-1.htm, URN: NBN: fi-fe19981151.
Accessed 8th February 2013.
*Pengarang untuk surat-menyurat; email: hazizi@upm.edu.my
|
|||
|
