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"Obesity is performed by genetic, environmental, and complex interaction between genetic and environmental factors.Fatness levels in obese children are indicative of increased risk for elevated blood pressure, cholesterol, and lipoproteinratios children and adolescents. Serum cholesterol and blood pressure are related to raise atherosclerotic lesion. Certaincardiovascular disease risk factors in obese children are related to the earliest stages of atherosclerosis disease. Obesechildren have the high risk factors of certain cardiovascular disease. Genetic factors affecting metabolic rate can besuccessfully managed by the introduction of environmental factors such as decrease caloric intake and increase physicalactivity. The treatment of obesity and of atherosclerotic patients should include dietary restriction (protein sparingmodified fast and hypocaloric balanced diet), nutrition education, increased physical activity, behavior modification, andfamilial support. Success fully management of obesity can improve the quality of life and reduce the risk of morbidityand mortality associated with obesity."

"Obesitas telah menyerang dengan kekuatan penuh dan dampaknya adalah meningkatnya prevalensi di seluruh dunia seiring dengan meningkatnya angka kematian dan penyakit yang berhubungan dengan obesitas. Faktor genetik, hormonal dan lingkungan berinteraksi satu sama lain menyebabkan obesitas. Diet rendah kalori dan gaya hidup aktif secara fisik adalah cara utama untuk menangani obesitas. Penanganan tambahan adalah melalui intervensi farmakologis, menggunakan dua obat baru, yaitu cyclobutane methanamine HCl dan tetrahidrolipstatin, yang potensial untuk pengaturan obesitas. Cara terakhir untuk memecahkan masalah ini adalah dengan melakukan pembedahan. Akhir kata, pasien harus berkonsultasi dengan dokternya dalam memutuskan metode mana yang paling efektif untuk mencari solusi terhadap obesitas. (Med J Indones 2003; 12: 53-62)

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Obesity has struck with all its might and the results are the increased world-wide prevalence along with increased mortality rate and other obesity-related diseases. Genetic, hormonal and environmental factors interact to cause obesity. Very low calorie diet and physically active lifestyle are the primary means to treat obesity. Additional intervention is by pharmacological treatment, using two new drugs, namely cyclobutane methanamine HCl and tetra hidrolipstatin that are potential for the management of obesity. Another way to solve this problem is by performing a surgery. In conclusion, patients should consult their physicians in order to decide which methods are the most effective to find a solution to combat obesity. (Med J Indones 2003; 12: 53-62)"

"ABSTRAKEra globalisasi memiliki dampak positif dan negatif terhadap status kesehatan masyarakat. Seiring bertambahnya populasi masyarakat yang tinggal di perkotaan, meningkat pula masalah kesehatan yang timbul, salah satunya yaitu obesitas pada anak usia sekolah. Obesitas pada anak usia sekolah harus segera ditangani melalui asuhan keperawatan keluarga. Tujuan dilakukannya intervensi keperawatan mengacu pada lima tugas kesehatan keluarga. Intervensi unggulan yang dilakukan berupa pengaturan pola makan berdasarkan pedoman gizi seimbang. Asuhan keperawatan keluarga dilakukan berdasarkan lima tahapan proses keperawatan. Hasil evaluasi menunjukkan bahwa secara kognitif dan psikomotor keluarga tentang pengaturan pola makan mengalami peningkatan dan terjadi penurunan berat badan pada anak. Diharapkan perawat dapat melakukan pembinaan keluarga dengan anak usia sekolah yang memiliki masalah gizi melalui asuhan keperawatan keluarga secara rutin dan berkelanjutan.

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ABSTRACTGlobalization era has positive and negative effects to public health. Increasing urban population, increased health problems too. One of the health problems is obesity in school aged children. Obesity in school aged children should be treated immediately through family nursing care. The aim of the intervention refers to five family heatlh tasks. The major nursing intervention that implemented is dietary adjustments based on balance nutrition guidelines. Family nursing care implemented based on nursing process. Evaluation shows the increasing family rsquo s cognitive and psychomotor about dietary adjustments and weight loss occurs in children. Hopefully, nurses can conduct the family with school aged children who have nutritional problems through family nursing care regularly and sustainably."

"[Latar belakang: Konsumsi MRDPG meningkat secara paralel dengan peningkatan prevalens obesitas di seluruh dunia sehingga diduga menjadi salah satu faktor risiko obesitas yang bermakna. Data di Indonesia terbatas. Tujuan: Mengetahui pola konsumsi MRDPG dan hubungannya dengan obesitas pada anak sekolah usia 10-12 tahun. Metode: Penelitian ini terdiri dari 2 tahap. Tahap I (studi potong lintang) didesain untuk mengetahui pola konsumsi MRDPG (total sampling). Uji hipotesis dilakukan pada Tahap II (studi kasus kontrol) secara purposive sampling (subjek obes dan gizi baik) dengan matching (usia dan jenis kelamin). MRDPG yang diteliti adalah soda, fruit drink, sport drink, energy drink, teh manis, dan kopi instan/siap saji. Konsumsi MRDPG dinilai dengan semi kuantitatif FFQ yang telah divalidasi sebelumnya. Pemeriksaan antropometri dilakukan dengan cara standar sesuai protokol. Risiko obes karena konsumsi MRDPG dianalisis dengan conditional logistic regression bersama dengan faktor perancu. Hasil: Sebanyak 421 dan 182 subjek memenuhi kriteria penelitian tahap I dan II. Proporsi subjek yang mengonsumsi MRDPG adalah 92,2% dan 63,9% di antaranya mengonsumsi 1 kali atau lebih setiap hari. Konsumsi MRDPG pada anak lelaki lebih banyak dibandingkan perempuan (P<0,001). Rerata konsumsi MRDPG berdasarkan volume, kalori, dan gula tambahan adalah 348 ml, 117 kkal, dan 26,6 gram per hari (≈ 5 sdt gula pasir setiap hari). Kontribusi kalori terbesar adalah teh manis dan yang terkecil soda. Subjek mengonsumsi MRDPG di antara 2 waktu makan dan di semua tempat. Setelah mengontrol faktor perancu, subjek yang mengonsumsi MRDPG 1 kali atau lebih setiap hari memiliki risiko obes sebesar 2,54 kali (RO 2,54; IK 95% 1,07-6,05; P=0,03). Risiko tersebut bertambah sebesar 45% untuk setiap konsumsi 1 porsi (RO 1,45; IK 95% 1,08-1,94; P=0,01)(1 porsi=240 ml). Teh manis dan kopi instan/siap saji menunjukkan hubungan yang bermakna dengan obesitas. Simpulan: Pola konsumsi MRDPG pada anak sekolah usia 10-12 tahun mengkhawatirkan. Semakin sering seorang anak mengonsumsi MRDPG, semakin besar kemungkinannya menjadi obes;Background: there is a global parallel increased between SSB consumption and obesity prevalence. Therefore, SSB consumption has been hypotized as one of risk factors of obesity. Limited data found in Indonesia. Aim: to describe the pattern of SSBs consumption and its association with obesity in school children age 10-12 years old. Method: a two phase study has been studied. Phase I (a cross sectional study) was designed to describe the pattern of SSB consumption as a total sampling. Hypotesis test was done in phase II (a case control study) as a purposive sampling (obese and healthy weight subjects) with individual matching (sex and age) between groups. SSBs were include reguler soda, fruit drink, sport drink, energy drink, sweat tea, and instant/ready to drink coffee. SSBs consumption were measured with a previously validated FFQ. Anthropometrical measures were taken using standardize protocol. Obesity risk related to SSB consumption was assesed together with confounding factors in a conditional logistic regression multivariate analysis. Result: There were 421 and 182 subjects fullfilled the criteria of study in phase I and II. The proportion of subject to consume SSBs was 92,2% and 63,9% of them consumed it one or more daily. Boys were more in drinking SSBs than girls (P<0,001). Mean of SSBs consumption based on volume, calories, and added-sugar were 348 ml, 117 kkal, and 26,6 gram per day (≈ 5 tsp of table sugar per day). The highest contribution of energy was found in sweat tea and the lowest was soda. All subjects consumed SSBs between 2 time meal at all place. After controling the confounding factors, We found a risk of obesity related to SSB consumption as 2,54 higher (RO 2,54; 95% CI 1,07-6,05; P=0,003) if they drank SSBs one or more daily. Besides, each additional daily serving was associated with a 45% relative increased in the risk of obesity (RO 1,45; 95% CI 1,08-1,94; P=0,01)(1 serving=240 ml). Sweat tea and instant/ready to drink coffee were significantly associated with obesity in this study. Conclusion: The pattern of SSBs consumption in school children age 10-12 years old is concerned. The more frequent in drinking SSBs the more likely a child to become obese., Background: there is a global parallel increased between SSB consumption and obesity prevalence. Therefore, SSB consumption has been hypotized as one of risk factors of obesity. Limited data found in Indonesia. Aim: to describe the pattern of SSBs consumption and its association with obesity in school children age 10-12 years old. Method: a two phase study has been studied. Phase I (a cross sectional study) was designed to describe the pattern of SSB consumption as a total sampling. Hypotesis test was done in phase II (a case control study) as a purposive sampling (obese and healthy weight subjects) with individual matching (sex and age) between groups. SSBs were include reguler soda, fruit drink, sport drink, energy drink, sweat tea, and instant/ready to drink coffee. SSBs consumption were measured with a previously validated FFQ. Anthropometrical measures were taken using standardize protocol. Obesity risk related to SSB consumption was assesed together with confounding factors in a conditional logistic regression multivariate analysis. Result: There were 421 and 182 subjects fullfilled the criteria of study in phase I and II. The proportion of subject to consume SSBs was 92,2% and 63,9% of them consumed it one or more daily. Boys were more in drinking SSBs than girls (P<0,001). Mean of SSBs consumption based on volume, calories, and added-sugar were 348 ml, 117 kkal, and 26,6 gram per day (≈ 5 tsp of table sugar per day). The highest contribution of energy was found in sweat tea and the lowest was soda. All subjects consumed SSBs between 2 time meal at all place. After controling the confounding factors, We found a risk of obesity related to SSB consumption as 2,54 higher (RO 2,54; 95% CI 1,07-6,05; P=0,003) if they drank SSBs one or more daily. Besides, each additional daily serving was associated with a 45% relative increased in the risk of obesity (RO 1,45; 95% CI 1,08-1,94; P=0,01)(1 serving=240 ml). Sweat tea and instant/ready to drink coffee were significantly associated with obesity in this study. Conclusion: The pattern of SSBs consumption in school children age 10-12 years old is concerned. The more frequent in drinking SSBs the more likely a child to become obese.]"

"Obesitas merupakan kondisi kelebihan lemak dalam tubuh akibat ketidakseimbangan energi. Obesitas dapat terjadi karena kombinasi dari faktor lingkungan dan faktor genetik. Beberapa penelitian menunjukkan bahwa single nucleotide polymorphism SNP rs1421085 gen fat mass and obesity-associated FTO bersosiasi dengan obesitas. Penelitian ini bertujuan untuk menentukan asosiasi alel risiko SNP rs1421085 dengan obesitas pada populasi Bali. Studi dilakukan pada 573 sampel arsip yang berasal dari empat desa, yaitu Desa Legian yang mewakili populasi urban, serta Desa Penglipuran, Nusa Ceningan, dan Pedawa yang mewakili populasi rural. Obesitas dikategorikan berdasarkan indeks massa tubuh IMT dan obesitas sentral berdasarkan lingkar pinggang LP mengikuti klasifikasi WHO dan IDF untuk populasi Asia: IMT ge; 25 kg/m2 baik pada pria dan wanita, LP ge; 90 cm untuk pria dan LP ge; 80 cm untuk wanita. Deteksi alel dilakukan menggunakan metode amplification refractory mutation system polymerase chain reaction ARMS PCR. Analisis asosiasi SNP rs1421085 dengan obesitas dan obesitas sentral dilakukan menggunakan uji regresi logistik ordinal dengan penyesuaian usia dan jenis kelamin. Hasil penelitian menunjukkan bahwa frekuensi alel minor SNP rs1421085 ditemukan sebesar 0,41 serta distribusi genotipe sesuai dengan keseimbangan Hardy-Weinberg p = 0,227. Keberadaan dua alel C pada seorang individu kelompok rural berasosiasi dengan obesitas berdasarkan tiga model genetik, yaitu kodominan koefisien = 1,065, p = 0,008, resesif koefisien = 0,812, p = 0,016, dan aditif koefisien = 0,527, p = 0,010.

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Obesity is a condition of excess fat in the body due to energy imbalance. Obesity can occur due to a combination of environmental factors and genetic factors. Several studies have shown that single nucleotide polymorphism SNP rs1421085 of fat mass and obesity associated FTO gene is associated with obesity. This study was conducted to determine the association of SNP rs1421085 risk allele with obesity in Balinese population.

The study was conducted on 573 archive samples from four villages Legian village representing urban population, and Penglipuran, Nusa Ceningan, and Pedawa villages representing rural population. Obesity was categorized based on body mass index BMI and central obesity based on waist circumference WC following WHO and IDF standard for Asian populations BMI ge 25 kg m2 both in male and female, WC ge 90 cm for male and WC ge 80 cm for female.

Allele detection was performed using amplification refractory mutation system polymerase chain reaction ARMS PCR method. Association analysis of SNP rs1421085 with obesity and central obesity was performed with ordinal logistic regression test with adjustments for age and gender.

The minor allele frequency of SNP rs1421085 was 0.41 and the genotype distribution corresponded to Hardy Weinberg equilibrium p 0.227. The existence of two C alleles in an individual of Balinese rural population was associated with obesity based on codominant genetic model coefficient 1.065, p 0.008, recessive genetic model coefficient 0.812, p 0.016, and additive genetic model coefficient 0.527, p 0.010."

"Pendahuluan: WHO menyatakan pada tahun 2013 terdapat lebih dari 42 juta anak-anak mengalami obesitas. Penelitian ini bertujuan untuk mengetahui apakah terdapat hubungan antara pola makan dengan obesitas pada anak usia sekolah dasar. Metode: Penelitian ini menggunakan desain penelitian potong lintang yang dilakukan pada Juli-September 2015 di SDN 01 Menteng Jakarta. Pengambilan data dilakukan dengan antropometri dan kuesioner food recall 48 jam. Data yang diperoleh kemudian di analisis dengan menggunakan uji Chi-Square. Hasil: Hasil uji statistik menunjukkan bahwa pola makan tidak memiliki hubungan yang bermakna dengan obesitas dengan nilai p>0.05. Diskusi: Hasil ini berbedadengan beberapa penelitian terdahulu yang mungkin disebabkan oleh pro.

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Introduction: WHO states that in 2013 there were more than 42 million children are obese. This study aims to determine whether there is a relationship between diet and obesity in primary school age.

Method: This study uses a crosssectional study design conducted in July-September 2015 at SDN 01 Menteng Jakarta. Data taken from anthropometry and 48-hour food recall questionnaire. The data analyzed using Chi-Square test.

Result: Statistical analysis showed that the diet has no significant association with obesity with p> 0.05.

Discussion: This result is in contrast to some previous studies that might be caused by inappropriate proportion of subjects, information bias, and low questionnaires return rate."

"ABSTRAKLatar Belakang: Leptin yang diketemukan oleh Zhang dan Friedman pada tahun 1994, dihasilkan oleh adiposit dan berhubungan dengan obesitas. Pada hewan coba, selain mempengaruhi homeostasis berat badan, leptin juga mempengaruhi metabolisme lipid pada jaringan perifer, seperti lipolisis dan lipogenesis. Peningkatan lipolisis dan penurunan lipogenesis menyebabkan peningkatan asam lemak bebas, yang kemudian diikuti oleh peningkatan konsentrasi trigliserida. Pada saat konsentrasi trigliserida tinggi, terjadi pembentukan small dense LDL, yang merupakan komponen dari dislipidemia aterogenik, terutama pada individu obes. Penelitian ini berusaha memperlihatkan perbedaan antara konsentrasi leptin dan profil lipid pada obes dan non-obes, dan terdapatnya hubungan antara leptin dan small dense LDL pada obesitas.Subyek: Berhasil dikumpulkan 297 laki-laki subyek penelitian, yang terdiri dari 205 subyek dengan obesitas sentral dan 92 subyek non-obes, yang presentase terbesar berusia antara 30-59 tahun. Variabel yang diamati pada penelitan ini antara lain, Indeks Massa Tubuh (IMT), lingkar perut, konsentrasi leptin, trigliserida, asam lemak bebas, kolesterol LDL, ApoB, ratio kolesterol LDL dan ApoB, kolesterol HDL, glukosa puasa dan insulin.Metodologi: Penelitian ini menggunakan disain potong lintang, Hubungan antara leptin dengan variabel-variabel seperti IMT, lingkar perut, leptin, trigliserida asam lemak bebas, kolesterol LDL, ApoB, kolesterol HDL dan insulin dianalisis dengan unpaired Nest, dibandingkan antara kelompok obes sentral dan non-obes. Sedangkan hubungan antara leptin dan small dense LDL dianalisis dengan menggunakan regresi logistik.Pemeriksaan laboratorium dari tiap variabel dilakukan dengan metode antara lain, konsentrasi trigliserida dan asam lemak bebas diukur dengan metode kolorimetri enzimatik, kolesterol LDL dan kolesterol HDL diukur dengan metode homogenisasi. Konsentrasi insulin diukur dengan metode ELISA, kadar leptin diukur dengan metode immunoassay.Hasil dan Pembahasan: Terdapat perbedaan karateristik antara kelompok obes dan non-obes, antara lain plasma leptin lebih tinggi pada kelompok obes sentral dibandingkan dengan kelompok normal; 9,71 (1,92) ng/mL vs. 2,63 (2,09) ng/mL, (P<0,001); rerata trigliserida 159,1 (6,97) mg/dL vs. 119,4 (4,8) mg/dL; (P<0,001), asam lemak bebas 0,42 (0,01) mmol/L vs. 0,36 (0,02) mmol/L; (p=0,001), apoB 108,05 (21,1) mg/dL vs. 101,4 (20,4) mg/dL(p=0,012) juga lebih tinggi pada kelompok obes dibandingkan non-obes, kolesterol HDL lebih rendah pada kelompok obes yaitu 40,6 (1,2) mg/dL vs. 46,2 (1,2) mg/dL; (P<0,001). Sedangkan rerata kolesterol LDL tidak berbeda bermakna antara kelompok obes dan non-obes 138,9 (32,2) mg/dL vs. 137,8 (31,9) mg/dL; (P=0,792). Pada subyek dengan Inleptin < 7,5 pg/mL (1,8 ng/mL) peningkatan kemungkinan didapatkannya small dense LDL sebesar 5,92 kali dibandingkan dengan subyek dengan lnleptin > 9,87 pg/mL (19,34 ng/mL).Penentuan indeks massa tubuh sebagai kriteria obesitas; penelitian ini memperkuat pendapat untuk menggunakan kriteria Asia Pasifik (1MT > 25 kg/m2) sebagai klasifikasi indeks massa tubuh (IMT) untuk populasi orang Indonesia.Hubungan lingkar perut dengan small dense LDL, leptin, IMT, dan HOMA-IR; Lingkar perut mempunyai korelasi yang baik dan bermakna secara statistik dengan konsentrasi leptin (r=0,72 dan P<0,05) dan HOMA-IR (r~0,53 dan P<0,05). Lingkar perut pada subyek dengan dan tanpa small dense LDL berbeda bermakna (P=0,016).Nilai normal konsentrasi leptin bagi IMT normal adalah 2,04 ng/mL dengan kisaran: 0,45 - 9,26 ng/mL. dan rerata konsentrasi leptin pada subyek obes sentral adalah 9,71 ng/mL dan subyek non-obes : 2,63 ng/mL.Resistensi dan defisiensi leptin pada obesitas; pada obesitas sentral dapat terjadi resistensi leptin atau defisiensi leptin dan mungkin ambang terjadinya resistensi leptin pada subyek penelitian ini lebih rendah (< 20 ng/mL) dibandingkan etnik Kaukasia.Peran enzim lipase hepatik (HL) pada pembentukan small dense LDL; hubungan peningkatan konsentrasi leptin dengan didapatkannya small dense LDL dapat dihubungkan dengan efek enzim lipase hepatik. Bila pengaruh leptin terhadap didapatkannya small dense LDL terjadi dengan bantuan enzim lipase hepatik (HL) sebagai katalisator dapat dibuktikan, maka akan memperkuat bukti adanya hubungan antara leptin dengan didapatkannya small dense LDL.Hipotesis baru penelitian ini adalah, leptin mempunyai efek inhibisi terhadap enzim lipase hepatik di hati, atau analog dengan efek inhibisi insulin terhadap enzim HSL pada adiposit.Hasil penelitian dibandingkan dengan penelitian lipid sebelumnya; hasil penelitian ini dapat membuktikan perbedaan leptin dan profil lipid, yaitu konsentrasi asam lemak bebas, trigliserida dan kolesterol HDL pada kelompok subyek obesitas sentral dan subyek non-obes. Beberapa penelitian sebelumnya memberikan hasil yang berbeda.Simpulan: Penelitian ini adalah penelitian pertama yang membandingkan konsentrasi leptin dan hubungannya dengan small dense LDL pada kelompok obes dan non-obes pada populasi di Indonesia maupun di dunia. Hasil penelitian ini memperlihatkan bahwa konsentrasi leptin lebih tinggi secara bermakna pada kelompok obes sentral dibandingkan dengan kelompok non-obes, serta berhubungan secara bermakna dengan konsentrasi trigliserida, asam lemak bebas, apoB dan kolesterol HOL. Lebih jauh lagi, penelitian ini juga memperlihatkan hubungan antara leptin dan didapatkannya small dense LDL, di mana makin rendah leptin akan makin meningkatkan kemungkinan terdapatnya small dense LDL, Pada laki-laki dengan obesitas sentral, leptin berhubungan dengan prediksi didapatkannya small dense LDL. Leptin secara independen mempunyai efek protektif terhadap didapatkannya small dense LDL.

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ABSTRACT

Background: Leptin which is discovered by Zhang and Friedman (1994) is secreted by adipocytes and associated with obesity. In animals it has been shown that beside its effect on weight homeostasis, leptin also exerts peripheral effects that include lipid metabolism, i.e. lipogenesis and lipolysis. The results of studies on humans are conflicting. The increased lipolysis and decreased lipogenesis resulted in an increase synthesis of fatty acids which is followed by triglycerides. At a certain level of triglycerides, small dense LDL formation occur, an established component of atherogenic lipoprotein phenotype (ALP). Leptin has been implicated in this process especially in central obese individuals. The aim of the study is to show that leptin and lipid levels are higher in central obese as compared to non-obese individuals and to investigate the relationship between leptin levels and small dense LDL in central obese individuals.

Subjects: A total of 297 male subjects comprising 205 central obese and 92 nonobese age 30-59 years were enrolled in the study. Variables under study includes body mass index (BMI), serum leptin, triglyceride, free fatty acids, LDL-cholesterol, apoB, LDL-cholesterollapoB ratio, HDL-cholesterol and insulin levels.

Methods: This is a cross sectional study. The correlation between leptin and some variables, such as body mass index (BMI), triglycerides, free fatty acids, LDL-cholesterol, apoB, LDL-cholesterollapoB ratio, HDL-cholesterol and insulin levels was analyzed by unpaired t-test. Correlation between leptin and small dense LDL was analyzed by logistic regression. Plasma tryglycerides and free fatty acids were measured by enzymatic colorimetry method; apoB by immunoturbidimetry, LDL-cholesterol and HDL-cholesterol by homogenous method, insulin level by enzym-linked immunosorbent assay (BLISA), Plasma leptin was measured by immunoassay.

Results & Discussion: The characteristics between obese and nonobese subjects were different, such as mean plasma leptin levels were significantly higher in central obese than in nonobese individuals 9.71 (1.92) ng/mL vs. 2.63 (2.09) ng/mL, (P<0.001); mean triglycerides 159.1 (6.97) mg/dL vs. 119.4 (4.8) mg/dL; (P<0.001), free fatty acids 0.42 (0.01) mmol/L vs. 0.36 (0.02) mmol/L; (P=0.001), apoB 108.05 (21.1) mg/dL vs. 101.4 (20.4) mg/dL (P=0.012) were also higher in central obese than in nonobese individuals, and HDL-cholesterol is lower 40.6 (1.2) mg/dL vs. 46.2 (1.2) mg/dL; (P<0.001). LDL-cholesterol 138.9 (32.2) mg/dL vs. 137.8 (31.9) mg/dL (P=0.792). Among subjects with lnleptin < 7.5 pg/mL (L8 ng/mL) the risk of having small dense LDL increases by 5.92 times compared to subjects with lnleptin 9.87 pg/mL (19.34 ng/mL).

In regard to body mass index and the classification of obesity, the present study is in favor with the Asia Pacific classification and criteria for obesity, i.e. BMI > 25 kg/rn2 to be used for Indonesian population.

Relationship between waist circumferences, small dense LDL, leptin, BMI, dan HOMA-IR. There is a statistically significant strong relationship between waist circumference and leptin (r=0.72; P<0.05) and HOMA-IR P<0.05). Furthermore, mean of waist circumference differ significantly between subjects with and without small dense LDL (P=0.016).

Normal leptin levels for subjects with normal BMI is 2.04 ng/mL (range 0.45-9.26 ng/mL); and mean leptin levels for obese and nonobese were 9.71 and 2.63 ng/mL, respectively.

In regard to leptin resistance and leptin deficiency in obese subjects. Both leptin resistance and leptin dificiency is found in obese subjects, and the result indicate that leptin resistance in this population developed at lower leptin level (<20 ng/mL) as compared to Caucasian.

The possible role of hepatic lipase in small dense LDL formation. The relationship of increased leptin levels and the presence of small dense LDL could possibly be due to hepatic lipase (HL) effect. If the effect of leptin on small dense LDL formation is by way of HL as catalysator can be proven, this finding will then support the evidence of relationship between leptin and small dense LDL.

The hypothesis generated from the present study is that leptin inhibits the effect of HL in the liver in analogy with the inhibitory effect of insulin on HSL in the adipocyte.

Results arising from the present study support the view that leptin levels and lipid profile, i.e. free fatty acids, triglycerides, dan HDL cholesterol in obese differ from nonobese subjects, whereas other studies give different results.

Conclusion: This is the first study that compare leptin levels and determine the relationship between leptin and small dense LDL in central obese and nonobese male Indonesian subjects. The results showed that leptin levels are significantly higher in central obese as compared to nonobese individuals, and is correlated with triglycerides, free fatty acids, apoB and HDL-cholesterol in central obese individuals. Furthermore, this study also showed a relationship between leptin levels and small dense LDL in central obese individuals, in which lower leptin levels carries a higher probability of having more small dense LDL. Leptin has an independent protective effect for the occurrence of small dense LDL."