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"Latar belakang : Kejadian jatuh yang tinggi pada usia lanjut berhubungan erat dengan penurunan kekuatan otot. Seiring bertambahnya usia terjadi sarkopenia dimana massa otot berkurang sebesar 1-2% setiap tahun dan menyebabkan penurunan kekuatan otot sebesar 3%. Vitamin D mempunyai aksi biologis pada otot sehingga menjadi salah satu modalitas terapi sarkopenia. Walaupun peran vitamin D pada kekuatan otot masih kontroversial, namun studi sebelumnya menunjukkan analog vitamin D (alfacalcidol) dapat meningkatkan kekuatan otot dengan memakai luaran kekuatan otot ekstremitas bawah.Tujuan : Menentukan pengaruh alfacalcidol terhadap kekuatan otot ekstremitas atas yang diukur dengan pemeriksaan kekuatan genggam tangan pada perempuan usia lanjut Indonesia.Metode : Studi ini merupakan uji klinis acak tersamar ganda yang dilakukan selama bulan April-September 2012 di poliklinik Geriatri RS. Cipto Mangunkusumo, Jakarta. Subjek penelitian adalah perempuan berusia ≥ 60 tahun dengan kekuatan genggam tangan £ 22 kg yang diukur dengan dinamometer. Subjek dirandomisasi dalam dua kelompok yaitu kelompok yang menerima alfalcalcidol 1x0,5 mg dan kelompok kontrol menerima plasebo. Masing-masing kelompok mendapat kalsium laktat 500 mg dan diamati selama 90 hari. Pada akhir penelitian dilakukan pemeriksaan kekuatan genggam tangan.Hasil : Sebanyak 122 subjek direkrut, namun terdapat 27 subjek yang mempunyai kriteria eksklusi sehingga randomisasi membagi 95 subjek masing-masing 47 subjek pada kelompok alfacalcidol dan 48 subjek pada kelompok plasebo. Sebanyak 88 subjek menyelesaikan penelitian hingga akhir (7 drop out) dan dianalisis dengan uji Mann Whitney. Terdapat perbedaan peningkatan kekuatan otot yang bermakna antara kelompok alfacalcidol dibanding kelompok plasebo (15,50 kg vs. 13,75 kg ; p= 0,003).Kesimpulan: Analog vitamin D (alfacalcidol) dapat meningkatkan kekuatan otot perempuan usia lanjut Indonesia yang mempunyai kekuatan genggam tangan yang rendah dibandingkan pemberian plasebo.

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Background : The age-related increase in falls is strongly associated with a decline in muscle strength. Sarcopenia develops in concomitant with aging, where muscle mass decrease 1-2% annually, lead to 3% reduction in muscle strength. Vitamin D was known to have a biological action on muscle, so it was used as one of the therapy for sarcopenia. Although the role of vitamin D on muscle strength was still controversial, previous studies in vitamin D analog (alfacalcidol) reveal a promising effect in lower extremity muscle strength.Objective : To determine the effect of alfacalcidol on upper extremities muscle strength in elderly ambulatory Indonesian women.Methods : This was a randomized, double-blind clinical trial, which was conducted at Geriatrics Outpatient Clinic of Cipto Mangunkusumo General Hospital Jakarta, during April to September of 2012. The study subject consists of elderly women (aged ≥60 years old) with handgrip strength of ≤ 22 kg, measured with a handheld dynamometer. Subject was then randomized to two groups, one receiving alfacalcidol 1x0.5 mcg and the other receiving identically packaged placebo. Each group also received 500mg calcium lactate daily and then was observed for 12 weeks. At the end of the observation period, a second measurement of handgrip by using handheld dynamometer was performed.Outcome : A total 122 subjects were enrolled in this study. There were 95 subjects fulfilled the eligible criteria consist of 47 subjects receiving alfacalcidol and 48 subjects as a control. A number of 88 subjects were able to complete the intervention period and then the results were analyzed with Mann Whitney test. The study showed a significant increase of muscle strength in the intervention group compared to placebo (15.50 kg vs. 13.75 kg; p = 0.003).Conclusion : Daily doses of 0.5 mg alfacalcidol significantly improved muscle strength in elderly Indonesian women with low handgrip strength compared to placebo."

"Latar belakang: Peningkatan usia lanjut menimbulkan dampak kesehatan, diantaranya adalah sarkopenia dan kerapuhan. Kekuatan genggam tangan merupakan komponensarkopenia, fenotip sindrom kerapuhan, dan bersifat dinamis. Berbagai studi potonglintang menilai hubungan kekuataan genggam tangan dengan usia, jenis kelamin, statusnutrisi, status fungsional, status mental, dan komorbiditas namun temuan masihberagam. Selain itu, belum ada studi longitudinal untuk mengetahui hubunganperubahan kekuatan genggam tangan dengan usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas di Indonesia.Tujuan: Mengetahui hubungan antara usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas dengan perubahan kekuatan genggamtangan pada pasien usia lanjut.Metode: Penelitian kohort prospektif menggunakan data sekunder pasien usia lanjutyang kontrol rutin di Poliklinik Geriatri RSCM Jakarta dari register studi longitudinalINA-FRAGILE yang telah diobservasi selama 1 tahun (2013-2014). Uji analisismultivariat regresi logistik digunakan untuk menilai hubungan antara usia, jeniskelamin, status nutrisi (skor MNA), status fungsional (skor ADL), status mental (skorGDS-SF), indeks komorbiditas (skor CIRS) dengan perubahan kekuatan genggamtangan.Hasil: Dalam 1 tahun pengamatan dari 162 subjek, didapatkan rerata usia 72,9 (SB 5,9)tahun, jenis kelamin terbanyak perempuan (57,41%), memiliki nutrisi baik (83,9%),mandiri (median ADL 9–20), tidak depresi (median GDS-SF 0–11), rerata indekskomorbiditas 11,8 (SB 3,7), dan 53,1% mengalami penurunan kekuatan genggamtangan. Status nutrisi (OR=2,7; p=0,033) dan indeks komorbiditas (OR 0,3; p<0,002)berhubungan dengan kekuatan genggam tangan.Simpulan: Status nutrisi dan komorbiditas memengaruhi perubahan kekuatan genggamtangan pada pasien usia lanjut dalam 1 tahun di rawat jalan.

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Background: Increasing elderly population throughout the world has been related to

increased prevalence of sarcopenia and frailty. Handgrip strength is a component of

sarcopenia, one of frailty syndrome phenotypes, and a dynamic process. Previous

cross-sectional studies have assessed association of age, sex, nutritional status,

functional status, mental status and comorbodity but the results were varied. That being

said, there was no longitudinal study has been done to determine the correlation of

handgrip strength changes with age, sex, nutritional status, functional status, mental

status, and comorbidity in Indonesia.

Objective: To examine correlation between age, sex, nutritional status, functional

status, depressive symptopms, comorbidity, and handgrip strength changes in elderly

patients.

Methods: A prospective cohort study using secondary data of elderly patients whom

routinely visiting Geriatric Out-Patients Clinic at Cipto Mangunkusumo Hospital,

Jakarta from INA-FRAGILE register that have been observed for 1 year (2013-2014).

The multivariate logistic regression analysis was used to assess correlation between

sex, age, nutrional status (MNA score), functional status (ADL score), depressive

symptoms (GDS-SF score), comorbidities (CIRS score) and handgrip strength changes.

Results: From 162 subjects which were included in the study, the mean age was 72.9

(SB 5.9) years, predominantly female (57.41%), with good nutrition (83.9%),

independent (median 9- 20), not depressed (median 0-11), has average comorbidity

index 11.8 (SB 3.7), and 53.1% experienced decreased handgrip strength. Nutritional

status (OR = 2.7, p = 0.033) and comorbidity index (OR 0.3, p <0.002) correlated with

handgrip strength changes.

Conclusion: Nutritional status and comorbidity correlates with handgrip strength

changes in out-patients elderly within 1 year."

"Latar belakang: Peningkatan usia lanjut menimbulkan dampak kesehatan, diantaranya adalah sarkopenia dan kerapuhan. Kekuatan genggam tangan merupakan komponen sarkopenia, fenotip sindrom kerapuhan, dan bersifat dinamis. Berbagai studi potong lintang menilai hubungan kekuataan genggam tangan dengan usia, jenis kelamin, status nutrisi, status fungsional, status mental, dan komorbiditas namun temuan masih beragam. Selain itu, belum ada studi longitudinal untuk mengetahui hubungan perubahan kekuatan genggam tangan dengan usia, jenis kelamin, status nutrisi, status fungsional, status mental dan komorbiditas di Indonesia.Tujuan: Mengetahui hubungan antara usia, jenis kelamin, status nutrisi, status fungsional, status mental dan komorbiditas dengan perubahan kekuatan genggam tangan pada pasien usia lanjut.Metode: Penelitian kohort prospektif menggunakan data sekunder pasien usia lanjut yang kontrol rutin di Poliklinik Geriatri RSCM Jakarta dari register studi longitudinal INA-FRAGILE yang telah diobservasi selama 1 tahun (2013-2014). Uji analisis multivariat regresi logistik digunakan untuk menilai hubungan antara usia, jenis kelamin, status nutrisi (skor MNA), status fungsional (skor ADL), status mental (skor GDS-SF), indeks komorbiditas (skor CIRS) dengan perubahan kekuatan genggam tangan.Hasil: Dalam 1 tahun pengamatan dari 162 subjek, didapatkan rerata usia 72,9 (SB 5,9) tahun, jenis kelamin terbanyak perempuan (57,41%), memiliki nutrisi baik (83,9%), mandiri (median ADL 9–20), tidak depresi (median GDS-SF 0–11), rerata indeks komorbiditas 11,8 (SB 3,7), dan 53,1% mengalami penurunan kekuatan genggam tangan. Status nutrisi (OR=2,7; p=0,033) dan indeks komorbiditas (OR 0,3; p<0,002) berhubungan dengan kekuatan genggam tangan.Simpulan: Status nutrisi dan komorbiditas memengaruhi perubahan kekuatan genggam tangan pada pasien usia lanjut dalam 1 tahun di rawat jalan.

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Background: Increasing elderly population throughout the world has been related to increased prevalence of sarcopenia and frailty. Handgrip strength is a component of sarcopenia, one of frailty syndrome phenotypes, and a dynamic process. Previous cross-sectional studies have assessed association of age, sex, nutritional status, functional status, mental status and comorbodity but the results were varied. That being said, there was no longitudinal study has been done to determine the correlation of handgrip strength changes with age, sex, nutritional status, functional status, mental status, and comorbidity in Indonesia.

Objective: To examine correlation between age, sex, nutritional status, functional status, depressive symptopms, comorbidity, and handgrip strength changes in elderly patients.

Methods: A prospective cohort study using secondary data of elderly patients whom routinely visiting Geriatric Out-Patients Clinic at Cipto Mangunkusumo Hospital, Jakarta from INA-FRAGILE register that have been observed for 1 year (2013-2014). The multivariate logistic regression analysis was used to assess correlation between sex, age, nutrional status (MNA score), functional status (ADL score), depressive symptoms (GDS-SF score), comorbidities (CIRS score) and handgrip strength changes.

Results: From 162 subjects which were included in the study, the mean age was 72.9 (SB 5.9) years, predominantly female (57.41%), with good nutrition (83.9%), independent (median 9- 20), not depressed (median 0-11), has average comorbidity index 11.8 (SB 3.7), and 53.1% experienced decreased handgrip strength. Nutritional status (OR = 2.7, p = 0.033) and comorbidity index (OR 0.3, p <0.002) correlated with handgrip strength changes.

Conclusion: Nutritional status and comorbidity correlates with handgrip strength changes in out-patients elderly within 1 year."

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Penurunan massa otot pada usia lanjut menimbulkan sarkopenia,salah satu penyebabnya adalah proses inflamasi. Rasio asam lemak omega-3/omega-6 dapat memengaruhi proses inflamasi, namun hubungannya dengan massa otot masih menunjukkan hasil yang beragam. Penelitian potong lintang ini bertujuan untuk mengeksplorasi korelasi rasio asupan asam lemak omega-3/omega-6 dan kadar asam lemak omega-3 dengan massa otot pada usia lanjut di lima panti wreda yang terdaftar di Kota Tangerang Selatan. Penelitian ini melibatkan 101 usila yang didapatkan menggunakan proportional random sampling. Rasio asupan asam lemak omega-3 dan omega-6 dinilai menggunakan food record 3x24 jam dan food frequency questionnaire semikuantitatif, kadar asam lemak omega-3 membran eritrosit diukur menggunakan gas chromatography-mass spectrometry, dan pemeriksaan massa otot menggunakan bioelectrical impedance analysis. Analisis korelasi menggunakan uji Spearman. Didapatkan rerata usia subjek adalah 75.5 ± 7.6 tahun dengan 73.3% subjek adalah perempuan. Rasio asupan asam lemak omega-3/omega-6 subjek menggunakan food record adalah 0,09 (0,05-0,22) dan 0,08 (0,05-0,23) menggunakan FFQ semikuantitatif. Nilai tengah kadar asam lemak omega-3 membran eritrosit subjek untuk ALA=10,06 (4,9-24,9) µg/mL, EPA=14,6 (5,06-81,02) µg/mL, DHA=115,5 (20,6-275,09) µg/mL, dan total omega-3=144,1 (89,3-332,1) µg/mL. Nilai tengah massa otot subjek adalah 35,5 (22,8-63,5) kg. Hasil penelitian ini menunjukkan tidak terdapat korelasi antara rasio asupan asam lemak omega-3/omega-6 dengan massa otot baik menggunakan food record (r = -0.2, p = 0.07), maupun FFQ semikuantitatif (r = 0.01, p = 0.9), dan tidak terdapat korelasi antara kadar ALA, EPA, DHA, total asam lemak omega-3 membran eritrosit dengan massa otot berturut-turut (r = -0.03, p = 0.8; r = 0.01, p = 0.9; r = -0.06, p = 0.5; dan r = -0.02, p = 0.8).

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The phenomenon of muscle mass deterioration appeared in the elderly called sarcopenia, one of the reasons was the inflammatory process. The ratio of omega-3 and omega-6 fatty acids are known to influence the inflammatory process. However, the relationship of this ratio with muscle mass are still conflicting. This cross-sectional study aimed to explore the correlations of omega-3/omega-6 fatty acids intake ratio and omega-3 fatty acids erythrocyte membrane levels with muscle mass among the elderly in five registered nursing homes in South Tangerang City. This study involved 101 elderly from the proportional random sampling method. The ratio of omega-3 and omega-6 fatty acids intake was assessed using 3-days food records and semi-quantitative food frequency questionnaire (SQ-FFQ). Moreover, omega-3 fatty acid erythrocyte membrane levels were measured using gas chromatography-mass spectrometry and muscle mass were examined using bioelectrical impedance analysis. We used Spearman analysis to investigate the correlation. The mean age of the participants was 75.5 ± 7.6 years and most of the participants were female (73.3%). Furthermore, the median value of omega-3 and omega-6 fatty acid intake ratio was 0.09 (0.05 – 0.22) using 3-days food records and 0.08 (0.05 – 0.23) using SQ-FFQ, the median value of omega-3 erythrocyte membrane levels for ALA = 10.06 (4.9-24.9) µg/mL, EPA = 14.6 (5.06 – 81.02) µg/mL, DHA = 115.5 (20.6 – 275.09) µg/mL, total omega-3 = 144.1 (89.3 – 332.1) µg/mL, and the median value of muscle mass were 35.5 (22.8 – 63.5) kg. We did not find strong correlation between omega-3/omega-6 fatty acids intake ratio and muscle mass using either 3-days food records (r = -0.2, p = 0.07), or SQ-FFQ (r = 0.01, p = 0.9), and no strong correlations found between ALA, EPA, DHA, total omega-3 fatty acids erythrocyte membrane levels and muscle mass (r = -0.03, p = 0.8; r = 0.01, p = 0.9; r = -0.06, p = 0.5; and r = -0.02, p = 0.8), respectively.

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"ABSTRAKLatar belakangBerbagai studi terdahulu melaporkan bahwa alfacalcidol mampu meningkatkan kekuatan otot, keseimbangan dan signifikan dalam menurunkan kejadian jatuh pada ras Kaukasia. Namun belum ada penelitian yang membuktikan peran alfacalcidol terhadap mobilitas fungsional pada ras Asia.TujuanMengetahui pengaruh pemberian alfacacidol 0,5 µg selama 90 hari terhadap mobilitas fungsional dasar perempuan usia lanjut di Indonesia.MetodeDilakukan uji klinis acak tersamar ganda pada bulan April-September 2012 terhadap 95 pasien perempuan usia lanjut di Poliklinik Geriatri RS Cipto Mangunkusumo Jakarta, Indonesia. Subyek dibagi menjadi kelompok yang mendapat alfacalcidol dan kalsium 500 mg sehari sekali selama 90 hari dan kelompok yang mendapat plasebo dan kalsium 500 mg. Dilakukan uji timed-up and Go Test (TUG) pada awal dan akhir penelitian. Dilakukan analisis per protokol dan uji Mann-Whitney untuk melihat perbedaaan mobilitas fungsional pada kedua kelompok setelah intervensi.Hasil95 subyek dirandomisasi dan dibagi menjadi dua kelompok, terdiri dari 48 subyek yang mendapat plasebo dan 47 subyek mendapat alfacalcidol. Setelah tiga bulan pengamatan didapatkan perbaikan waktu uji TUG yang signifikan pada kedua kelompok (2,49 vs 1,83 detik; p<.0001). Terdapat perbaikan waktu uji TUG yang signifikan dari kelompok alfacalcidol dibandingkan dengan kelompok plasebo (9,01 vs.10,07 detik; p = 0.028).KesimpulanAlfacalcidol dengan dosis 0,5 µg satu kali per hari selama 90 hari terbukti mampu meningkatkan mobilitas fungsional dasar pada perempuan usia lanjut Indonesia.

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ABSTRACTBackgroundPrevious studies reported the D-analog alfacalcidol, increases muscle power and balance and lead to a highly significant decreases in the number of fallers and falls in Caucasian elderly community-dwelling population.ObjectiveTo determine the effect of alfacalcidol on functional mobility in Indonesian elderly women community-dwelling population.MethodsA randomized, double-blind controlled trial was conducted in elderly women subjects geriatric clinic of Cipto Mangunkusumo National Hospital Jakarta Indonesia on April-September 2012. Intervention group was given 0,5 mcg alfacalcidol and 500 mg calcium daily for 90 days and another group was given placebo and 500 mg calcium. Balance test, Timed-up and Go Test (TUG) was measured at the beginning and after 3 months. Per protocol analysis to functional mobility after intervention between the two groups was performed.Results95 subjects were fulfiling study criteria and randomized into 2 groups, containing 47 subjects in alfacalcidol group and 48 subjects in placebo group. Both groups were comparable in all important prognostic factors including age, BMI, nutritional status, muscle strength. After three months the mean time in alfacalcidol group used for the TUG was decrease significantly by 2,49 s (p<.0001). There were significant improvement of the median time for TUG in the group that received alfacalcidol compared to placebo (9,01 vs.10,07 p = 0.028).ConclusionTreatment with 0.5 mg alfacalcidol with calcium effectively improved functional mobility in Indonesian elderly women."

"Tesis ini disusun untuk mengetahui hubungan antara tingkat aktivitas fisik dan performa fisik dengan keadaan sarkopenia pada penderita obesitas usia lanjut di komunitas. Penelitian ini merupakan studi deskriptif analitik potong-lintang dengan teknik pengambilan secara konsekutif. Kriteria inklusi diantaranya adalah subjek berusia ≥ 60 tahun, indeks massa tubuh ≥ 25 Kg / m2, mampu berjalan minimal 10 meter dan fungsi kognitif baik, Subjek yang menggunakan alat pacu jantung, terdapat implant metal di dalam tubuh, memiliki riwayat penyakit kanker, gangguan kardiovaskular dan respirasi akut, deformitas atau nyeri pada ekstremitas dan mendapatkan latihan terapeutik atau olahraga teratur dieksklusi dari penelitian ini. Pengukuran tingkat aktivitas fisik menggunakan kuesioner Physical Activity Scale for Elderly (PASE) dan performa fisik menggunakan uji kecepatan berjalan 6 meter dan uji timed up and go test (TUG). Penegakkan sarkopenia berdasarkan kriteria Asian Working Group of Sarcopenia 2019 dengan pengukuran komposisi tubuh menggunakan Bioelectric Impedance Analysis (BIA). Pada penelitian ini, didapatkan proporsi sarkopenia pada keseluruhan subjek (n = 119) adalah 23,5% dengan 71,4% berjenis kelamin perempuan. Hasil analisis menunjukkan bahwa tidak ada hubungan yang signifikan pada variabel tingkat aktivitas fisik (p > 0,05) dan hubungan yang signifikan pada variabel kecepatan berjalan dan uji TUG (p < 0,05). Kesimpulan pada penelitian adalah terdapat hubungan yang signifikan antara performa fisik dengan kondisi sarkopenia pada penderita obesitas usia lanjut di komunitas.

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This thesis was aimed to determine the association between physical activity level and physical performance with sarcopenia in elderly obese patient in community. The research design is a cross sectional study with consecutive sampling. Inclusion criteria included subjects with age ≥ 60 years old, body mass index ≥ 25 Kg / m2, able to walk at least 10 meters, and has a good cognitive function. Subjects with pacemaker, have metal implants, history of cancer, acute cardiovascular and respiratory disorders, deformities or pain in extremities and receive regular therapeutic exercise were excluded from this research. Measurement of physical activity level using Physical Activity Scale for Elderly (PASE) questionnaire and physical performance using 6meter walking speed test and timed up and go test (TUG). Sarcopenia is based on criteria from Asian Working Group of Sarcopenia 2019 with body composition assessment using Bioelectric Impedance Analysis (BIA). In this research, the proportion of sarcopenia in all subjects (n = 119) was 23,5% with 71,4% was female. The results showed that there was no significant association on physical activity level (p > 0,05) and a significant association on walking speed and TUG test (p < 0,05). This research concluded that there is a significant association between physical performance with sarcopenia in elderly obese patient in the community."

"Latar Belakang: Sarkopenia mempengaruhi prognosis karsinoma sel hati (KSH). Dalam penilaian klasifikasi Barcelona Clinic Liver Cancer (BCLC) terkandung penilaian status performa Eastern Cooperative Oncology Group (ECOG). Status performa ECOG merupakan penilaian aktivitas fisik terkait sarkopenia. Pemeriksaan baku emas sarkopenia pada KSH mahal dan membutuhkan banyak waktu. Pemeriksaan tebal otot paha dapat digunakan sebagai modalitas yang baru. Studi ini bertujuan untuk menilai hubungan antara status performa ECOG dengan sarkopenia pada KSH, mengetahui perbedaan rerata antara tebal otot paha pasien status performa ECOG rendah dengan status performa ECOG tinggi pada KSH, dan mengetahui perbedaan rerata antara tebal otot paha pasien sarkopenia dengan non sarkopenia pada KSH.Metode: Studi ini dilakukan di RS tersier selama Januari – Oktober 2021. Analisis statistik dilakukan untuk memperoleh hubungan antara status performa ECOG, tebal otot paha, dan status sarkopenik pasien KSH.Hasil: Delapan puluh lima subjek pasien KSH (usia median, 52 tahun) dilakukan analisis. Sarkopenia diamati pada 30,6% pasien KSH. Setelah melalui analisis multivariat, status performa ECOG buruk berhubungan dengan sarkopenia pada KSH (adjusted OR = 6,35, IK 95% 2,06-19,60). Terdapat perbedaan signifikan rerata tebal otot paha pasien status performa ECOG rendah dengan status performa ECOG tinggi pada KSH (p < 0,001). Terdapat juga perbedaan signifikan rerata tebal otot paha pasien sarkopenia dan non sarkopenia (p < 0,001).Kesimpulan: Terdapat hubungan antara status performa ECOG tinggi dengan sarkopenia pada KSH (aOR = 6,35, IK 95% 2,06-19,60). Rerata tebal otot paha pasien status performa ECOG rendah lebih besar dibanding dengan status performa ECOG tinggi pada karsinoma sel hati. Rerata tebal otot paha pasien non sarkopenia lebih besar dibanding dengan sarkopenia pada karsinoma sel hati.

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Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. HCC staging consists of Eastern Cooperative Oncology Group performance status (ECOG-PS). ECOG-PS is an assessment of physical activity related to sarcopenia. Gold standard examinations for sarcopenia in HCC are expensive and time-consuming. Thigh muscle thickness can be used as a new modality. This study was aimed to explore the association between ECOG-PS with sarcopenia, to seek thigh muscle thickness difference between poor and good performance status, and to know thigh muscle thickness difference between sarcopenic and non-sarcopenic patients with HCC.

Methods: The study was conducted in a tertiary hospital during January – October 2021. Statistical analysis was performed to obtain an association between ECOG-PS, thigh muscle thickness, and sarcopenic status of HCC patients.

Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 30,6% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 6,35, 95% CI 2,06-19,6, p < 0,001). There was a significant difference in thigh muscle thickness between good and poor performance status (p < 0,001). There was also a significant difference in thigh muscle thickness between sarcopenic and non-sarcopenic patients (p < 0,001).

Conclusion: There were association between ECOG-PS and sarcopenia in HCC (aOR = 6,35, IK 95% 2,06-19,60). Mean thigh muscle thickness was larger in HCC patients with good ECOG-PS than poor ECOG-PS. Mean thigh muscle thickness was larger in non-sarcopenic HCC patients than sarcopenic ones."

"Sarkopenia menyebabkan luaran buruk pada populasi hemodialisis reguler. Panduan diagnosis dan cara pengukuran yang berbeda menyebabkan rentang prevalensi yang besar. Faktor yang berperan terhadap sarkopenia pada hemodialisis reguler belum diketahui. Tujuan: Mengetahui prevalensi dan hubungan fosfat dengan sarkopenia pada hemodialisis reguler. Metode: Studi potong lintang observasional pada 96 pasien hemodialisis reguler, usia ≥18 tahun, lama hemodialisis ≥120 hari di RSCM (Maret-Mei 2022).Uji deskriptif, analisis bivariat, dan regresi logistik mendapatkan prevalensi dan hubungan antara Simplify Creatinine Index, DM type 2, IL-6, status gizi, aktivitas fisik, dan fosfat dengan sarkopenia. Diagnosis sarkopenia menggunakan kriteria AWGS 2019. Hand Grip Strength untuk kekuatan otot, massa otot dengan Bioimpedance Spectroscopy dan performa fisik dengan uji berjalan 6 meter. Hasil: Prevalensi sarkopenia adalah 54,2% dan rerata kadar fosfat 4,08 mg/dL (SB 1,45 mg/dL). Beda rerata kadar fosfat kelompok sarkopenia dengan kelompok tanpa sarkopenia adalah 3,73mg/dL vs 4,5 mg/dL, p=0,008. Faktor lain yang berhubungan dengan sarkopenia adalah SCI (p=0,005), dan aktivitas fisik ringan (p=0,006). Fosfat tidak berhubungan bermakna setelah menambahkan perancu. Kesimpulan: Prevalensi sarkopenia dengan kriteria AWGS 2019 pada populasi hemodialisis reguler adalah 54,2%. Kelompok sarkopenia memiliki rerata fosfat lebih rendah dibandingkan dengan kelompok tanpa sarkopenia, hubungan menjadi tidak bermakna setelah menambahkan variabel perancu.

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Sarcopenia asscociated with worse outcomes in MHD patients. Difference in criteria and methods used to diagnose causing wide range of prevalence. Factors asscociated with sarcopenia in MHD have not been well studied. Objective: to investigate the prevalence and asscociation between phosphate and sarcopenia in MHD. Methods: Observational cross-sectional study in 96 MHD patients ≥18 years old, dialysis vintage ≥120 days in RSCM March-May 2022. Descriptive, bivariate, and logistic regression used to find prevalence and asccociation with Simplify Creatinine Index, type 2 DM, IL-6, nutritional status, physical activity, and phosphate. AWGS 2019 criteria used to diagnose sarcopenia, Hand Grip Strength for muscle strength, Bioimpedance Spectroscopy for muscle mass, and 6-meter walk for physical performance. Results: Sarcopenia prevalence was 54.2% and mean phosphate was 4,08 mg/dL (SD 1,45 mg/dL). Mean difference of phosphate in sarcopenia group compared to non-sarcopenia group is 3,73mg/dL vs 4,5 mg/dL, p=0,008. Factors with significant association were SCI (p=0.005) and low physical activity (p-0.006). Phosphate no longer asscociate significantly with sarcopenia after adjustement. Conclusions: Sarcopenia prevalence in MHD population with AWGS 2019 criteria was 54.2%. Sarcopenia group has significant lower mean phosphate compared to non-sarcopenia group, but the asscociation no longer significant after adjustment with confounding variables."

"Latar Belakang: Sarkopenia dan obesitas sering ditemukan pada populasi lanjut usia (lansia). Kombinasi sarkopenia dan obesitas, yaitu obesitas sarkopenia, memiliki morbiditas dan mortalitas lebih tinggi dibandingkan salah satu entitas saja. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara obesitas perifer dan sentral dengan komponen sarkopenia. Metode: Studi potong-lintang ini memakai data sekunder dari penelitian validasi skor Sarcopenia Quality of Life (SARQoL) terhadap lansia ≥60 tahun di Poliklinik Geriatri Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia, periode April–Juni 2018. Analisis multivariat dilakukan terhadap obesitas (indeks massa tubuh [IMT] dan lingkar pinggang [LP]) dan komponen sarkopenia (kekuatan genggam tangan [KGT], indeks massa otot [appendicular skeletal muscle mass per tinggi badan kuadrat, ASMM/TB2], dan kecepatan berjalan) untuk disesuaikan dengan perancu (usia, diabetes melitus, dan aktivitas fisik). Nilai potong diagnostik masing-masing komponen sarkopenia memakai panduan the Asian Working Group on Sarcopenia (AWGS) 2019. Hasil: Rerata usia dari 120 subjek adalah 71,89 (6,11) tahun, dengan proporsi wanita 61,70%. Seluruh subjek menunjukkan rerata IMT 22,48 (4,60) kg/m2; median LP 91,48 (65,40-113,00) cm; rerata ASMM/TB2 6,88 (0,96) kg/m2; median KGT 20 (10,00-40,00) kg; dan rerata kecepatan berjalan 0,76 (0,23) meter/detik. KGT rendah ditemukan lebih sedikit pada kelompok obesitas perifer dibandingkan nonobesitas perifer (adjusted odds ratio OR 0,419; interval kepercayaan IK 95% 0,183-0,959; p=0,040). ASMM/TB2 rendah lebih sedikit pada kelompok obesitas sentral dibandingkan nonobesitas sentral (adjusted OR 0,087; IK 95% 0,029-0,262; p <0,001). Simpulan: Terdapat efek protektif obesitas perifer dan sentral terhadap sarkopenia, tetapi hubungan ini terbatas pada IMT <30 kg/m2.

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Background: Increasing number of elderly is accompanied by increasing prevalence of sarcopenia and obesity. Combination of sarcopenia and obesity, which is called as sarcopenic obesity, associated with higher morbidity and mortality compared to either obesity or sarcopenia alone. Objectives: This study aimed to determine the association between obesity profiles and sarcopenia components.

Methods: This cross-sectional study was using data from the validation study of Sarcopenia Quality of Life (SARQoL) score, of which conducted in geriatric outpatient clinic of Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Multivariate analysis between obesity (body mass index [BMI] and waist circumference [WC]) and sarcopenia components (handgrip strength [HGS], muscle mass index [appendicular skeletal muscle mass/ height square, ASMM/h2], and gait speed was adjusted to age, diabetes mellitus, and physical activities.

Results: Out of 120 subjects, there was 61.70% women. All subjects had mean of age 71.89 (6.11) years old; mean of BMI 22.48 (4.60) kg/m2; median of WC 91.48 (65.40-113.00) cm; mean of ASMM/h2 6.88 (0.96) kg/m2; median of HGS 20 (10.00-40.00) kg; and mean of gait speed 0.76 (0.23) meter/second. Low HGS was found statistically significant in lower proportion for peripheral obesity group than non-peripheral obesity group (adjusted odds ratio OR 0.419, 95% confidence interval CI 0.183-0.959, p=0.040); and low muscle mass index was lower in central obesity group than non-central obesity group (adjusted OR 0.087, 95% CI 0.029-0.262, p <0.001).

Conclusion: There were protective effects of peripheral and central obesity against sarcopenia"