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"Latar belakang: Resistensi insulin dan obesitas sentral adalah keadaan yang sering ditemukan pada wanita PCOS dan ditandai dengan abnormalitas penanda biologi yang terkait dengan terjadinya gangguan metabolik. Hubungan antara adiponektin dan resistensi insulin telah banyak diteliti, namun penelitian terhadap pasien PCOS baru sedikit yang dilakukan. Penelitian ini bertujuan untuk menentukan kemungkinan hubungan polimorfisme T45G dengan penanda biologi PCOS dan pengaruhnya terhadap adiponektin serum pada populasi Indonesia.Metode: Lima puluh dua pasien PCOS dan 52 subjek ovulasi normal tanpa hiperandrogenisme sebagai kontrol disertakan dalam penelitian ini. Sampel darah dikumpulkan antara hari ke 3 dan 5 siklus menstruasi spontan, jam 7 hingga 9 pagi, setelah menjalani puasa. Dilakukan pengukuran kadar serum FSH, LH, testosteron, SHBG, glukosa, insulin, profil lipid dan adiponektin. Resistensi insulin ditentukan dengan HOMA-IR, HOMA-β, dan SHBG. DNA genom dari darah perifer pasien dan subjek kontrol digunakan untuk memeriksa polimorfisme T45G menggunakan metode PCR.Hasil: Terdapat perbedaan yang signifikan antara kelompok PCOS dan kontrol terhadap IMT, LH, testosteron, SHBG, dan FAI, tetapi tidak signifikan terhadap frekuensi distribusi polimorfisme gen T45G. Kadar adiponektin ditemukan lebih rendah pada kelompok PCOS daripada kontrol, dan terdapat hubungan antara resistensi insulin dengan PCOS. Pada pasien PCOS frekuensi polimorfisme T45G ditemukan lebih tinggi pada wanita dengan adiponektin kadar rendah dari pada kelompok adiponektin kadar tinggi, meskipun tidak bermakna secara statistik. Tidak ditemukan hubungan antara penanda biologi PCOS (LH, testosteron, SHBG, dan FAI) dengan polimorfisme gen T45G.Kesimpulan: Polimorfisme gen adiponektin (T45G) tidak berhubungan langsung dengan penanda biologi PCOS, namun demikian hubungannya dengan adiponektin perlu penelitian lebih lanjut.

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Background: Insulin resistance and central adiposity are frequent disorders in PCOS women, which are marked by biological marker dysregulation related to this metabolic abnormalities. Association between adiponectin and insulin resistance has been investigated in many studies, while only a few studies were done in PCOS patients. This study is to determine the association of T45G polymorphisms in Indonesian population with PCOS biological markers and their influence to adiponectin serum.

Methods: Fifty-two PCOS patients and 52 normal ovulatory women without hyperandrogenism as control subjects were included. Blood samples were collected between day 3 and 5 of a spontaneous menstrual cycle at 7 to 9 am, after overnight fasting. Serum levels of FSH, LH, testosterone, SHBG, glucose, insulin, lipid profile and adiponectin were measured. Insulin resistance was estimated by HOMA-IR, HOMA-β, and SHBG. T45G gene polymorphisms were determined by PCR after genomic DNA was obtained from peripheral blood of patients and control subjects.

Results: There were significant difference between PCOS and control group in term of BMI, LH, testosterone, SHBG, and FAI, but not significant to T45G gene polymorphisms frequency distribution. Adiponectin levels were lower in PCOS patients than control. There was an association between insulin resistance with PCOS. Among PCOS patients, no association between adiponectin LH, testosterone, SHBG, and FAI with T45G gene polymorphisms. T45G gene polymorphisms were more frequent in PCOS with low adiponectin levels compared to those with high adiponectin levels, although not significant statistically.

Conclusion: T45G gene polymorphisms has no direct association with PCOS biological markers, but its association with adiponectin needs further study."

"Objektif : Untuk mengetahui asosiasi antara profil antropometri,dan lipid dengan kejadian resistensi insulin pada subjek SOPK.Latar belakang: Patofisiologi Hiperandrogen dan gangguan ovulasi pada SOPKadalah resistensi insulin (RI) dan kondisi hiperinsulinemia. kondisi tersebut dapatterjadi di ovarium dan kelenjar adrenal, kondisi ini dilaporkan terjadi pada 40%-70% pada subjek SOPK, SOPK pengukuran golden standar denganHyperinsulinaemic euglycaemic clamp technique,tehnik untuk menilai sekresi danresistensi insulin, namun tehnik tersebut kompleks serta membutuhkankemampuan ahli dan kurang tepat untuk praktik klinis. Penilaian Pengukuranresistensi insulin pengganti dengan homeostatik model assessment insulinresistance (HOMA-IR), disini digunakan titik potong 2,69. Subjek SOPKsebagian besar memiliki profil antropometri yang abnormal lebih dari delapanpuluh persen (> 80%), dan dengan kondisi dislipidemia (> 70%), peneliti inginmengetahui asosiasi profil antropometri, lipid terhadap resistensi Insulin padaSOPK.Metodologi: Penelitian ini merupakan penelitian lanjutan dari uji klinis DLBS3233 yang selesai pada bulan juni 2019, analisis data tambahan dilakukan sejakJuli-Desember 2019. Tempat pelaksanaan pengambilan sampel penelitian iniadalah di RSUPN Dr. Cipto Mangunkusumo dan Klinik Yasmin RSCM Kencana.Dilakukan analisis asosiasi antaraprofil antropometri dan profil lipid terhadapresistensi insulin.Hasil : Didapatkan faktor-faktor yang berhubungan dengan kejadian resistensiinsulin pada subjek SOPK, pada profil antropometri didapatkan variabel lingkarpinggang dan index masa tubuh berhubungan dengan kejadian resistensi insulin,pada metabolik didapatkan variabel GD2PP, insulin puasa, LDL, Tigliseridaberhubungan dengan.Didapatkan bahwa variabel Trigliserida memiliki pengaruhkuat pada resistensi insulin, dengan confounding faktor variabel IMT.Kesimpulan : didapatkan profil antropometri IMT dan dan profil lipidTrigliserida berhubungan dengan kejadian resistensi insulin di RSCM berdasarkangambaran profil pasien di RSCM.

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Objective: To determine the association between anthropometric and lipidprofiles with the incidence of insulin resistance among PCOS subjects.Background: Insulin resistance (IR) and hyperinsulinemia conditions is thekey of pathophysiology and ovulation disorders in PCOS. These conditions canoccur in the ovaries and adrenal glands, reported occur in 40%-70% amongPCOS subjects, golden standard measurement IR with hyperinsulinaemiceuglycaemic clamp technique, a technique to assess insulin secretion andresistance, but the technique is complex and requires expert ability and notappropriate for clinical practice. Assessment Measuring substitute insulinresistance with a homeostatic insulin resistance assessment model (HOMA-IR),we use cutoff point of 2.69. PCOS subjects mostly had an abnormalanthropometric profile (> 80%), and with dyslipidemia (>70%), researcherswanted to know the association of anthropometric profiles, lipids to Insulinresistance in PCOSMethodology: This study is a follow-up study of DLBS 3233 clinical trialcompleted in June 2019, additional data analysis was carried out since July-December 2019. The place for conducting the sample collection was atDr.Cipto Mangunkusumo Hospital and Yasmin Clinic RSCM Kencana. Anassociation analysis was performed between anthropometric profiles and lipidprofiles on insulin resistance.Result: Waist circumference and body mass index as antropometric factorassociated with insulin resistanc, 2 hour fasting glucose, fasting insulin, LDL,triglycerida as lipid factor associated with insulin resistance in PCOS. It wasfound that the triglyceride had a strong influence on insulin resistance, andbody mass index as confounding factor of insulin resistance in PCOSConclusions : Triglyceride and body mass index related to the incidence ofinsulin resistance in RSCM based on the profile of patients in RSCM."

"ABSTRAKResistensi insulin adalah kondisi yang mendasari terjadinya diabetes melitus. Prevalensi diabetes melitus kian meningkat dari tahun ke tahun, termasuk di Indonesia. Proporsi penderita diabetes melitus ditemukan lebih tinggi pada perempuan. Perubahan fisiologis yang terjadi selama kehamilan merupakan salah satu penyebab terjadinya resistensi insulin dan resistensi insulin ini dapat bertahan hingga masa postpartum. Laktasi serta nutrien salah satunya seng, dapat memengaruhi resistensi insulin. Penelitian dengan desain potong lintang ini bertujuan menilai kadar seng serum dan korelasinya dengan resistensi insulin pada ibu laktasi di Jakarta. Pengambilan subjek dilakukan di Puskesmas Kecamatan Cilincing, Jakarta Utara dan Grogol Petamburan, Jakarta Barat pada bulan Februari-April 2019. Sebanyak 75 orang ibu laktasi pada 3-6 bulan postpartum yang berusia 20-40 tahun direkrut menjadi subjek penelitian ini. Sekitar 76% (n=57) subjek memiliki kadar seng rendah dengan rerata sebesar 62,33±11,89 µg/dL. Resistensi insulin dinilai dengan menggunakan HOMA-IR (homeostasis model assessment-insulin resistance). Median HOMA-IR adalah 0,54 (0,22-2,21). Sebanyak 13,3% (n=10) subjek diprediksi mengalami resistensi insulin. Dilakukan uji korelasi antara kadar seng serum dengan HOMA-IR. Tidak ditemukan adanya korelasi bermakna antara kadar seng serum dengan HOMA-IR (r=0,003, p=0,977)."

"Penelitian ini bertujuan untuk menilai efek suplementasi probiotik pada masa kanak-kanak terhadap indeks resistensi insulin pada masa remaja. Studi ini merupakan studi tindak lanjut tahun ke-10 dari uji klinis pemberian probiotik dan kalsium pada anak-anak yang tinggal di daerah sosioekonomi rendah di Jakarta Timur, yang diadakan pada bulan Januari hingga Maret 2019. Studi ini melibatkan 154 remaja berusia 11-17 tahun, yang terbagi menjadi 3 kelompok berdasarkan intervensi terdahulu (kalsium regular (KR) sebagai kelompok kontrol, kelompok reuteri, dan kelompok casei). Luaran utama berupa perbedaan resistensi insulin yang dinilai dengan homeostatic model assessment for insulin resistance (indeks HOMA-IR) diantara ketiga kelompok sesudah dilakukan penyesuaian terhadap faktor perancu, seperti usia, jenis kelamin, status pubertas, status nutrisi, aktivtas fisik, dan pola asupan makanan. Studi ini memperoleh karakteristik subjek tidak berbeda bermakna diantara kelompok KR, casei, dan reuteri. Pola asupan makanan subjek juga tidak berbeda bermakna diantara kelompok RC, casei, dan reuteri. Rerata indeks HOMA-IR pada kelompok casei, reuteri, dan KR berturut-turut adalah 3,5 ± 1,9; 3,2 ± 1,7; 3,2 ± 1,6. Rerata indeks HOMA-IR tidak berbeda bermakna diantara kelompok casei dan RC (mean differences (MD): 1,10 [95% CI: 0.9-1.33]), diantara kelompok reuteri dan RC (MD:0.99 [95% CI: 0.82-1.22]) sesudah penyesuaian terhadap usia, jenis kelamin, status gizi, asupan serat, dana asupan lemak. Suplementasi probiotik selama 6 bulan pada masa kanak-kanak diduga tidak memengaruhi indeks resistensi insulin pada masa remaja.

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Objective: To investigate the effect of probiotic supplementation in the childhood toward insulin resistance index in adolescence.

Methods: This study was a 10-year follow-up study on probiotic and calcium trial in children living in low-socioeconomic urban area of East Jakarta between January and March 2019. This study involved 154 adolescents aged 11-17 years, divided into 3 groups based on previous intervention (regular calcium as a control group, reuteri group, and casei group). Primary outcome was differences in insulin resistance that measured by homeostatic model assessment for insulin resistance (HOMA-IR index) between the three groups after adjustment of the confounding factor, such as age, gender, pubertal status, nutritional status, physical activity, and dietary intake patterns.

Results: Subjects' characteristics were not significantly different among casei, reuteri, and RC. Subjects' dietary intake patterns also were not significantly different among casei, reuteri, and RC. The mean HOMA-IR in casei, reuteri, and RC were 3.5 ± 1.9, 3.2 ± 1.7, 3.2 ± 1.6, irrespectively. The mean HOMA-IR index were no significantly different between casei and RC (mean differences (MD): 1,10 [95% CI: 0.9-1.33]), between reuteri and RC (MD:0.99 [95% CI: 0.82-1.22]) after adjusted with age, gender, nutritional status, fiber intake, and fat intake.

Conclusion: Probiotic supplementation for 6 months in childhood may not affect insulin resistance index in adolescence."

"Tujuan: Untuk meneliti korelasi antara penanda biokimia Angptl3, FABP4 dan HOMA-IR pada populasi pria Indonesia dengan kondisi obesitas sentral non diabetes. Metode: Penelitian ini menggunakan metode potong lintang pada 133 individu pria dengan obesitas sentral non diabetes (dengan kriteria lingkar pinggang > 90 cm; konsentrasi glukosa darah puasa < 126 mg/dL; dan tidak adanya keluhan khas diabetes) usia 30-60 tahun yang dilakukan di Jakarta, Indonesia. Penanda biokimia yang ditentukan meliputi Angptl3, FABP4, FFA, insulin puasa, dan glukosa puasa. Di samping itu dilakukan penentuan berat badan, tinggi badan, lingkar pinggang (LP), tekanan darah sistolik (TDS), dan tekanan darah diastolik (TDD). Hubungan antara berbagai penanda biokimia didapatkan melalui uji korelasi Pearson dan Spearman. Hasil: Hasil uji korelasi Pearson dan Spearman menunjukkan adanya korelasi positif yang bermakna antara Angptl3 dan FABP4 (r = 0,319; P = 0,000), Angptl3 dan FFA (r = 0,171; P = 0,049), FABP4 dan HOMA-IR (r = 0,202; P = 0,019), FFA dan FABP4 (r = 0,506; P = 0,000), LP dan HOMA-IR (r = 0,323; P = 0,000), LP dan FABP4 (r = 0,387; P = 0,000), Indeks Massa Tubuh (IMT) dan HOMA-IR (r = 0,270; P = 0,002), serta IMT dan FABP4 (r = 0,362; P = 0,000). Kesimpulan: Adanya korelasi positif yang bermakna antara Angptl3-FABP4, Angptl3-FFA, FFA-FABP4 serta FABP4-HOMA-IR menimbulkan dugaan bahwa Angptl3 memicu lipolisis dalam jaringan adiposa melalui hubungannya dengan FABP4 serta berhubungan dengan peningkatan resistensi insulin pada individu pria obes non diabetes.

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AbstractAim: To reveal the correlation between Angptl3, FABP4 and HOMA-IR among Indonesian obese non diabetic males. Methods: This is a cross sectional study with 133 obese non diabetic males volunteers (characterized by waist circumference > 90 cm; fasting blood glucose < 126 mg/dL; and no diabetic specific symptoms) age between 30-60 years which was done in Jakarta, Indonesia. We measured biochemical markers such as Angptl3, FABP4, FFA, fasting insulin and fasting glucose. We also measured weight, height, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Correlation between each marker was measured using Pearson and Spearman?s analysis. Results: Pearson and Spearman?s correlation analysis showed significant positive correlation between Angptl3 and FABP4 (r = 0.319; P = 0.000), Angptl3 and FFA (r = 0.171; r = 0.049), FABP4 and HOMA-IR (r = 0.202; P = 0.019), FFA and FABP4 (r = 0.506; P = 0.000), WC and HOMA-IR (r = 0.323; P = 0.000), WC and FABP4 (r = 0.387; P = 0.000), Body Mass Index (BMI) and HOMA-IR (r = 0.270; P = 0.002), BMI and FABP4 (r = 0.362; P = 0.000). Conclusion: This study showed positive significant correlations between Angptl3-FABP4, Angptl3-FFA, FFA-FABP4 and FABP4-HOMA-IR. We suggest that Angptl3 can activate lipolysis in adipose tissue (through its correlation with FABP4), and Angptl3 concentration is related to insulin resistance risk among Indonesian obese non diabetic males."

"Resistensi insulin adalah penurunan kemampuan jaringan (otot, hati, dan jaringan adiposa) untuk merespon insulin yang bersirkulasi secara normal dalam darah yang berisiko berkembang menjadi penyakit diabetes melitus tipe 2. Rasio tinggi asupan asam lemak omega-6/omega-3 diduga berperan dalam menurunkan sensitivitas insulin. Penelitian ini bertujuan untuk mengetahui hubungan antara rasio asupan omega-6/omega-3 dan HOMA-IR pada perempuan usia reproduktif. Studi potong lintang ini dilakukan di Jakarta, pada bulan Juli sampai Oktober 2021. Pengambilan sampel menggunakan metode consecutive sampling dan diperoleh 79 subjek perempuan yang memenuhi kriteria penelitian. Pengumpulan data dilakukan melalui wawancara 24-hours food recall sebanyak 3 kali, pengukuran antropometri untuk menilai status gizi, dan pengambilan serum untuk mengukur kadar glukosa darah puasa dan insulin. Rerata asupan omega-6 pada subjek adalah 9.43 ± 3.69 gram/hari, median asupan omega-3 pada subjek adalah 0.79 (0.23–3.53) gram/hari, dan rerata rasio asupan omega-6/omega-3 adalah 12.32 ± 4.32. Rerata HOMA-IR pada subjek adalah 3.04 ± 1.24. Terdapat korelasi positif lemah antara rasio asupan omega-6/omega-3 dan HOMA-IR, namun tidak signifikan (r=0.161, p=0.157). Ditemukan hubungan signifikan antara DHA dan HOMA-IR setelah mengontrol faktor perancu (p=0.014). Tidak ada hubungan antara rasio asupan asam lemak omega-6/omega-3 dan HOMA-IR pada perempuan usia reproduktif. Namun, ditemukan hubungan antara asupan DHA dan HOMA-IR yang menunjukkan bahwa peningkatan asupan asam lemak tidak jenuh dapat mencegah terjadinya resistensi insulin.

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Insulin resistance is a decrease in the ability of tissues (muscle, liver, and adipose tissue) to respond to insulin that circulates normally in the blood which is at risk of developing type 2 diabetes mellitus. A high ratio of omega-6/omega-3 fatty acid intake is thought to play a role in reducing insulin sensitivity. This study aims to determine the association between the ratio of omega-6/omega-3 intake and HOMA-IR in reproductive-aged women. This cross-sectional study was conducted in Jakarta, from July to October 2021. Sampling used the consecutive sampling method and obtained 79 women subjects who met the research criteria. Data was collected through 24-hour food recall interviews 3 times, anthropometric measurements to assess nutritional status, and serum sampling to measure fasting blood glucose and insulin levels. The mean omega-6 intake in the subjects was 9.43 ± 3.69 grams/day, the median omega-3 intake in the subjects was 0.79 (0.23–3.53) grams/day, and the mean ratio of omega-6/omega-3 intake was 12.32 ± 4.32. The mean HOMA-IR in the subjects was 3.04 ± 1.24. There was weak positive correlation between the ratio of omega-6/omega-3 intake and HOMA-IR, but not significant (r=0.161, p=0.157). A significant relationship was found between DHA and HOMA-IR after adjusted confounding factors (p=0.014). There was no association between the ratio of omega-6/omega-3 fatty acid intake and HOMA-IR in reproductive-aged women. However, it was found that there was a assocation between DHA intake and HOMA-IR which indicated that increasing intake of unsaturated fatty acids could prevent insulin resistance"

"Latar Belakang: Pegawai kantor dengan obesitas memiliki risiko tinggi mengalami diabetes melitus (DM) tipe 2. Pemeriksaan sensitivitas insulin jarang dilakukan karena kendala teknis dan biaya. Berbagai studi sebelumnya menunjukkan adanya hubungan negatif antara massa lemak tubuh dengan HOMA-IR, namun hasil penelitian di Indonesia menunjukkan hasil yang tidak konsisten. Indeks TyG disebut sebagai penanda resistensi insulin yang lebih akurat jika dibandingkan dengan HOMA-IR pada populasi Asia. Belum ada penelitian yang menilai hubungan massa lemak tubuh dengan Indeks TyG di Indonesia.Metode: Studi potong lintang dilakukan pada 89 pekerja kantor dengan obesitas (IMT ≥25 kg/m2) tanpa riwayat DM di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Agustus hingga Oktober tahun 2022. Dilakukan pengambilan data demografis (usia, jenis kelamin, riwayat DM, kebiasaan merokok), antropometri, analisis asupan menggunakan 24-hour food recall 3x24 jam, serta penilaian tingkat aktivitas fisik berdasarkan Global Physical Activity Questionnaire Score. Pengukuran persentase lemak tubuh total dan massa lemak viseral menggunakan multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Sensitivitas insulin dinilai menggunakan kadar HOMA-IR dan Indeks TyG serum. Analisis korelasi menggunakan uji Spearman dan dilakukan analisis multivariat untuk menilai faktor-faktor yang paling berhubungan dengan sensitivitas insulin.Hasil: Didapatkan sebanyak 89 subjek dengan proporsi perempuan:laki-laki sekitar 2:1, median usia 40 (21-59) tahun, dan mayoritas memiliki tingkat aktivitas sedang, tidak memiliki riwayat DM pada keluarga, tidak merokok, serta memiliki persentase kecukupan asupan melebihi kebutuhan energi individual dengan persentase makronutrien masih masuk dalam rentang normal. Korelasi persentase lemak tubuh total dengan HOMA-IR menunjukkan korelasi positif lemah yang bermakna (r=0,262, p=0,013). Korelasi massa lemak viseral dengan Indeks TyG menunjukkan korelasi positif lemah yang bermakna (r=0,234, p=0,027). Hasil korelasi persentase lemak tubuh total dengan indeks TyG dan korelasi massa lemak viseral dengan HOMA-IR menunjukkan hasil yang tidak signifikan secara statistik. Persentase lemak tubuh total tidak berhubungan signifikan dengan HOMA-IR setelah disesuaikan dengan variabel jenis kelamin, tingkat aktivitas fisik, indeks massa tubuh, lemak viseral, trigliserida, HDL, lingkar pinggang, dan persentase asupan karbohidrat. Massa lemak viseral tidak berhubungan signifikan dengan Indeks TyG setelah disesuaikan dengan variabel usia, jenis kelamin, lemak viseral, persentase asupan protein, dan HDL.Kesimpulan: Didapatkan korelasi positif lemah antara persentase lemak tubuh total dengan HOMA-IR dan korelasi positif lemah antara massa lemak viseral dengan Indeks TyG pada pegawai kantor obesitas di RSUPN Cipto Mangkunsumo.

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Background: Obese office workers have a high risk of developing type 2 diabetes mellitus (DM). Insulin sensitivity tests are rarely performed due to technical and cost constraints. Previous studies have shown a negative relationship between body fat mass and HOMA-IR. However, the results of research in Indonesia have shown inconsistent results. No study has assessed the relationship between body fat mass and the TyG index in Indonesia. In contrast, some research showed that The TyG index is a more accurate marker of insulin resistance in Asian populations.

Methods: A cross-sectional study was conducted on 89 office workers with obesity (BMI ≥25 kg/m2) without a history of DM at RSUPN Dr. Cipto Mangunkusumo, Jakarta, on August-October 2022. Demographic data were collected (age, gender, history of DM, smoking habits), anthropometry, analysis of energy intake and macronutrients using a 3- days 24-hour food recall, as well as an assessment of the level of physical activity based on the Global Physical Activity Questionnaire Score. The total body fat percentage and visceral fat mass were measured using a multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Insulin sensitivity was assessed using HOMA-IR levels and serum TyG Index. Correlation analysis used the Spearman test, and multivariate analysis was performed to assess the factors most related to insulin sensitivity.

Results: There were 89 subjects with a proportion of women: men around 2:1, the median age was 40 (21-59) years, and the majority had moderate activity levels, had no family history of DM, did not smoke, and had intakes exceeding individual energy needs with the percentage of macronutrients within normal range. The total body fat percentage correlation with HOMA-IR showed a significant positive correlation with weak strength (r=0.262, p=0.013). The correlation of visceral fat mass with the TyG index showed a significant positive correlation with weak strength (r=0.234, p=0.027). The results of the correlation of total body fat percentage with the TyG index and the correlation of visceral fat mass with HOMA-IR showed results that were not statistically significant. The total body fat percentage was not significantly related to HOMA-IR after adjusting for variables such as gender, level of physical activity, body mass index, visceral fat, triglycerides, HDL, waist circumference, and percentage of carbohydrate intake. Visceral fat mass did not have a significant relationship with the TyG index after adjusting for age, sex, visceral fat, percentage of protein intake, and HDL.

Conclusion: A weak positive correlation was found between the percentage of total body fat and HOMA-IR and a weak positive correlation between visceral fat mass and the TyG index in obese office workers at Cipto Mangkunsumo General Hospital."

"ABSTRAK Latar Belakang. Disfungsi miokardiak subklinis merupakan salah satu konsekuensi berbahaya dari sindrom metabolik, dimana diduga disebabkan oleh resistensi insulin. Kelainan tersebut merupakan kondisi patologis awal, yang berisiko menimbulkan gagal jantung ke depannya. Melalui Two Dimensional-Speckle Tracking Echocardiography 2D-STE dengan parameter Global Longitudinal Strain GLS yang memiliki sensitivitas dan spesifisitas tinggi, disfungsi miokardiak tersebut dapat dideteksi lebih dini. Tujuan Mengetahui hubungan antara resistensi insulin pada sindrom metabolik terhadap disfungsi sistolik VKi subklinis.Metode. Studi ini merupakan studi potong lintang, dengan menggunakan 483 datasekunder dari pegawai RS Jantung Harapan Kita. Dari total data, 119 subjek masuk dalam kriteria inklusi dan eksklusi, yang kemudian dilakukan pemeriksaan GLS.Subjek tersebut terbagi menjadi dua kelompok non resistensi insulin dan resistensi insulin berdasarkan nilai Homeostasis Model Assessment of Insulin Resistance HOMA-IR dengan nilai cut-off 2.0.Hasil. Terdapat perbedaan nilai GLS yang bermakna antara kelompok resistensi insulin dan non resistensi insulin rerata -18.3 SD 3.05 vs -19.7 2.2 , 95 IK -2.39 ndash; -0.37 , p=0.008 . Variabel resistensi insulin memiliki risiko terbesar diikuti variabel trigliserida adjusted OR 2.8, p=0.009 dan 2.4, p=0.03 secara berurutan terhadap disfungsi sistolik VKi subklinis pada sindrom metabolik. Kesimpulan. Resistensi insulin menunjukkan fungsi sistolik VKi yang lebihrendah secara signifikan yang dinyatakan dengan nilai GLS dibandingkan nonresistensi insulin pada sindrom metabolik. Resistensi insulin dan trigliserida adalah petanda independen disfungsi sistolik VKi subklinis diantara komponen sindrom metabolik lain.Kata kunci. resistensi insulin, HOMA-IR, disfungsi sistolik VKi subklinis, GLS,sindrom metabolik, trigliseridaABSTRACT Background. Subclinical myocardial dysfunction is a dangerous consequence ofthe metabolic syndrome, which is thought to be caused by insulin resistance. Thedisorder is an early pathological condition, which poses a risk of heart failure in thefuture. Through Two Dimensional Speckle Tracking Echocardiography 2D STE with the Global Longitudinal Strain GLS parameters that have high sensitivityand specificity, these myocardial dysfunctions can be detected earlier.Objective. To determine the relationship between insulin resistance in metabolicsyndrome to subclinical left ventricle systolic dysfunction.Methods. A cross sectional study, using 483 secondary data from employees of theNational Heart Center of Harapan Kita. 119 subjects were included in the inclusionand exclusion criteria, which were performed 2D STE with GLS parameter. Thesubjects were divided into two groups of non insulin resistance and insulinresistance based on the value of Homeostasis Model Assessment of InsulinResistance HOMA IR with a cut off value of 2.0.Results. There were significant differences in GLS values between the insulinresistance group and non insulin resistance mean 18.3 SD 3.05 vs 19.7 2.2 ,95 CI 2.39 0.37 , p 0.008 . Insulin resistance have the greatest risk followedby triglyceride levels adjusted OR 2.8, p 0.009 and 2.4, p 0.03 respectively tosubclinical left ventricle systolic dysfunction in the metabolic syndrome.Conclusion. Insulin resistance showed a lower left ventricle systolic function asexpressed by GLS score significantly than non insulin resistance in the metabolicsyndrome. Insulin resistance and triglycerides are an independent marker ofsubclinical left ventricle systolic dysfunction among other components of themetabolic syndrome. "

"Latar belakang: Sindrom metabolik merupakan kumpulan gejala abnormalitas metabolik tubuh yang meliputi hipertensi, obesitas sentral, hiperglikemia, resistensi insulin, dan dislipidemia. Hal ini menurunkan kualitas hidup seseorang dan berdampak meningkatnya biaya pengobatan. Salah satu faktor risikonya adalah kebiasaan konsumsi produk instan tinggi fruktosa. Penelitian ini bertujuan membuktikan hubungan antara kebiasaan konsumsi makanan dan/atau minuman yang mengandung fruktosa dengan terjadinya resistensi insulin yang bermanifestasi sindrom metabolik pada subjek di Posyandu Lansia Monjok Kota Mataram.Metode: Penelitian ini merupakan studi cross-sectional. Pengambilan sampel ditetapkan secara consecutive sampling. Subjek penelitian sebanyak 48 orang berusia 45-90 tahun dari Posyandu Lansia Monjok. Data diperoleh dari wawancara subjek, Puskesmas Mataram, dan Posyandu Monjok. Asupan fruktosa dikumpulkan dengan metode food recall 24hour dan dinilai dengan software nutrisurvey. Resistensi insulin ditetapkan dengan metode TyG Index. Sindrom metabolik ditetapkan berdasarkan parameter National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III).Hasil: Hasil penelitian menunjukkan 52.1% subjek di Posyandu Lansia Monjok Kota Mataram mengalami resistensi insulin dan 62.5% sindrom metabolik. Uji Chi-Square menunjukkan terdapat hubungan signifikan antara kebiasaan konsumsi fruktosa dengan terjadinya resistensi insulin (p=0.000) dan sindrom metabolik (p=0.001).Kesimpulan: Sebagian subjek di Posyandu Lansia Monjok Kota Mataram memiliki kebiasaan konsumsi tinggi fruktosa sehingga menyebabkan terjadinya resistensi insulin yang bermanifestasi menjadi sindrom metabolik.

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Introduction: Metabolic syndrome is a collection of symptoms of metabolic abnormalities, including hypertension, central obesity, hyperglycemia, insulin resistance, and dyslipidemia. This matter reduce a person’s quality of life and impact financially due to high treatment costs. One of the risk factors that trigger metabolic syndrome is the habit of consuming instant food or beverages that contain high fructose. This study aims to prove the relationship between the habit of consuming food and/or drinks containing fructose and the occurrence of insulin resistance manifesting metabolic syndrome among subjects at Monjok Elderly Integrated Healthcare Center Mataram.

Method: This study was cross-sectional. Sampling was determined using consecutive sampling. Subjects, as many as 48 people, aged 45-90 years form Monjok Elderly Integrated Healthcare Center Mataram. Data were obtained from subject interviews and data from Mataram Public Health Center and Monjok Integrated Healthcare Center. Fructose intake was collected using a 24-hour food recall method and assessed using NutriSurvey software. Insulin resistance was determined by the TyG Index method. Metabolic syndrome was determined based on the Adult Care Panel of the National Cholesterol Education Program III (NCEP ATP III).

Result: The results showed that 52.1% subjects at Monjok Elderly Integrated Healthcare Center experienced insulin resistance and 62.5% metabolic syndrome. The Chi-Square test showed a significant correlation between fructose consumption habits and the occurrence of insulin resistance (p=0.000) and metabolic syndrome (p=0.001).

Conclusion: Half of the subjects at Monjok Elderly Integrated Healthcare Center had a high fructose consumption habit that cause to insulin resistance manifesting metabolic syndrome."

"Latar Belakang: Dermatitis seboroik (DS) merupakan kelainan inflamasi kronik pada area kulit yang kaya kelenjar sebasea. Hingga saat ini patogenesis DS terus berkembang, termasuk dikaitkan dengan kejadian sindrom metabolik. Oleh karena sindrom metabolik terjadi akibat resistensi insulin yang diperankan oleh jaringan lemak viseral, maka diduga kedua hal tersebut juga memiliki peran terhadap kejadian DS.Tujuan: mengetahui rerata HOMA-IR dan skala jaringan lemak viseral pada pasien DS, serta menilai perbedaannya dibandingkan dengan kontrol.Metode: Penelitian kasus-kontrol berpasangan ini dilakukan di Poliklinik Dermato-venereologi RSCM selama Juli-Agustus 2022. Kelompok kasus ialah pasien berusia ≥18 tahun, tidak hamil, IMT ≥18,5 kg/m2 yang terdiagnosis DS secara klinis, serta tidak memiliki penyakit imunokompromais, infeksi kronis, kanker, autoimun, atau degeneratif lainnya. Kelompok kontrol ialah pasien non-DS yang match berdasarkan usia, jenis kelamin, dan kategori IMT. Seluruh subjek menjalani pemeriksaan klinis, laboratorium, dan pengukuran skala lemak viseral menggunakan alat BIA TANITA® SC330.Hasil: Masing-masing kelompok DS dan kontrol berjumlah 36 subjek pada studi ini. Median(min-maks) usia kelompok DS ialah 26,5(20-45) tahun, jenis kelamin laki-laki 52,8%, dan median(min-maks) IMT sebesar 24,2(18,5-38,8) kg/m2. Median HOMA-IR ditemukan lebih tinggi pada kelompok DS dibandingkan kontrol (1,54[0,72-4,09] VS. 1,22[0,53-2,73]; p=0,031). Namun, tidak terdapat perbedaan yang bermakna secara statistik untuk skala lemak viseral antara kelompok DS dengan kontrol (6,5[1-14] VS. 6,0[1-12]; p=0,149).Kesimpulan: Nilai median HOMA-IR dan skala jaringan lemak viseral pada pasien DS adalah masing-masing 1,54 (IK95% 0,72-4,09) dan 6,5 (IK95% 1-14). Nilai HOMA-IR pada pasien DS lebih tinggi dibandingkan dengan kontrol dan bermakna secara statistik, tetapi tidak terdapat perbedaan bermakna secara statistik untuk skala lemak viseral.

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Background: Seborrheic dermatitis (SD) is a chronic inflammatory disorder in sebaceous gland-rich skin. Until today the pathogenesis of SD continues to develop, including investigation about the link association between SD and metabolic syndrome. Metabolic syndrome is a disease caused by insulin resistance in which visceral fat tissue may play important role, therefore insulin resistance and visceral fat tissue are hypothesized to influence the development of SD.

Objective: To measure the HOMA-IR and visceral fat rating scale in SD patients, and to investigate the differences compared to the control group.

Methods: A matched case-control study was conducted in Dermatovenereology Clinic Cipto Mangunkusumo General Hospital in July-August 2022. Case group was non-pregnant patients aged ≥18 years old and BMI ≥18,5 kg/m2 which were clinically diagnosed with SD, and did not have any of immunocompromise, chronic infection, cancer, autoimmune, or degenerative disease. Control group was non-SD patients that were matched according to the age, gender, and BMI categories. All the subjects assigned for clinical and laboratory examination, and visceral fat measurement using BIA TANITA® SC330.

This study involved 36 subjects in each SD and control group. Median(min-max) of age in SD group was 26.5(20-45) yo, male 52.8%, and median(min-max) of BMI was 24.2(18.5-38.8) kg/m2. Median HOMA-IR was significantly higher in SD group compared to the control group (1.54[0.72-4.09] VS. 1.22[0.53-2.73]; p=0.031). However, there was no significant difference for visceral fat rating scale between SD and control group (6.5[1-14] VS. 6.0[1-12]; p=0.149).

Conclusion: The median HOMA-IR and visceral fat rating scale in SD were 1.54 (95%CI 0.72-4.09) and 6.5 (95%CI 1-14). HOMA-IR in SD group is higher to the control group and statistically significant, but there is no significant difference for visceral fat rating scale."