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"Telah dilakukan penelitian terhadap kestabilanvitamin B12 dalam sediaan ohat suntik campuran vitamin Bi,vitamin B6 dan vitamin B12 yang disimpan pada temperaturkamar dan pada kondisi penyimpanan yang dipercepat pada0 0temperatur •di atas temperatur kamar yaitu 60 C, 70 C dan080C.Sediaari obat suntik mi dibuat dalam 4 macam formulay a i tu- Formula vitamin B12 tunggal- Formula vitamin B12 dengan vitamin B6-- Formula vitamin B12 derigan vitamin Bi- Formula vitamin B12, vitamin B6 dan vitamin BiUntuk setiap formula, konsentrasi vitamin B12 0,333 mg/ml,vitamin B6 33,33 mg/ml dan vitamin Bi 33,33 mg/mi. Bahanpembantu yang digunakan untuk setiap formula juga samayaitu Kiorbutanol 0,5 % b/v, t'Ia2EDTA 0,01 % h/v.Propilenglikol 5 % v/v, Dietanol amin / asarn asetatsecukupnya sampai PH 3,8 serta dialiri gas inert N2.Sediaan mi diperiksa terhadap stabilitas kadarvitamin B12 nya dengari menggunakan metoda spektrofotometrjderivatjf. Ternyata vitamin Bi menurunkan stabilitasvitamin B12 dan adanya vitamin B6 mempertinggi pengarubburuk vitamin Bi terhadap stabilitas vitamin B12."

"Tujuan: Mengetahui pengaruh suplementasi vitamin B12 400 µg/hari selama enam minggu terhadap kadar vitamin B12 dan homosistein serum pada adventis vegan dewasa. Tempat: Gereja Masehi Advent Hari Ketujuh, Jakarta Barat. Metadologi: Penelitian pro dan pasca perlakuan pada 27 orang subjek, berusia 20-60 tahun. Setiap subjek mengkonsumsi suplemen vitamin B12 400 µg/hari dosis tunggal selama 42 hari. Data yang dikumpulkan meliputi data demografi, antropometri pra dan pasca perlakuan, asupan nutrisi (energi, karbohidrat, protein, dan lemak) dengan metode recall 1 x 24 jam dua kali seminggu pra, pertengahan dan pasca perlakuan. Data asupan vitamin B6, B12 dan asam folat dengan FFQ semi kuantitatif serta data laboratorium meliputi kadar vitamin B12, asam folat, dan homosistein serum pra dan pasta perlakuan. Hasil: Data demografi menunjukkan sebagian besar (81,5%) subjek berpendidikan tinggi dan semua subjek berpenghasilan di atas garis kemiskinan. Data antropometri pada pra dan pasca perlakuan menunjukkan seluruh subjek mempunyai IMT dalam batas normal. Asupan nutrisi selama perlakuan yang meliputi asupan energi, karbohidrat, lemak dan protein tidak mengalami perubahan. Bila dibandingkan dengan AKG tahun 1988 asupan energi, sebagian besar subjek termasuk cukup, asupan karbohidrat, dan protein termasuk kurang; asupan lemak termasuk lebih, Asupan vitamin B6 pada akhir perlakuan tidak menunjukkan penurunan secara signifikan (p=0,6874), sebaliknya dengan asupan vitamin B12 yang menunjukkan peningkatan signifikan (p = 0,021) dan asam folat yang menunjukkan penurunan signifikan (p = 0,0001). Hasil pemeriksaan laboratoriurn pada akhir perlakuan menunjukkan peningkatan signifikan pada kadar vitamin B12 (p = 0,0000) sebesar 202,6%, dari median 127 (58,0-193,0) pg/mL menjadi 376 (183,0-1168,0) pg/mL dan penurunan kadar homosistein yang signifikan (p = 0,0000) sebesar 39% dari median 14,50 (11,1-34,2) } µmol/L menjadi 9,50 (5,6-24,8) µmol/L. Kadar asam folat tidak mengalami penurunan bermakna (p = 0,2960). Kesimpulan: Suplementasi vitamin B12 sebanyak 400 µg/hari selama 42 hari pada vegan terbukti meningkatkan kadar vitamin B12 dan menununkan kadar homosistein.

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The Effect Of Vitamin B12 Supplementation On Homocysteine Level Of Adult VegansObjective: To investigate the effect of 400 µg /day vitamin B12 supplementation for 42 days on serum vitamin B12, and homocysteine levels of 27 adult vegan subjects.

Location: Seventh Day Adventists Church, West Jakarta.

Method: A pre and post test design study was carried out on 27 subjects, aged 20-60 years, who fulfilled the criteria of the selection. Subjects were given 400 µg/day vitamin B12 single dose supplementation for 42 consecutive days. Data collected were demographic, anthropometric, nutritional, and laboratory. The data of energy, carbohydrate, protein, and fat intake were collected using 1 x 24 recall method twice a week at the beginning, within, and the end of the study; whilst vitamin B6, B12 and folk acid intake were obtained with FF0 semi-quantitative method at the beginning and the end of the study. Laboratory data were collected before and after study including serum vitamin B12, folk acid and homocysteine

Results: Demographic data showed that most of the subjects had high formal education level (81.5%) and all subjects had income above the poverty line. Anthropometric data showed that BMI at the beginning and in the end of the study were in normal range. Dietary intake estimation including energy, carbohydrate, protein, and fat, were not significantly changed. Compared to Indonesian RDA 1998, intake of energy was considered adequate, carbohydrate and protein were low, and fat was high. Vitamin B6 intake did not decrease significantly (p = 0.6874) However vitamin B12 intake increased (p = 0.021) and folic acid intake decreased significantly (p = 0.0001). Median value of serum vitamin B12 after supplementation increased significantly (p = 0,0000) by 202.6% from 127 (58.0-193.0) pg/mL to 376 (183.0-1168.0) pg/mL. There was no significant difference in the serum level of folic acid (p = 0.2960). Median value of homocysteine after supplementation decreased significantly (p = 0.0000) by 39% from 14.50 (3.8-34.2) man, to 9.50 (5.6-24.8) µmol/L.

Conclusion: Supplementation of single dose 400 µg vitamin B12 for 42 consecutive days on adult vegan subjects was proven to elevate the level of serum vitamin B12 and decrease the level of homocysteine."

"Latar Belakang : Peningkatan kadar homosistein merupakan faktor risiko terjadinya aterosklerosis dan trombogenesis. Baik faktor genetik maupun lingkungan mempunyai pengaruh terhadap kadar plasma homosistein. Pada penelitian ini, kami meneliti gambaran dari homosistein pada populasi PJK di Jakarta dan Malang serta hubungannya dengan enzim MTHFR, Vit. B6, Vil. B12, dan asam folat.Metode dan Hasil : Penelitian deskriptif ini melibatkan 30 pasien PJK di Jakarta dan 12 pasien di Malang. Subyek yang direkrut di Malang lebih muda, tetapi tidak ada perbedaan dalam jenis kelamin, 1MT, diabetes, dan merokok. Tidak ada perbedaan pada profil lipid diantara dua populasi. Subyek di Malang mempunyai kadar homosistein lebih tinggi (median 18 mmol/dL vs 9,1 mmol/dL; p < 0,001), kadar MTHFR yang lebih rendah (median 0,105 IU vs 0,157 IU; p = 0,019) kadar asam folat yang lebih rendah (median 7,1 vs 11,2 ng/mL; p = 0,005), kadar vit. B12 yang lebih rendah (median 273 ng/mL vs 429,5 ng/mL; p = 0,032). Tidak ada perbedaan pada kadar vit B6. Analisis dari hubungan menunjukkan hubungan yang terbalik antara homosistein dan pit. B12 (r = - 0,43, p = 0,004) dan asam folat (r = -0,39,p = 0,01).Kesimpulan : Tidak ada perbedaan kadar homosistein, MTHFR, asam folat, dan vitamin B12 pada populasi PJK (Jakarta dan Malang). Terdapat hubungan yang terbalik antara homosistein dan vit. B12 serta asam folat.

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Background : Increased homocysleine level is a risk factor for atherosclerosis and thrombogenesis_ Both genetic and environmental factors influence plasma level of homocysteine. In this study, we examine the distribution of homocysteine in population of CAD in Malang and Jakarta and the association between homocysteine, enzyme MTHFR, Vit. B6, Vii. B12, and folic acid.Methods and Results : This is a descriptive study including 30 CAD patients in Jakarta and 12 in Malang. Subjects recruited in Malang is younger, but no difference in gender, BMI, smoking and diabetes. No difference in lipid profile between both populations. Subjects in Malang have higher level of homocysteine (median 18 mmol/dL vs 9.1 mmol/dL; p <0.001), lower level of MTHFR (median 0.105 IU vs 0.157 IU; p = 0.019), lower level of Folic acid (median 7.1 vs 11.2 ng/mL; p = 0.005), lower level of Vit. B12 (median 273 ng/mL vs 429.5 ng/mL; p = 0.032). There is no difference in level of Vit. B6. Analysis of association showed inverse relationship between homocysteine and vit B12(r - -0.43, p = 0.004) and folic acid (r = -0.39,p =0.01).Conclusion : There is difference in level of homocysteine, MTHFR, folic acid and vii. B12 between populations coronary artery disease ( Jakarta and Malang). There is inverse relationship between homocysteine and vit B12 and folic acid."

"Telah dilakukan penelitian untuk mengetahui waktu optimum pemajanan sinar ultraviolet (UV) yang menyebabkan mutasi pada bakteri penghasil vitamin BU Pseudomonas denitrificans BIOMCC B12 F942/288. Pemajanan sinar UV untuk perlakuan mutasi menggunakan illuminator UV pada panjang gelombang 254 nm dengan intensitas sebesar 590 uW/cm2. Waktu pemajanan optimum untuk perlakuan mutasi dengan sinar UV adalah yang menyebabkan rasio kematian 90?95%. Pengambilan data mutasi dengan variasi waktu pemajanan selama 30, 60, 90, dan 120 detik. Waktu pemajanan sinar UV yang menghasilkan rasio kematian 90-95% adalah 90 detik.

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Optimal time in ultraviolet illumination as mutagen for bacteria vitamin BU producer Pseudomonas denitrificans Schlegel BioMCC BI2 F942/288 had been researched. Ultraviolet was illuminated at wavelength 254 nm with intensity 590 uW/cm2. Optimal time of illumination will make 90?95% death rate. Illumination was done in several variation time (30,60,90, and 120 second). Optimal time for make 90?95% death rate of bacteria vitamin 812 producer Pseudomonas denitrificans Schlegel BioMCC B!2 F942/288 is 90 second."

"ABSTRAKTujuan penelitian ini adalah untuk mengetahui suplernentasi vitamin B12 pada penderita HIV terhadap jumlah CD4, sehingga diharapkan dapat mencegah progresivitas penyakit HIV. Penelitiam ini merupakan uji klinis tanpa pembanding, terhadap 15 orang pasien HIV di poliklinik UPT HIV RSUPNCM Jakarta mulai satu Februari sampai dengan 20 April 2010. Subyek mendapat suplementasi vitamin B12 (metilkobalamin) 1000 pg/had, peroral, sclama enam minggu. Data dikumpulkan meliputi data demografi (usia dan jenis kelamin), adanya hepatitis gastroenteritis dan infeksi akut selama penelitian, status gizi (indeks massa tubuh), analisis asupan zat gizi dengan metode had record 3 x24 jam dan FFQ semikuantitatit2 lcadar vitamin B12 serum dan jumlah CD4. Analisis data menggunakan uji t berpasangan atau Wiicoxon dengan batas kemaknaan p < 0,05. Sebanyak 15 subyek mengikuti penelitian sampaj sclesai. Setelah enam minggu perlakuan, didapatkan adanya peningkatan yang bennakna terhadap kadar vitamin Bn serum awal 270,71 i 71,04 pmol/L, pada akhir perlakuan 419,11 =4= 122,95 pmol/L meningkat signiiikan (p > 0,001). Terdapat 11 dari 15 subyek mengalami peningicatan jumlah CD4 pada akhir penelitian. Median jumlah CD4 subyek pada awal penelitian 143 (23 - 372) sei/pL dibandingkan dengan median pada akhir pcrlakuan 166 (18 - 428) /pL, didapatkan perubahan signifikan (p = 0,03l). Uji korelasi Spearman, tidak menunjukan korelasi bermakna antara perbedaan jumlah CD4 dengan perbedaan kadar vitamin B12 serum (r= -0,375, p= 0,l68). Dcngan demikian dapat disimpulkan bahwa, walaupun tidak terdapat korelasi pada perbedaan jumlah CD4 dan kadar vitamin B12, namun suplementasi vitamin B12 menggunakan metilkobalamin 1000 pg/hari, peroral, selama enam minggu pada penderita HIV dapat meningkatkan secara bcrmakna kadar vitamin Bn serum dan terdapat perubahan bermakna jumlah CD4.

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ABSTRACT

The aim of this study is to find the effect of Vitamin B12 supplementation in HIV patients on the counts of CD4 so it would prevent the HIV progressiveness in RSUPNCM Jakarta. It is an one-armed clinical trial in 15 HIV patients in UPT HIV RSUPNCM Jakarta. The subjects received vitamin B12 (methylcobalamin) supplementation 1000 ug/day, per oral, for six weeks. The data was collected included demographic data (age and sex), the presence of hepatitis co-infection and gastroente1itis,and acute infection during nutritional status (body mass index), nutrition intake analysis with 3 x24 hours food record method and semi-quantitative FFQ, the level of serum vitamin B12 and CD4 counts. The study used paired t-test or Wilcoxon with significant value p < 0,05. There were I5 subjects who completely participated. After six weeks of intervention, there as a significant increment of early serum Vitamin Bl; level which was 270,71 1 71,04 pmol/L, and at the end ofthe intervention was 419,11 :h 122,95 pmol/L; increased significantly (p > 0,00l). There were ll of 15 subjects who had an increment at the end of the study. Early CD4 counts at the beginning of the study was 143 (23 - 372) cells/pL then changed significantly at the end of the study which was 166 (18 - 428) cells/pl., p = 0,03l. Though there was no significant correlation in CD4 counts difference to serum vitamin B12 level (r= -0,375, p= 0,l68)- It can be concluded that after six week intervention with vitamin B12 supplementation in methycobalamin form 1000 ug/day, per oral, in HIV patients would significantly increase serum vitamin B12 level and would significantly change CD4 counts, even-though there was no correlation on CD4 difference and vitamin Bl; level difference."

"Nama : Irena UjiantiProgram Studi : Program Magister Ilmu BiomedikJudul Tesis :Dampak Restriksi Vitamin B12 Terhadap Kadar Homosistein, Resistensi Insulin Dan Gambaran NAFLDPembimbing : dr. Imelda Rosalyn Sianipar, M.Biomed, Ph.D dan Dr. dr. Dewi Irawati Soeria Santoso, MS Latar Belakang: Perlemakan hati merupakan penyakit hati kronik terbesar di dunia. Kondisi yang mendasari terjadinya perlemakan hati dimulai dari kondisi resistensi insulin. Salah satu patogenesis terjadinya resistensi insulin adalah gangguan pada pensinyalan insulin oleh zat toksik tertentu yang akan berinteraksi dengan protein yang menyusun jalur pensinyalan insulin. Peningkatan homosistein dikaitkan dengan resistensi insulin. Homosistein akan meningkat sejalan dengan terganggunya jalur metilasi dari siklus metionin. Pemberian diet restriksi vitamin B12 akan memicu terjadinya resistensi insulin lewat jalur stres oksidatif yang ditimbulkan oleh homosistein.Bahan dan Metode: Penelitian ini menggunakan metode eksperimental terhadap 24 tikus Sprague Dawley jantan Rattus norvegicus, 300-350 gram, usia 35-40 minggu , terbagi ke dalam 4 kelompok yaitu kontrol K , Kelompok perlakuan 4 minggu P-1 , Kelompok Perlakuan 8 minggu P-2 dan kelompok perlakuan 12 minggu P-3 . Pada Kelompok kontrol, diberikan diet standar AIN-93M sedangkan kelompok perlakuan diberikan pakan modifikasi restriksi vitamin B12 AIN-93 sesuai usia perlakuan.Hasil: Kelompok perlakuan 8 minggu paling baik dalam menggambarkan kondisi perlemakan hati dibandingkan kelompok kontrol dan perlakuan 4 minggu, sedangkan kelompok perlakuan 12 minggu telah mempresentasikan kondisi NASH Non Alcoholic Steatohepatitis . Hasil ini sejalan dengan kondisi peningkatan homosistein plasma pada kelompok kontrol dan masing-masing usia perlakuan.Kesimpulan: Peningkatan homosistein akibat diet restriksi vitamin B12 mengakibatkan kondisi steatosis dan steatohepatitits pada hati, sebagai akibat dari kondisi resistensi insulin dan kerusakan sebagian dari sel beta pankreas. Kata kunci: Homosistein, Restriksi vitamin B12, NAFLD, Resistensi Insulin

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ABSTRACT Name Irena UjiantiStudy Program Master Program of Biomedical SciencesThesis Title Impact of Vitamin B12 Restriction on Homocysteine Levels, Insulin Resistance and NAFLDCounselor dr. Imelda Rosalyn Sianipar, M.Biomed, Ph.D. dr. Dewi Irawati Soeria Santoso, MS Background The fatty liver is the biggest chronic liver disease in the world. The underlying condition of fatty liver starts from the condition of insulin resistance. One of the pathomechanisms of insulin resistance is the disturbance in insulin signaling by certain toxic substances that will interact with one of the proteins that make up the insulin signaling pathway. Increased homosisteine is associated with insulin resistance. Homosisteine will increase in line with the disruption of the methionin metionin pathway. Dietary vitamin B12 deficiency will trigger insulin resistance through the path of oxidative stress generated by homocysteine.Materials and Methods This study used an experimental method of 24 male Sprague Dawley rats Rattus norvegicus, 300 400 gram, age 7 8 months , divided into 4 groups kontrol K , 4 weeks treatment group P 1 , 8 weeks treatment group P 2 and 12 week treatment group P 3 . In the kontrol group, a standard AIN 93 diet was administered while the feeding group was administered vitamin A deficiency deficiency AIN 93M according to treatment age.Results The best 8 weeks treatment group described the conditions of fatty liver compared to the 4 week kontrol and treatment group, while the 12 week treatment group presented the NASH condition. These results are consistent with the elevated plasma homocysteine conditions in the kontrol group and each treatment age.Conclusion Increased homocysteine due to dietary vitamin B12 deficiency is able to induce the condition of steatosis and steatohepatitits in the liver, as a result of the condition of insulin resistance and beta cell pancrease damage as the underlying patomechanism. Keywords Homocysteine, vitamin B12 Deficiency, NAFLD, Insulin Resistance "