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"Latar Belakang. Obesitas pada anak merupakan masalah kesehatan global. Small dense low density lipoprotein (sdLDL) merupakan salah satu faktor risiko kejadian penyakit kardiovaskular. Peningkatan sdLDL sebagai manifestasi dislipidemi pada remaja dapat terus berlanjut pada usia dewasa dan menyebabkan morbiditas dan mortalitas yang lebih tinggi. Penyebab timbulnya sdLDL pada remaja multifaktor. Tujuan. Mengetahui prevalens sdLDL dan faktor-faktor yang memengaruhi timbulnya sdLDL pada remaja siswa sekolah menengah pertama di Jakarta. Metode. Studi potong lintang pada 97 anak usia 12-15 tahun siswa SMP di Jakarta Pusat pada periode Juni-Juli 2012 dan April-Mei 2014 di Jakarta Timur. Pada subjek penelitian dilakukan pemeriksaan berat badan, tinggi badan, indeks massa tubuh (IMT), massa lemak tubuh (MLT), tekanan darah dan pemeriksaan darah sdLDL. Kriteria obesitas menggunakan IMT ≥P95 berdasarkan usia dan jenis kelamin. Massa lemak tubuh diukur menggunakan Tanita Inner Scan Body Composition Monitor tipe BC-545. Hasil dan pembahasan. Sebanyak 97 remaja obes diikutsertakan dalam penelitian. Prevalens sdLDL terjadi sebanyak 17,2 %. Terdapat hipertensi sebanyak 26,8 %, IMT pada nilai 30-39,9 sebanyak 51,5 % , MLT pada > P98 67 % dan lingkar pinggang > P90 52,5 %. Pada analisis bivariat dengan uji Mann-Whitney dan Kai-kuadrat tidak didapatkan hubungan antara sdLDL dengan faktor-faktor di atas. Simpulan. Prevalens sdLDL pada remaja obes ditemukan sebesar 17,2 %. Tidak ditemukan hubungan antara sdLDL dengan IMT, tekanan darah, MLT dan lingkar pinggang.

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Background. Childhood obesity is a global health problem. Plasma concentrations of small dense sdLDL are associated with the prevalence of atherosclerosis events. Atherosclerosis has already started to develop in childhood and adolescent obese. Increased sdLDL in adolescent to adult can cause higher morbidity and mortality. Contributing factors of sdLDL in adolescent are multifactorial.

Objectives. To know the prevalence of sdLDL in obese adolescents and the affecting factors, such as body mass index, body fat mass, blood pressure and waist circumference.

Methods. This was a cross-sectional study performed in obese adolescents, aged 12-15 years old, in several junior high schools in Central and East Jakarta, from May to June 2012 and April to Mei 2014. Physic examination was perfomed, including body mass index, body fat mass, blood pressure and waist circumference. and sd LDL as a blood examination.. Body mass index with the percentile ≥95 according to age and gender was used for obesity criteria, body fat mass was calculated using Tanita Inner Scan Body Composition Monitor Type BC-545.

Results. Of 97 obese adolescents in this study, sdLDL was found in 17,2 % subjects. The prevalence of each factors was 26,8 % hypertension, 51,5 % for body mass index at 30-39,9, 67 % for body fat mass >P98 and 52,5 % for central obesity P>P99. Based on bivariate analyse, such as Mann-Whitney and Kai-Kuadrat, there were no correlation between sdLDL and it?s factors.

Conclusion. sdLDL has a prevalence of 17,2 % in obese adolescent in this study, with no association found between body mass index, body fat mass, blood pressure and waist circumference."

"Latar Belakang. Obesitas pada anak merupakan masalah kesehatan global. Small dense low density lipoprotein (sdLDL) merupakan salah satu faktor risiko kejadian penyakit kardiovaskular. Peningkatan sdLDL sebagai manifestasi dislipidemi pada remaja dapat terus berlanjut pada usia dewasa dan menyebabkan morbiditas dan mortalitas yang lebih tinggi. Belum jelas faktor-faktor yang memengaruhi timbulnya sdLDL pada remaja obes.Tujuan. Mengetahui prevalens sdLDL dan faktor-faktor yang memengaruhi timbulnya sdLDL pada remaja siswa sekolah menengah pertama di Jakarta.Metode. Studi potong lintang pada 97 anak usia 12-15 tahun siswa SMP di Jakarta Pusat pada periode Juni-Juli 2012 dan April-Mei 2014 di Jakarta Timur. Pada subjek penelitian dilakukan pemeriksaan berat badan, tinggi badan, indeks massa tubuh (IMT), massa lemak tubuh (MLT), tekanan darah dan pemeriksaan darah sdLDL. Kriteria obesitas menggunakan IMT ≥P95 berdasarkan usia dan jenis kelamin. Massa lemak tubuh diukur menggunakan Tanita Inner Scan Body Composition Monitor tipe BC-545.Hasil dan pembahasan. Sebanyak 97 remaja obes diikutsertakan dalam penelitian. Prevalens sdLDL terjadi sebanyak 17,2 %. Terdapat hipertensi sebanyak 26,8 %, IMT pada nilai 30-39,9 sebanyak 51,5 % , MLT > P98 67 % dan lingkar pinggang> P90 52,5 %. Pada analisis bivariat dengan uji Mann-Whitney dan Kai-kuadrat tidak didapatkan hubungan antara sdLDL dengan faktor-faktor di atasKesimpulan : Prevalens sdLDL pada remaja obes ditemukan sebesar 17,2 %. Tidak ditemukan hubungan antara sdLDL dengan IMT, tekanan darah, MLT dan lingkar pinggang.

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Background : Childhood obesity is a global health problem. Plasma concentrations of small dense (sd)-LDL are associated with the prevalence of atherosclerosis events. Atherosclerosis already start to develop in childhood and adolescent obese. Increase of sdLDL in adolescent develop to adult and caused high morbidity and mortality. There are still not clear what factors influenced sdLDL.

Objectives. To know the prevalence of sdLDL in obese adolescents and the affecting factors, such as body mass index, body fat mass, blood pressure and waist circumference.

Methods. This was a cross-sectional study performed in obese adolescents, aged 12-15 years old, in several junior high schools in Central and East Jakarta, from May to June 2012 and April to Mei 2014. Physic examination was perfomed, including body mass index, body fat mass, blood pressure and waist circumference. and sd LDL as a blood examination.. Body mass index with the percentile ≥95 according to age and gender was used for obesity criteria, body fat mass was calculated using Tanita Inner Scan Body Composition Monitor Type BC-545.

Results. Of 97 obese adolescents in this study, sdLDL was found in 17,2 % subjects. The prevalence of each factors was 26,8 % hypertension, 51,5 % for body mass index at 30-39,9, 67 % for body fat mass >P98 and 52,5 % for central obesity P>P99. Based on bivariate analyse, such as Mann-Whitney and Kai-Kuadrat, there were no correlation between sdLDL and it’s factors.

Conclusion. sdLDL has a prevalence of 17,2 % in obese adolescent in this study, with no association found between body mass index, body fat mass, blood pressure and waist circumference."

"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."

"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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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."

"Prevalensi obesitas cenderung meningkat di berbagai belahan dunia sehingga dapat meningkatkan risiko kardiometabolik pada berbagai penyakit. Salah satu tata laksana obesitas yang paling efektif adalah modifikasi gaya hidup, yaitu pengaturan diet. Penelitian ini merupakan studi pendahuluan dengan desain uji klinis acak tersamar ganda, paralel, dua kelompok, bertujuan mengetahui pengaruh suplementasi serat larut dan diet rendah kalori seimbang (DRKS) selama 4 minggu berturut-turut terhadap berat badan (BB), kadar kolesterol highdensity lipoprotein (HDL) dan trigliserida (TG) serum pada subyek obes I usia 30-50 tahun. Berdasarkan kriteria inklusi, didapatkan 31 subyek yang dibagi menjadi dua kelompok, 15 orang kelompok perlakuan (KP) mendapat DRKS 1200 kkal/hari dan psyllium husk (PH) 8,4 g/hari, dan 16 orang kelompok kontrol (KK) mendapat DRKS 1200 kkal/hari dan plasebo. Sebanyak 28 subyek menyelesaikan penelitian ini. Suplementasi PH ditoleransi dengan baik dan tidak ada efek samping yang serius. Jumlah asupan energi total subyek KP 1130,9 ± 221,9 kkal/hari lebih tinggi signifikan (p = 0,02) daripada KK 1024,3 ± 269,9 kkal/hari. Asupan serat subyek rendah; KP 17,2 ± 2,8 dan KK 8,6 (5,2−15,2) g/hari, walaupun dengan suplementasi PH. Penurunan BB dan peningkatan kadar kolesterol HDL serum sedikit lebih banyak tidak signifikan pada KP (-1,8 ± 0,8 kg dan 0,0 ± 4,3 mg/dL) dibandingkan KK (-1,6 ± 0,9 kg dan -0,4 ± 5,9 mg/dL). Penurunan kadar TG serum KP -1,5 (-416−77) mg/dL lebih rendah tidak signifikan dibandingkan dengan KK -10,0 ± 31,3 mg/dL. Pada penelitian ini belum dapat dibuktikan suplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari dibandingkan DRKS 1200 kkal/hari saja selama 4 minggu berturut-turut lebih baik dalam menurunkan BB dan mempengaruhi kadar kolesterol HDL dan TG serum pada subyek obes I.

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The prevalence of obesity has been increasing globally, thus it likewise made an escalation the risk of cardio metabolic diseases. One method to encounter obesity is lifestyle modification such as the diet. This research was a preliminary study with double blinded randomized clinical trial, parallel, two groups, aims to understand the effects of soluble fiber suplementation and low calorie balanced diet (LCBD) on weight, high-density lipoprotein (HDL) cholesterol and triglycerides serum for obese I subjects age 30-50 years, for four weeks successively. Base on inclusion criteria, 31 subjects are divided into two groups, 15 subjects for treatment (T) receive 1200 kcal/day of LCBD and 8,4 g/day of psyllium husk (PH) and 16 subjects for control (C) receive 1200 kcal/day of LCBD and placebo. 28 subjects accomplish this research. PH suplement were being tolerate decently, and no serious side effect developed. Total energy intake from all T subjects were 1130,9 ± 221,9 kcal, significantly higher (p = 0,02) than C subjects 1024,3 ± 269,9 kcal/day. Subjects intake of fibers were low, even adding PH supplementation; 17,2 ± 2,8 for T subjects and 8,6 (5,2-15,2) g/day for C subjects. Weight loss and HDL cholesterol serum level enhancement were insignificantly higher on T subjects (-1,8 ± 0,8 kg and 0,0 ± 4,3 mg/dL) compared to C subjects (-1,6 ± 0,9 kg and -0,4 ± 5,9 mg/dL). TG serum level derivation on T subjects are -1,5 (-416−77) mg/dL insignificantly lower than C subjects -10,0 ± 31,3 mg/dL. This research has still yet able to prove that suplementation of PG 8,4 g/day and LCBD 1200 kcal/day in compare to only 1200 kcal/day of LCBD and placebo in 4 weeks consecutively are better in weight loss and affect the level of HDL cholesterol and TG serum on obese I subjects."

"Skripsi ini membahas mengenai faktor apa saja yang berhubungan dengan pengetahuan dan sikap ibu mengenai perilaku berisiko obesitas pada anak. Penelitian yang digunakan adalah penelitian kuantitatif dengan desain crosssectional.Hasil penelitian menunjukkan bahwa tidak ada hubungan yang bermakna secara statistik antara faktor karakteristik ibu (usia, tingkat pendidikan, dan pekerjaan) dengan pengetahuan dan sikap ibu mengenai perilaku berisiko obesitas anak. Tetapi terdapat konsistensi antara pengetahuan dengan sikap yang diteliti tersebut.Berdasarkan hasil penelitian, maka saran yang dapat diberikan adalah supaya institusi kesehatan dapat lebih emperhatikan kejadian obesitas pada anak di Indonesia, dan mencegahnya dengan memberikan informasi yang memadai dan lengkap bagi para orang tua, khususnya ibu.

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This study presents factors related to mothers knowledge and attitude on children?s obesity-risk-behavior. This quantitative, descriptive research uses cross-sectional design.

The results show that there are no statistical relation between mothers? characteristics (age, educational level, and job) and mothers knowledge and attitude about children?s obesity-risk-behavior. However, we found consistency between mothers knowledge and attitude.

Based on the results, it is suggested that health institutions could pay more attention on obesity level on children in Indonesia, and could also prevent it by giving adequate and complete information to their parents, especially mothers."

"Skripsi ini membahas faktor-faktor perilaku yang berhubungan dengan kejadian obesitas pada murid SD Pembangunan Jaya, Bintaro tahun 2009. Penelitian ini adalah penelitian kuantitatif dengan desain cross-sectional. Dari variabel-variabel yang diteliti, yang memiliki hubungan yang bermakna dengan kejadian obesitas adalah variabel kebiasaan makan fast food (tingkat keseringan makan fast food). Hasil penelitian menyarankan bahwa perlu diadakannya penyuluhan terhadap orang tua dan anak akan bahaya fast food. Selain itu, berkaitan dengan cukup tingginya angka kejadian obesitas di sekolah ini, perlu diaktifkan kembali UKS yang sesuai dengan fungsinya (preventif), diantaranya dengan melakukan penimbangan berat dan tinggi badan murid secara berkala oleh sekolah.

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This research discuss about behavioral factors which is related to obesity at Pembangunan Jaya Elementary School, Bintaro year 2009. This research is quantitative with cross-sectional design. Fast food eat frequent rate variable is related to obesity. From the result of this research, it is suggested to create an illumination about fast food risk for student and their parents. Besides, because the number of obesity in this school (getting up to 29.8%), it is necessary to reactivate School Health Practise (Usaha Kesehatan Sekolah). According with the function of UKS (prevention), school can measure the body weight and body height all students periodical."

"Kegemukan merupakan masalah kesehatan dunia yang sering ditemukan di berbagai negara (Daniels, 2009). Berat badan lebih atau gemuk adalah keadaan dimana seseorang memiliki berat badan yang lebih dibandingkan berat badan idealnya yang disebabkan karena terjadinya penumpukan lemak di dalam tubuh (Supariasa, 2000). Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan Kegemukan pada Anak di Sekolah Dasar Katolik Ignatius Slamet Riyadi II Jakarta Timur Tahun 2019. Penelitian ini merupakan penelitian kuantitatif dengan desain studi cross-sectional yang dilakukan pada bulan Mei tahun 2019 di SDK Ignatius Slamet Riyadi II Jakarta Timur dengan jumlah responden sebanyak 128 orang. Pengumpulan data dilakukan dengan wawancara dan pengisian kuesioner secara mandiri oleh responden. Data yang diperoleh kemudian dianalisis secara univariat, analisis bivariat dengan uji Chi-Square, dan analisis multivariat dengan uji regresi logistik ganda model prediksi. Hasil penelitian menunjukkan bahwa 55.5% anak di SDK Ignatius Slamet Riyadi II Jakarta Timur mengalami kegemukan. Berdasarkan hasil uji statistik, variabel jenis kelamin (p-value =0.020;OR=2.483), asupan energi (p-value=0.0001;OR=7.347), asupan protein (p-value=0.0001;OR=4.055), asupan karbohidrat (p-value=0.001; OR=6.349), dan asupan lemak (p-value=0.044; OR=2.300) berhubungan dengan kegemukan pada anak. Selain itu, diketahui juga jenis kelamin merupakan faktor dominan yang berhubungan dengan kegemukan dimana anak laki-laki 3.166 kali lebih berisiko untuk mengalami kegemukan. Berdasarkan hasil penelitian, peneliti menyarankan kepada siswa untuk lebih memperhatikan berat badan dan tinggi badan dengan melakukan pengukuran antropometri berkala di sekolah dan memperhatikan asupan makan dengan mengonsumsi makanan bergizi seimbang, serta tidak mengonsumsi fast food dan minuman manis kemasan bergula berlebihan. Sekolah disarankan melakukan pemantauan berat badan dan tinggi badan siswa dengan mengadakan pengukuran antropometri secara berkala, melakukan edukasi kepada orang tua murid tentang gizi seimbang, serta membuat program senam pagi bersama di sekolah.

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Overweight is a world health problem that is often found in various countries (Daniels, 2009). Overweight is a condition where a person has more weight than his ideal body weight due to the accumulation of fat in the body (Supariasa, 2000). This aim of this study is to know determine factors that associated with overweight in children at Katolik Elementary School Ignatius Slamet Riyadi II Jakarta Timur 2019. This is a quantitative study with a cross-sectional design conducted in May 2019 at SDK Ignatius Slamet Riyadi II Jakarta Timur, with 128 respondents. Data collection was done by interviewing and also use of self-administered questionnaire. Data were analyzed using univariate, bivariate using Chi-Square test, and multivariate using multiple logistic regression models of prediction. The univariate results showed that 55.5% of children in SDK Ignatius Slamet Riyadi II Jakarta Timur were overweight. Based on the results of statistical tests, gender variables (p-value = 0.020; OR = 2.483), energy intake (p-value = 0.0001; OR = 7.347), protein intake (p-value = 0.0001; OR = 4,055), carbohydrate intake (p-value = 0.001; OR = 6,349), and fat intake (p-value = 0.044; OR = 2,300) associated with overweight in children. In addition, it is also known that gender is the dominant factor associated with overweight where boys are 3,166 times more at risk for overweight. Based on the results of the study, the researchers suggested that students pay more attention to their weight and height by conducting periodic anthropometric measurements at school and paying attention to food intake by eating balanced nutritious foods, and not consuming fast food and sugar sweetened beverages. Schools are advised to monitor students' body weight and height by conducting regular anthropometric measurements, educating parents about balanced nutrition, and making a morning exercise program at school."

"Latar belakang: Obesitas dan sindrom metabolik (SM) yang terjadi pada usia dini akan menjadi faktor risiko diabetes melitus tipe 2 dan penyakit jantung koroner. Prevalens SM meningkat secara paralel dengan peningkatan obesitas. Penelitian mengenai SM pada anak dan remaja sangat terbatas. Tujuan: Mengetahui prevalens SM pada remaja obes usia 12-16 tahun dan faktor-faktor yang memengaruhinya. Metode: Sebuah penelitian potong lintang pada tiga sekolah menengah pertama negeri di Jakarta yang dipilih secara purposive sampling (remaja dan obes). Dilakukan pengukuran antropometri, tekanan darah dan pemeriksaan laboratorium darah. Diagnosis SM ditentukan sesuai kriteria International Diabetes Federation (IDF), yaitu lingkar pinggang > persentil 90 menurut usia dan jenis kelamin, dan memenuhi > 2 kriteria sebagai berikut: trigliserida > 150 mg/dl, HDL > 40 mg/dl, glukosa darah puasa > 100 mg/dl atau terdiagnosis diabetes melitus tipe 2 (DMT2), tekanan darah > 130/85 mmHg. Penyakit kardiovaskular atau DMT2 orangtua, riwayat diabetes pada ibu selama kehamilan, bayi berat lahir rendah (BBLR), pola makan tinggi lemak dan gula, aktivitas sedentari, orangtua obes, dan pajanan asap rokok diduga meningkatkan kejadian SM. Data diolah dengan tes Pearson atau Fisher untuk menentukan faktor-faktor yang memengaruhi dan angka kejadian SM ditampilkan dalam prevalens.Hasil: Prevalens obes pada penelitian ini adalah 5,9%. Penelitian dilakukan pada 95 subyek obes usia 12-16 tahun. Sebanyak 35,8% subyek memiliki IMT >p95-p97 dan 64,2% memiliki IMT >p97, semuanya telah mengalami pubertas. Prevalens SM adalah 15,8% dan meningkat hingga 21,3% pada kelompok super-obes. Terdapat perbedaan bermakna prevalens SM pada kedua kelompok IMT (p=0,048). Hipertrigliseridemia dan kadar HDL rendah adalah kriteria diagnosis terbanyak pada remaja obes dengan SM. Tidak ditemukan hubungan yang bermakna antara faktor-faktor yang memengaruhi terhadap kejadian SM. Simpulan: Prevalens SM pada penelitian ini 15,8% dan meningkat hingga 21,3% pada remaja super-obes. Tidak ditemukan hubungan yang bermakna antara faktor-faktor yang memengaruhi dengan kejadian SM. Dislipidemia adalah perubahan metabolik yang paling sering dijumpai pada remaja obes dengan SM.

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Background: Obesity and metabolic syndrome (MS) beginning in childhood lead to a substansial risk for type 2 diabetes mellitus and coronary heart disease. Prevalence of MS increases accordingly with the incidence of obesity. The study of the MS among children and adolescents were limited. Aim: The purpose of this study is to define the prevalence and factors that affect the incidence of MS among obese adolescents. Methods: A cross-sectional study selected by purposive sampling was conducted on three junior high school in Jakarta. The anthropometric, blood pressure, lipid profile, and glucose serum level from venous blood sample were taken. The definition of MS was made according to criteria of IDF. Parental history of cardiovascular disease or type 2 diabetes mellitus, history of maternal diabetes during pregnancy, low birth weight, high-fat and sugar diet, sedentary lifestyle, obese parents, and cigarette smoke expossure are considered as the factors affected the incidence of MS. Pearson or Fisher test was used to determine the factors that affect MS and the prevalence of MS were described as descriptive data.Results: Prevalence of obese were 5.9%. A total of 95 subjects with median age 12-16 years, were enrolled into the study. All subjects were obese, and 64.3% of them were superobese (BMI >p97 for age and sex). The prevalence of MS was 15.8% and increased to 21.3% among superobese group. There was a significant difference in the prevalence of MS in obese and super-obese (p = 0.048). Hypertriglyceridemia and low HDL levels are the diagnostic criteria found the most in MS subjects. There was no significant association between factors affecting MS. Conclusion: The prevalence of MS was 15.8% and increased to 21.3% among superobese. There was no significant association between factors affecting MS in adolescents. Dyslipidemia is the most common metabolic change in obese adolescents with MS."

"[ABSTRAKLatar belakang: Obesitas pada anak merupakan predisposisi terjadinya obesitas saat dewasa yang berhubungan dengan timbulnya penyakit ko-morbiditas metabolik. Obesitas ditandai dengan penimbunan jaringan adiposa tubuh secara berlebihan sehingga menghasilkan sitokin dan mediator inflamasi yang berperan dalam terjadinya inflamasi subklinis.Tujuan: Untuk mengetahui profil penanda inflamasi subklinis pada anak obes usia 9-12 tahun melalui pemeriksaan sitokin inflamasi (Interleukin-6) dan protein fase akut (C-reactive protein dan alpha-1-acid glycoprotein).Metode: Penelitian deskriptif potong lintang yang dilakukan pada siswa SD obes dan non-obes usia 9-12 tahun di Jakarta Selatan dan bersedia diukur antropometri serta diperiksa laboratorium IL-6, CRP, dan AGP.Hasil: Dari 30 anak obes dan 30 anak non-obes didapatkan kadar median IL-6 anak obes lebih tinggi bila dibandingkan dengan anak non-obes yaitu 3,09 (1,16-6,49) vs 1,27 (0,51-3,86), kadar median CRP pada kelompok obes lebih tinggi dibandingkan kelompok non-obes, yaitu 2,25 (0,4-64) vs 0,2 (<0,2-2,6) dan kadar rerata AGP kelompok obes lebih tinggi dibandingkan kelompok non-obes, yaitu 93,13 ± 18,29 vs 71 ± 18,89.Simpulan: Inflamasi subklinis telah terjadi pada anak obes berusia 9-12 tahun. Kadar sitokin inflamasi IL-6, kadar protein fase akut CRP dan AGP lebih tinggi pada anak obes dibandingkan anak non-obes.

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ABSTRACTBackground: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children.;Background: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children.;Background: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children., Background: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children.]"