Hasil Pencarian  ::  Simpan CSV :: Kembali

"Diabetes mellitus tipe 2 merupakan penyakit dengan prevalensi yang terus meningkat setiap tahunnya. Indonesia terbukti sebagai negara keenam dengan prevalensi DM tipe 2 terbesar di dunia. Sebagai penyakit multifaktorial, salah satu faktor yang disebutkan berpengaruh dalam kejadian DM tipe 2 adalah aktivitas fisik, yang didefinisikan sebagai pergerakan badan yang diproduksi kontraksi otot rangka yang meningkatkan konsumsi energi di atas level basal. Adapun penelitian ini bertujuan untuk mengetahui apakah terdapat perbedaan aktivitas fisik antara karyawan Fakultas Kedokteran Universitas Indonesia penderita DM tipe 2 dan tanpa DM tipe 2. Pengambilan data dilakukan dengan rekam data aktivitas fisik selama 2 hari kerja dan 1 hari libur melalui kuesioner Bouchard dan anamnesis. Hasil pengolahan data menggunakan uji Kolmogorov-Smirnov menunjukkan tidak adanya perbedaan bermakna tingkat aktivitas fisik pada subjek DM tipe 2 dan tanpa DM tipe 2 (p = 0,988). Melalui penelitian ini didapatkan kesimpulan bahwa aktivitas fisik tidak menjadi variabel tunggal dalam menyebabkan DM tipe 2.

---

Diabetes mellitus type 2 is a disease whose prevalence is increasing every year. Indonesia is considered as the 6th country of highest prevalence of DM type 2. As a multifactorial disease, one of factors that believed to be involved in causing DM type 2 is physical activity, which defined as bodily movement produced by skeletal muscle which increases energy expenditure above basal level. This research aims to know whether there is different physical activity level between DM type 2 and non DM type 2 employees of Faculty of Medicine Universitas Indonesia. Collecting data is performed by recording of the physical activity in 2 weekdays and 1 weekend through Bouchard questionnaire and anamnesis. The result of data analysis using Kolmogorov-Smirnov test showed that there was no significant difference of physical activity level of the subjects (p = 0,988). According to this research, physical activity level is not the only contributing factor of DM type 2."

"Latar Belakang: Individu dengan diabetes melitus tipe 2 (DMT2) dilaporkan mengalami peningkatan risiko terjadinya sarkopenia dan juga sebaliknya. Penelitian mengenai DMT2 dengan sarkopenia mayoritas berasal dari populasi geriatri. Sampai saat ini belum ada studi yang membandingkan profil metabolik dan parameter inflamasi di kelompok DMT2 dengan dan tanpa sarkopenia pada usia yang lebih muda.Tujuan: Penelitian ini bertujuan untuk mengetahui adanya perbedaan rerata profil metabolik dan parameter inflamasi pada penyandang DMT2 nongeriatri dengan dan tanpa sarkopenia.Metode: Penelitian potong lintang ini melibatkan individu dengan DMT2 nongeriatri berusia  18-59 tahun yang berobat di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta, Indonesia pada bulan Januari 2021- Januari 2022. Dilakukan pengambilan data sekunder berupa antropometri dan laboratorium yang mencakup Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), HbA1c dan profil lipid. Kadar interleukin (IL)-6 dan IL-10 serum diukur menggunakan teknik ELISA. Kelompok sarkopenia terdiri atas possible dan true sarcopenia berdasarkan kriteria Asian Working Group for Sarcopenia (AWGS) 2019.Hasil: Dari 100 subjek, 35 subjek dikategorikan ke dalam possible sarkopenia dan 4 subjek true sarkopenia. Subjek DMT2 nongeriatri dengan sarkopenia memiliki median (RIK) nilai HOMA-IR dan kadar HbA1c yang lebih tinggi dibanding subjek tanpa sarkopenia yaitu berturut-turut [6,52 (4,05-17,26) vs. 4,66 (2,61-10,14); p=0,025] dan [9,0% (7,3-10,3)% vs. 7,4% (6,6-8,45)%; p=0,002]. Tidak terdapat perbedaan kadar profil metabolik lain dan IL-6 antara kedua kelompok, sementara kadar IL-10 hanya terdeteksi pada 33 sampel sehingga tidak dapat dianalisis lebih lanjut.Kesimpulan: Median nilai HOMA-IR dan kadar HbA1c kelompok DMT2 nongeriatri dengan sarkopenia lebih tinggi dibanding kelompok tanpa sarkopenia. Tidak ditemukan perbedaan kadar profil metabolik lain dan IL-6 sebagai parameter inflamasi antara kedua kelompok tersebut. Tidak dilakukan analisis beda rerata kadar IL-10 karena sedikitnya sampel yang terdeteksi.

---

Background: Individuals with type 2 diabetes mellitus (T2DM) are at increased risk for sarcopenia and vice versa. Studies in T2DM with sarcopenia mostly came from the geriatric population. To date, no study has compared the metabolic profile and inflammatory parameters in younger T2DM subjects with and without sarcopenia.

Aim: This study aimed to assess the mean differences in the metabolic profile and inflammatory parameters of nongeriatric T2DM individuals with vs. without sarcopenia.

Method: This cross-sectional study involved nongeriatric T2DM individuals aged 18-59 years old visiting Cipto Mangunkusumo Hospital, Jakarta, Indonesia between January 2021 and January 2022. Secondary data was obtained, namely anthropometric and laboratory data including Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), HbA1c and lipid profile. Serum levels of interleukin (IL)-6 and IL-10 were measured using the ELISA technique. The sarcopenia group consists of individuals with possible and true sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria.

Results: From 100 subjects, 35 was categorized as possible sarcopenia and 4 as true sarcopenia. Nongeriatric T2DM subjects with sarcopenia had significantly higher median (interquartile range) HOMA-IR and HbA1c compared to nonsarcopenic subjects [6.52 (4.05-17.26) vs. 4.66 (2.61-10.14); p=0.025] and [9.0% (7.3-10.3)% vs. 7.4% (6.6-8.45)%; p=0.002]. There were no differences in other levels of metabolic profile and IL-6 between the two groups, while IL-10 levels were only detected in 33 samples and could not be analyzed further.

Conclusion: Median HOMA-IR and HbA1c nongeriatric T2DM subjects with sarcopenia was higher than those without sarcopenia. There was no difference in other metabolic profile and IL-6 level as inflammation parameter between the two groups. IL-10 was not analysed further due to the small sample number that were detected."

"Diabetes mellitus (DM) is one of the public health problems worldwide, including in Indonesia. Cardiovascular disease was the main cause of death (75-80%) in DM, three-fourths of this death was caused by coronary heart disease (CHD). Approximately 34.2% of patients with acute coronary syndrome (ACS) receiving care at ICCU of Dr. Cipto Mangunkusumo General Hospital (RSCM) suffered from DM. Mortality rates of ACS in DM patients were still high and ACS prognosis in DM patients were still unfavorable. There are many factors playing a part in atherosclerosis and ACS incidence in DM patients, such as metabolic disorders due to hyperglycemia and the fomration of advanced glycation end product (AGE), oxidative stress, atherogenic dyslipidemia in DM in the form of high triglyceride level and low HDL cholesterol as well as an increase in small dense LDL, and insulin resistance. In addition, other risk factors of CHD frequently encountered with DM were hypertension, obesity, thrombocytc hyperaggregation and hypercoagulation. The management ofthis disease which was based on the control of risk factors was not yet satisfactory.Inflammatory response played an important role in pathogenesis of atherosclerosis, beginning with early lesion up to acute coronary syndrome. Increase in inflammatory responses (hsCRP) could predict cardiovascular event and predict post-ACS prognosis. Studies in DM population showed an increase in inflammation. ln-depth studies on inflammatory responses in ACS DM patients have not yet been reported. In normal condition, there was a balance of proinflammatory and antiinflammatory cytokines. The ratio of proinflammatory and antiinflammatory cytokines in ACS, particularly DM patients has not been studied. The relationship between metabolic factor (blood glucose, glyco Hb and lipid) and inflammatory response in ACS DM patients has not yet also been studied.Currently, the effort to decrease inflammatory response is made, among others, by aspirin, statin hypolipidemic medication and insulin sensitizer. Although aspirin and statin were used routinely in ACS patients and have proved to reduce inflammation, morbidity and mortality rates of ACS patients were still high. Thus, we would like to observe whether an addition of other medications in standard therapy could reduce inflammation better. Curcumin in experimental animals-and humans) showed -hypolipidemic effect (decrease 'in absorption and increase in catabolism) and hypoglycemia (effect on PPAR-7). Curcumin also demonstrated antiinflammatory effect. In this study we would like to observe the effects of curcumin on both metabolic factors and inflammatory responses in ACS patients.PROBLEM IDENTIFICATIONThe above elaboration showed a discrepancy associated with inflammatory response in DM ACS patients. Up to now, the relationship of metabolic factor and inflammatory response in DM ACS has not been clear yet. Likewise, the effects of curcumin on metabolic factor and inflammatory response in ACS have not yet been identified.OBJECTIVESTo evaluate inflammatory responses in DM ACS and its relationship with metabolic factors (glucose, blood; glyco Hb, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride); to evaluate the ratio of proinflammatory and antiinflammatory cytokines (IL-6/IL-10) in ACS DM patients, and to identify the effects of curcumin on metabolic factors and inflammatory responses in ACS patients.SETTINGThe study was conducted at ICCU of RSCM, ICCU of Persahabatan, ICCU of RS MMC and ICCU of Medistra Hospital, Cardiology Polyclinic, Department of Internal Medicine, Faculty of Medicine University of Indonesia! RSCM and Integrated Cardiac Service Poiyclinic of RSCM.STUDY SUBJECTSACS patients (DM and non-DM) and CHD (DM and non-DM).DESIGNThere were two studies: l. Observational design to observe inflammatory responses (hscRP, IL-6, IL-IO, VCAM and ICAM) in DM ACS, non-DM ACS, DM CI-ID, and non-DM CHD; to evaluate the relationship between metabolic factors (fasting blood glucose, blood glucose 2 hours PP, glyco Hb, total cholesterol, LDL cholesterol, HDI.. cholesterol and triglyceride) and inflammatory responses (hsCRP, IL-6, IL-10, VCAM and ICAM) in ACS DM. 2. Interventional study which was a double-blind randomized trial to evaluate the effects of curcumin at escalating doses (low dose 3:-:IS mglday, moderate dose 3x30 mg/day and high dose 3x60 mg/day on metabolic factors (fasting blood glucose. blood glucose 2 hours PP and glyco Hb) and the effects of curcumin at escalating doses on inflammatory responses (hsCRP, ll.-6, VCAM and ICAM) in ACS patients.RESULTSIn observational study, |46 subjects were analyzed, consisting of 84 ACS patients, (30 DM ACS patients and 54 non-DM ACS), and 62 CHD (25 DM CHD patients and 37 non-DM CHD patients). The results of the study in the four groups of patients showed: 1. Inflammatory response in DM ACS was higher than in DM CHD (hsCRP, p=0.00; II..-6, p=0.00; IL-10, p=0.00) and non-DM ACS (ICAM, P=0.03). 2. The ratio of proinflammatory and antiinflammatory cytokines (IL-6/II..-10) in DM ACS did not differ from that of DM CHD (p=0.2l) and non-DM ACS (p=0.5 l). 3. There was a relationship between metabolic factors and inflammatory responses in DM ACS: triglyceride and ll.-6 (r=O.39, p=0.03) and II..-I0 (r=0.37, p=o.o4).In interventional study we performed randomization in 75 ACS patients divided into four groups, consisting of low-dose curcumin group of 15 patients, moderate-dose curcumin group of 15 patients, high-dose curcumin group of IS patients, and placebo group of 30 patients. The results of the study in these four groups showed: l. Low-dose curcumin showed a decrease in hsCRP in one week ofthe first month after intervention, there was a significant difference liom that of placebo (p=0.04). Low-dose, moderate-dose, high-dose curcumin groups showed a decrease in IL-6, but was not significantly different from placebo. Low-dose, moderate-dose, high-dose curcumin did not show a decrease in VCAM and ICAM after intervention of 2 months. 2. Low-dose curcumin group tended to experience a decrease in glyco Hb level after intervention of 2 months (p=0.06); however, it was not significantly different from that of placebo. 3. There was a tendency that low-dose curcumin reduced total cholesterol and LDI. cholesterol; however, it was not significantly different from that of placebo. There was a tendency that low-dose curcumin increased HDL cholesterol; however, it was not significantly different from that of placebo. 4. There was a tendency that the pattern of escalating doses had some effects in inflammatory responses and metabolic factors, in which low-dose curcumin showed the best effects, followed by moderate-dose and finally high- dose curcumin.CONCLUSIONSIn this study, inflammatory responses in DM ACS patients were higher than those in DM CHD and non-DM ACS patients. There was no difference in the ratio of proinflammatory and antiinflammatory cytokines (IL-6fIL-IO) in DM ACS compared with DM CHD and non-DM ACS. ln addition, the present study identified some of the relationships between metabolic factors and inflammatory responses. Low-dose curcumin reduced hsCRP in one week of the first month after the intervention in ACS patients. There was a tendency that low-dose curcumin reduced glyco Hb level in ACS."