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"Latar Belakang. Sepsis neonatal awitan dini SNAD masih merupakan masalah di Indonesia. Vitamin D memiliki efek pada fungsi imunitas. Neonatus kurang bulan NKB berisiko mengalami defisiensi kadar vitamin D. Hubungan kadar vitamin D dengan kejadian SNAD pada NKB belum jelas.Tujuan. Menganalisis hubungan kadar vitamin D dengan kejadian SNAD pada NKB.Metode. Duapuluh NKB dengan klinis dan pemeriksaan laboratorium menyokong SNAD kelompok kasus dan 20 NKB tanpa hasil laboratorium SNAD kelompok kontrol ikut dalam penelitian ini. Subjek penelitian adalah NKB usia gestasi ge; 28 sampai dengan < 37 minggu dirawat di RSUPN Cipto Mangunkusumo selama bulan Juli - September 2017. Pemeriksaaan kadar vitamin D 25 OH D dengan metode competitive chemiluminescense immunoassay CLIA direk dengan alat Diasorin Liaison.Hasil. Median kadar vitamin D pada NKB dengan SNAD 8,95 4,10 - 16,30 ng/mL dengan rerata usia gestasi 33,25 1,71 minggu dan rerata berat lahir 1863,75 415,06 gram. Median kadar vitamin D tanpa SNAD 11,75 5,80 - 42,80 ng/mL dengan rerata usia gestasi 34,67 1,53 minggu dan rerata berat lahir 2125,0 340,55 gram. Median kadar vitamin D NKB SNAD lebih rendah secara bermakna dibandingkan NKB tanpa SNAD.

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Background. Early onset neonatal sepsis EONS is still a problem in Indonesia. Vitamin D has effect on immune function. Preterm infants have a risk of deficiency of vitamin D levels. The association between vitamin D levels with EONS were unclear.Objective. To determine the association between vitamin D levels with EONS in preterm infants.Methods. Twenty preterm infants with clinical and laboratory finding of EONS study group and 20 preterm infants with no signs of laboratory infection control group were enrolled this study. The subjects were preterm infants of gestational age ge 28 37 weeks in Cipto Mangunkusumo Hospital during July September 2017. Vitamin D 25 OH D levels were measured using Diasorin Liason with competitive chemilunescence immunoassay CLIA technique.Results. Median vitamin D levels with EONS was 8,95 4,10 16,30 ng mL, mean of gestational age and birth weight were 33,25 1,71 weeks and 1863,75 415,06 g, respectively. Median vitamin D levels without EONS was 11,75 5,80 42,80 ng mL, mean of gestational age and birth weight were 34,67 1,53 weeks and 2125,0 340,55 g, respectively. Median vitamin D levels of preterm infants with EONS was significantly lower than without EONS.Conclusion. Vitamin D levels are associated with EONS in preterm infants."

"Latar Belakang :Insidensi terjadinya ketuban pecah dini (KPD) pada kehamilan preterm adalah 3-10,% dari semua persalinan. Lama terjadinya ketuban pecah dini berpengaruh pada kejadian infeksi maternal dan sepsis pada bayi. Sepsis, termasuk sepsis neonatal awitan dini (SNAD), masih menjadi penyebab utama kematian bayi prematur. Vitamin D berperan meningkatkan imunitas tubuh terutama saat menghadapi infeksi. Tujuan penelitian ini ingin mengetahui hubungan antara lama KPD, leukosit maternal, kadar vitamin D maternal dan tali pusat dengan luaran sepsis awitan dini pada bayi prematur.Metode : Desain penelitian kohort retrospektif dengan menggunakan rekam medis dan data penelitian sebelumnya. Mencatat lama ketuban pecah dini, kadar leukosit maternal, kadar vitamin D maternal dan tali pusat dankejadian sepsis pada bayi yang dilahirkan usia 28-34 minggudi Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo dan Rumah Sakit Umum Pusat Persahabatan, Jakarta. Subjek penelitian diambil secaraConsecutivesampling.Hasil : Selama periode penelitian didapatkan 72 subjek bayi yang dilahirkan dari ibu dengan KPD, 22 bayi (31%) diantaranya mengalami SNAD, sedangkan 50 bayi lainnya tidak mengalami SAD. Tidak terdapat hubungan antara lama KPD, jumlah leukosit maternal dengan kejadian SNAD tetapi didapatkan hubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD.

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Background:The incidence of premature rupture of membranes (PROM) in preterm pregnancy is 3-10,% of all deliveries. The duration of premature rupture of the membranes affects the incidence of maternal infection and sepsis in infants. Sepsis, including early onset neonatal sepsis (EONS), is still the main cause of premature infant mortality. Vitamin D acts to increase the body s immunity, especially when facing infection. The purpose of this study was to determine the relationship between the length of the ROM, maternal leukocytes level, maternal and umbilical cord vitamin D levels with early onset sepsis in premature infants.

Method:Design of a retrospective cohort study using medical records and previous research data. Note the duration of premature rupture of the membranes, maternal leukocyte levels, maternal vitamin D levels and umbilical cord and the incidence of sepsis in infants born 28-34 weeks at the National Center General Hospital Dr. Cipto Mangunkusumo and Center General Hospital Pesahabatan, Jakarta. The research subjects were taken by consecutive sampling.

Results: During the study period 72 subjects were born from mothers with ROM, 22 infants (31%) among them experienced EONS, while 50 other infants did not experience EONS. There was no relationship between the duration of ROM, the number of maternal leukocytes with the incidence of EONS, but a significant relationship was found between maternal vitamin D levels and umbilical cord with EONS events."

"Latar Belakang:. Sepsis neonatorum awitan dini masih menjadi penyebab kesakitan dan kematian yang utama pada neonatus, dengan angka lebih tinggi terjadi pada bayi kurang bulan. Berbagai faktor diketahui berhubungan dengan kejadian sepsis neonatorum awitan dini, namun penelitian yang dilakukan pada bayi prematur masih terbatas. Tujuan:. Mengetahui faktor-faktor risiko yang berhubungan dengan kejadian sepsis neonatorum awitan ini pada bayi kurang bulan di RSCM.Metode:. Penelitian desain case-control dengan mengambil data dari rekam medis bayi lahir kurang bulan di RSCM pada rentang waktu Januari 2016-Desember 2017 sebanyak 186 sampel (93 untuk masing-masing kelompok). Data dianalisis secara bivariat dan multivariat.Hasil: Terdapat perbedaan bermakna dari karakteristik bayi kurang bulan antara kelompok kasus dan kontrol yaitu usia gestasi, jenis kelamin laki-laki, dan berat lahir. Gejala klinis tersering ditemukan adalah sesak napas. Dari 7 faktor yang dianalisis, infeksi intrauterin, nilai APGAR 1 menit pertama, dan nilai APGAR 5 menit pertama pada analisis bivariat dimasukkan ke analisis multivariat (p<0,25) sementara pada faktor lainnya tidak ditemukan hubungan yang bermakna. Pada analisis multivariat, ditemukan bahwa jenis kelamin laki-laki, usia gestasi, infeksi intrauterin, dan nilai APGAR 1 menit pertama memiliki hasil yang bermakna secara statistik.Kesimpulan: Jenis kelamin laki-laki, usia gestasi, infeksi intrauterin, dan nilai APGAR 1 menit pertama merupakan faktor risiko independen sepsis neonatorum awitan dini pada bayi kurang bulan. Penelitian lebih lanjut dibutuhkan untuk mengetahui pengaruh faktor-faktor tersebut terhadap kejadian sepsis neonatorum awitan dini pada bayi kurang bulan.

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Background: Early onset neonatal sepsis is still considered as a common cause of morbidity and mortality in neonates, with a higher prevalence found in preterm infants. Many factors are known to be correlating to the cases of early onset neonatal sepsis, but research done specifically in preterm infants is limited.

Objective: To determine the factors associated with early onset neonatal sepsis in preterm infants.

Method: This research was done using a case-control design, where the data is taken from the medical record of preterm patients born in RSCM within January 2016-December 2017. The total sample is 186 (93 for each group). Data was then analyzed using bivariate and multivariate analysis.

Result: A significant result was found in characteristic such as gestational age, gender, and birth weight. Out of 7 factors that were analysed, the factors that were analysed using multivariate analysis were intrauterine infection, low APGAR score in the first minute, and low APGAR score in the fifth minute. From multivariate analysis, gender, gestational age, intrauterine inflammation, and low APGAR score in the first minute were stastically significant.

Conclusion: gender, gestational age, intrauterine inflammation, and low APGAR score in the first minute are independent risk factors for early onset neonatal sepsis. Further study is needed to understand the correlation between those factors and early onset neonatal sepsis in preterm infants."

"Latar belakang: Menurut data WHO, sebanyak 15 juta bayi di dunia dilahirkan kurang bulan setiap tahunnya, dan Indonesia menduduki peringkat ke-5 di dunia. Salah satu komplikasi pada bayi kurang bulan yang sering terjadi adalah sepsis. Sepsis Neonatorum Awitan Dini (SNAD) merupakan infeksi sistemik pada bayi pada usia kurang dari 72 jam yang seringkali disebabkan oleh transmisi patogen secara vertikal sebelum atau saat proses kelahiran. Strategi utama dalam penanggulangan kejadian SNAD bergantung pada identifikasi faktor risiko, termasuk ketuban pecah berkepanjangan. Namun, sampai saat ini masih belum ada kesepakatan terkait ambang batas waktu ketuban pecah yang meningkatkan risiko kejadian SNAD secara signifikan pada populasi bayi kurang bulan. Tujuan: (1) Mengetahui sebaran subjek penelitian berdasarkan karakteristik jenis kelamin, usia gestasi, usia ibu, berat lahir dan metode persalinan. (2) Mengetahui sebaran subjek penelitian berdasaran gejala klinis dan hasil pemeriksaan kultur. (3) Mengetahui hubungan antara waktu ketuban pecah dengan kejadian SNAD pada ambang batas waktu 24 jam, 18 jam dan 12 jam di RSCM. Metode penelitian: Sebuah studi kasus-kontrol dilakukan pada populasi bayi kurang bulan yang lahir di RSCM dari tahun 2016-2017. Subjek dibagi menjadi 2 kelompok: (1) kelompok kasus yang mengalami SNAD; dan (2) kelompok kontrol yang tidak mengalami SNAD; dipilih secara simple random sampling. Jumlah total subjek pada penelitian ini adalah 154 bayi kurang bulan (77 kasus dan 77 kontrol). Pengambilan data dilakukan pada Januari-Agustus 2018 dengan melihat rekam medis subjek penelitian, dilanjutkan dengan analisis bivariat menggunakan uji Chi Squared dan analisis multivariat menggunakan regresi logistik. Hasil penelitian: Semua karakteristik tidak memiliki perbedaan yang bermakna, kecuali usia gestasi (p=0,012) dan berat lahir (p=0,02). Gejala klinis yang paling sering ditemukan dan memiliki hubungan yang bermakna adalah sesak napas (63,0%; p<0,001) dan instabilitas suhu (40,9%; p<0,001). Kesimpulan: Terdapat hubungan yang signifikan antara waktu ketuban pecah dengan kejadian SNAD pada bayi kurang bulan di RSCM pada ambang batas waktu 12 jam, 18 jam dan 24 jam. Ketuban pecah lebih dari 12, 18 dan 24 jam meningkatkan risiko SNAD pada bayi kurang bulan 2,3 kali lipat, dan ketuban pecah lebih dari  12 jam meningkatkan risiko 2,9 kali lipat setelah adjustment.

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Introduction: According to WHO, 15 million babies are born premature annually, and  Indonesia ranks 5th worldwide. One of the most frequent complications in preterm infants is sepsis. Early onset neonatal sepsis (EONS) is defined as the systemic infection in infants less than 72 hours old which is often caused by vertical transmission of pathogens before or during labour. With the current lack of consensus in the definition of neonatal sepsis, identification risk factors, including prolonged premature preterm rupture of membranes (ROM), becomes the main strategy. Unfortunately, there is also currently lack of worldwide agreement in the threshold of duration of ROM which significantly increases the risk of EONS in preterm infants.

Objectives: (1) To determine the distribution of subjects based on selected characteristics: gender, gestational age, maternal age, birth weight and mode of delivery. (2) To determine the distribution of subjects based on clinical symptoms and bacterial culture examination. (3) To determine the association between the duration of ROM and the incidence of EONS in preterm infants, at the thresholds of 24 hours, 18 hours and 12 hours, in RSCM.

Methods: A case-control study was done on preterm infants born in RSCM in 2016-2017. The subjects were divided into 2 groups: (1) the case group for preterm infants who had EONS; and (2) the control group for preterm infants who did not have EONS; each selected by simple random sampling. The total number of subjects in the study was 154 preterm infants (77 in the case group and 77 in the control group). Data collection from the medical records of the subjects was performed in January-August 2018, followed by bivariate analysis using Chi Square Test and  multivariate analysis using logistic regression.

Result: Characteristics had insignificant differences, except gestational age (p=0,012) and birth weight (p=0,02). The clinical symptoms which were most frequent and had significant associations with EONS were respiratory instability (63,0%, p<0,001) and temperature instability (40,9%, p<0,001).

Conclusion. There is a significant association between the duration of ROM at 12, 18 and 24 hours, and the incidence of EONS in preterm infants, especially at duration of more than 12 hours. Prolonged PPROM for 12, 18, and 24 hours increases the risk of EONS in preterm infants 2.3 times (unadjusted) and PPROM for 12 hours increases the risk of EONS in preterm infants 2.9 times after adjustment for other factors."

"Respiratory Distress Syndrome (RDS), Feeding Intolerance (FI), dan sepsis merupakan morbiditas yang sering dialami bayi prematur. Salah satu faktor yang memengaruhi morbiditas adalah defisiensi vitamin D. Kadar vitamin D berkorelasi dengan sel Treg pada penyakit inflamasi bayi baru lahir. Sel Treg berperan dalam keseimbangan mikrobiota di usus. Tujuan penelitian ini untuk mengetahui peran vitamin D dengan kejadian RDS, FI, dan sepsis pada bayi sangat prematur dan/atau BBLSR melalui jalur sel Treg dan disbiosis usus. Design penelitian ini adalah kohort prospektif pada bayi sangat prematur dan/atau BBLSR, dilakukan bulan November 2019–Januari 2021 di Unit Neonatal RSCM. Pemeriksaan kadar vitamin D ibu dan bayi menggunakan metode CLIA dan Treg dengan flow cytometry menggunakan Treg detection kit CD4+CD127lowCD25+. Penilaian mikrobiota dengan Real Time PCR dan enteropati dengan Alpha-1 Antitrypsin. Pada penelitian ini didapatkan sebesar 88,3 % ibu defisiensi vitamin D (rerata 12,23 ± 5,07 ng/mL) dan 53% bayi defisiensi vitamin D (rerata 15,79  6,9 ng/mL). Didapatkan korelasi antara kadar vitamin D ibu dan bayi (r = 0,76, p < 0,001). Kadar vitamin ibu dan bayi tidak berhubungan dengan dengan kejadian RDS, FI, dan sepsis. Terdapat hubungan bermakna antara disregulasi sel Treg dengan kejadian FI (p = 0,04) dan sepsis (p = 0,03). Semua bayi mengalami disbiosis. Tidak didapatkan perbedaan komposisi mikrobiota pada RDS, FI, dan sepsis. Terdapat hubungan bermakna antara enteropati dengan kejadian sepsis (p = 0,02). Simpulan : Ibu defisiensi vitamin D akan melahirkan bayi defisiensi vitamin D. Kadar vitamin D tidak berpengaruh terhadap kejadian RDS, FI, dan sepsis. Pada bayi dengan disregulasi sel Treg, kejadian FI dan sepsis lebih tinggi dibandingkan yang tidak. Bayi dengan kondisi disbiosis tidak berbeda untuk terjadinya RDS, FI, dan sepsis. Kondisi enteropati menyebabkan kejadian sepsis lebih tinggi.

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Respiratory distress syndrome, feeding intolerance, and sepsis are the most common morbidities found in premature babies. One of the factors affecting morbidity is vitamin D level. Vitamin D level is correlated with the role of Treg cells in inflammatory neonatal. Treg cells act in balancing microbiota in the intestines. This study aimed to determine the role of vitamin D in increasing the incidence of sepsis, feeding intolerance, and respiratory distress syndrome in very premature and/or very low birth weight babies through Treg cells and intestinal dysbiosis. This is a cohort study conducted on very premature (< 32 weeks) and/or very low birth weight (birth weight < 1,500 g) babies, from November 2019–January 2021 in the Neonatal Unit of RSCM. Vitamin D levels of the mothers and babies were measured using the CLIA and Treg methods with flow cytometry using the Treg detection kit CD4+CD127lowCD25+. Treg was tested from umbilical cords blood. The fecal examination was conducted to determine intestinal bacteria using realtime PCR and Alpha-1 Antitrypsin. Most mothers (88.3%) had vitamin D deficiency with a mean value of 12.33 ± 5.07 ng/mL. The vitamin D level of the umbilical cord was 15.79 ± 6.9 ng/mL. There was a significant correlation between the vitamin D level of mothers and babies (r = 0.76, p < 0.001). There were no difference between maternal and babies vitamin D serum levels with incidence of RDS, FI, and sepsis.There were a significant correlation between Treg cell dysregulation and the incidence of FI (p = 0.04) and sepsis (p = 0.03) but not in RDS. All subjects experienced dysbiosis. There was a significant correlation between enteropathy and the incidence of sepsis (p = 0.02) but not in RDS and FI. Conclusion: Mothers with vitamin D deficiency will give birth to babies with vitamin D deficiency. There were no correlation between vitamin D and the incidence of RDS, FI, and sepsis. In babies with Treg cell dysregulation, the incidence of feeding intolerance and sepsis will be higher. The composition of the microbiota did not affect the incidence of RDS, FI, sepsis. In babies with enteropathy, the incidence of sepsis will be higher."

"Salah satu peran sistem imunitas terhadap infeksi M.leprae adalah respons makrofag melalui interaksinya dengan vitamin D dan reseptor vitamin D (RVD). Interaksi vitamin D dengan RVD pada berbagai sel imun akan menstimulasi ekspresi katelisidin. Penelitian ini bertujuan untuk menganalisis kadar serum 25-hydroxyvitamin D (25(OH)D) dan kadar plasma RVD serta hubungannya dengan IB pada pasien kusta. Penelitian ini berupa observasional-analitik dengan desain potong lintang. Sebanyak 28 subjek penelitian (SP) menjalani pemeriksaan slit-skin smear kemudian diagnosis kusta ditegakkan berdasarkan tanda kardinal kusta. Penelitian ini juga menilai kecukupan pajanan matahari menggunakan kuesioner pajanan matahari mingguan. Kadar serum 25(OH)D diperiksa dengan metode chemiluminescent immunoassay (CLIA) dan kadar plasma RVD dilakukan dengan metode enzyme linked immunosorbent assay (ELISA). Median kadar serum 25(OH)D adalah 12,68 ng/ml (4,88 – 44,74). Median kadar plasma RVD adalah 1,36 ng/ml (0,26 – 8,04). Berdasarkan analisis regresi multivariat, tidak terdapat hubungan antara IB dengan kadar serum 25(OH)D dan kadar plasma RVD (R square = 0,055). Tedapat korelasi positif kuat antara kadar serum 25(OH)D dengan skor pajanan sinar matahari (r = 0,863; p < 0,001).

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One of many immunity system’s roles against M. leprae infection is macrophage response through its interaction with vitamin D and vitamin D receptor (VDR). The interaction between vitamin D and VDR in various immune cells will stimulate the expression of cathelicidin. The objective is to analyze the serum level of 25-hydroxyvitamin D₃ (25(OH)D) and plasma level of VDR as well as their association with IB in leprosy patients. This observational analytic study was performed with cross-sectional design. A total of 28 subjects underwent a slit-skin smear examination and then the diagnosis of leprosy was made based on the cardinal signs. This study also assessed the patient’s sun exposure with weekly sun exposure questionnaire. Serum 25(OH)D level was assessed with chemiluminescent immunoassay (CLIA) method and RVD plasma level was measured by enzyme linked immunosorbent assay (ELISA). Median serum level of 25(OH)D was 12.68 ng/ml (4.88 – 44.74). Median plasma level of VDR was 1.36 ng/ml (0.26 – 8.04). Based on multivariate regression analysis, there was no significant association between BI and serum level of 25(OH)D and plasma level of VDR (R square = 0.055). There was strong positive correlation between serum level of 25(OH)D and sun exposure score (r = 0.863; p < 0.001)."

"ABSTRAKBerbagai studi terkini menunjukkan hubungan antara vitamin D dan sepsis. Vitamin D berperan sebagai stimulator produksi peptida antimikroba dan mencegah inflamasi yang berlebihan. Insufisiensi dan defisiensi vitamin D berhubungan dengan risiko terjadinya sepsis. Saat ini belum terdapat data mengenai hubungan status vitamin D dengan pasien infeksi tanpa sepsis, sepsis, dan sepsis berat. Tujuan penelitian ini dilakukan untuk mendapatkan hubungan antara proporsi status vitamin D dengan pasien infeksi tanpa sepsis, sepsis, dan sepsis berat.Desain penelitian potong lintang, terdiri dari 60 pasien infeksi terbagi menjadi kelompok infeksi tanpa sepsis, sepsis, dan sepsis berat masing-masing 20 pasien. Diagnosis sepsis berdasarkan modifikasi SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference 2001. Status vitamin D ditetapkan menurut rekomendasi Holick. Pada ketiga kelompok tersebut dicatat data karakteristik subjek dan dilakukan pemeriksaan 25(OH)D.Status vitamin D pada subjek penelitian ini didapatkan sebanyak 5 (8,33%) orang insufisiensi dan 55 (91,67%) orang defisiensi vitamin D Proporsi insufisiensi pada kelompok infeksi tanpa sepsis adalah 5%, sepsis 10%, dan sepsis berat 10%. Proporsi defisiensi pada kelompok infeksi tanpa sepsis adalah 95%, sepsis 90%, dan sepsis berat 90%. Didapatkan perbedaan tidak bermakna proporsi insufisiensi dan defisiensi vitamin D pada kelompok infeksi tanpa sepsis, sepsis, dan sepsis berat.Kami menyimpulkan status vitamin D tidak berhubungan dengan beratnya sepsis. Proporsi insufisiensi dan defisiensi pada pasien infeksi tanpa sepsis, sepsis, dan sepsis berat masing-masing didapatkan 5% dan 95%; 10% dan 90%; 10% dan 90%.

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ABSTRACTRecent studies have shown that there is a relationship between vitamin D and sepsis. Vitamin D has a a role as a potent stimulator of antimicrobial peptides and prevent an over reaction of the inflammatory response. Insufficiency and deficiency of vitamin D have been associated with sepsis event. Nevertheless, there is no data about the relationship between vitamin D status with infection without sepsis, sepsis, and severe sepsis patient. The aim of this study was to obtain the relationship between proportions of vitamin D with infection without sepsis, sepsis, and severe sepsis patient.This was a cross-sectional study, 60 patients with infection were divided into groups of infection without sepsis, sepsis, and severe sepsis, each consisted of 20 patients. Diagnosis of sepsis was based on modified SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference 2001. Vitamin D status was defined according to Holick recommendations. Baseline characteristics of subjects were recorded and 25(OH)D concentrations were measured in subjects of each groups.According to status of Vitamin D, 5 (8,33%) subjects were insufficiency and 55 (91,67%) were deficiency. The proportions of vitamin D insufficiency at infection without sepsis group were 5%, sepsis 10%, and severe sepsis 10%. The proportions of vitamin D deficiency at infection without sepsis group were 95%, sepsis 90%, and severe sepsis 90%. The proportions of insufficiency and deficiency at infection without sepsis, sepsis, and severe sepsis patient were not significantly different (p > 0.05).It is concluded that vitamin D status were not related to infection severity. The proportions of vitamin D insufficiency and deficiency at infection without sepsis, sepsis, and severe sepsis, i.e. 5% and 95%; 10% and 90%; 10% and 90%, respectively."

"Latar Belakang. Populasi penderita DM tipe 2 semakin meningkat, seringkali disertai dengan komorbid, salah satunya depresi dengan prevalensi bervariasi. Depresi dapat mempengaruhi keluaran penyakit DM tipe 2. Beberapa obat antidepresan diketahui dapat mengganggu kontrol gula darah. Vitamin D, telah lama diketahui berkaitan dengan berbagai penyakit kronik, berpotensi memperbaiki gejala depresi, walaupun belum diketahui hubungannya.Tujuan. Mengetahui adanya hubungan antara kadar vitamin D pada pasien DM tipe dengan kejadian depresi pada pasien dengan DM tipe 2.Metode. Penelitian ini merupakan studi dengan desain potong lintang, dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM). Pasien DM tipe 2 yang memenuhi kriteria inklusi pada, dilakukan penapisan depresi menggunakan kuesioner BDI-II, kemudian dibagi menjadi dua kelompok, depresi (BDI-II ≥14) dan tanpa depresi (BDI-II <14). Kemudian kedua kelompok dilakukan pemeriksaan kadar vitamin D, dan dilakukan analisis perbedaan rerata pada kedua kelompok tersebut. Kemudian dilakukan analisis multivariat regresi logistik terhadap variabel perancu.Hasil. Dari 60 subjek dengan DM tipe 2 yang yang memenuhi kriteria, didapatkan 23 subjek (38,3%) yang depresi, dan 37 subjek (61,7%) yang tidak depresi. Didapatkan median kadar vitamin D 21,8 ng/mL (RIK 14,9-26,6) pada kelompok depresi, sementara median kadar vitamin D 26,5 ng/mL (RIK 23,96-34,08) pada kelompok tanpa depresi. Terdapat perbedaan bermakna antara keduanya (p = 0,001). Setelah dilakukan analisis multivariat dengan variabel perancu jenis kelamin, paparan sinar matahari, dan IMT, didapatkan adjusted odds ratio(adjusted OR) 1,123 (IK 95%: 1,003-1,259) dengan nilai p=0,045.Kesimpulan. Kadar vitamin D yang lebih rendah meningkatkan kejadian depresi pada pasien DM tipe 2.

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Background. The population of people with type 2 diabetes is increasing, which is often accompanied by comorbid, one of them is depression. The presence of depression can affect the outcome of type 2 diabetes mellitus. Some of antidepressants are known to interfere with blood sugar control. Vitamin D levels have long been known to be associated with a variety of chronic diseases, have the potential to improve symptoms of depression, although the relationship is not yet known.

Methods. This research is a cross sectional study conducted at Cipto Mangunkusumo Hospital. Patients with type 2 DM who met the inclusion criteria on an outpatient basis were screened for depression using BDI-II questionnaire, then divided into two groups, depressed (BDI-II ≥ 14), and without depression (BDI-II <14). Then both groups were examined for vitamin D levels using the ELISA method, and an analysis of the mean difference between the two groups was performed.

Results. From the 60 subjects with type 2 DM who met the criteria, 23 subjects (38.3%) were depressed, and 37 subjects (61.7%) were not depressed. The median of vitamin D level was 21.8 ng/mL (IQR 14.9-26.6) in the depressed group, while the median vitamin D level was 26.5 ng/mL (IQR 23.96-34.08) in the non-depressed group (p = 0.001). After doing multivariate analysis with confounding variables the adjusted odds ratio was 1.123 (95% CI: 1.003-1.259) with p value=0.045.

Conclusion. Lower levels of vitamin D increase the incidence of depression in type 2 DM patients."

"Vitamin D memiliki efek mempertahankan fungsi endovaskular dan mengatur aktivitas inflamasi dalam dinding pembuluh darah. Lemak viseral, disebutkan sebagai prediktor risiko yang baik untuk penyakit vaskular karena berperan aktif secara metabolik serta bersifat meningkatkan pengeluaran sitokin proinflamasi Kedua hal ini berpengaruh dalam peningkatan risiko kejadian stroke akut. Sampai saat ini penelitian yang membahas korelasi antara kedua faktor tersebut masih inkosisten. Studi potong lintang dilakukan pada subyek berusia >18 tahun dengan stroke akut yang menjalani perawatan di RSUPN Dr. Cipto Mangunkusumo dan RS Universitas Indonesia. Pengukuran kadar lemak viseral menggunakan bioelectrical impedance analysis bedridden multifrekuensi. Penilaian kadar serum vitamin D (25 (OH)D) menggunakan metode chemiluminescent immunoassay. Terdapat total 73 subyek penelitian, sebanyak 55 subyek (75,3%) dengan insufisiensi dan 15 subyek (20,5%) mengalami defisiensi vitamin D, dengan nilai rerata di 17,08±7,85 ng/mL. Sejumlah 78,1% subyek memiliki kadar lemak viseral yang tinggi. Terdapat korelasi negatif (r= -0,271) yang signifikan (p <0,021) antara kadar lemak viseral dan kadar vitamin D serum pada stroke akut. Dilakukan analisis multivariat lanjutan, didapatkan kadar lemak viseral dan jenis pakaian (pakaian tertutup) menjadi faktor paling signifikan dalam menilai kadar vitamin D serum.Terdapat korelasi yang signifikan antara kadar lemak viseral dengan kadar vitamin D 25 (OH) pada pasien stroke akut.

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Vitamin D has effects in maintaining endovascular function and regulating inflammatory activity in the vascular wall. Visceral fat is said to be a good risk predictor for vascular disease because it plays a metabolically active role and increases the release of pro-inflammatory cytokines, both of which are influential in increasing the risk of acute stroke events. Studies that discuss the correlation between these two factors are still inconsistent.  A cross-sectional study was conducted on subjects aged >18 years with acute stroke who underwent treatment at Dr. Cipto Mangunkusumo Hospital and University of Indonesia Hospital. Measurement of visceral fat levels using bioelectrical impedance analysis bedridden multifrequency. Assessment of serum vitamin D (25(OH)D) levels using chemiluminescent immunoassay method.  In a total of 73 subjects, 55 (75.3%) subjects had vitamin D insufficiency and 15 (20,5%) subject had deficiency, with mean values at 17.08±7.85 ng/mL. A total of 78.1% of subjects had high visceral fat levels. There was a significant (p<0.021) negative correlation (r= -0.271) between visceral fat and serum vitamin D levels in acute stroke. In a further multivariate analysis, visceral fat content and type of clothing (concealing clothing) was found to be the most significant factor in assessing serum vitamin D levels. There is a significant correlation between visceral fat levels and 25 (OH) vitamin D levels in acute stroke patients."

"Latar Belakang: Vitamin D memiliki efek non-skeletal dalam mempertahankan fungsi endovaskular dan mengatur aktivitas inflamasi dalam dinding pembuluh darah. Lemak viseral, disebutkan sebagai prediktor risiko yang baik untuk penyakit vaskular karena berperan aktif secara metabolik serta bersifat meningkatkan pengeluaran sitokin proinflamasi Kedua hal ini berpengaruh dalam peningkatan risiko kejadian stroke akut. Sampai saat ini penelitian yang membahas korelasi antara kedua faktor tersebut masih inkosisten. Penelitian ini bertujuan untuk mengetahui korelasi antara kadar lemak viseral dan kadar vitamin D serum pada pasien stroke akut.Metode: Studi potong lintang dilakukan pada subyek berusia >18 tahun dengan stroke akut yang menjalani perawatan di RSUPN Dr. Cipto Mangunkusumo dan RS Universitas Indonesia selama bulan November -Desember 2023. Pengukuran kadar lemak viseral menggunakan bioelectrical impedance analysis (BIA) bedridden multifrekuensi. Penilaian kadar serum vitamin D (25 (OH)D) menggunakan metode chemiluminescent immunoassay (CMIA). Analisis bivariat dan multivariat digunakan untuk menilai korelasi dan hubungan antara variable bebas dan terikat, serta mengidentifikasi faktor perancu lain yang berhubungan dengan kadar vitamin D serum.Hasil: Terdapat total 73 subyek penelitian, sebanyak 55 subyek (75,3%) dengan insufisiensi dan 15 subyek (20,5%) mengalami defisiensi vitamin D, dengan nilai rerata di 17,08±7,85 ng/mL. Sejumlah 78,1% subyek memiliki kadar lemak viseral yang tinggi. Terdapat korelasi negatif (r= -0,271) yang signifikan (p <0,021) antara kadar lemak viseral dan kadar vitamin D serum pada stroke akut. Dilakukan analisis multivariat lanjutan dengan regresi linear untuk faktor perancu lain, hanya didapatkan kadar lemak viseral dan jenis pakaian (pakaian tertutup) yang menjadi faktor paling signifikan dalam menilai kadar vitamin D serum.Kesimpulan: Terdapat korelasi yang signifikan antara kadar lemak viseral dengan kadar vitamin D 25 (OH) pada pasien stroke akut.

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Background: Vitamin D has non-skeletal effects in maintaining endovascular function and regulating inflammatory activity in the vascular wall. Visceral fat is said to be a good risk predictor for vascular disease because it plays a metabolically active role and increases the release of pro-inflammatory cytokines, both of which are influential in increasing the risk of acute stroke events. Until now, studies that discuss the correlation between these two factors are still inconsistent. This study aims to determine the correlation between visceral fat levels and serum vitamin D levels in acute stroke patients.

Methods: A cross-sectional study was conducted on subjects aged >18 years with acute stroke who underwent treatment at Dr. Cipto Mangunkusumo Hospital and University of Indonesia Hospital during November - December 2023. Measurement of visceral fat levels using bioelectrical impedance analysis (BIA) bedridden multifrequency. Assessment of serum vitamin D (25(OH)D) levels using chemiluminescent immunoassay (CMIA) method. Bivariate and multivariate analyses were used to assess the correlation and relationship between independent and dependent variables, as well as identify other confounding factors associated with serum vitamin D levels.

Results: In a total of 73 subjects, 55 (75.3%) subjects had vitamin D insufficiency and 15 (20,5%) subject had deficiency, with mean values at 17.08±7.85 ng/mL. A total of 78.1% of subjects had high visceral fat levels. There was a significant (p<0.021) negative correlation (r= -0.271) between visceral fat and serum vitamin D levels in acute stroke. In a further multivariate analysis with linear regression for other confounding factors, only visceral fat content and type of clothing (concealing clothing) was found to be the most significant factor in assessing serum vitamin D levels.

Conclusion: There is a significant correlation between visceral fat levels and 25 (OH) vitamin D levels in acute stroke patients."