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"ABSTRACTAlthough it is common to assess visceral adipose tissue (VAT) by CT and MRI with a single slice at the umbilicus or the fourth and fifth lumbar vertebrae (L4-L5), recent studies reported that this single-slice method for determining an individual's VAT may be inaccurate. Therefore, VAT accumulation should be based on total volume and determined with multiple slices rather than by cross-sectional area. However, obtaining multiple slices is burdensome for both subjects and analysts and lacks versatility despite its accuracy. The purpose of this study was to develop a new equation model for predicting VAT volume while maintaining the measurement accuracy of the multiple-slice method. We analyzed data from 214 Japanese male adults (48.5±9.3 years) and developed multiple, stepwise, linear regressions with VAT volume as a dependent variable and age, BMI, waist circumference and VAT areas (the standard L4-L5 measurement site 0 cm, +5 cm, +10 cm) as independent variables. From these results, we determined the best prediction equation for VAT volume as follows: VAT volume = (30.4×BMI) + (17.9×VAT area at L4-L5+10 cm) - 501.5. The model explained 93.1% of VAT variance and the predicted VAT volume significantly correlated with the measured VAT volume (r=0.97). This study developed a new VAT assessment method with a high level of accuracy. The method is significantly less burdensome in measurement and analysis than the multiple-slice method. Researchers can use this equation when they require an accurate evaluation of VAT accumulation. However, they should bear in mind that this equation was derived from data acquired from middle-aged, overweight and obese male subjects."

"Obesitas merupakan pandemi yang prevalensinya semakin meningkat termasuk di Indonesia, yang komplikasinya dapat diccegah dengan penatalaksanaan dini. Obesitas sentral ditemukan pada penelitian sebelumnya dengan nilai luas penampang VAT ≥ 100 cm2. Saat ini di Indonesia belum ada yang meneliti mengenai luas penampang lemak viseral pada populasi perempuan usia 18-50 tahun untuk mengetahui komposisi lemak tubuh. Penelitian ini bertujuan untuk mengetahui korelasi antara parameter antropometri dengan luas penampang lemak viseral (VAT) pada perempuan berusia 18-50 tahun. Dilakukan  studi cross sectional pada subjek yang CT-scan regio abdomen di departemen radiologi RSCM dan kemudian dilakukan pengukuran parameter antropometri yang mencakup lingkar pinggang (WC), rasio lingkar pinggang-tinggi badan (WtHR), dan indeks massa tubuh (IMT). Analisis korelasi, analisis bivariat dan multivariat dilakukan pada paremeter antropometri tersebut untuk mendapatkan formula yang dapat memprediksi komposisi lemak viseral tubuh. Ditemukan 51,9% subjek memiliki status gizi overweight dan obesitas, dan ditemukan 28,8% subjek memiliki luas penampang VAT ≥ 100 cm2. WC, WtHR, dan IMT memiliki korelasi positif kuat terhadap nilai luas penampang VAT dengan nilai p <0,0001 dan nilai R masing-masing 0,770, 0,770, dan 0,797. Ditemukan titik potong untuk nilai luas penampang VAT = 100cm2 untuk WC=83,1 cm (sensitivitas,spesifisitas: 93,3%,83,3%), WtHR= 0,5376 (86,7%, 81,1%), dan IMT = 24,1203 (86,7, 81,1%). Sebagai simpulan, terdapat korelasi positif kuat antara WC, WtHR, dan IMT terhadap luas penampang VAT. Ditemukan titik potong untuk nilai VAT = 100cm2 untuk masing-masing parameter antropometri yang dapat memprediksi terjadinya obesitas sentral.

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Obesity has become pandemic and it’s prevalence has been increasing each years, including in Indonesia, and the complication can be prevented with early intervention. Central obesity has been measured based on previous studies with VAT surface area ≥ 100 cm2. At the moment in Indonesia there are no studies regarding VAT surface area in 18-50 years old women. This study aims to identify the correlation of antropometric profile to Visceral Adipose Tissue surface area in 18-50 years old women. A cross-sectional study was conducted on subjects who had a CT scan of the abdominal region at the RSCM radiology department and then anthropometric parameters were measured including waist circumference (WC), waist circumference-height ratio (WtHR), and body mass index (BMI). Correlation analysis, bivariate and multivariate analysis were carried out on these anthropometric parameters to obtain a formula that can predict the body's visceral fat composition. It was found that 51.9% of subjects had overweight and obesity nutritional status, and it was found that 28.8% of subjects had a VAT cross-sectional area ≥ 100 cm2. WC, WtHR, and IMT have a strong positive correlation with the VAT cross-sectional area value with a p value <0.0001 and an R value of 0.770, 0.770, and 0.797, respectively. The cut point was found for the cross-sectional area value VAT = 100cm2 for WC = 83.1 cm (sensitivity, specificity: 93.3%, 83.3%), WtHR = 0.5376 (86.7%, 81.1%), and BMI = 24.1203 (86.7, 81.1%). In conclusion, there is a strong positive correlation between WC, WtHR, and BMI on VAT cross-sectional area. A cut point was found for the VAT value = 100cm2 for each anthropometric parameter which can predict the occurrence of central obesity."

"ABSTRAKPeningkatan tekanan darah (TD) merupakan salah satu permasalahan dunia. Salah satu penyebabnya adalah gaya hidup masyarakat yang mengarah ke obesitas sentral. Rasio lemak viseral abdomen (LVA) terhadap lemak subkutan abdomen (LSA) merupakan indikator obesitas sentral yang dapat digunakan untuk mendeteksi dini peningkatan TD. Disain penelitian ini merupakan potong lintang dengan tujuan untuk mengetahui korelasi antara rasio LVA : LSA dengan TD pada laki-laki usia produktif dengan aktivitas sedang di Indonesia. Pengambilan data dilakukan di salah satu perusahaan di Bekasi pada bulan Oktober 2014. Sebanyak 52 orang subjek bersedia ikut serta dalam penelitian dan memenuhi kriteria penelitian. Didapatkan hasil rerata indeks massa tubuh (IMT) subjek 24,60 kg/m2, dan sebagian besar subjek mempunyai IMT dengan BB lebih. Rerata persentase massa lemak (ML) subjek 18,92%, dan sebagian besar subjek mempunyai persentase ML dapat diterima. Seluruh subjek mempunyai TD sistolik dan diastolik normal. Nilai tengah luas area LVA sebesar 90 cm2 dan LSA 142 cm2. Seluruh subjek mempunyai rasio LVA : LSA normal. Korelasi antara rasio LVA : LSA dengan TD adalah r= 0,356 untuk TD sistolik dan r= 0,244 untuk TD diastolik. Kesimpulan penelitian ini adalah terdapat korelasi yang tidak bermakna secara statistik antara rasio LVA : LSA dengan TD, namun terdapat kcenderungan korelasi yang cukup kuat.

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ABSTRACTIncreased blood pressure (BP) is one of the world's problems. It might be caused by lifestyles that lead to central obesity. The ratio of abdominal visceral adipose tissue (VAT) to the abdominal subcutaneous adipose tissue (SAT) is one indicator of central obesity which can be used for early detection of elevated BP. This study used cross-sectional study with aim to determine the correlation between ratio of abdominal VAT : SAT with BP in men of reproductive age with moderate activity in Indonesia. The data were obtained in one company in Bekasi on October 2014, 52 subjects signed the consent and matched the study criterias. Subjects showed a mean BMI 24.60 kg /m2, and most of them were overweight. The mean of subjects’ FM percentage was 18.92%, and most of them had an acceptable FM percentage. All subjects had normal systolic and diastolic BP. The median VAT area was 90 cm2 and SAT area was 142 cm2. All of the subjects had normal ratio of abdominal VAT : SAT. Correlation between ratio of abdominal VAT : SAT were r= 0,356 for systolic BP and r= 0,244 for diastolic BP. The conclussion of the study is there was not significant correlation between ratio of abdominal VAT : SAT with BP, although there were a tedency for fairly strong correlation."

"This book is designed to provide a comprehensive insight into current perspectives and challenges in adipose tissue biology. In Adipose tissue biology, scientists and clinicians discuss adipocyte precursors, differentiation and growth, brown and white adipose tissue, gender, inflammation, dietary and genetic determinants of fat mass, together with evolutionary and developmental aspects of adiposity."

"Latar Belakang: Obesitas merupakan suatu keadaan terdapatnya jaringan lemak dalam tubuh yang berlebihan. Kondisi ini berhubungan dengan penyakit kardiovaskular, salah satunya adalah aterosklerosis. Aterosklerosis pada sistem pembuluh darah karotis hingga saat ini merupakan penyebab terbesar stroke iskemik di dunia dengan jumlah kasus terbanyak pada rentang usia 45-64 tahun. Dengan menggunakan teknik single slice CT-scan dapat dihitung komposisi lemak viseral (VAT) maupun lemak subkutan (SAT) tubuh dengan baik. Sedangkan USG merupakan modalitas radiologi yang baik untuk skrining aterosklerosis pada arteri karotis komunis dengan mengukur ­Intima-Media Thickness (IMT). Tujuan: Tujuan penelitian ini adalah untuk menentukan komposisi lemak yang berhubungan terhadap aterosklerosis karotis komunis dan lingkar pinggang. Metode: Sebanyak 32 subjek penelitian yang melakukan pemeriksaan CT-scan regio abdomen, dilakukan penghitungan luas penampang VAT, SAT dan rasio VAT/SAT dengan menggunakan software volumetri SyngoTM, pengukuran IMT arteri karotis komunis kanan dan kiri menggunakan USG yang dilengkapi dengan software auto-IMT, dan pengukuran lingkar pinggang. Kemudian dilakukan analisa korelasi antara VAT, SAT, dan rasio VAT/SAT terhadap IMT karotis serta lingkar pinggang (WC). Hasil: Terdapat korelasi lemah antara luas penampang VAT terhadap IMT karotis komunis (ρ = 0,21 ; p = 0,248), antara luas penampang SAT terhadap IMT karotis komunis (ρ = 0,37 ; p = 0,036) dan korelasi negatif lemah antara rasio VAT/SAT terhadap IMT karotis komunis (ρ = -0,24 ; p = 0,193). Selain itu didapatkan korelasi kuat antara VAT terhadap lingkar pinggang (ρ = 0,73 ; p < 0,05), korelasi positif sangat kuat antara SAT terhadap lingkar pinggang (ρ = 0,87 ; p < 0,05), dan korelasi negatif lemah antara rasio VAT/SAT terhadap lingkar pinggang (ρ = -0,37 ; p = 0,038). Kesimpulan: Luas penampang VAT dan SAT berkorelasi lemah terhadap IMT karotis komunis. Luas penampang VAT berkorelasi kuat terhadap lingkar pinggang, luas penampang SAT berkorelasi sangat kuat terhadap lingkar pinggang. Rasio VAT/SAT memiliki korelasi negatif lemah terhadap IMT karotis komunis dan lingkar pinggang. Pengukuran lingkar pinggang dapat digunakan unuk memprediksi volume VAT dan SAT.

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Backgorund: Obesity is a condition with high level of fat deposition in the body. This condition is related to cardiovacular diseases including atherosclerosis. Carotid athersclerosis until now is known as the main cause of ischemic stroke in the world with the most cases ranged between 45-64 years old. With single slice CT-scan technique, we can estimate the composition of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) very well. USG is the best modality for carotid atherosclerosis screnning by measuring ­Intima-Media Thickness (IMT) of the common carotid artery.

Purpose: of this study is to determine which one of these fat is correlated to carotid atherosclerosis and waist circumference (WC).

Methods: Thirty two subjects that underwent an abdominal CT-scanning were calculated for their area of VAT, SAT, dan VAT/SAT ratio using SyngoTM volumetric software. Measurement of the IMT was done by using auto-IMT software in USG. Their waist circumference were also measured. Correlational analysis were done between VAT, SAT, VAT/SAT ratio with carotid IMT and waist circumference (WC).

Result: There was a low correlation between VAT and common carotid IMT (ρ = 0,21 ; p = 0,248), SAT and common carotid IMT (ρ = 0,37 ; p = 0,036). Low negative correlation was shown between VAT/SAT ratio and carotid IMT (ρ = -0,24 ; p = 0,193). This study also showed a strong correlation between VAT and waist circumference (ρ = 0,73 ; p < 0,05), very strong correlation between SAT and waist circumference (ρ = 0,87 ; p < 0,05), also low negative correlation between VAT/SAT ratio and waist circumference (ρ = -0,37 ; p = 0,038).

Conclusion: There are low correlation between VAT and SAT and common carotid IMT. There is strong correlation between VAT and waist circufmerence, very strong correlation between SAT and waist circumference. There is low inverse correlation between VAT/SAT ratio and waist circumference. Therefore the measurement of waist circumference can be used to predict VAT and SAT volume."

"Latar Belakang Peningkatan konsumsi diet tinggi fruktosa kolesterol (DTFK) pada masa ini telah memicu obesitas yang menyebabkan berbagai gangguan kesehatan. Pada kondisi obesitas, Interleukin-10 (IL-10) merupakan mediator inflamasi yang akan mengalami penurunan di jaringan adiposa. Tanaman Acalypha indica (Ai) merupakan salah satu tanaman yang terbukti memiliki beberapa senyawa yang menghambat inflamasi yang terjadi dalam kondisi obesitas. Penelitian ini menganalisis senyawa dalam akar Ai yang memiliki ikatan dengan IL-10 menggunakan metode molecular docking dan mengukur kadar IL-10 di jaringan adiposa viseral tikus obesitas. Metode Studi molecular docking dilakukan pada 17 senyawa ekstrak akar Ai untuk membuktikan afinitasnya dengan IL-10 (PDB: 2H24) sebagai protein target. Kemudian, studi eksperimental dilakukan pada 23 ekor tikus Sprague-Dawley jantan yang dibagi ke dalam empat kelompok, yakni kelompok diet normal, kelompok DTFK (kontrol negatif), DTFK+Ai, dan kelompok DTFK+Gemfibrozil (kontrol positif). Setelah 28 hari, tikustikus tersebut diterminasi dan diukur kadar IL-10 pada jaringan adiposa viseral menggunakan ELISA dan Bradford Protein Assay. Hasil Hasil studi molecular docking menunjukkan bahwa keseluruhan senyawa memiliki ikatan terhadap IL-10 dengan afinitas tertinggi dimiliki oleh stigmasterol (ΔG: -7,95 kkal/mol; Ki: 1,49 mikromolar) dan stigmast-5-en-3-ol (ΔG: -6,86 kkal/mol; Ki: 9,31 milimolar). Pemberian Ai terbukti memberikan hasil peningkatan kadar IL-10 sebesar 3x terhadap kelompok DTFK (DTFK = 0,157+0,041; DTFK+Ai = 0,485+0,021) yang berbeda bermakna (p<0,05). Kesimpulan Pemberian ekstrak akar Ai dapat meningkatkan kadar IL-10 pada jaringan adiposa viseral tikus obesitas yang diperkirakan melalui interaksi utama ligan stigmasterol dan stigmast- 5-en-3-ol dalam senyawa Ai.

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Introduction Increasing consumption of a high fructose corn syrup (DTFK) diet during this period has triggered obesity, which causes various health problems. In obesity-related diseases, Interleukin-10 (IL-10) is an inflammatory mediator that decreases in adipose tissue. The Acalypha indica (Ai) plant is one that has been proven to have several compounds that inhibit inflammation that occurs in obesity-related conditions. This study analyzed compounds in Ai roots that bind to IL-10 using the molecular docking method and measured IL-10 levels in the visceral adipose tissue of obese mice. Method Molecular docking was performed on 17 ligands of Ai root extract to prove their affinity with IL-10 (PDB: 2H24) as a target protein. Then, an experimental study was conducted on 23 male Sprague-Dawley rats, which were divided into four groups: normal diet, DTFK (negative control), DTFK+Ai, and DTFK+ Gemfibrozil (positive control). After 28 days, these rats were terminated and IL-10 levels were measured using ELISA and Bradford Protein Assay. Results The results of molecular docking studies show that all compounds bind to IL-10 with the highest affinity in stigmasterol (ΔG: -7.95 kcal/mol; Ki: 1.49 micromolar) and stigmast- 5-en-3-ol (ΔG: -6.86 kcal/mol; Ki: 9.31 millimolar). The administration of Ai was proven to increase 3x IL-10 levels in the DTFK group (DTFK = 0.157+0.041; DTFK+Ai = 0.485+0.021), which was significantly different (p<0.05). Conclusion Administration of Ai root extract can increase IL-10 levels in visceral adipose tissue of obese mice which is thought to be through the main interaction of the stigmasterol and stigmast-5-en-3-ol ligands in the Ai compound."

"Hiperlipidemia dan atherosklerosis berperan dalam patogenesis penyakit kardiovaskular, yang merupakan penyebab mortalitas tertinggi di Indonesia dalam kategori penyakit tidak menular (PTM). Pengobatan standar bagi hiperlipidemia, yaitu golongan statin dan fibrat, memiliki banyak efek samping. Ekstrak etanol akar Acalypha indica Linn. memiliki aktivitas antioksidan yang memiliki efek hipolipidemik namun belum diketahui efeknya pada jaringan adiposa. Oleh karena itu, pada penelitian ini akan diteliti aktivitas hipolipidemik ekstrak etanol akar Acalypha indica Linn. pada jaringan adiposa viseral tikus jika dibandingkan dengan simvastatin dan gemfibrozil. Penelitian ini memiliki desain studi eksperimental dengan membandingkan jaringan adiposa viseral tikus jantan Sprague-Dawley yang telah diinduksi diit tinggi kolesterol-fruktosa dan diberi terapi ekstrak, simvastatin, gemfibrozil, kombinasi ekstrak dan simvastatin, serta kombinasi ekstrak dan gemfibrozil selama 4 minggu. Penelitian dilakukan di Departemen Farmasi dan Histologi Fakultas Kedokteran Universitas Indonesia, Jakarta, pada Juli-November 2015. Selularitas jaringan adiposa yang diwarnai dengan Hematoxylin-Eosin (HE) dinilai dengan diameter reratanya menggunakan perangkat lunak Adiposoft®. Data yang diperoleh diuji dengan uji one-way ANOVA yang diikuti post-hoc atau uji Kruskal-Wallis. Tikus yang diberi terapi ekstrak memiliki berat lemak viseral dan diameter adiposit yang paling rendah serta jumlah sel/lapang pandang yang paling banyak. Namun secara statistik, tidak ada perbedaan bermakna antara terapi ekstrak, simvastatin dan gemfibrozil untuk menurunkan deposisi lemak pada jaringan adiposa viseral (p>0,05).

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Hyperlipidemia and atherosclerosis have a role in pathogenesis of cardiovascular disease, the biggest non-communicable cause of mortality. Its standard therapy, statin and fibrate, have several side effects. Ethanolic root extract of Acalypha indica Linn. has antioxidant properties that can act as hypolipidemic agent. But then, its effect on visceral adipose tissue (VAT) is not known yet. Therefore, this research will seek the comparison of hypolipidemic activity between ethanolic root extract of Acalypha indica Linn., simvastatin and gemfibrozil towards fat deposit in VAT.

This research compares VAT in Sprague-Dawley male rat induced with high cholesterol-fructose diet and given 5 types of therapy (extract, simvastatin, gemfibrozil, extract + simvastatin, and extract + gemfibrozil). The research was conducted in Faculty of Medicine Universitas Indonesia, Jakarta, on July- November 2015. Adipose is then stained with Hematoxylin-Eosin and its cellularity is measured digitally by using Adiposoft®. Data is analyzed with one-way ANOVA with post-hoc Tukey or Kruskal-Wallis test. Rats given with extract have the lowest fat mass, lowest adipocyte diameter, and highest number of cell/field of all therapy group. There is no significant difference in extract, simvastatin, and gemfibrozil therapy in minimising fat deposition in VAT (p>0.05)."

"Latar belakang: Ada berbagai cara pemrosesan jaringan lemak sebelum dikultur, tergantung jenis sampelnya yang dapat mempengaruhi hasil kultur. Penelitian ini bertujuan membandingkan berbagai modifi kasi prosedur kultur dan subkultur jaringan lemak yang disesuaikan dengan kondisi lab yang ada.Metode: Penelitian ini adalah penelitian deskriptif yang dilakukan di Makmal Terpadu Imunologi dan Endokrinologi, Universitas Indonesia, mulai Oktober 2009 sampai April 2010. Kami membandingan tiga cara pemrosesan, berbagai jumlah sel yang ditanam yang tergatung jumlah perolehan sel, dan dua cara subkultur, lalu membandingkan hasilnya dalam hal jumlah sel yang dihasilkan dan waktu yang diperlukan. Pada cara pemrosesan pertama, pencernaan dengan collagenase-1 dilakukan selama 30 menit dan jumlah sel yang ditanam adalah 24.000 dan 36.000 sel per wadah kultur; pada cara kedua, pencernaan dengan collagenase-1 dilakukan selama 60 menit dan jumlah sel yang ditanam adalah 24.000, 48.000, dan 72.000 per wadah kultur; dan pada cara ketiga, sisa jaringan lemak dari pemrosesan pertama dicerna kembali selama 45 menit dan jumlah sel yang ditanam adalah 74.000 dan 148.000 per wadah kultur. Perbedaan cara subkultur adalah pada ada atau tidaknya tahap pencucian.Hasil: Prosedur -1 menghasilkan jumlah sel yang paling sedikit, dan sesudah dikultur, selnya tumbuh sangat lambat, dan terkontaminasi sebelum panenan kultur primer. Prosedur-2 dan -3 berhasil menumbuhkan kultur primer. Beberapa kultur terkontaminasi, sehingga tidak dapat dilanjutkan dengan subkultur, dan hanya satu cara pemrosesan (prosedur-2: pencernaan collagenase-1 selama 60 menit tanpa penggunaan dapar pelisis, dan jumlah sel yang ditanam 48.000 dan 72.000) yang berhasil menyelesaikan semua proses yang direncanakan sampai subkultur ketiga. Walaupun beberapa prosedur tidak mencapai subkultur ketiga, hasilnya tetap dapat disimpulkan. Kesimpulan: Penelitian pendahuluan ini menunjukkan bahwa pencernaan collagenase-1 selama 60 menit dipadu dengan goyangan berkala setiap 5 menit dan jumlah sel yang ditanam sekitar 50.000 atau lebih, diikuti dengan cara subkultur tanpa tahap pencucian memberi hasil yang terbaik.

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AbstractBackground: There are various methods of processing adipose tissue before culture, depending on the adipose tissue samples. The aim of this study is to compare several modifi cations of culturing and sub-culturing procedures of adipose tissue to fi t the condition in our laboratory.Method: This is a descriptive study that was done in the Immunology and Endocrinology Integrated Laboratory, University of Indonesia, from October 2009 to April 2010. Three adipose tissue processing procedures, various amount of seeding and two subculture methods were compared in term of cell yield and time needed. In the fi rst procedure, collagenase-1 digestion was done in 30minutes, cell seeding were 24,000 and 36,000 per fl ask; in the second procedure, collagenase-1 digestion was done in 60minutes, cell seeding were 24,000, 48,000, and 72,000 per fl ask; and in the third procedure, the adipose tissue remnants from the fi rst procedure were again digested for another 45 minutes, cell seeding were 74,000, and 148,000 per fl ask. Difference in subculture methods were the presence or absence of washing step.Result: Procedure 1 yielded the lowest amount of cell, and after culture, the cells grew very slow, and was contaminated before harvest of primary culture. Procedure-2 and -3 succeeded to yield primary cultures. Some of the cultures were contaminated, so that further subculture was not applicable, and only one tissue processing procedure (procedure 2: 60 minute collagenase-1 digestion, without lysis buffer, cell seeding 48,000 and 72,000) could complete the three subcultures. Though some of the procedures could not be completed, fi nal result could be concluded.Conclusion: In this preliminary study, 60 minute colagenase-1 digestion with intermittent shaking every 5 minutes and cell seeding around 50,000 or more, followed by subculture method without washing step gave the best result."

"This brief book on Newton method is a user-oriented guide to algorithms and implementation. In just over 100 pages, it shows, via algorithms in pseudocode, in MATLAB, and with several examples, how one can choose an appropriate Newton-type method for a given problem, diagnose problems, and write an efficient solver or apply one written by others. Solving Nonlinear Equations with Newton's Method contains trouble-shooting guides to the major algorithms, their most common failure modes, and the likely causes of failure. It also includes many worked-out examples (available on the SIAM website) in pseudocode and a collection of MATLAB codes, allowing readers to experiment with the algorithms easily and implement them in other languages. This book is intended to complement Kelley larger book, Iterative Methods for Linear and Nonlinear Equations (SIAM, 1995), which focuses on in-depth treatment of convergence theory, but does not discuss the details of solving particular problems, implementation in any particular language, or evaluating a solver for a given problem."