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"Diabetes mellitus (DM) merupakan penyakit metabolik yang disebabkan berkurangnya sekresi hormon insulin, menurunnya sensitivitas insulin atau kombinasi keduanya. DM tipe2 merupakan salah satu jenis diabetes melitus yang paling banyak penyandangnya. Defisiensi vitamin D sering dikaitkan dengan kejadian DM tipe 2. Vitamin D merupakan salah satu vitamin yang berpotensi untuk memperbaiki sintesis dan sekresi insulin. Penelitian ini bertujuan untuk menilai pengaruh suplementasi vitamin D 5.000 IU/hari selama 3 dan 6 bulan terhadap fungsi sel beta pankreas yang dilihat dari penanda antioksidan (SOD), inflamasi (IL-6), PDX-1, HbA1c dan resistensi insulin (HOMA-IR) serta keamanan pemberian vitamin D yang dilihat dari peningkatan kadar 25-(OH)D dan ekspresi VDR.Penelitian ini menggunakan desain double blind randomized controlled trial mengikutsertakan 94 penyandang DM tipe 2 dengan usia 35‒80 tahun di Puskesmas Kecamatan Mampang Jakarta Selatan. Hasil randomisasi terdapat 47 subjek kelompok kontrol dan 47 subjek kelompok vitamin D. Kelompok kontrol mendapatkan plasebo sedangkan kelompok vitamin D mendapatkan plasebo dan vitamin D 5.000 IU selama 6 bulan. Studi dilakukan mulai bulan Januari─Desember 2022. SOD, IL-6, PDX-1, VDR, HbA1c, glukosa darah, insulin puasa, 25-(OH)D, HOMA-IR diperiksa pada awal penelitian, pascasuplementasi 3 dan 6 bulan. Analisis statistik dengan SPSS 20 menggunakan uji ANOVA general linear repeated measurement dan Mann Whitney.Karakteristik subjek penelitian pada kelompok vitamin D dan kelompok kontrol pada awal penelitian menunjukkan kedua kelompok setara baik pada karaktersitik demografis, laboratorium, dan asupan nutrien. Pascasuplementasi vitamin D selama 3 dan 6 bulan terdapat perbedaan bermakna kadar 25-(OH)D (p = 0,000), tidak terdapat perbedaan bermakna HbA1c dan glukosa darah (p = 0,360 dan p = 0,296) antara kelompok kontrol dan kelompok vitamin D. Terdapat perbedaan bermakna kadar insulin pasca suplementasi 3 dan 6 bulan (p = 0,034 dan p = 0,013) serta perbedaan bermakna HOMA-IR pasca suplementasi 3 dan 6 bulan (p = 0,033 dan p = 0,031) antara kelompok kontrol dan kelompok vitamin D. Kadar insulin pada kedua kelompok mengalami peningkatan tetapi peningkatan kadar insulin pada kelompok kontrol lebih tinggi. HOMA-IR pada kedua kelompok mengalami peningkatan tetapi peningkatan HOMA-IR pada kelompok kontrol lebih tinggi. Terdapatnya kadar insulin dan HOMA-IR yang lebih rendah pada kelompok vitamin D menunjukkan adanya perbaikan resistensi insulin.Untuk PDX-1 tidak terdapat perbedaan bermakna pasca suplementasi 3 dan 6 bulan (p = 0,464 dan p = 0,499) antara kelompok kontrol dan kelompok vitamin D. Vitamin D tidak terbukti meningkatkan SOD dan VDR serta tidak terbukti menurunkan IL-6.Simpulan: Suplementasi vitamin D 5.000 IU/hari selama 6 bulan dapat meningkatkan kadar 25-(OH)D dalam batas normal, serta dapat memperbaiki resistensi insulin melalui penurunan HOMA-IR dan penurunan sekresi insulin. Efek terhadap HbA1c, SOD, IL-6, PDX-1, dan VDR tidak terbukti.

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Diabetes mellitus (DM) is a metabolic disease that is caused by reduced insulin secretion, reduced insulin sensitivity, or a combination of the two. Type 2 DM is one of the types of diabetes mellitus with the greatest number of cases. Vitamin D deficiency is frequently associated with the incidence of type 2 DM. Vitamin D is one of the vitamins with the potential to improve insulin synthesis and secretion. This study aimed to evaluate the effect of supplementation of vitamin D at 5.000 IU/day for 3 and 6 months on pancreatic beta cell function from the perspective of antioxidant (SOD) and inflammatory (IL-6) markers, PDX-1 expression, HbA1c concentration, and insulin resistance (HOMA-IR), and the safety of vitamin D administration as shown by 25-(OH)D concentration and vitamin D receptor (VDR) expression. This study was a double blind randomized controlled trial involving 94 patients with type 2 DM aged 35‒80 years at Mampang District Public Health Center, South Jakarta. Randomization resulted in 47 subjects in the control group and 47 subjects in the vitamin D group. The control group received placebo whereas the vitamin D group received placebo and vitamin D at 5.000 IU for 6 months. The study was conducted from January‒December 2022. SOD, IL-6, PDX-1, VDR, HbA1c, blood glucose, fasting insulin, 25-(OH)D, and HOMA-IR were determined at baseline and after supplementation for 3 and 6 months. Statistical analysis by SPSS 20 used ANOVA general linear repeated measurement and Mann-Whitney tests. Characteristics of study subjects in the vitamin D and control groups at baseline showed that both groups were similar in demographic characteristics, laboratory measures, and nutrient intake. After supplementation of vitamin D for 3 and 6 months there were significant differences in 25-(OH)D concentration (p = 0.000), but no significant differences in HbA1c and blood glucose (p = 0.360 and p = 0.296) between control and vitamin D groups. There were significant differences in insulin concentration after supplementation for 3 and 6 months (p = 0.034 and p = 0.013) and significant differences in HOMA-IR after supplementation for 3 and 6 months (p = 0.033 and p = 0.031) between control and vitamin D groups. Insulin concentrations increased in both groups but the increase insulin concentrations was higher in the control group. HOMA-IR increased in both groups but the increase in HOMA-IR was higher in the control group. The lower insulin concentrations and decreased HOMA-IR in the vitamin D group indicated improve insulin resistance. With regard to PDX-1 there were no significant differences after supplementation for 3 and 6 months (p = 0.464 and p = 0.499) between control and vitamin D groups. Vitamin D was not proven to increase SOD and VDR, and was not proven to reduce IL-6.

Conclusion: Supplementation of vitamin D at 5.000 IU/day for 6 months was able to increase 25-(OH)D concentration within normal limits and was able to improve insulin resistance through reduction in HOMA-IR and decreased insulin secretion . Effects on HbA1c, SOD, IL-6, PDX-1, and VDR were not proven."

"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)."

"Polimorfisme gen reseptor vitamin D (RVD) merupakan kandidat genetik yang dapat menjelaskan rentannya suatu populasi terhadap tuberkulosis. Namun, hingga kini, sejumlah penelitian yang mencoba membuktikan hal tersebut menunjukkan hasil bervariasi pada berbagai populasi. Studi ini merupakan studi kasus-kontrol yang mengikutsertakan 35 pasien pascatuberkulosis paru (14 laki-laki dan 21 perempuan, median usia 40) serta 35 kontrol serumah (14 laki-laki dan 21 perempuan, median usia 39) yang tinggal di Nusa Tenggara Timur, salah satu provinsi di Indonesia dengan prevalensi tuberkulosis paru yang tinggi. Polimorfisme genetik diperiksa melalui metode polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) dengan menggunakan enzim restriksi BsmI dari sampel darah yang diisolasi dan ditambahkan EDTA. Sebaran frekuensi genotipe BsmI RVD pada kelompok kasus adalah BB=9 (26%), Bb=24 (69%), dan bb=2 (5%) sementara pada kelompok kontrol adalah BB=5 (14%), Bb=25 (72%), dan bb=5 (14%) dengan p=0,232 (OR 2,07, IK 95% 0,62-6,98). Distribusi frekuensi alel pada kelompok kasus adalah B=42 (60%) dan b=28 (40%) sementara pada kelompok kontrol adalah B=35 (50%) dan b=35 (50%). Frekuensi alel varian (alel b) pada penelitian ini adalah 0,45. Distribusi genotipe pada penelitian ini tidak memenuhi persamaan Hardy-Weinberg. Sebagai kesimpulan, penelitian ini tidak menunjukkan adanya hubungan antara polimorfisme gen RVD terhadap kejadian tuberkulosis paru.

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Vitamin D receptor gene (VDR) polymorphism is a genetic candidate which may explain the susceptibility of tuberculosis (TB) in a single population. However, until now, some studies which had tried to prove this showed varied results in different populations. This is a case-control study involving 35 post pulmonary tuberculosis patients (14 males and 21 females, median age 40) and 35 healthy household controls (14 males and 21 females, median age 39) who dwelled in East Nusa Tenggara, one of the provinces in Indonesia with high prevalence of pulmonary tuberculosis. The genetic polymorphism was examined using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method with BsmI restriction enzyme from EDTA added-isolated blood sample. The distribution of VDR BsmI genotype frequency in case group was BB=9 (26%), Bb=24 (69%), and bb=2 (5%) whereas in control group was BB=5 (14%), Bb=25 (72%), and bb=5 (14%) with p=0.232 (OR 2.07, 95% CI 0.62-6.98). Furthermore, the distribution frequency of allele in case group was B=42 (60%) and b=28 (40%) whereas in control group was B=35 (50%) and b=35 (50%). Frequency of variant allele in this study was 0.45. Genotype distribution in this study did not meet the Hardy-Weinberg equilibrium. As conclusion, this study did not show any association between VDR gene polymorphism and pulmonary tuberculosis."

"Insidens kasus tuberkulosis (TBC) anak di Indonesia diperkirakan mencapai 11,7% dari total kasus. Tidak semua individu terpapar TBC akan menjadi sakit, namun kemungkinan reaktivasi lebih tinggi pada anak , terutama pada anak di bawah lima tahun. Kontak serumah lebih berisiko. Studi menyatakan Vitamin D dan Seng berperan dalam peningkatan imunitas. Namun penelitian tentang pemberian suplementasi vitamin D dan Seng serta upaya perbaikan nutrisi dalam pencegahan infeksi TBC pada balita belum dilakukan. Penelitian ini bertujuan untuk mengetahui kejadian infeksi TBC dengan pemberian suplementasi dan konseling diet pada balita kontakserumah TBC paru terkonfirmasi bakteriologis di DKI Jakarta. Kami melakukan penelitian quasi eksperimen pada balita kontak serumah TBC paru bakteriologis di 25 kecamatan di DKI Jakarta. Kelompok intervensi diberikan vitamin D 400-600 IU/hari dan Seng 10-20mg/hari tergantung usia selama 3 bulan serta konseling diet pada orang tua. Balita yang masuk dalam sampel adalah balita yang tidak terinfeksi dan atau sakit TBC, tidak gizi buruk, HIV negative dan tidak menderita penyakit kronis lain. Setiap bulan dilakukan recall diet 24 jam untuk mengukur nutrisi dan status gizi. Setelah 3 bulan akan dihitung balita yang terinfeksi dan tidak dengan menggunakan tes tuberculin. Berdasarkan hasil penelitian, insidens kumulatif infeksi TBC pada kelompok intervensi 5% sedangkan pada kelompok kontrol 23%. Pemberian intervensi meningkatkan konsumsi vitamin D pada balita yakni dari 3 mcg menjadi 14,9 mcg dan Seng 3.8 mg menjadi 18.2 mg. Pada balita terinfeksi, konsumsi vitamin D dan Seng lebih rendah.

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The incidence of childhood tuberculosis (TB) in Indonesia is estimated to be 11.7% of total TB cases. Not all individuals exposed to TB will become ill, but the likelihood of reactivation is higher in children, especially children under five years old. Household contacts are more at risk. Studies suggest that vitamin D and zinc play a role in boosting immunity. However, research on vitamin D and zinc supplementation and nutritional improvement efforts in preventing tuberculosis infection in children under five years of age has not been conducted. This study aims to determine the effect of supplementation and dietary counseling in preventing TB infection in young children with bacteriologically confirmed pulmonary TB in DKI Jakarta. We conducted a quasi-experimental study among infants with bacteriologically confirmed pulmonary TB home contacts in 25 subdistricts in DKI Jakarta. The intervention group received vitamin D 400-600 IU/day and Zinc 10-20mg/day depending on age for 3 months, as well as nutritional counseling for parents. Included in the sample were infants who were not infected and/or sick with TB, not malnourished, HIV negative, and not suffering from any other chronic diseases. A 24-hour dietary recall to measure diet and nutritional status was conducted every month. After 3 months, infected and uninfected children were counted using the tuberculin test. Based on the results of the study, the cumulative incidence of TB infection was 5% in the intervention group and 23% in the control group. The intervention increased vitamin D consumption in toddlers from 3 mcg to 14.9 mcg and zinc from 3.8 mg to 18.2 mg. Vitamin D and zinc intake was lower among infected infants."

"Latar belakang: Prediabetes didefinisikan sebagai keadaan hiperglikemia dengan kadar glukosa di atas normal dan dapat berkembang menjadi keadaan diabetes. Beberapa studi membuktikan keadaan defisiensi vitamin D berhubungan dengan keadaan resistensi insulin. Penelitian ini bertujuan untuk menganalisis efek modulasi suplementasi vitamin D terhadap mekanisme molekular pada kondisi resistensi insulin melaluli regulasi persinyalan jalur inflamasi dan mikrobiota usus pada tikus prediabetes.Metode: Penelitian ini dilakukan pada tahun 2019-2021 di Fakultas Kedokteran Universitas Indonesia dan Medica Satwa Laboratory Bogor. Eksperimen dilakukan pada tikus Wistar jantan berumur 4 minggu. Tikus akan dibagi secara acak, yaitu tikus yang menerima diet normal dan diet tinggi lemak dan tinggi glukosa (DTL-G)yang dikombinasi dengan dosis rendah injeksi streptozotocin 30 mg/kgBB intraperitoneal pada minggu ketiga. Setelah itu dilakukan tes toleransi glukosa oral (TTGO) dengan dosis 2 gram/kgBB pada tikus. Jika telah terjadi resistensi insulin (model tikus prediabetes) maka tikus prediabetes dibagi dalam tiga kelompok secara acak yaitu: (1) kelompok yang tidak diberi terapi, (2) kelompok yang diterapi vitamin D3 dosis 100 IU/kg/hari, (3) kelompok yang diterapi vitamin D3 dosis 1000 IU/kgBB/hari bersamaan dengan induksi DTL-G 12 minggu. Setelah itu akan dilakukan pengukuran kadar glukosa darah puasa (GDP), kadar glukosa darah 2 jam pasca-bebas glukosa, nilai HOMA-IR, kadar Glycated albumin, profil hematologi, kadar 25(OH)D3,pengamatan histopatologi pankreas, kadar TNF-alpha, IL-6, IL-10, NF-κB, TLR2, TLR4, PPARg, IRS1, dan komposisi mikrobiota usus.Hasil: Pada tikus prediabetes terjadi peningkatan nilai glukosa darah puasa, kadar glukosa darah 2 jam pasca-bebas glukosa, nilai HOMA-IR, kadar Glycated albumin, serta perubahan profil hematologi. Pemberian vitamin D 1000 IU mampu menurunkan nilai GDP, TTGO, Glycated albumin, HOMA-IR, serta mampu mengurangi degenerasi pada pulau Langerhans. Vitamin D 1000 IU mampu meningkatan sitokin anti-inflamasi IL-10, menurunkan ekspresi TLR2 dan TLR4, mengembalikan ekspresi IRS seperti kelompok normal, serta dapat meningkatkan keragaman mikrobiota. Suplementasi vitamin D berkorelasi dengan kadar PPARg, IRS1, TLR2, TLR4, dan sel beta pankreas.Kesimpulan: Pemberian vitamin D 1000 IU bersamaan dengan DTL-G pada tikus prediabetes dapat memberikan perbaikan kondisi resistensi insulin, meningkatkan sitokin anti-inflamasi, mengembalikan nilai ekspresi PPARg, meningkatkan ekspresi protein IRS1 kembali seperti kelompok normal, serta meningkatkan keragaman mikrobiota yang berkorelasi dengan regulasi persinyalan sitokin inflamasi.

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Introduction: Prediabetes is defined as a state of intermediate hyperglycemia and can lead to type 2 diabetes. Several studies have shown that vitamin D deficiency is associated with insulin resistance. This study aimed to analyze the modulating effect of vitamin D supplementation on the molecular mechanisms of insulin resistance through signaling regulation pathways of inflammation and gut microbiota in prediabetic rats.

Methods: The study was conducted during 2019-2021 at the Faculty of Medicine, Universitas Indonesia and Medica Satwa Laboratory Bogor. The experiments was conducted on male Wistar rats of 4 weeks. Rats were divided randomly into control and a high-fat and high-glucose (HFD-G) diet combined with 30 mg/kg intraperitoneal injection of streptozotocin in the third week. Oral glucose tolerance test (OGTT) was performed at 2 grams/kgBW gluocose. If insulin resistance has occurred (prediabetic rat model) then rats were randomly divided into three groups, namely: (1) the group that was not given therapy, (2) the group with vitamin D3 at a dose of 100 IU/kgBW/day, (3) the group with vitamin D3 at a dose of 1000 IU/kgBW/day together with HFD-G in 12 weeks. Fasting blood glucose (FBG) levels, OGTT, HOMA-IR, Glycated albumin levels, hematological profiles, 25(OH)D3 levels, pancreatic histopathological observations, TNF-alpha, IL-6, IL-10, NF-B, TLR2, TLR4, PPARg, IRS1, and gut microbiota composition was evaluated.

Results: In prediabetic rats there was an increase in FBG, OGTT, HOMA-IR, Glycated albumin levels, and changes in hematological profiles. The administration of vitamin D 1000 IU could reduce the levels of FBG, OGTT, Glycated albumin, HOMA-IR, and could reduce degeneration of the islets of Langerhans. Vitamin D 1000 IU increased the anti-inflammatory cytokine IL-10, decreased the expression of TLR2 and TLR4, increased IRS1 expression like the normal group, and increased the diversity of gut microbiota. Vitamin D supplementation correlated with levels of PPARg, IRS1, TLR2, TLR4, and pancreatic beta cells.

Conclusion: Vitamin D 1000 IU vitamin D together with HFD-G in prediabetic rat could reduce insulin resistance, increased anti-inflammatory cytokines, increased PPARg expression level, increased IRS1 protein expression, and increased diversity of gut microbiota which correlates with signaling regulation of Inflammatory Pathways."

"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."

"Latar Belakang: Diabetes melitus (DM) tipe 2 merupakan penyakit metabolik kronik progresif dengan sebagian besar populasi berada pada usia produktif. Di Indonesia, capaian kendali glikemik yang optimal hanya didapatkan pada 20-30% pasien. Hal ini meningkatkan risiko komplikasi muskuloskeletal seperti sarkopenia yang sudah mulai terjadi sejak usia 20 tahun. Vitamin D merupakan salah satu suplementasi nutrisi yang direkomendasikan dalam tata laksana sarkopenia.Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara vitamin D dengan sarkopenia pada populasi DM tipe 2 usia dewasa nongeriatri.Metode: Penelitian potong lintang ini melibatkan populasi DM tipe 2 berusia 18-59 tahun yang berobat di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta, Indonesia pada bulan Januari 2021 sampai dengan April 2022. Dilakukan pengukuran massa otot dengan bioimpedance analysis (BIA), kekuatan genggam tangan, kecepatan berjalan, antropometri, serta kadar HbA1c dan vitamin D serum. Titik potong vitamin D ditentukan berdasarkan kurva receiver-operating characteristic (ROC).

Hasil: Dari 99 subjek, 38,4% mengalami sarkopenia, yang terdiri dari 94,7% possible sarcopenia dan 5,3% true sarcopenia. Kadar vitamin D di bawah 32 ng/mL didapatkan pada 78,9% kelompok sarkopenia. Berdasarkan analisis multivariat, prevalensi sarkopenia pada populasi DM tipe 2 dengan defisiensi vitamin D didapatkan 1,94 kali lebih tinggi (p=0,043) dibandingkan dengan populasi DM tipe 2 tanpa defisiensi vitamin D, setelah dilakukan penyesuaian dengan usia, jenis kelamin, HbA1c, dan obesitas.

Kesimpulan: Terdapat hubungan bermakna antara kadar vitamin D dengan sarkopenia pada populasi DM tipe 2 usia dewasa nongeriatri, setelah penyesuaian dengan faktor usia, jenis kelamin, HbA1c, dan obesitas.

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Type 2 diabetes mellitus (T2DM) is a chronic progressive metabolic disease with most of the population being at productive age. In Indonesia, optimal glycemic control is only achieved in 20-30% of patients which increases the risk of musculoskeletal complications such as sarcopenia. Sarcopenia has been known to develop since the age of 20. Vitamin D is one of the recommended nutritional supplementations in the management of sarcopenia.

Aim: We aimed to determine the association between serum vitamin D and sarcopenia in nongeriatric adults with T2DM.

Methods: This cross-sectional study involved 18-59 years old T2DM outpatients in Cipto Mangunkusumo Hospital, Jakarta, Indonesia between January 2021 and April 2022. We performed muscle mass measurement using bioimpedance analysis (BIA), handgrip strength, gait speed, anthropometrics, as well as serum vitamin D and HbA1c levels. The cut-off Vitamin D level was determined using receiver-operating characteristic (ROC) curve.

Results: A total of 99 subjects were analyzed of which 38.4% had sarcopenia. The proportion of possible sarcopenia was 94.7% and true sarcopenia 5.3%. Vitamin D level below 32 ng/mL was found in 78.9% of the sarcopenia group. Based on multivariate analysis, the prevalence of sarcopenia in the T2DM population with vitamin D deficiency was found to be 1.94 times higher (p=0.043) compared to the T2DM population without vitamin D deficiency, after adjusting for age, sex, HbA1c, and obesity.

Conclusion: There is a significant relationship between vitamin D levels and sarcopenia in nongeriatric adults with T2DM, after adjusting for age, sex, HbA1c, and obesity."