Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 182750 dokumen yang sesuai dengan query
cover
Rizka Yurianda
"Ketimpangan antara kadar vitamin D25(OH) rendah dan keadaan resistensi insulin pada penderita SOPK dengan anovulasi kronik menarik untuk digali lebih jauh. Anovulasi kronik pada SOPK diyakini disebabkan terhentinya pertumbuhan folikel di ovarium. Pada resistensi insulin, vitamin D diperkirakan berperan di sel sasaran dengan menambah substrat reseptor insulin. Perlu diungkap pengaruh vitamin D terhadap pertumbuhan folikel ovarium dengan mengukur kadar AMH, kemudian diperbandingkan antara penderita S-OPK-RI dan SOPK-nir-RI berdasarkan perubahan kadar reseptor insulin darah. Penelitian ini bertujuan menentukan pengaruh pemberian vitamin D3 terhadap pertum-buhan folikel ovarium dan penurunan kadar AMH melalui jalur reseptor insulin dan resep-tor vitamin D darah. Penelitian dua tahap dilakukan dari 14 Agustus 2018 hingga 25 Fe-bruari 2019 terhadap 35 subjek SOPK-RI dan 35 subjek SOPK-nir-RI di Poliklinik Infer-tilitas dan Endokrinologi Departemen Obstetri dan Ginekologi RSPAD Gatot Soebroto (RSGS), Jakarta. Tahap pertama adalah iris-silang antara SOPK-RI dan nir-RI untuk mem-bandingkan kadar vitamin D25(OH), AMH, reseptor insulin dan reseptor vitamin D darah. Tahap kedua adalah uji kuasi-eksprimental untuk mengetahui pengaruh pemberian vitamin D3 12.000 IU per minggu selama tiga bulan terhadap pertumbuhan folikel dengan peman-tauan USG-transvaginal atau transrektal sebulan sekali dan kadar AMH pada SOPK-RI dan nir-RI. Kadar glukosa puasa, insulin puasa, vitamin D25(OH), AMH diukur dari darah. Reseptor vitamin D darah dan reseptor insulin darah diperiksa dari sel mononukleus darah tepi (SMDT). Hasil penelitian memperlihatkan bahwa: (1) prapemberian vitamin D3 nilai yang berbeda bermakna antara SOPK-RI dan SOPK-nir-RI adalah kadar glukosa puasa (84 vs. 78 mg/dL; p = 0,016), insulin puasa (20,3 vs. 7,49 μIU/mL; p < 0,001) (2) pascapemberian vitamin D3 yang berbeda bermakna adalah kadar glukosa puasa (82 vs. 79 mg/dL; p = 0,049), insulin puasa (23,19 vs. 10,54; p < 0,001), reseptor insulin lebih tinggi pada SOPK-RI diban-dingkan SOPK-nir-RI (18,80 vs. 14,78 ng/mL; p = 0,020), reseptor vitamin D pada SOPK-nir-RI menurun bermakna (63,29%); (3) pascapemberian vitamin D3 ditemukan: (a) delta perubahan kadar vitamin D25(OH) pasca (8,38 ng/mL (63,4%) [SD 4,06] SOPK-RI vs. 12,31 ng/mL (10,29%) SOPK-nir-RI, p < 0,001); (b) delta perubahan penurunan kadar AMH pasca SOPK RI 10,29 vs. SOPK-nir-RI 14,61%; p = 0,492); (c) delta peningkatan diameter folikel antara dua kelompok SPOK meningkat pada bulan pertama (14,3% vs. 50%), kedua (33,3% vs. 66,7%), dan ketiga (50% vs. 66,7%), tetapi yang berbeda bermak-na (p < 0,05) hanya pada bulan pertama, yaitu lebih besar pada SOPK-nir-RI. Disimpulkan bahwa vitamin D3 menurunkan kadar AMH pada SOPK-RI dan SOPK-nir-RI, serta meningkatkan pertumbuhan folikel pada kededua kelompok SOPK, pada bulan pertama perubahan diameter folikel lebih besar pada SOPK nir-RI. Prapemberian vitamin D3 tidak ditemukan perbedaan kadar reseptor insulin dan reseptor vitamin D pada kededua kelompok SOPK, sedangkan pascapemberian vitamin D3 terdapat penurunan kadar reseptor vitamin D pada SOPK-nir-RI.

Discrepancy between low-level vitamin 25(OH)D and insulin resistance in PCOS patients with chronic anovulation required to be further explored. Chronic anovulation in PCOS is believed to be caused by the follicular arrest in the ovary. In insulin resistance the vitamin D is thought to play a role in target cell by adding the insulin receptor substrate. It is nec-essary to elucidate the effect of vitamin D on the ovarian folliculogenesis by measuring the AMH levels, which are then compared between patients with IR-PCOS and non-IR-PCOS based on the changes in blood insulin receptor levels. The aim of this study is to determine the effect of vitamin D3 administration on ovarian follicular growth and reduction of AMH through insulin receptor and blood vitamin D re-ceptor pathways. The two stages study was carried out from 14th August 2018 to 25th February 2019 on 35 IR-PCOS and 35 non-IR-PCOS subjects at the Infertility and Endo-crinology Out-patient Clinic, Department of Obstetrics and Gynecology, Gatot Soebroto Central Army Hospital (RSGS), Jakarta. The first stage was a cross-section study between IR-PCOS and non-IR-PCOS to compare levels of vitamin 25(OH)D, AMH, blood insulin receptors and vitamin D receptors; the second is a quasi-experimental test to determine the effect of 12,000 IU vitamin D3 administration per week for 3 months on follicular growth with transvaginal or transrectal ultrasound monthly and AMH levels on IR-PCOS-and non-IR-PCOS. Fasting glucose, fasting insulin, vitamin D25(OH), AMH levels are measured from the blood. Blood vitamin D receptor and insulin receptor were measured from the peripheral blood mononuclear cells (PBMC). The results of the study demonstrated that: (1) before administration of vitamin D3, there were differences in fasting glucose (84 vs. 78 mg/dL; p = 0.016) and fasting insulin (20.3 vs. 7.49 μIU/mL; p < 0.001) between the two groups; (2) after vitamin D3 administration, significant differences were found between the two groups for the levels of fasting glucose (82 vs. 79 mg / dL; p = 0.049), fasting insulin (23.19 vs. 10.54; p < 0.001); higher insulin receptors was found in IR-PCOS compared to non-IR-PCOS (18.80 vs. 14.78 ng / mL; p = 0.020), the vitamin D receptors in non-IR-PCOS decreased significantly (63.29%); (3) vitamin 25(OH)D levels before vitamin D3 administration were not significantly different in the two groups (13.84 vs. 10.97 ng/mL; p = 0.327), while after vitamin D3 administration the levels increased significantly (8.38 ng/mL (63.4%) [SD 4.06] in IR-PCOS vs. 12.31 ng/mL (10.29%) in non-IR-PCOS, p < 0.001); (4) AMH levels decreased in the both groups after vitamin D3 admin-istration but the ratio of the decrease was not significantly different (10.29 vs. 14.61%; p = 0.492); (5) follicular diameter between the two groups increased in the first month (14.3% vs. 50%), the second month (33.3% vs. 66.7%), and the third month (50% vs. 66.7% ) after vitamin D3 administration, but the significant difference (< 0.05) was demonstrated only in the first month, which was greater in non-IR-PCOS than that in the IR-PCOS. It is concluded that vitamin D3 decreases AMH levels in both IR-PCOS and non-IR-PCOS. It increases folliculogenesis in both PCOS groups; in the first month, the changes in follic-ular diameter are greater in non-IR-PCOS. Before vitamin D3 administration, there is no difference in the levels of insulin receptors and vitamin D receptors between the two groups, whereas after vitamin D3 administration there is a decrease in the levels of vitamin D re-ceptors in non-IR-PCOS. Keywords: AMH, IR-PCOS, non-IR-PCOS, PBMC, vitamin D receptor, insulin receptor, vitamin D25(OH)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
D-pdf
UI - Disertasi Membership  Universitas Indonesia Library
cover
Indra
"ABSTRAK
Latar Belakang: Sindroma ovarium polikistik (SOPK) merupakan kelainan
kompleks endokrin terbanyak pada usia reproduksi. Ketidakseimbangan hormon
merupakan salah satu temuan SOPK yang terkait dengan patofisiologinya.
Adanya perbedaan kejadian resistensi insulin mungkin terkait dengan perbedaan
karakteristik hormon pada pasien SOPK pada berbagai fenotipe, salah satunya
Hormon Anti-Mullerian (HAM).
Metode: Desain penelitian potong lintang (cross sectional), pengambilan subjek
dimulai dari identifikasi kelompok dengan SOPK menggunakan titik potong
HAM >4,45 ng/dl, lalu akan dikelompokkan menjadi empat kelompok sesuai
dengan fenotipnya berdasarkan kriteria Rotterdam 2003, di klinik Yasmin dan
Makmal Endokrinologi di bagian Obstetri dan Ginekologi RSUPN Dr.Cipto
Mangunkusumo selama tahun 2011 ?2014. Resistensi insulin dinilai
menggunakan homeostatic model assessment for insulin resistance (HOMA IR).
Hasil: Didapatkan 125 subjek SOPK dengan kadar HAM cenderung lebih tinggi
pada fenotipe 1 dan lebih rendah pada fenotipe 4 (p<0,05). Selain itu, ditemukan
perbedaan kadar LH dan rasio LH/FSH pada keempat fenotipe (p<0,05). Nilai
HOMA IR juga lebih tinggi pada fenotipe 1 (p<0,05). Berdasarkan analisis regresi
linear, didapatkan indeks massa tubuh dan HAM berkorelasi positif dengan nilai
HOMA IR (r=0,19 p=0,015 dan r=0,53 p<0,001, berturut-turut).
Kesimpulan: Terdapat korelasi positif kadar HAM terhadap nilai HOMA IR.
Pada keempat fenotipe SOPK didapatkan kadar HAM dan HOMA IR lebih tinggi
pada fenotipe 1 dan semakin rendah pada fenotipe 4. ABSTRACT Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that is
the most complex in the reproductive age. Hormonal imbalance remains a part of
its pathophysiology. Insulin resistance might be linked with difference in
hormonal parameter across four phenotypes of PCOS, especillay in AMH level.
Method: The study design was cross-sectional (cross-sectional). Subject retrieval
starts from the identification of the group with PCOS (with cutt-off AMH serum
>4.45 ng/dl), and will be grouped into four groups according to their phenotype
based on the criteria of Rotterdam in 2003, in the clinic Yasmin and
Endocrinology Laboratory at the Obstetrics and Gynecology RSUPN Dr.Cipto
Mangunkusomo during 2011 -2014. Insulin resistance was counted using
homeostatic model assessment for insulin resistance (HOMA IR).
Result: A total of 125 PCOS patients were recruited with AMH serum
significantly higher among phenotype 1 and lower among phenotype 4 (p<0.05).
Besides, Lh serum and LH/FSH ratio were also different across four phenotypes
(p<0.05). The value of HOMA IR tend to be higher among phenotype 1 (p<0.05).
Using multivariable linear regression analysis, body mass index and AMH serum
were positively correlated with HOMA IR (r=0.19 p=0.015 and r=0.53 p<0.001,
respectively).
Conclusion: There was a positive correlation between AMH serum and HOMA
IR value. The four PCOS phenotypes had significantly different value of HAM
serum and HOMA IR with phenotype 1 possed higher value among the others.
;Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that is
the most complex in the reproductive age. Hormonal imbalance remains a part of
its pathophysiology. Insulin resistance might be linked with difference in
hormonal parameter across four phenotypes of PCOS, especillay in AMH level.
Method: The study design was cross-sectional (cross-sectional). Subject retrieval
starts from the identification of the group with PCOS (with cutt-off AMH serum
>4.45 ng/dl), and will be grouped into four groups according to their phenotype
based on the criteria of Rotterdam in 2003, in the clinic Yasmin and
Endocrinology Laboratory at the Obstetrics and Gynecology RSUPN Dr.Cipto
Mangunkusomo during 2011 -2014. Insulin resistance was counted using
homeostatic model assessment for insulin resistance (HOMA IR).
Result: A total of 125 PCOS patients were recruited with AMH serum
significantly higher among phenotype 1 and lower among phenotype 4 (p<0.05).
Besides, Lh serum and LH/FSH ratio were also different across four phenotypes
(p<0.05). The value of HOMA IR tend to be higher among phenotype 1 (p<0.05).
Using multivariable linear regression analysis, body mass index and AMH serum
were positively correlated with HOMA IR (r=0.19 p=0.015 and r=0.53 p<0.001,
respectively).
Conclusion: There was a positive correlation between AMH serum and HOMA
IR value. The four PCOS phenotypes had significantly different value of HAM
serum and HOMA IR with phenotype 1 possed higher value among the others.
;Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that is
the most complex in the reproductive age. Hormonal imbalance remains a part of
its pathophysiology. Insulin resistance might be linked with difference in
hormonal parameter across four phenotypes of PCOS, especillay in AMH level.
Method: The study design was cross-sectional (cross-sectional). Subject retrieval
starts from the identification of the group with PCOS (with cutt-off AMH serum
>4.45 ng/dl), and will be grouped into four groups according to their phenotype
based on the criteria of Rotterdam in 2003, in the clinic Yasmin and
Endocrinology Laboratory at the Obstetrics and Gynecology RSUPN Dr.Cipto
Mangunkusomo during 2011 -2014. Insulin resistance was counted using
homeostatic model assessment for insulin resistance (HOMA IR).
Result: A total of 125 PCOS patients were recruited with AMH serum
significantly higher among phenotype 1 and lower among phenotype 4 (p<0.05).
Besides, Lh serum and LH/FSH ratio were also different across four phenotypes
(p<0.05). The value of HOMA IR tend to be higher among phenotype 1 (p<0.05).
Using multivariable linear regression analysis, body mass index and AMH serum
were positively correlated with HOMA IR (r=0.19 p=0.015 and r=0.53 p<0.001,
respectively).
Conclusion: There was a positive correlation between AMH serum and HOMA
IR value. The four PCOS phenotypes had significantly different value of HAM
serum and HOMA IR with phenotype 1 possed higher value among the others.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Sukma Dewi Pawestri
"Latar Belakang: Sindroma ovarium polikistik (SOPK) merupakan sebuah penyakti dengan prevalensi yang tinggi dan beban kesehatan yang besar. Hingga saat ini, penyebab SOPK masih belum jelas. Penelitian sebelumnya mengenai ekspresi reseptor vitamin D (VDR) pada pasien SOPK menunjukkan hasil yang menjanjikan namun belum terbukti secara jelas. Oleh sebab itu, diduga bahwa polimorfisme VDR berperan penting dalam kejadian dan beratnya gejala SOPK.
Metode: Penelitian potong lintang dilakukan pada pasien SOPK dan wanita usia reproduktif non-SOPK sebagai kontrol pada November 2019 hingga 2021. Pasien hamil, menyusui, memiliki riwayat gangguan hormon adrenal, tiroid, maupun prolaktin, atau mengonsumsi obat hormonal dalam 6 bulan terakhir dieksklusi dari penelitian. Subjek penelitian direkrut secara konsekutif. Ekspresi VDR dinilai dari ekspresi mRNA VDR yang dinilai dengan pemeriksaan PCR. Polimorfisme VDR dinilai pada tiga titik regio penyandi gen, yakni rs7975232, rs11574113, dan rs11574114.
Hasil: Sebanyak 80 pasien SOPK dan 80 pasien kontrol diikutsertakan dalam penelitian. genotip A/A pada regio rs7975232 dan genotip C/C pada regio rs11574113 lebih banyak didapatkan pada pasien dengan SOPK. Di sisi lain, genotip A/C pada regio rs7975232 dan genotip C/G pada regio rs11574114 lebih banyak didapatkan pada kelompok kontrol (p < 0,05). Tidak terdapat perbedaan ekspresi VDR pada pasien dengan polimorfisme yang berbeda (p > 0,05).
Kesimpulan: Didapatkan polimorfisme gen penyandi VDR yang berbeda antara pasien SOPK dan non-SOPK. Tidak didapatkan perbedaan ekspresi VDR yang bermakna antara pasien SOPK dan non-SOPK.

Background: Polycystic ovary syndrome (SOPK) is a disease with a high prevalence and a large health burden. Until now, the cause of SOPK is still unclear. Previous studies on vitamin D receptor (VDR) expression in PCOS patients have shown promising results but have not been clearly proven. Therefore, it is suspected that the VDR polymorphism plays an important role in the incidence and severity of PCOS symptoms.
Methods: A cross-sectional study was conducted on PCOS patients and non-SOPK women of reproductive age as controls from November 2019 to 2021. Patients who were pregnant, breastfeeding, had a history of adrenal, thyroid, or prolactin hormone disorders, or had taken hormonal drugs in the last 6 months were excluded from the study. study. Research subjects were recruited consecutively. VDR expression was assessed from VDR mRNA expression assessed by PCR examination. VDR polymorphism was assessed at three points in the gene encoding region, namely rs7975232, rs11574113, and rs11574114.
Results: A total of 80 PCOS patients and 80 control patients were included in the study. A/A genotypes in the rs7975232 region and C/C genotypes in the rs11574113 region were more common in patients with PCOS. On the other hand, the A/C genotype in the rs7975232 region and the C/G genotype in the rs11574114 region were more common in the control group (p < 0.05). There was no difference in VDR expression in patients with different polymorphisms (p > 0.05).
Conclusions: Different polymorphisms of the VDR coding gene were found between PCOS and non-SOPK patients. There was no significant difference in VDR expression between PCOS and non-SOPK patients.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Noto Dwimartutie
"Prevalensi pre-frail tinggi pada usia lanjut dan kondisi tersebut dapat berubah menjadi frail. Kolekalsiferol diduga memiliki potensi untuk memperbaiki sindrom frailty pada usia lanjut. Penelitian ini bertujuan mengkaji pengaruh kolekalsiferol terhadap kekuatan genggam tangan, kecepatan berjalan serta reseptor vitamin D (vitamin D receptor/VDR), interleukin-6 (IL-6), dan insulin-like growth factor-1 (IGF-1) monosit pada usia lanjut dengan pre-frail. Uji klinis acak tersamar ganda dilakukan di Poliklinik Geriatri RSCM pada bulan April–Desember 2021. Sebanyak 120 subjek dirandomisasi menjadi kelompok yang mendapat kolekalsiferol 4.000 IU/hari (60 subjek) serta kelompok yang mendapat plasebo/hari (60 subjek). Seluruh subjek mendapat suplementasi kalsium laktat 500 mg /hari. Pengamatan dilakukan selama 12 minggu. Terdapat 57 subjek pada kelompok kolekalsiferol dan 56 subjek pada kelompok plasebo yang menjalani penelitian hingga selesai. Analisis intention to treat dilakukan untuk mengevaluasi luaran kekuatan genggam tangan dan kecepatan berjalan, sedangkan analisis per protokol untuk mengevaluasi VDR, IL-6 dan IGF-1 monosit. Pada akhir pengamatan, tidak terdapat perbedaan bermakna pada kekuatan genggam tangan (p = 0,228), kecepatan berjalan (p = 0,734), VDR monosit (p = 0,45), IL-6 monosit (p = 0,57) dan IGF-1 monosit (p = 0,72) antara kedua kelompok perlakuan. Tidak ada korelasi antara perubahan VDR, IL-6 dan IGF-1 monosit dengan kekuatan genggam tangan dan kecepatan berjalan. Terdapat peningkatan kadar 25(OH)D yang bermakna pada masing-masing kelompok perlakuan dan peningkatan bermakna pada kelompok kolekalsiferol dibandingkan plasebo. Pemberian kolekalsiferol 4.000 IU pada usia lanjut pre-frail 12 minggu meningkatkan kadar 25(OH)D secara bermakna, namun belum terbukti dapat memperbaiki kekuatan genggam tangan, kecepatan berjalan, meningkatkan VDR dan IGF-1 monosit serta menurunkan IL-6 monosit. Fungsi ginjal memiliki pengaruh terhadap efek kolekalsiferol pada IGF-1 monosit. Kolekalsiferol meningkatkan jumlah monosit dengan IGF-1+ pada eGFR > 90, namun tidak pada eGFR 30–59.

Pre-frail prevalence is higher in the elderly. Frailty status is a dynamic condition. Pre-frail can fall into a frail condition. Cholecalciferol is regarded to have potential effect to improve frailty syndrome in the elderly. This study aimed to determine the effect of cholecalciferol on hand grip strength, walking speed, vitamin D receptors, IL-6, and IGF-1 monocyte in pre-frail elderly. A randomized double-blind clinical trial study at the RSCM Geriatric Polyclinic was conducted from April to December 2021. A total of 120 subjects were randomized into groups receiving 4000 IU cholecalciferol/day (60 subjects) and groups receiving placebo/day (60 subjects). All subjects received calcium lactate supplementation 500 mg/day. Observations were made for 12 weeks. There were 57 subjects in the cholecalciferol group and 56 subjects in the placebo group who completed the study. An intention to treat analysis was performed to evaluate the output of hand grip strength and walking speed, while a per protocol analysis was performed to evaluate monocyte VDR, IL-6 and IGF-1.There were no significant differences in hand grip strength (p = 0,228), walking speed (p = 0,734), VDR monocyte (p = 0,45), IL-6 monocyte (p = 0,57) and IGF-1 monocyte (p = 0,72) between treatment groups. There were no correlation between changes in the VDR, IL-6 and IGF-1 monocytes with changes in hand grip strength and walking speed. There was a significant increase in 25(OH)D levels in each group and a significant difference between groups. Supplementation of cholecalciferol 4.000 IU daily for 12 weeks increased serum 25(OH)D level significantly, however it did not improve hand grip strength and walking speed, and did not affect VDR, IL-6 and IGF-1 monocytes in pre-frail elderly. Kidney function had an influence on the effect of cholecalciferol on monocyte IGF-1. Cholecalciferol increased the number of monocytes with IGF-1+ at eGFR > 90, but not at eGFR 30–59."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
D-pdf
UI - Disertasi Membership  Universitas Indonesia Library
cover
Rizka Farah Hilma
"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).

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)."
Depok: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Yohanes Handoko
"Tujuan: Penelitian ini membandingkan kadar 25- OH -vitamin D3 pada serum maternal, darah tali pusat dan jaringan plasenta pada ibu hamil normal dan preeklamsia. Metode: Penelitian ini merupakan studi potong lintang dengan jumlah sampel 86 pasien yang melakukan persalinan di RS Cipto Mangunkusumo dan RSUD Tangerang. Setelah itu data disajikan dalam tabel dan dianalisis dengan uji parametrik, yaitu uji-t berpasangan bila sebaran data normal atau uji non parametrik, yaitu uji Mann-Whitney bila sebaran data tidak normal Hasil: Didapatkan kadar 25- OH -vitamin D3 serum maternal kelompok preeklamsia sebesar 16.30 6.20-49.00 ng/mL sedangkan pada sampel kelompok tidak preeklamsia, sebesar 13.50 4.80 ndash; 29.20 ng/mL di mana didapatkan nilai p = 0,459, dengan tidak ada perbedaan bermakna secara statistik. Didapatkan kadar 25- OH -vitamin D3 tali pusat kelompok preeklamsia sebesar 11.80 3.50 ndash; 38.60 ng/mL sedangkan kelompok tidak preeklamsia sebesar 11.70 1.00 ndash; 28.80 ng/m, di mana didapatkan nilai p = 0.964, dengan tidak ada perbedaan bermakna secara statistik. Didapatkan kadar 25- OH -vitamin D3 jaringan plasenta kelompok preeklamsia sebesar 49.00 22.00 ndash; 411.00 ng/mL. sedangkan kelompok tidak preeklamsia, sebesar 43.40 11.80 ndash; 153.00 ng/mL, di mana didapatkan nilai p 0.354 dengan tidak ada perbedaan bermakna secara statistik Didapatkan hasil kadar 25- OH -vitamin D3 serum kelompok preeklamsia awitan dini sebesar 10.80 6.20 ndash; 41.90 ng/mL sedangkan kelompok preeklamsia awitan lanjut sebesar 18.00 7.00 ndash; 49.00 ng/mL dengan nilai p = 0,133, di mana tidak didapatkan perbedaan bermakna secara statistik. Didapatkan hasil kadar 25- OH -vitamin D3 tali pusat kelompok preeklamsia awitan dini sebesar 10.65 3.50 ndash; 38.60 ng/mL. sedangkan pada kelompok preeklamsia awitan lanjut, sebesar 12.65 6.40 ndash; 33.20 ng/mL. di mana didapatkan nilai p = 0.377 dengan tidak didapatkan perbedaan bermakna secara statistik. Didapatkan kadar 25- OH -vitamin D3 pada jaringan plasenta kelompok preeklamsia sebesar 79.00 36.00 ndash; 411.00 ng/g. sedangkan pada kelompok tidak preeklamsia sebesar 40.00 22.00 ndash; 171.00 ng/g. di mana didapatkan nilai p 0.006, dengan didapatkan perbedaan bermakna secara statistik pada rerata kadar 25- OH -vitamin D3 jaringan plasenta Kesimpulan: Tidak terdapat perbedaan bermakna secara statistik pada rerata kadar 25- OH -vitamin D3 pada darah serum, tali pusat dan jaringan maternal pada wanita preeklamsia dan tidak preeklamsia. Tidak terdapat perbedaan bermakna secara statistik pada rerata kadar 25- OH -vitamin D3 pada darah serum dan tali pusat pada wanita preeklamsia dan tidak preeklamsia Terdapat perbedaan bermakna secara statistik pada rerata kadar 25- OH -vitamin D3 pada plasenta wanita preeklamsia dan tidak preeklamsiaKata kunci: 25- OH -vitamin D3, preeklamsia, serum, tali pusat, jaringan plasenta

Abstract Objective: This study is designed for comparing 25- OH -vitamin D3 levels in maternal serum, cord blood and placental tissue in non preeclampsia and preeclampsia pregnant women.Methods: This study is a cross sectional study with the number of samples of 86 patients who deliver in Cipto Mangunkusumo Hospital and Tangerang District Hospital. After that the data is presented in the table and analyzed by parametric test, ie paired t-test when the distribution of normal data or non parametric test, ie Mann-Whitney test when the data distribution is not normal..Results: The serum maternal 25- OH -vitamin D3 levels of preeclampsia group were 16.30 6.20-49.00 ng / mL while in the non-preeclamptic sample group, 13.50 4.80 - 29.20 ng / mL were obtained p = 0.459, with no statistically significant difference . The umbilical cord 25- OH -vitamin D3 levels of preeclampsia group were 11.80 3.50 - 38.60 ng / mL while the preeclampsia group was 11.70 1.00 - 28.80 ng / m, where p = 0.964 was obtained, with no statistically significant difference. Obtained 25- OH -vitamin D3 levels of placental tissue in the preeclampsia group by 49.00 22.00 - 411.00 ng / mL. while the group did not preeclampsia, amounting to 43.40 11.80 - 153.00 ng / mL, where p value of 0.354 was obtained with no statistically significant difference Earning serum 25- OH -vitamin D3 serum pre-eclampsia group onset was 10.80 6.20 - 41.90 ng / mL whereas the onset of pre-eclampsia group was 18.00 7.00 - 49.00 ng / mL with p value = 0.133, where no statistically significant difference was obtained. The results of the umbilical cord 25- OH -vitamin D3 levels of early onset preeclampsia group were 10.65 3.50 - 38.60 ng / mL. whereas in the onset of pre-eclampsia group, it was 12.65 6.40 - 33.20 ng / mL. where obtained p value = 0.377 with no statistically significant difference. Obtained 25- OH -vitamin D3 levels in placental tissue preeclampsia group of 79.00 36.00 - 411.00 ng / g. while in the pre-eclampsia group was 40.00 22.00 - 171.00 ng / g. where obtained p value of 0.006, with statistically significant difference in mean 25- OH -vitamin D3 levels of placental tissueConclusion: There was no statistically significant difference in mean serum 25- OH -vitamin D3 levels in serum, cord blood and maternal tissue in women with preeclampsia and not preeclampsia. There was no statistically significant difference in mean 25- OH -vitamin D3 levels in serum and umbilical blood in pre-eclampsia and non-preeclampsia women. There were statistically significant differences in mean 25- OH -vitamin D3 levels in female placenta preeclampsia and not preeclampsia Keywords: 25- OH -vitamin D3, preeclampsia, serum, umbilical cord, placental tissue "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T57669
UI - Tesis Membership  Universitas Indonesia Library
cover
Nunki Febriastuti
"Latar Belakang : Preeklamsia terjadi akibat adanya gangguan pada proses implantasi dan desidualisasi pada awal kehamilan. Vitamin D memainkan peranan penting pada proses desidualisasi, implantasi dan plasentasi. Penelitian terbaru menunjukkan bahwa kadar 25(OH)D yang rendah dalam serum merupakan faktor risiko preeklamsia. Bukti terbaru mendukung peran suplementasi vitamin D yang dimulai pada saat sebelum, awal dan selama kehamilan dalam mengurangi risiko preeklamsia. Tujuan penelitian ini adalah untuk mengetahui peranan suplementasi vitamin D 5000 IU/hari pada implantasi dan plasentasi melalui pemeriksaan PI A. Uterina dan PlGF serum maternal pada wanita hamil trimester pertama.
Metode : Uji klinis paralel acak tersamar tunggal. Subjek wanita hamil usia 7-11 minggu yang dibagi 2 kelompok, yaitu normal dan risiko tinggi berdasarkan kriteria risiko tinggi ACOG. Tiap kelompok dibagi lagi menjadi kontrol yang hanya mendapat obat standar dan perlakuan yang mendapat vitamin D 5000 IU/hari. Semua pasien diperiksa kadar 25(OH)D awal, kemudian diberikan intervensi selama 1 bulan dan diperiksa ulang kadar 25(OH)D akhir, PlGF serum maternal dan PI. A. Uterina. Menilai perbandingan kenaikan kadar 25(OH)D, PlGF, dan PI A. Uterina diantara semua kelompok
Hasil : Subjek awal berjumlah 92 orang, dieksklusi sebanyak 12 orang dan tersisa 80 subjek yang menyelesaikan penelitian. Semua subjek mengalami defisiensi vitamin D. Dibandingkan pasien kontrol kenaikan kadar 25(OH)D pada kelompok perlakuan normal masih lebih tinggi dibandingkan dengan kelompok perlakuan risiko tinggi yaitu 12,33±6,26 ng/mL dan 10,45±5,09 ng/mL dengan nilai p<0,001. Kelompok normal, penurunan PI A. Uterina dibandingkan antara kontrol dan perlakuan bermakna sebesar 0,57±0,36 dan 1,08±0,29 (p<0,001) sedangkan kadar PlGF juga berbeda bermakna antara kontrol (84,27±10,02) dan perlakuan (107,87±31,97) dengan nilai p 0,005. Pada kelompok risiko tinggi, perbadingan rerata kadar PlGF pada kontrol dan perlakuan berbeda bermakna yaitu 37,59±9,67 dan 70,53±18,32) nilai p<0,001. Pada pasien intervensi baik kelompok normal dan risiko tinggi rerata penurunan PI A. Uterina (1,08±0,29 vs 0,43±0,26; nilai p<0,001) dan kadar PlGF (107,87±31,97 vs 70,53±18,32; nilai p<0,001) berbeda bermakna.

Background : Preeclampsia occurs due to disruption of the implantation and decidualization in early pregnancy. Vitamin D plays an important role in decidualization, implantation, and placentation. Recent evidence supports the role of vitamin D supplementation initiated before, early and during pregnancy in reducing the risk of preeclampsia. The study aim is to determine the effect of vitamin D supplementation of 5000 IU/day on implantation and placentation through examination of Uterine Artery PI (UtA-PI) and maternal serum PlGF in first trimester pregnant women.
Methods: Using a single-blind, randomized parallel clinical trial. Subjects were pregnant women 7-11 weeks gestation and divided into 2 groups, normal and high risk, based on ACOG preeclampsia high risk criteria. Each group was further divided into controls who received the standard drug and interventions who received 5000 IU of vitamin D/day. Subjects were examined for 25(OH)D levels before and after the 1 month intervention, including maternal serum PlGF and UtA-PI levels. Both groups were compared for the difference of 25(OH)D levels, mean PlGF, and UtA-PI.
Results: We have 80 subjects who have vitamin D deficiency. The normal and high-risk intervention group showed the increase of 25(OH)D levels, 12.33±6.26 ng/mL and 10.45±5.09 ng/mL with p<0.001 accordingly. For the normal group, the decrease of UtA-PI compared between control and intervention was significant 0,57±0,36 and 1,08±0,29 (p<0.001) while PlGF levels were also significantly different between control (84,27±10,02) and intervention (107,87±31,97) with p<0.05. While in high-risk group, the PlGF levels of control and intervention were significantly different, 37.59±9.67 and 70.53±18.32 with p<0.001. In intervention patients, both normal and high-risk groups, the decrease of UtA-PI (1.08±0.29 vs 0.43±0.26; p<0.001) and PlGF levels (107.87±31.97 vs 70.53±18.32; p<0.001) were significantly different.
"
Depok: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Inayah Syafitri
"Tujuan: Mengetahui dosis terapi vitamin D yang optimal untuk ibu hamil dengan defisiensi dan insufisiensi vitamin D
Metode: Uji klinis acak terkontrol dilakukan Juni 2019–Desember 2022 di RSUPN Cipto Mangunkusumo dan RSUD Koja, Jakarta. Subjek adalah wanita hamil usia kehamilan ≤14 minggu dengan defisiensi atau insufisiensi vitamin D (25(OH)D<30 ng/ml). Subjek dibagi menjadi 2 kelompok, kelompok pertama mendapatkan terapi vitamin D3 50.000 IU/minggu dan kelompok kedua mendapatkan terapi vitamin D3 5.000 IU/hari. Intervensi diberikan selama 4 minggu. Pengukuran kadar 25(OH)D dan 1,25(OH)2D dilakukan pada awal dan akhir intervensi.
Hasil: Subjek awal berjumlah 60 orang, dan 8 subjek mengalami drop out. Karakteristik dasar subjek pada kedua kelompok setara. Kadar awal 25(OH)D tidak menunjukkan perbedaan bermakna di antara kedua kelompok (p=0,552). Pemberian terapi vitamin D3 50.000 IU/minggu selama 4 minggu meningkatkan kadar 25(OH)D secara signifikan (dari 14,5±4,3 menjadi 27,9±9,3 ng/mL, p<0,001) dan meningkatkan kadar 1,25(OH)2D namun secara statistik tidak signifikan (p=0,257). Pemberian terapi vitamin D3 5.000 IU/hari selama 4 minggu meningkatkan kadar 25(OH)D secara signifikan (dari 15,3±4,7 ng/mL menjadi 26,9±6,1 ng/mL, p<0,001) dan juga meningkatkan kadar 1,25(OH)2D secara signifikan (p=0,042). Namun tidak didapatkan perbedaan yang bermakna baik pada delta 25(OH)D (p=0,694), maupun delta 1,25(OH)2D di antara kedua kelompok dosis (p=0,641).
Kesimpulan: Terapi vitamin D3 50.000 IU/minggu selama 4 minggu sama efektifnya dengan vitamin D3 5.000 IU/hari dalam meningkatkan kadar 25(OH)D serum pada wanita hamil dengan defisiensi dan insufisiensi vitamin D. Kedua dosis tersebut juga aman dan dapat ditoleransi oleh ibu hamil.

Objective: To determine the optimal therapeutic dose of vitamin D for pregnant women with insufficiency or deficiency of Vitamin D
Methods: A randomized controlled trial was conducted from June 2019 to December 2022 at Cipto Mangunkusumo National Center General Hospital and Koja District Hospital in Jakarta, Indonesia. Subjects were ≤14 weeks gestation pregnant women with insufficiency or deficiency of Vitamin D (25(OH)D<30 ng/ml]. Two intervention groups were randomly assigned: 5,000 IU vitamin D3 daily or 50,000 IU weekly. Maternal blood samples were collected before and after four weeks of interventions to assess changes in serum concentrations of 25(OH)D and 1,25(OH)2D).
Result: Sixty subjects were randomized into two groups, and eight subjects were dropped out. The basic demographics of subjects in both groups were equivalent. There were no differences in baseline levels of 25(OH)D between two groups (p=0.552). In the 50,000 group, 25(OH)D levels increased from 15.3 ± 4.7 ng/mL to 26.9 ± 6.1 ng/mL (p<0.001). The 1,25(OH)2D levels increased however, the increase is not statistically significant. While in the 5,000 group, the 25(OH)D levels increased from 14.5 ± 4.3 ng/mL to 27.9 ± 9.3 ng/mL (p<0.001) and the 1,25(OH)2D levels increased significantly (p=0.042). However, the increment 25(OH)D and 1,25(OH)2D were not statistically significant between two groups.
Conclusion: Vitamin D3 50,000 IU weekly is equally effective and safe as 5,000 IU daily in increasing 25(OH)D serum levels in pregnant women with insufficiency or deficiency of Vitamin D.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Ayu Mulia Sundari
"Sindrom ovarium polikistik (SOPK) merupakan kelainan yang ditandai oleh hiperandrogenemia, ovarium disfungsi, dan polikistik ovarium yang dapat menyebabkan infertilitas. Meski etiologi pastinya belum diketahui, obesitas merupakan ciri khas umum pada SOPK di mana sekitar 40--80% wanita SOPK meningkatkan obesitas. Kej Vitamin D Receptor (VDR) terkait dengan SOPK melalui peradangan kronik tingkat rendah. Tujuan penelitian adalah mempelajari ekspresi mRNA gen VDR pada wanita obesitas dan non-obesitas dengan SOPK dan normal. Sampel darah dari 120 subjek dibagi menjadi empat kelompok, yaitu 30 normal non-obesitas (BMI <25), 30 normal non-obesitas (BMI> 25), SOPK non-obesitas (BMI <35), dan 30 SOPK obesitas (BMI> 25) kemudian dianalisis menggunakan kuantitatif Real-Time PCR (qPCR) dengan metode kurva standar. Hasil penelitian menunjukkan bukti mRNA gen VDR pada subjek obesitas dan SOPK secara signifikan lebih tinggi dibandingkan kedua kontrol. Hasil ini menunjukkan bahwa gen VDR terkait dengan obesitas dan SOPK.

Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenemia, ovarian dysfunction, and polycystic ovaries that can cause infertility. Although the exact etiology is unknown, obesity is a hallmark common in PCOS where about 40-80% of PCOS increase obesity. Vitamin D Receptor (VDR) is associated with PCOS through low-level chronic inflammation. The aim of the study was to study the expression of VDR gene mRNA on obese and non-obese women with PCOS and normal. Blood samples from 120 subjects were divided into four groups, namely 30 normal non-obese (BMI <25), 30 normal non-obese (BMI> 25), non-obese PCOS (BMI <35), and 30 obese PCOS
(BMI> 25) was then analyzed using quantitative Real-Time PCR (qPCR) with the standard curve method. The results showed evidence of VDR gene mRNA in obese and PCOS subjects was significantly higher than the two controls. These results indicate that the VDR gene is associated with obesity and PCOS.
"
Depok: Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Indonesia, 2019
S-pdf
UI - Skripsi Membership  Universitas Indonesia Library
cover
Mala Kurniati
"LATAR BELAKANG: Anti Mullerian Hormon (AMH) adalah anggota dari golongan Transforming Growth Factor-β yang berperan dalam pengaturan folikuligenesis pada reproduksi wanita. Peningkatan kadar AMH 2 sampai 3 kali dijumpai pada pasien SOPK (Sindrom Ovarium Polikistik) daripada wanita dengan ovulasi normal. Pada penelitian ini dideteksi varian sekuen disepanjang daerah promoter gen AMH. Adanya variasi promoter gen AMH diduga mempengaruhi proses transkripsi gen AMH yang selanjutnya berimplikasi pada pembentukan protein AMH. Apabila terjadi gangguan pada pembentukan protein AMH maka akan berpengaruh terhadap kadar protein tersebut di dalam darah.
BAHAN DAN CARA KERJA: Sampel penelitian ini berjumlah 114 pasien yang terdiri dari 60 pasien SOPK dan 54 pasien non SOPK (Kontrol). Kadar AMH dan Jumlah folikel antral didapatkan dari data rekam medik pasien Klinik IVF Yasmin, RSCM Kencana Jakarta. Analisis molekuler dan genotyping dilakukan dengan teknik PCR dan sekuensing kemudian dilanjutkan dengan analisis bioinformatika.
HASIL : Dari penelitian ini ditemukan 60 titik varian mutasi promoter gen AMH. Jenis varian mutasi terbesar yang ditemukan adalah -674 G/A (100 %), -245 C/CT (88,2 %), dan -444 A/G (17,9 %) dari seluruh sampel. Berdasarkan hasil uji Wilcoxon Signed Ranks, pada kelompok SOPK ditemukan jumlah mutasi yang terjadi berpengaruh secara bermakna terhadap kadar AMH dan jumlah folikel antral (p<0,05). Pada kelompok kontrol ditemukan bahwa jumlah mutasi tidak berpengaruh secara bermakna terhadap kadar AMH (p>0,05), tetapi berpengaruh secara bermakna terhadap jumlah folikel antral (p<0.05). Ditemukan 60 titik varian pada promoter gen AMH. Jumlah mutasi pada promoter gen AMH berpengaruh terhadap kadar AMH dan jumlah folikel antral pada SOPK. Mutasi pada titik -674 G/A merupakan titik mutasi baru yang belum pernah dilaporkan oleh NCBI, ditemukan pada seluruh subyek penelitian baik kelompok SOPK maupun non SOPK.

INTRODUCTION : Anti-Mullerian Hormone (AMH) is a member of the Transforming Growth Factor-β group which plays an important role in the regulation of the female reproductive folliculogenesis. A 2-3 fold increase in AMH levels was found in patients with PCOS (Polycystic Ovary Syndrome) compared to women with normal ovulation. This study detected sequence variants in the AMH gene promoter region. The AMH gene promoter variation is thought to affect AMH gene transcription process implicated in the formation of proteins. In the event of disruption in the formation of these AMH proteins, the levels of these proteins in the blood will be affected. The purpose of this study was to detect variants of AMH gene promoter sequences.
MATERIALS AND METHODS: The sample size was 114 patients consisting of 60 PCOS patients and 54 non-PCOS patients as control. The AMH levels and anthral follicle number obtained from the patients? medical records of the Yasmin IVF Clinic, RSCM Kencana Hospital, Jakarta. Molecular analysis and genotyping were performed by PCR and sequencing was followed by bioinformatics analysis.
RESULTS: There were 60 point mutations in the AMH gene promoter variants. The highest variant types of mutations found was -674 G/A (100%), followed by -245 C/CT (88.2%), and -444 A/G (17.9%) in the entire sample. Based on the results of the Wilcoxon Signed Rank test, the number of mutations in the PCOS group were significant to effect the serum AMH level and the anthral follicle number (p<0.05). In the control group, the number of mutations had no significant effect on the levels of AMH (p>0.05), but significantly affected the number of anthral follicles (P<0.05). There were 60 point variances in the AMH gene promoter. The number of mutations in the gene promoter affected serum AMH levels and the number of anthral follicles in PCOS. A new point mutation was found in all subjects at position -674 G/A, which have not been reported by the NCBI.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
<<   1 2 3 4 5 6 7 8 9 10   >>