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Abstrak :
Peningkatan Apolipoprotein B-48 sebagai marker kilomikron remnan lebih akurat mengenali penebalan tunika intima media arteri, bahkan pada kadar trigliserida normal. Sayangnya, pemeriksaan ini mahal untuk diaplikasikan dalam praktek sehari-hari. Oleh sebab itu, penelitian ini bertujuan membentuk sebuah indeks risiko obesitas yang setara dengan nilai ApoB-48 namun lebih murah untuk diaplikasikan. Sebanyak 94 wanita, usia 19-50 tahun dengan IMT ge;25kg/m2 bergabung dalam penelitian kroseksional ini. Indeks risiko obesitas dibentuk melalui 2 fase, fase pertama adalah mencari hubungan antara faktor risiko obesitas pemeriksaan antropometri, asupan lemak polyunsaturated, monounsaturated, saturated, trans fatty acids, kolesterol dan kadar trigliserida terhadap ApoB-48. Asupan lemak dianalisis dengan recall 2x24 jam. Tahap berikutnya adalah pembentukan indeks. Fase ini dibagi atas membuat short list kuesioner untuk asupan, validasi short list kuesioner untuk asupan, setelah itu mencari hubungan antara skor indeks dengan ApoB-48. Semakin tinggi skor maka semakin tinggi ApoB-48. Sebagian besar subyek memiliki asupan lemak total, saturated fat, dan kolesterol di atas nilai rekomendasi 56,9 18,6 g vs 22.8 9.61 g vs 260.7 165.1 mg . ApoB-48 secara signifikan berhubungan dengan trigliserida B= 0.40, 95 CI= 0.02, 0.07, p=

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Elevated level of Apolipoprotein B 48 as a marker of chylomicron remnants is shown to be more accurate than trigliceride in predicting higher intimal media artery thickness, even in normal triglycerides subject. However, this assesment is expensive to be routinely applied in health care practice. Therefore, we developed an easy and economical obesity risk factor index that is expected to be equivalent with apoB 48 marker. A cross sectional study was carried out enrolling 94 healthy obese women aged 19 50 y.o with body mass index of ge 25kg m2. Obesity risk factor index was developed in two phases. The first phase was to determine the association between risk factor of obesity anthropometric measurement, dietary fat intake polyunsaturated, monounsaturated, saturated, trans fatty acids, cholesterol , and triglyceride level with apoB 48 value. The second phase was to develop an obesity risk factor index. Dietary fat were assessed by 2 repeated 24 hour recall. Only triglicerides level and cholesterol intake showed association with apoB 48. Later, development phase of the index was divided into development of short list questionairre intake, validation of short list cholesterol intake, and association analysis score of obesity risk factor index with ApoB 48. Higher total risk factor score indicates an increment ApoB 48 level. The majority of subject had total fat, saturated fat, and cholesterol intake above the recommended value 56,9 18,6 g vs 22.8 9.61 g vs 260.7 165.1 mg . A significant positive correlation was found in total score of the obesity risk factor index with ApoB 48 coefficient correlation 0.48, p

Abstrak :
Peningkatan Apolipoprotein B-48 sebagai marker kilomikron remnan lebih akurat mengenali penebalan tunika intima media arteri, bahkan pada kadar trigliserida normal. Sayangnya, pemeriksaan ini mahal untuk diaplikasikan dalam praktek sehari-hari. Oleh sebab itu, penelitian ini bertujuan membentuk sebuah indeks risiko obesitas yang setara dengan nilai ApoB-48 namun lebih murah untuk diaplikasikan. Sebanyak 94 wanita, usia 19-50 tahun dengan IMT ge;25kg/m2 bergabung dalam penelitian kroseksional ini. Indeks risiko obesitas dibentuk melalui 2 fase, fase pertama adalah mencari hubungan antara faktor risiko obesitas pemeriksaan antropometri, asupan lemak polyunsaturated, monounsaturated, saturated, trans fatty acids, kolesterol dan kadar trigliserida terhadap ApoB-48. Asupan lemak dianalisis dengan recall 2x24 jam. Tahap berikutnya adalah pembentukan indeks. Fase ini dibagi atas membuat short list kuesioner untuk asupan, validasi short list kuesioner untuk asupan, setelah itu mencari hubungan antara skor indeks dengan ApoB-48. Semakin tinggi skor maka semakin tinggi ApoB-48. Sebagian besar subyek memiliki asupan lemak total, saturated fat, dan kolesterol di atas nilai rekomendasi 56,9 18,6 g vs 22.8 9.61 g vs 260.7 165.1 mg . ApoB-48 secara signifikan berhubungan dengan trigliserida B= 0.40, 95 CI= 0.02, 0.07, p=

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Elevated level of Apolipoprotein B 48 as a marker of chylomicron remnants is shown to be more accurate than trigliceride in predicting higher intimal media artery thickness, even in normal triglycerides subject. However, this assesment is expensive to be routinely applied in health care practice. Therefore, we developed an easy and economical obesity risk factor index that is expected to be equivalent with apoB 48 marker. A cross sectional study was carried out enrolling 94 healthy obese women aged 19 50 y.o with body mass index of ge 25kg m2. Obesity risk factor index was developed in two phases. The first phase was to determine the association between risk factor of obesity anthropometric measurement, dietary fat intake polyunsaturated, monounsaturated, saturated, trans fatty acids, cholesterol , and triglyceride level with apoB 48 value. The second phase was to develop an obesity risk factor index. Dietary fat were assessed by 2 repeated 24 hour recall. Only triglicerides level and cholesterol intake showed association with apoB 48. Later, development phase of the index was divided into development of short list questionairre intake, validation of short list cholesterol intake, and association analysis score of obesity risk factor index with ApoB 48. Higher total risk factor score indicates an increment ApoB 48 level. The majority of subject had total fat, saturated fat, and cholesterol intake above the recommended value 56,9 18,6 g vs 22.8 9.61 g vs 260.7 165.1 mg . A significant positive correlation was found in total score of the obesity risk factor index with ApoB 48 coefficient correlation 0.48, p

Abstrak :
Sekitar 15-20% pasien poliklinik dan unit gawat darurat datang dengan masalah sawar kulit seperti pemfigus, toxic epidermal necrolysis (TEN), dan eritroderma. Masalah nutrisi terjadi pada penyakit sawar kulit melalui beberapa hal, yaitu kondisi hipermetabolisme sedang sampai berat, masalah pemenuhan nutrisi, kehilangan protein dari lesi kulit, dan efek samping metabolik akibat terapi steroid dosis tinggi jangka panjang. Empat pasien serial kasus dengan diagnosis pemfigus, TEN, dan eritroderma dengan masing-masing kondisi penyerta seperti gangguan hati, obesitas, DM tipe lain dan sepsis. Terapi medik gizi diberikan berdasarkan kondisi klinis, toleransi asupan, dan hasil laboratorium pasien. Target pemberian nutrisi dihitung menggunakan Harris Benedict dengan tambahan faktor stress 1,3-1,5. Diberikan nutrisi dengan komposisi seimbang, terdiri atas protein 1,32 g/kg BB ideal/hari, lemak 2530%, dan karbohidrat 4565%. Mikronutrien yang diberikan berupa vitamin B kompleks 3x1, asam folat 1x1 mg, vitamin A 12.000 IU, vitamin C 500-1000 mg, dan seng 2x20 mg. dari monitoring dan evaluasi dilaporkan bahwa pemberian mikronutrien pada penyakit sawar kulit dapat meningkatkan penyembuhan luka dan menurunkan risiko metabolik. Dari empat pasien serial kasus ini, didapatkan satu kasus mortalitas yaitu pada pasien dengan penyulit sepsis. Ketiga pasien kasus lainnya mengalami perbaikan kondisi klinis, penyembuhan luka baik, tidak ada infeksi dan komplikasi selama perawatan, kontrol glikemik baik, perbaikan kapasitas fungsional, dan lama rawat pasien lebih singkat. Ketiga pasien dipulangkan untuk rawat jalan. Terapi medik gizi yang optimal dapat memerbaiki luaran klinis serta menurunkan angka morbiditas dan mortalitas pasien pemfigus, TEN, eritroderma tanpa penyulit metabolik ......One in five to six patients at the polyclinic and emergency department present with skin barrier problems such as pemphigus, toxic epidermal necrolysis (TEN), and erythroderma. Nutritional problems occur in skin barrier disease through several things, namely moderate to severe hypermetabolic conditions, problems with nutritional compliance, loss of protein from skin lesions, and metabolic side effects due to long-term high dose steroid therapy. Three case series patients with pemphigus, TEN with hepatic complications, and erythroderma with obese nutritional status I and one case of pemphigus complicating sepsis and other types of DM. Nutritional medical therapy is given based on the clinical condition, intake tolerance, and laboratory results of the patient. The target of nutrition intake is calculated using Harris Benedict with a stress factor of 1.3-1.5, with a balanced composition, consisting of protein 1.3-2 g / kg ideal body weight / day, 25-30% fat, and 45-65% carbihydrates. The micronutrients were given in the form of 3x1 vitamin B complex, 1x1 mg folic acid, 12,000 IU vitamin A, 500-1000 mg vitamin C, and 2x20 mg zinc. Administration of micronutrients in skin barrier disease can improve wound healing and reduce metabolic risk. In four case series patients, there was one case mortality in a patient with complicated sepsis. The others had improved clinical conditions, good wound healing, no infection and complications during treatment, good glycemic control, improved functional capacity, and shorter patient length of stay. The three patients were discharged for outpatient care. Optimal nutritional medical therapy can improve clinical outcomes and reduce morbidity and mortality in patients with pemphigus, TEN, erythroderma without metabolic complications