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"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."

"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."

"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."