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"Ruang Lingkup dan Cara Penelitian :Dalam rangka pengembangan kontrasepsi hormonal pria, penggunaan TE (Testosteron Enantat) dan DMPA (Depot Medroksi Progesteron Asetat), menunjukkan hasil tingkat azoospermia yang lebih tinggi (90-100%) pada bangsa Asia, sedangkan bangsa Kaukasia hanya mencapai 70% atau kurang. Diduga ada 2 faktor yang mempengaruhi perbedaan tersebut yaitu faktor genetik dan faktor lingkungan termasuk makanan/diet. Telah diketahui bahwa diet negara Barat (Western Diet) mengandung lemak dan protein tinggi, sedang diet negara Asia (Asian Diet) mengandung karbohidrat tinggi. Dari penelitian dilaporkan bahwa status nutrisi tampaknya merupakan salah satu faktor yang mengatur konsentrasi SHBG (Sex Hormone Binding Globulin) yang dapat mempengaruhi jumlah testosteron bebas yang akan digunakan dalam mekanisme umpan balik negatif. SHBG adalah glikoprotein yang berfungsi sebagai alat pengangkut hormon steroid, mempunyai afinitas yang kuat terhadap dehidrotestosteron dan testosteron, sedangkan terhadap estradiol afinitasnya lebih lemah. Berbagai hasil penelitian di luar negeri menunjukkan bahwa korelasi antara konsentrasi SHBG dengan testosteron, insulin dan BMI hasilnya belum seragam dan satu sama lain berbeda-beda. Oleh karena itu kami merasa perlu mengadakan penelitian ulang pada orang Kaukasia yang berada di Jakarta. Pengukuran konsentrasi SHBG, menggunakan immunoradiometric assay (IRMA), sedangkan testosteron total, testosteron bebas dan insulin menggunakan radiommunoassay (RIA). Pengukuran glukosa, trigliserida dan albumin dengan menggunakan spektrofotometer. Untuk mengetahui komposisi makronutrien karbohidrat, lemak dan protein dilakukan pencatatan makanan (food record) selama 3 hari. Analisis korelasi dilakukan untuk mengetahui korelasi antara konsentrasi SHBG dengan parameter-parameter yang diukur dan analisis regresi ganda untuk mengetahui hubungan yang paling erat antara konsentrasi SHBG dengan parameter-parameter yang diukur.Hasil dan Kesimpulan :Hasil penelitian menunjukkan bahwa SHBG mempunyai korelasi positif dengan testosteron total (r = 0,483, P = 0,002), dan SHBG mempunyai korelasi negatif dengan testosteron bebas (r = 0,087, P = 0,312), insulin (r = 180, P = 0,134) dan BMI (r = 0,366, P = 0,017). Konsentrasi SHBG mempunyai hubungan paling erat dengan konsentrasi testosteron total (P = 0,001).

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Scope and Research Method:

In developing men hormonal contraception, the utilization of TE (Testosterone Enantat) and DMPA (Depot Medroksi Progesterone Acetate), indicated higher level of azoospermia (90-100%) at Asian Men, while Caucasian men reached 70% or less only. Presumably, there were two factors affecting this discrepancy, genetic and environmental factor including meal/diet. It has been well known that Western Diet consists of high fat and protein while Asian Diet consists of high carbohydrate. From the research, it was reported that nutrition status seemed to be one of many factors bringing about the concentration of SHBG (Sex Hormone Binding Globulin) affecting the number of free testosterone that would be used in the negative feedback mechanism. SHBG is glycoprotein acting as steroid hormone transporter, having strong affinity against dehydrotesterone and testosterone, in the same time its affinity against estradiol is weak. Many researches in foreign countries demonstrated that the correlation between concentration of SHBG and testosterone, insulin and BMI did not result in the uniform output and it was different one another. Therefore, we needed to repeat the research at Caucasian men in Jakarta. The measurement of SHBG concentration was using immunoradiometric assay (IRMA), while the measurement for total testosterone, free testosterone and insulin was using radioimmunoassay (RIA). The measurement of glucose, triglyceride and albumin was performed using spectrophotometer. To see the composition of macronutrient carbohydrate, fat and protein food record was conducted for 3 days. Correlation analysis was carried out to see the correlation between the concentration of SHBG and other parameters measured and multiple regression analysis was held to see the closest relation between SHBG concentration and other measured parameters.

Result and conclusion:

The research results indicated that SHBG had positive correlation with total testosterone (r= 0.483, P = 0.002), and SHBG had negative correlation with free testosterone (r=0.087, P = 0.312), insulin (r= 0.180, P = 0.134), and BMI (r= 0.366, P = 0.017). SHBG concentration had the closest relation with total testosterone concentration (p=0.001)."

"Ruang Lingkup dan Cara Penelitian: Penggunaan testosteron enantat (TE) saja atau kombinasinya dengan depot medroksiprogesteron asetat (TE + DMPA) atau testosteron undekanoat (TU) saja dalam kontrasepsi hormon memiliki efektivitas yang berbeda dalam menekan spermatogenesis antara bangsa Asia dengan Kaukasia. Perbedaan efektivitas penekan spermatogenesis tersebut mungkin disebabkan oleh perbedaan asupan lipid-protein dan polimorfisme SHBG. Tujuan penelitian ini untuk mengetahui pengaruh perbedaan asupan lipid-protein dan polimorfisme SHBG terhadap kadar SHBG, testosteron total, testosteron bebas antara pria Indonesia dengan pria Kaukasia. Selain itu juga ingin diketahui hubungan antara kadar SHBG, testosteron total, testosteron bebas, persentase testosteron bebas, indeks testosteran bebas dan insulin. Penelitian ini merupakan studi potong lintang. Food recall 3 hari berturut-turut dilakukan terhadap semua subyek, kemudian dianalisis dengan World Food 2 Program. Kadar SHBG, testosteron total, testosteron bebas dan insulin dalam serum diukur dengan metoda radio immuno assay (RIA). Elektroforesis dan western blotting dilakukan untuk menentukan macam fenotip SHBG. Subyek penelitian dibagi menjadi 3 kelompok berdasarkan asupan lipid-protein dan dibagi menjadi 2 kelompok berdasarkan fenotip SHBG. Tiga puluh sembilan pria Indonesia asupan lipid-protein rendah sebagai kelompok I, 28 pria Indonesia asupan lipid-protein sedang sebagai kelompok II dan 27 pria Kaukasia asupan lipid-protein tinggi sebagai kelompok III. Tujuh puluh enam dari 94 subyek penelitian fenotipnya SHBG normal (2 pita SHBG) dan 18 dari 94 subyek penelitian fenotipnya SHBG varian (3 pita SHBG).Hasil dan Kesimpulan: Kadar SHBG dan testosteron bebas kelompok I lebih tinggi dibanding kelompok II dan III, tetapi kelompok 1I tidak berbeda dengan kelompok III. Kadar testosteron total kelompok I lebih tinggi dibanding kelompok III dan kelompok II paling rendah. Karena kadar SHBG, testosteron total dan testosteron bebas antar kelompok berbeda (p < 0.05), maka kadar SHBG, testosteron total dan testosteron bebas dipengaruhi oleh asupan lipid-protein. Kadar SHBG, testosteron total dan testosteron bebas antara fenotip SHBG normal tidak berbeda dengan fenotip SHBG Marian (p > 0.05). Karena kadar SHBG, testosteron total dan testosteron bebas antar kelompok fenotip SHBG tidak berbeda, maka kadar SHBG, testosteron total dan testosteron.

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The Influence Of Lipid-Protein Intakes And SHBG Polimorphysm On SHBG Level Of Indonesian And Caucasian MenScope and Methods of study: The development of hormonal contraception method for men using testosterone enanthate (TB) alone or in combination with depot medroxyprogesteron acetate (TE + DMPA) or testosterone undecanoat (TU) alone has different efficacy in suppressing the spermatogenesis of Asians or Caucasians. The difference of efficacy in suppressing the spermatogenesis of Asian or Caucasian maybe caused by the difference of lipid-protein intake and SHBG polymorphism. The main aim of this research was to investigate the effects of difference in lipid-protein intake and polymorphism of SHBG on the level of SHBG, total testosterone and free testosterone of Indonesian men with low lipid-protein intake, medium lipid-protein intake and Caucasian men with high lipid-protein intake. This research was cross sectional study. Three days repeated food recall for all subjects analyzed with World Food 2 Program. The measurement of serum SHBG, total testosterone, free testosterone and insulin were done with radio immuno assay (RIA) technique. Electrophoresis and western blotting were done to determine 2 types of SHBG phenotype. Subjects in this research were divided into 3 groups base on lipid-protein intake and 2 groups base on SHBG phenotype. Thirty nine Indonesian men with low lipid-protein intake as group I, 28 Indonesian men with medium lipid-protein intake as group II and 27 Caucasian men with high lipid-protein intake as group III. Seventy six out of 94 subjects as normal SHBG phenotype (double-banded SHBG) and I8 out of 94 subjects as variant SHBG phenotype (triple-banded SHBG).Result and conclusion: The level of SHBG and free testosterone in the group I was higher compared to both group II and group III (p r 0.05), but the group II and group III was not different (p > 0.05). The level of total testosterone in the group I was higher compared to group ill, and the group II was the lowest (p < 0.05). Because the level of SHBG, total testosterone and free testosterone in the group I, II and III were different (p < 0.05), then they were affected by lipid-protein intake. The level of SHBG in the normal SHBG phenotype was not different compared to the variant SHBG phenotype (p > 0.05), then the level of SHBG was not affected by SHBG polymorphism."