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Abstrak :
protein-energy malnutrition is common in patients with liver cirrhosis , especially in advanced and severe stage. Liver cirrchosis patients with malnutrition have increasing risk to get post-operative complication and mortality....

Abstrak :
Protein energy wasting (PEW) merupakan sindrom gangguan nutrisi yang sering terjadi pada pasien penyakit ginjal kronik (PGK) dengan hemodialisis rutin sekitar 28-80%. Proses hemodialisis dapat meyebabkan hilangnya nutrien seperti asama amino, meningkatkan proses inflamasi yang kemudian dapat meningkatkan katabolisme protein, dan dapat menghambat utilisasi asam amino dalam sintesis protein. Jika tidak ditangani, PEW dapat meningkatkan morbiditas dan mortalitas pasien PGK. Tujuan utama penelitian adalah untuk mengetahui profil asam amino pasien PGK dengan hemodialisis rutin. Desain penelitian adalah potong lintang dengan 60 subjek pasien PGK usia >18 tahun dengan hemodialisis rutin di RS. Umum Pusat Nasional Dr. Cipto Mangukusumo. Sampel berupa dried blood spot (DBS) dan pemeriksaan asam amino menggunakan metode Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). Asam amino yang diperiksa adalah asam amino nonesensial (alanin, arginin, asam aspartat, asam glutamat, asparagin, glisin, glutamin, prolin, serin, tirosin), esensial (histidin, fenilalanin, isoleusin, leusin, lisin, metionin, treonin, triptofan, valin), dan khusus (ornitin, sitrulin). Hasil penelitian didapatkan hampir semua kadar asam amino pada subjek lebih rendah terutama alanin, tirosin, histidin, dan valin; sebaliknya asam aspartat dan serin ditemukan lebih tinggi kadarnya dibandingkan nilai rujukan Mayo dan data internal dewasa sehat. Didapatkan adanya hubungan bermakna antara jenis kelamin dengan fenilalanin, isoleusin, leusin; hipoalbuminemia (albumin <4 g/dL) dengan glisin; hipoalbuminemia (<3,5 g/dL) dengan arginin, asam aspartat, asparagin, histidin, lisin, metionin, dan ornitin. Didapatkan korelasi yang bermakna antara usia dengan BCAA (isoleusin, leusin, valin), dan metionin; dan hemoglobin dengan isoleusin. Penelitian ini merupakan penilitian pertama tentang profil asam amino pada pasien PGK dengan hemodialisis di Indonesia dan penelitian pertama kali yang menggunakan sampel DBS pada orang dewasa. Dengan diketahuinya profil asam amino pada PGK dapat dimanfaatkan sebagai dasar pemberian jenis suplementasi asam amino yang sesuai dengan populasi pasien PGK dengan hemodialisis di Indonesia. ......Protein energy wasting (PEW) is a nutritional disorder syndrome that often occurs in patients with chronic kidney disease (CKD) on routine hemodialysis around 28-80%. The process of hemodialysis can cause the loss of nutrients such as amino acids, increase the inflammatory process which can increase protein catabolism, and be able to inhibit the utilization of amino acids in protein synthesis. If untreated, PEW can increase the morbidity and mortality of CKD patients. The main objective of the study was to determine the amino acid profile of CKD patients on routine hemodialysis. The study design was cross sectional with 60 subjects of CKD patients aged >18 years on routine hemodialysis at Dr. Cipto Mangunkusumo National Public Hospital. Samples in the form of dried blood spot (DBS) and amino acid examination using the Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) method. Amino acids examined were nonessential amino acids (alanine, arginine, aspartic acid, glutamic acid, asparagine, glycine, glutamine, proline, serine, tyrosine), essential (histidine, phenylalanine, isoleucine, leucine, lysine, methionine, glycine, glutamine, proline, serine, tyrosine), special (ornithine, citrulline). The results showed that almost all amino acid levels in the subjects were lower especially alanine, tyrosine, histidine, and valine; in contrast, aspartic acid and serine were found to be higher than Mayo reference value and internal data of healthy adults. A significant relationship was found between gender and phenylalanine, isoleucine, leucine; hypoalbuminemia (albumin <4g/dL) with glycine; hypoalbuminemia (<3.5 g/dL) with arginine, aspartate acid, asparagine, histidine, lysine, methionine, and ornithine. Significant correlation was obtained between age with BCAA (isoleucine, leucine, valine), and methionine; and hemoglobin with isoleucine. This study is the first study of the amino acid profile in CKD patients with hemodialysis in Indonesia and the first study using DBS samples in adults. Knowing the amino acid profile in CKD can be used as a basis for the of amino acid supplementation that is suitable for the population of CKD patients with hemodialysis in Indonesia.

Abstrak :
Latar Belakang: Hitung limfosit total berhubungan dengan prognosis serta harapan hidup pasien kanker kepala leher. Regulasi limfosit dipengaruhi berbagai hal termasuk nutrisi. Salah satu zat gizi yang berperan dalam proliferasi limfosit adalah asam amino rantai cabang. Penelitian ini bertujuan untuk melihat korelasi antara asupan asam amino rantai cabang dengan hitung limfosit total pada pasien kanker kepala dan leher. Metode: Studi potong lintang ini dilakukan pada subjek dewasa dengan kanker kepala leher yang belum menjalani terapi di poliklinik radioterapi dan hematologi onkologi medik RSCM. Asupan asam amino rantai cabang dinilai dengan 3 x 24-h food recall dan FFQ semi kuantitatif. Hitung limfosit total diukur dengan differential blood cell counter. Hasil: Sebanyak 85 subjek penelitian dengan rerata usia 53 tahun, dengan sebagian besar laki-laki, terdiagnosis kanker nasofaring dengan jenis karsinoma sel skuamosa dan stadium IV. Rerata subjek memiliki status gizi normal, dengan rerata asupan energi 29,99 ± 0,95 kkal/kgBB dan protein 1,39 ± 0,05 g/kgBB dengan penilaian FFQ semi kuantitatif. Rerata asupan AARC pada subjek sebesar 10,92 ± 0,48 gram dengan FFQ semi kuantitatif. Sebagian besar subyek memiliki hitung limfosit total pada rentang normal. Terdapat sebanyak 17.6% subyek dengan hitung limfosit total yang rendah. Terdapat korelasi lemah antara asupan asam amino rantai cabang dengan hitung limfosit total (r=0,230, p=0,029). Kesimpulan: Terdapat korelasi bermakna yang lemah antara asupan AARC dengan hitung limfosit total pada subjek kanker kepala leher yang belum menjalani kemoradioterapi. ......Background: Total lymphocyte count is related with prognosis and survival rate of head and neck cancer patients. Lymphocyte regulation is affected by multiple factors, including nutrition. One of the nutrients that plays role in lymphocyte proliferation is branched-chain amino acids. This study aims to investigate the correlation between branched-chain amino acid and total lymphocyte count in head and cancer patients. Method: This cross-sectional study was conducted on adults with head and neck cancer who had not undergone therapy at the radiotherapy and medical hematology oncology clinic at RSCM. Branched-chain amino acid intake was assessed using 3x24-h food recall and semi quantitative FFQ. Total lymphocyte count was measured with differential blood cell counter. Results: Eighty-five subjects with a mean age of 53 years, mostly are male, diagnosed with nasopharyngeal cancer, with histopathology appearance of squamous cell carcinoma, and stage IV cancer. The average subject had normal nutritional status, with an average intake of 29.99 ± 0.95 kcal/kgBW of energy and 1.39 ± 0.05 g/kgBW of protein with a semi quantitative FFQ assessment. The average branched-chain amino acid intake in subjects was 10,92 ± 0,48 gram with semi quantitative FFQ. There were 17.6% subjects with low total lymphocyte count. There was a low correlation between intake of branched-chain amino acids and total lymphocyte count (r=0,230, p=0,029). Conclusion: There was a significant low correlation between branched-chain amino acids intake with total lymphocyte count in head and neck cancer subjects who had not undergone chemoradiotherapy.