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"Latar Belakang: Laparotomi merupakan pembedahan mayor yang dapat menyebabkan penurunan massa otot rangka dan kapasitas fungsional, seperti kekuatan genggam tangan (KGT). Berbagai studi membuktikan penurunan KGT pascaoperasi menimbulkan komplikasi pascaoperasi, serta KGT berkorelasi erat dengan appendicular skeletal muscle index (ASMI). Pengaruh ASMI praoperasi terhadap KGT pascaoperasi belum banyak dilakukan penelitian, sehingga penelitian ini bertujuan menilai korelasi ASMI praoperasi dengan KGT pascaoperasi.Metode: Studi observasional prospektif dilakukan pada subjek berusia 18 – 65 tahun di RS pendidikan tersier, RSUPN Dr. Cipto Mangunkusumo, yang dirawat untuk laparotomi elektif pada Maret sampai Juni 2023. Pengukuran ASMI praoperasi menggunakan bioimpedance analysis (BIA) multifrequency seca® mBCA 525 dengan cutoff laki-laki > 7,0kg/mg2 dan perempuan >5,7 kg/m2. Pengukuran KGT pada tangan kanan dan kiri pascaoperasi pada hari ke-6 pascaoperasi (POD-6) dengan dinamometer tangan spring-type CAMRY® dengan cutoff laki-laki >28 kg/m2 dan perempuan >18 kg/m2. Analisis bivariat dan multivariat digunakan untuk menilai hubungan variabel bebas dan terikat, serta mengidentifikasi faktor perancu yang berhubungan dengan KGT pascaoperasi.Hasil: Pada 85 subjek penelitian, sebanyak 98,82% subjek memiliki ASMI praoperasi rendah, 72,94% subjek memiliki KGT pascaoperasi tangan kanan menurun, dan 80% subjek memiliki KGT pascaoperasi tangan kiri menurun dari cutoff. Didapatkan hasil signifikan pada korelasi ASMI praoperasi dengan KGT pascaoperasi tangan kanan (r=0,444, p<0,001) dan kiri (r=0,423, p<0,001). Analisis lanjutan dengan regresi linier untuk faktor perancu didapatkan indeks massa tubuh (IMT) adalah faktor paling signifikan meningkatkan KGT tangan kanan dan kiri pascaoperasi.Kesimpulan: Terdapat hubungan yang bermakna secara statistik pada korelasi ASMI praoperasi dengan KGT pascaoperasi laparotomi elektif.

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Background: Laparotomy is a major surgery that can lead to a decrease in skeletal muscle mass and functional capacity, such as handgrip strength (HGS). Various studies have shown that HGS is decreasing after surgery can result in postoperative complications, and HGS is closely correlated with the appendicular skeletal muscle index (ASMI). Research on the preoperative influence of ASMI on postoperative HGS is limited, so this study aims to assess the correlation between preoperative ASMI and postoperative HGS.

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Methods: A prospective observational study was conducted on subjects aged 18-65 years at the tertiary education hospital, RSUPN Dr. Cipto Mangunkusumo, who underwent elective laparotomy from March to June 2023. Preoperative ASMI measurements were taken using multifrequency bioimpedance analysis (BIA) with seca® mBCA 525, with a cutoff for males > 7.0 kg/m2 and females > 5.7 kg/m2. Postoperative HGS measurements for the right and left hands on postoperative day 6 (POD-6) were conducted using a spring-type hand dynamometer CAMRY® with a cutoff for males > 28 kg/m2 and females > 18 kg/m2. Bivariate and multivariate analyses were employed to assess the association between independent and dependent variables, as well as to identify confounding factors associated with postoperative HGS.

Results: In 85 research subjects, 98.82% had low preoperative ASMI, 72.94% experienced a decrease in postoperative right HGS, and 80% had a decrease in postoperative left HGS from the cutoff. Significant results were obtained in the correlation between preoperative ASMI and postoperative right HGS (r=0.444, p<0.001) and left HGS (r=0.423, p<0.001). Further analysis with linear regression for confounding factors revealed that body mass index (BMI) was the most significant factor in increasing postoperative HGS for both right and left hands.

Conclusion: There is a statistically significant in the correlation between preoperative ASMI and postoperative HGS in elective laparotomy."

"Latar Belakang: Stroke merupakan penyebab kematian kedua dan penyebab disabilitas ketiga di dunia. Stroke menimbulkan ketidakmampuan dan kelemahan yang berakibat pada penurunan kemampuan fungsional. Kemandirian aktivitas hidup sehari-hari pasien stroke sangat penting karena dapat meningkatkan kualitas hidup. Dari tahun 1990 hingga 2019, telah terjadi peningkatan kejadian stroke sebesar 70%. Selanjutnya stroke sendiri akan menyebabkan peningkatkan angka kematian sebesar 43% dan disability adjusted lifeyears (DALY) sebesar 143%. Penelitian ini bertujuan untuk mehilat hubungan antara kadar vitamin D serum terhadap massa otot bebas lemak pada kedua ektremitas pada pasien stroke dan luaran klinis dengan pada pasien stroke.Metode: Penelitian menggunakan desain potong lintang pada subjek berusia diatas 18 tahun yang menjalani perawatan di RSUPN Dr. Cipto mangunkusumo dan RS Universitas Indonesia Depok. karakteristik demografi meliputi usia, jenis kelamin, status gizi, jenis kulit, jenis pakaian , asupan vitamin D, pemakaian tabir surya, Indeks Barthel, asupan energi total, asupan protein, asupan lemak, asupan karbohidrat, skor pajanan sinar matahari dan kadar vitamin D serum. Dilakukan analisis hubungan kadar vitamin D serum dengan ASMI dan Indeks Barthel Hasil: Sebagian besar subjek rerata berusia 59 tahun, dengan jenis kelamin perempuan terbanyak. Status gizi 33,3% mengalami obesitas derajat 1 dan 13,3% obesitas derajat 2. Karakteristik subjek memiliki jenis kulit tipe 4 (moderate brown), dan hampir seluruh subjek sebanyak 83,3% tidak memakai tabir surya. Untuk kecupukan asupan, bebagian besar subjek 81,7% memiliki asupan energi total yang cukup, 50% subjek mengalami asupan protein yang kurang, 5% subjek memiliki asupan lemak yang kurang, dan hanya 1,7% subjek yang mengalami asupan karbohidrat yang kurang, disamping itu didapatkan 65% yang mengalami kurangnya asupan bahan makanan sumber vitamin D. Skor pajanan sinar matahari pada hampir seluruh subjek sebesar 81,7% termasuk dalam kategori rendah. Hasil penelitian ini juga didapatkan gambaran 30% sebagian subjek tergolong defisiensi vitamin D, dan 58,3% subjek yang mengalami insufisiensi vitamin D. Sebagian besar subjek pada hasil pemeriksaan ASMI menunjukkan gambaran 83,3% mengalami ASMI yang rendah, dengan proporsi pada subjek laki-laki sebanyak 86,2% dan perempuan sebanyak 80,6%. Untuk Indeks Barthel didapatkan 48,3% subjek mengalami ketergantungan sedang dalam menjalani akitivitas sehari-hari. Kesimpulan: Terdapat korelasi yang bermakna antara kadar vitamin D serum dengan ASMI dan Indeks Barthel.

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Background: Stroke is the second leading cause of death and the third leading cause of disability in the world. Stroke causes disability and weakness which results in decreased functional ability. Independence of daily living activities of stroke patients is very important because it can improve the quality of life. From 1990 to 2019, there has been a 70% increase in the incidence of stroke. Furthermore, stroke itself will cause an increase in mortality by 43% and disability adjusted lifeyears (DALY) by 143%. This study aims to investigate the relationship between serum vitamin D levels and fat-free muscle mass in both extremities in stroke patients and clinical outcomes with stroke patients.

Methods: The study used a cross-sectional design on subjects aged over 18 years who underwent treatment at Dr. Cipto Mangunkusumo Hospital and University of Indonesia Hospital Depok. Demographic characteristics include age, gender, nutritional status, skin type, clothing type, vitamin D intake, sunscreen use, Barthel Index, total energy intake, protein intake, fat intake, carbohydrate intake, sun exposure score and serum vitamin D levels. The association of serum vitamin D level with ASMI and Barthel Index was analyzed.

Results: Most of the subjects had an average age of 59 years, with the most female gender. The subjects had a skin type of type 4 (moderate brown), and almost all subjects as much as 83.3% did not wear sunscreen. For intake adequacy, most subjects 81.7% had sufficient total energy intake, 50% of subjects experienced insufficient protein intake, 5% of subjects had insufficient fat intake, and only 1.7% of subjects experienced insufficient carbohydrate intake, besides that 65% experienced insufficient intake of food sources of vitamin D. The sun exposure score in almost all subjects of 81.7% was in the low category. The results of this study also obtained a picture of 30% of subjects classified as vitamin D deficiency, and 58.3% of subjects who experienced vitamin D insufficiency. Most subjects in the ASMI examination results showed a picture of 83.3% experiencing low ASMI, with a proportion in male subjects as much as 86.2% and women as much as 80.6%. For the Barthel Index, 48.3% of subjects experienced moderate dependence in carrying out daily activities.

Conclusion: There is a significant correlation between serum vitamin D levels with ASMI and Barthel Index."

"Latar Belakang: Obesitas merupakan salah satu kondisi yang sering ditemukan pada penduduk dewasa di Indonesia, di mana 29,3% di antaranya adalah perempuan. Individu obesitas dapat mengalami penurunan massa otot yang disebabkan oleh inaktivitas dan penumpukan lemak yang menghambat proses sintesis otot. Jika tidak ditangani, obesitas dapat menyebabkan berbagai komplikasi, salah satunya adalah sarkopenia obesitas. Sarkopenia obesitas adalah kondisi yang ditandai dengan obesitas dan penurunan fungsi dan massa otot, terdiagnosis dengan  IMT >25 kg/m2, skeletal muscle index (SMI) yang menurun, dan kekuatan genggam tangan atau status performa yang rendah. Sarkopenia lebih sering terdeteksi pada lansia, namun penurunan massa otot sudah dapat terjadi sejak usia dewasa. Penelitian ini melihat apabila perempuan dewasa dengan obesitas sudah memiliki tanda-tanda sarkopenia obesitas seperti penurunan massa otot, SMI, dan hubungannya terhadap kekuatan genggam tangan.Metode: Studi ini merupakan studi potong lintang yang dilakukan pada 64 karyawati obesitas RSUPN Dr. Cipto Mangunkusumo. Massa otot diukur menggunakan body impedance analysis dan skeletal muscle index dihitung menggunakan massa otot dibagi dengan tinggi badan (m2). Kekuatan genggam tangan dihitung menggunakan dinamometer tangan. Analisis hubungan massa otot dan skeletal muscle index dengan kekuatan genggam tangan dihitung menggunakan uji korelasi Pearson.Hasil: Dari 64 subjek perempuan dewasa obesitas, 85,7% di antaranya memiliki massa otot yang rendah, dengan korelasi yang positif terhadap kekuatan genggam tangan kiri (p < 0,05, r = 0,354) dan tangan kanan (p < 0,05, r = 0,401). Namun hasil juga menunjukkan bahwa SMI subjek tidak memiliki korelasi dengan kekuatan genggam tangan mereka (p > 0,05), yang dapat disebabkan karena tinggi badan subjek yang lebih pendek dibandingkan standar tinggi sesuai usia.Kesimpulan: Hasil penelitian ini mendukung hipotesis bahwa perempuan obesitas memiliki kadar massa otot yang rendah, yang jika menetap dapat menyebabkan penurunan kekuatan genggam tangan, sehingga meningkatkan kerentanan mereka untuk mengidap sarkopenia obesitas.

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Background: Obesity is a condition prevalent in Indonesian adults, in which 29,3% of them are women. Obesity may come with decreased muscle mass due to inactivity and inhibition of protein synthesis by fat. In women, decreased muscle mass may also be caused by reduced estradiol. Obesity may lead to complications such as diabetes mellitus type 2, heart disease, stroke, osteoarthritis, and sarcopenic obesity. Sarcopenic obesity is a condition characterized by obesity and a decrease muscle mass and function, seen through body mass index of > 25 kg/m2, reduced skeletal muscle index (SMI), and reduced handgrip strength or physical performance. Sarcopenia is more prevalent in the elderly, but previous studies have proven that decreases in muscle mass begins earlier. This study was done to see if adult obese female workers in Dr. Cipto Mangunkusumo hospital have already experienced a decrease in muscle mass, SMI, and their correlation with handgrip strength.

Method: This cross-sectional study was done on  64 obese female adult workers in Dr. Cipto Mangunkusumo hospital. Their muscle mass was measured using body impedance analysis and their skeletal muscle index was calculated by their muscle mass divided by their height (m2). Their handgrip strength was measured using a hand dynamometer. Analysis of the correlation of muscle mass and skeletal muscle with their handgrip strength was done using Pearson correlation.

Result: Of 64 obese female subjects, 85,7% of them have decreased muscle mass. Their muscle mass has positive correlation with both their left handgrip strength (p < 0,05, r = 0,354) and right handgrip strength (p < 0,05, r = 0,401). However, this study shows that SMI of subjects are not correlated with their handgrip strengths (p > 0,05). This can be caused by the subjects’ height being lower than the national age-standardized height.

Conclusion: Therefore, the results of this study supports the hypothesis that obesity is associated with lower muscle mass which could subsequently reduce handgrip strength, which increases their risk of having sarcopenic obesity."