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"ABSTRAKKualitas hidup pada usia lanjut akan semakin menurun seiring dengan bertambahnya usia. Menurunnya kualitas hidup pada usia lanjut dapat disebabkan oleh penurunan massa otot, kekuatan otot, dan aktivitas fisik yang dikenal sebagai sarkopenia atau penyakit kronik-degeneratif. Salah satu bentuk skrining sarkopenia adalah menilai kekuatan genggam tangan. Kekuatan genggam tangan diduga dapat memprediksi kualitas hidup populasi usia lanjut. Penelitian ini bertujuan untuk mengetahui korelasi kekuatan genggam tangan yang diukur dengan dinamometer Jamar dengan kualitas hidup yang diukur dengan kuesioner EQ-5D dan EQ-5D VAS pada pasien usia lanjut. Penelitian ini menggunakan desain cross-sectional dan dilakukan pada 123 pasien usia lanjut di Poli Klinik Geriatri Terpadu RSUPN Cipto Mangunkusumo. Hasil analisis dengan uji Spearman menunjukkan bahwa terdapat korelasi bermakna antara kekuatan genggam tangan dan kualitas hidup yang diukur dengan kuesioner EQ-5D r = 0,219; p = 0,015 maupun EQ-5D VAS r = 0,266; p = 0,003 . Sebagai kesimpulan, kekuatan genggam tangan memiliki korelasi bermakna dengan kualitas hidup pada pasien usia lanjut.

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ABSTRAKThe quality of life in elderly will decrease with age. Declining quality of life in elderly due to decreased muscle mass, muscle strength, and physical activity is known as sarcopenia and suffering from chronic degenerative diseases. One form of sarcopenia screening is assessing the hand grip strength. Hand grip strength could be expected to predict the quality of life of the elderly population. This study aimed to determine the correlation of hand grip strength measured by Jamar dynamometer with the quality of life measured by the EQ 5D and EQ 5D VAS questionnaire in elderly patients. This study used cross sectional design and conducted on 123 elderly patients in Integrated Geriatric Poly Clinic Cipto Mangunkusumo General Hospital. The results of the analysis with Spearman test showed a significant correlation between hand grip strength with quality of life as measured by the EQ 5D questionnaire r 0.219 p 0.015 and EQ 5D VAS questionnaire r 0.266 p 0.003 . In conclusion, there are significant correlation between hand grip strength with quality of life in elderly patients."

"Penuaan adalah proses alamiah yang dapat dilihat dari penurunan massa otot atau sarkopenia. Sarkopenia merupakan masalah karena terkait dengan peningkatan risiko jatuh. Oleh karena itu, kemampuan fisik orang usia lanjut perlu diketahui sejak awal. Pengukuran kekuatan genggam tangan digunakan untuk mengukur kekuatan otot tangan dan timed up and go test digunakan untuk mengukur mobilitas fungsional. Sampai saat ini korelasi keduanya belum diketahui sehingga korelasi keduanya perlu diteliti di samping mencari rerata keduanya. Penelitian ini dilakukan pada 73 pasien usia lanjut di Poliklinik Geriatri RSCM berupa pengukuran kekuatan genggam tangan dengan dinamometer Jamar dan TUGT dengan pengukur waktu. Uji normalitas data tersebut dilakukan dan diikuti dengan uji korelasi Spearmann. Hasil penelitian menunjukkan bahwa terdapat korelasi yang bermakna dengan hubungan menengah r=-0,568, p=0,000 . Rerata kekuatan genggam tangan dalam mean yang didapatkan adalah sebesar 19,1 kg sedangkan rerata mobilitas fungsional yang didapatkan dalam median adalah sebesar 12,8 5,9-30,9 s.

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Aging is a normal process happened and can be viewed from muscle mass reduction or sarcopenia. Sarcopenia is problematic since it is correlated with higher fall risk. Based on that finding, early measurement of physical performance of elderly is a necessary. Hand grip strength can be measured to assess hand muscle strength while timed up and go test TUGT is used to assess functional mobility. However, correlation of both variable hasn rsquo t been clearly explained thus makes this research is needed. This research was also done to measure the average of hand grip strength and functional mobility on elderly patient. This research was done on elderly patient in Geriatric Policlinic of RSCM by measuring hand grip strength using Jamar dynamometer and measuring TUGT using stopwatch. Correlation between two variables are calculated by Spearmann correlation test after being tested their normality using normality test. The result showed there are significantly meaningful moderate correlation between hand grip strength and functional mobility p 0,000, r 0,568 . The average of the hand grip strength is 19,1 kg in mean and the average of the functional mobility is 12,8 5,9 30,9 s in median."

"ABSTRAKProses penuaan memberi dampak pada fungsi tubuh manusia, salah satunya adalah sarcopenia. Sarcopenia adalah pengurangan keseluruhan massa otot skeletal dan kekuatan secara progresif. Kondisi ini bisa berkembang menjadi lemah. Frailty akan menyebabkan perubahan keseimbangan energi yang malnutrisi. Pengurangan status Gizi biasanya ditemukan pada pasien usia lanjut. Jika tidak dirawat dengan benar, negara bisa progresif. Selain itu, kekuatan genggaman tangan yang dikenal memiliki beberapa kaitan dengan beberapa kondisi pada lansia seperti sarkopenia dan kerapuhan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara kekuatan genggaman tangan dan status gizi. Penelitian ini menggunakan rancangan cross sectional yang dilakukan di Poliklinik Geriatrik Rumah Sakit Cipto Mangunkusumo untuk pasien geriatri antara Januari September 2016. Kekuatan genggaman tangan dan status gizi diukur menggunakan Jamar Dynamometer dan Mini Nutritional Assessment. Dari 98 pasien, median kekuatan genggaman tangan adalah 18. Ada 6 pasien 6,1 dengan malnutrisi dan 59 pasien 60,2 dengan risiko kekurangan gizi dan 33 pasien 33,7 dengan status gizi normal. Berdasarkan uji korelasi Pearson, kekuatan genggaman tangan berhubungan dengan status gizi p 0,008 dan r 0,268. Kesimpulan dari penelitian ini adalah kekuatan genggaman tangan berhubungan dengan status gizi.

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ABSTRAKProcess of aging give some impact to function of human body, one of them is sarcopenia. Sarcopenia is overall reduction of skeletal muscle mass and power progressively. This condition can develop become frailty. Frailty will lead to change of energy balance which is malnutrition. Reduction of Nutritional status is commonly found in elderly patient. If it is not treated properly, the state can be progressive. Besides, hand grip strength well known has some association to several condition in elderly such as sarcopenia and frailty. The aim of this research is to find the correlation between hand grip strength and nutritional status. This research using cross sectional design was conducted in Geriatric Policlinic of Cipto Mangunkusumo Hospital to geriatric patients between January September 2016. Hand grip strength and nutritional status was measured using Jamar Dynamometer and Mini Nutritional Assessment. From 98 patients, the median of hand grip strength was 18. There were 6 patients 6,1 with malnutrition and 59 patients 60,2 with risk of malnutrition and 33 patients 33,7 with normal nutritional status. Based on Pearson correlation test, hand grip strength has correlation with nutritional status p 0,008 and r 0,268 . The conclusion of this research is hand grip strength has correlation with nutritional status."

"ABSTRAKLatar Belakang: : Peningkatan populasi usia lanjut di Indonesia diiringi denganmeningkatnya masalah kesehatan pada populasi tersebut, yang merupakan salahsatu dampak proses menua. Dampak serius proses menua terjadi pada otot rangka,yaitu terdapat penurunan massa dan kekuatan otot yang disebut sarkopenia.Kekuatan otot lebih berperan dari massa otot sebagai prediktor hendaya danmortalitas, sehingga penilaian kekuatan otot menjadi penting. Kekuatan genggamtangan dapat mewakili keseluruhan kekuatan otot dan pemeriksaannya sederhana,murah, serta mudah dilakukan. Berbagai faktor yang mempengaruhi kekuatangenggam tangan, faktor IMT dan lingkar pinggang masih kontroversi dan faktorpenyakit kronik terhadap kekuatan genggam tangan belum pernah diteliti sehinggaperlu diketahui faktor-faktor apa saja yang berhubungan dengan kekuatangenggam tangan.Tujuan: Mengetahui hubungan antara: usia, jenis kelamin, lingkar pinggang,status gizi dan penyakit kronik (DM, HT, stroke, PJK, PPOK) dengan kekuatangenggam tangan pada pasien usia lanjut.Metode: Penelitian potong lintang dilakukan bulan Agustus 2015 di poliklinikgeriatri RSCM Jakarta dan RSMH Palembang . Subjek adalah pasien usia lanjutberusia  60 tahun, yang kontrol rutin. Pemeriksaan meliputi anamnesis,pengukuran lingkar pinggang, lingkar lengan, lingkar betis, tinggi lutut, beratbadan, dan kekuatan genggam tangan. Uji analisis Cochran Mantel Haenzeldigunakan untuk menilai faktor-faktor yang berhubungan dengan kekuatangenggam tangan pada penelitian ini.Hasil: Dari 352 subjek ,didapatkan jenis kelamin terbanyak perempuan212(60,2)% rerata usia 69,7 (SB 6,3) tahun, rerata lingkar pinggang 90,6(SB10,7), Status gizi yang terbanyak adalah status gizi normal (86,4%),komorbiditas tertinggi hipertensi (44,3%), rerata kekuatan genggam tanganperempuan 19,8 (SB 5,1) dan laki=laki 29,1 (SB 6,9). Terdapat usia (p=<0,001,PR=3,6) dan status gizi /MNA (p<0,001, PR=2,8) berhubungan dengan kekuatangenggam tanganSimpulan: Faktor yang berhubungan dengan kekuatan genggam tangan pada usialanjut adalah usia dan status gizi

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ABSTRACTBackground: The increasing of the elderly population in Indonesia isaccompanied by increasing health problems in the population, which is one ofimpact of the aging process. Serious affect of the ageing process is occured inskeletal muscle. There is a decreasing of mass and muscle strength, calledsarcopenia. Muscle strength is more instrumental than muscle mass as predictorsof mortality and frailty status, so assessment of muscle strength becomesimportant. Handgrip strength can represent the overall muscle strength.Theexamination of handgrip strength is simple, inexpensive, and easy to do. There aremany determinand factors that can influence handgrip strength. Body mass indexand waist circumference still on controversy. Chronic diseases is still not observedyet. This aim of this research is to obtain determinant factors that can influencehandgrip strength in elderly.Objective : To obtain association of age, gender, waist circumference, nutrionalstatus, and chronic disease with handgrip strength in elderly patientMethods: This cross sectional study was conducted to elderly outpatient age 60years or above who visited Geriatric Clinic Cipto Mangunkusumo HospitalJakarta and Mohammad Hoesin Hospital Palembang in August 2015. Data of age,gender, nutritional status, chronic diseases, waist circumference, armcircumference, calf circumference, and handgrip strength were collected. CochranMantel Haenzel was used to obtain determinant factors of handgrip strengthResults: 352 subjects were recruited in this study. women which the most subjectwere 212 (60,2%), average of age was 69,7 years old (SB 6,3), average of waistcircumference was 90,6 (SB 10,7), the most nutritional status was normal(86,4%), the highest comorbidity was hyptertension (44,3%), and average ofhandgrip strength were 19,8 (SB 5,1) in women and 29,1 (SB 6,9) in men.Determinant factors of handgrip strength were age (p=<0,001, PR=3,6) andnutritional status (p<0,001, PR=2,8).Conclusions: Determinand factors of handgrip strength were comorbidity(hypertension, diabetes mellitus, stroke, coronary heart disase, chronic obstructivepulmonary disease), nutritional status, and increasing of age;;"

"ABSTRAKTerapi metformin berpotensi untuk memperbaiki sindrom frailty dengan memodifikasi resistensi insulin, inflamasi, dan konsentrasi miostatin.Penelitian ini bertujuan untuk mengkaji peran metformin terhadap kekuatan genggam tangan, kecepatan berjalan, konsentrasi miostatin serum, dan kualitas hidup terkait kesehatan pada pasien usia lanjut dengan pre-frail.Uji klinis acak tersamar ganda dilakukan pada pasien rawat jalan berusia 60 tahun dengan status pre-frail yang direkrut secara konsekutif Maret 2015 ndash;Juni 2016 di RSCM. Pasien dieksklusi bila menyandang diabetes melitus, skor Geriatric Depression Scale ge; 10, skor Abbreviated Mental Test < 8, fase akut penyakit, dan kontraindikasi terhadap metformin. Evaluasi luaran penelitian dilakukan sebelum dan pasca-intervensi selama 16 minggu.Randomisasi terhadap 120 subjek menempatkan 60 subjek untuk tiap kelompok perlakuan. Sebanyak 43 subjek kelompok metformin 3 x 500 mg dan 48 subjek kelompok plasebo menyelesaikan penelitian. Terdapat peningkatan kecepatan berjalan yang bermakna dengan rerata sebesar 0,39 0,77 detik atau 0,13 0,24 meter/detik pada kelompok metformin dan tetap bermakna setelah dilakukan penyesuaian terhadap faktor prognostik penting yang tidak setara p = 0,024 . Pada analisis ITT ada tidaknya peningkatan kecepatan berjalan > 0,1 meter/detik didapatkan ARR 8,3 IK95 -7,9 ndash;24 , dengan NNT sebesar 12. Tidak terdapat perbedaan bermakna kekuatan genggam tangan, konsentrasi miostatin serum, dan kualitas hidup terkait kesehatan antara kedua kelompok perlakuan. Konsentrasi miostatin serum berkorelasi negatif lemah r = -0,247; p = 0,018 dengan kecepatan berjalan, namun tidak berkorelasi dengan kekuatan genggam tangan. Skor indeks EQ-5D berkorelasi positif sedang dengan kecepatan berjalan r = 0,566; p = 0,000 dan berkorelasi positif lemah dengan kekuatan genggam tangan r = 0,355; p = 0,001.Sebagai simpulan, pemberian metformin 3 x 500 mg selama 16 minggu secara statistik dan klinis bermakna dalam meningkatkan kecepatan berjalan sebagai salah satu dimensi kualitas hidup terkait kesehatan, namun belum dapat meningkatkan skor indeks EQ-5D, tidak meningkatkan kekuatan genggam tangan, dan belum menurunkan konsentrasi miostatin serum.Kata kunci. kecepatan berjalan, kekuatan genggam tangan, kualitas hidup terkait kesehatan, metformin, miostatin, pre-frail, usia lanjut.

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ABSTRACT

Metformin is considered to have potential effects to improve frailty syndrome by modifying insulin resistance, inflammation, and myostatin serum level.

This study aimed at investigating the effect of metformin on handgrip strength, gait speed, myostatin serum level, and health related quality of life HR QoL in pre frail elderly.

A double blind randomized controlled trial was conducted on elderly outpatients aged 60 years and older with pre frail status consecutively recruited from March 2015 to June 2016 at Cipto Mangunkusumo Hospital. Patients with history of diabetes mellitus, Geriatric Depression Scale score ge 10, Abbreviated Mental Test score 8, acute phase of diseases, and contraindication s to metformin were excluded. The measurement of study outcomes was conducted at baseline and after 16 weeks of intervention.

One hundred twenty subjects were randomized and equally assigned into metformin 3 x 500 mg or placebo group. There were 43 subjects in metformin group and 48 subjects in placebo group completed the intervention. The mean gait speed in metformin group significantly improved by 0.39 0.77 second or 0.13 0.24 meter second, even after adjusted for importance prognostic factors p 0,024 . Intention to treat analysis on the presence or absence of increased gait speed 0.1 meter second showed ARR 8.3 95 CI 7.9 ndash 24 , with NNT of 12. There were no significant differences on handgrip strength, myostatin serum level, and HR QoL between the two intervention groups. Myostatin serum level had weak negative correlation with gait speed r 0.247 p 0.018 , but did not correlate with handgrip strength. EQ 5D index had moderate positive correlation with gait speed r 0.566 p 0.000 and weak positive correlation with handgrip strength r 0.355 p 0.001.

In conclusion, metformin 3 x 500 mg for 16 weeks significantly improved gait speed as one of the HR QoL dimensions, but not significantly improved the EQ 5D index score and handgrip strength nor decreased myostatin serum level.

Keywords. gait speed, handgrip strength, health related quality of life, metformin, myostatin, pre frail, elderly."

"Latar belakang: Peningkatan usia lanjut menimbulkan dampak kesehatan, diantaranya adalah sarkopenia dan kerapuhan. Kekuatan genggam tangan merupakan komponensarkopenia, fenotip sindrom kerapuhan, dan bersifat dinamis. Berbagai studi potonglintang menilai hubungan kekuataan genggam tangan dengan usia, jenis kelamin, statusnutrisi, status fungsional, status mental, dan komorbiditas namun temuan masihberagam. Selain itu, belum ada studi longitudinal untuk mengetahui hubunganperubahan kekuatan genggam tangan dengan usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas di Indonesia.Tujuan: Mengetahui hubungan antara usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas dengan perubahan kekuatan genggamtangan pada pasien usia lanjut.Metode: Penelitian kohort prospektif menggunakan data sekunder pasien usia lanjutyang kontrol rutin di Poliklinik Geriatri RSCM Jakarta dari register studi longitudinalINA-FRAGILE yang telah diobservasi selama 1 tahun (2013-2014). Uji analisismultivariat regresi logistik digunakan untuk menilai hubungan antara usia, jeniskelamin, status nutrisi (skor MNA), status fungsional (skor ADL), status mental (skorGDS-SF), indeks komorbiditas (skor CIRS) dengan perubahan kekuatan genggamtangan.Hasil: Dalam 1 tahun pengamatan dari 162 subjek, didapatkan rerata usia 72,9 (SB 5,9)tahun, jenis kelamin terbanyak perempuan (57,41%), memiliki nutrisi baik (83,9%),mandiri (median ADL 9–20), tidak depresi (median GDS-SF 0–11), rerata indekskomorbiditas 11,8 (SB 3,7), dan 53,1% mengalami penurunan kekuatan genggamtangan. Status nutrisi (OR=2,7; p=0,033) dan indeks komorbiditas (OR 0,3; p<0,002)berhubungan dengan kekuatan genggam tangan.Simpulan: Status nutrisi dan komorbiditas memengaruhi perubahan kekuatan genggamtangan pada pasien usia lanjut dalam 1 tahun di rawat jalan.

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Background: Increasing elderly population throughout the world has been related to

increased prevalence of sarcopenia and frailty. Handgrip strength is a component of

sarcopenia, one of frailty syndrome phenotypes, and a dynamic process. Previous

cross-sectional studies have assessed association of age, sex, nutritional status,

functional status, mental status and comorbodity but the results were varied. That being

said, there was no longitudinal study has been done to determine the correlation of

handgrip strength changes with age, sex, nutritional status, functional status, mental

status, and comorbidity in Indonesia.

Objective: To examine correlation between age, sex, nutritional status, functional

status, depressive symptopms, comorbidity, and handgrip strength changes in elderly

patients.

Methods: A prospective cohort study using secondary data of elderly patients whom

routinely visiting Geriatric Out-Patients Clinic at Cipto Mangunkusumo Hospital,

Jakarta from INA-FRAGILE register that have been observed for 1 year (2013-2014).

The multivariate logistic regression analysis was used to assess correlation between

sex, age, nutrional status (MNA score), functional status (ADL score), depressive

symptoms (GDS-SF score), comorbidities (CIRS score) and handgrip strength changes.

Results: From 162 subjects which were included in the study, the mean age was 72.9

(SB 5.9) years, predominantly female (57.41%), with good nutrition (83.9%),

independent (median 9- 20), not depressed (median 0-11), has average comorbidity

index 11.8 (SB 3.7), and 53.1% experienced decreased handgrip strength. Nutritional

status (OR = 2.7, p = 0.033) and comorbidity index (OR 0.3, p <0.002) correlated with

handgrip strength changes.

Conclusion: Nutritional status and comorbidity correlates with handgrip strength

changes in out-patients elderly within 1 year."

"Latar belakang: Peningkatan usia lanjut menimbulkan dampak kesehatan, diantaranya adalah sarkopenia dan kerapuhan. Kekuatan genggam tangan merupakan komponen sarkopenia, fenotip sindrom kerapuhan, dan bersifat dinamis. Berbagai studi potong lintang menilai hubungan kekuataan genggam tangan dengan usia, jenis kelamin, status nutrisi, status fungsional, status mental, dan komorbiditas namun temuan masih beragam. Selain itu, belum ada studi longitudinal untuk mengetahui hubungan perubahan kekuatan genggam tangan dengan usia, jenis kelamin, status nutrisi, status fungsional, status mental dan komorbiditas di Indonesia.Tujuan: Mengetahui hubungan antara usia, jenis kelamin, status nutrisi, status fungsional, status mental dan komorbiditas dengan perubahan kekuatan genggam tangan pada pasien usia lanjut.Metode: Penelitian kohort prospektif menggunakan data sekunder pasien usia lanjut yang kontrol rutin di Poliklinik Geriatri RSCM Jakarta dari register studi longitudinal INA-FRAGILE yang telah diobservasi selama 1 tahun (2013-2014). Uji analisis multivariat regresi logistik digunakan untuk menilai hubungan antara usia, jenis kelamin, status nutrisi (skor MNA), status fungsional (skor ADL), status mental (skor GDS-SF), indeks komorbiditas (skor CIRS) dengan perubahan kekuatan genggam tangan.Hasil: Dalam 1 tahun pengamatan dari 162 subjek, didapatkan rerata usia 72,9 (SB 5,9) tahun, jenis kelamin terbanyak perempuan (57,41%), memiliki nutrisi baik (83,9%), mandiri (median ADL 9–20), tidak depresi (median GDS-SF 0–11), rerata indeks komorbiditas 11,8 (SB 3,7), dan 53,1% mengalami penurunan kekuatan genggam tangan. Status nutrisi (OR=2,7; p=0,033) dan indeks komorbiditas (OR 0,3; p<0,002) berhubungan dengan kekuatan genggam tangan.Simpulan: Status nutrisi dan komorbiditas memengaruhi perubahan kekuatan genggam tangan pada pasien usia lanjut dalam 1 tahun di rawat jalan.

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Background: Increasing elderly population throughout the world has been related to increased prevalence of sarcopenia and frailty. Handgrip strength is a component of sarcopenia, one of frailty syndrome phenotypes, and a dynamic process. Previous cross-sectional studies have assessed association of age, sex, nutritional status, functional status, mental status and comorbodity but the results were varied. That being said, there was no longitudinal study has been done to determine the correlation of handgrip strength changes with age, sex, nutritional status, functional status, mental status, and comorbidity in Indonesia.

Objective: To examine correlation between age, sex, nutritional status, functional status, depressive symptopms, comorbidity, and handgrip strength changes in elderly patients.

Methods: A prospective cohort study using secondary data of elderly patients whom routinely visiting Geriatric Out-Patients Clinic at Cipto Mangunkusumo Hospital, Jakarta from INA-FRAGILE register that have been observed for 1 year (2013-2014). The multivariate logistic regression analysis was used to assess correlation between sex, age, nutrional status (MNA score), functional status (ADL score), depressive symptoms (GDS-SF score), comorbidities (CIRS score) and handgrip strength changes.

Results: From 162 subjects which were included in the study, the mean age was 72.9 (SB 5.9) years, predominantly female (57.41%), with good nutrition (83.9%), independent (median 9- 20), not depressed (median 0-11), has average comorbidity index 11.8 (SB 3.7), and 53.1% experienced decreased handgrip strength. Nutritional status (OR = 2.7, p = 0.033) and comorbidity index (OR 0.3, p <0.002) correlated with handgrip strength changes.

Conclusion: Nutritional status and comorbidity correlates with handgrip strength changes in out-patients elderly within 1 year."

"

Latar Belakang: Salah satu faktor utama yang terlibat dalam gangguan mineral tulang dan muskuloskeletal pada pasien penyakit ginjal kronik (PGK) adalah Fibroblast Growth Factor-23 (FGF-23). Peningkatan kadar FGF-23 terjadi pada awal PGK dan semakin meningkat pada PGK tahap akhir terutama yang menjalani dialisis. FGF-23 mendapat perhatian khusus karena perannya terhadap otot skeletal pada pasien PGK yang menjalani hemodialisis belum diketahui secara pasti. 

Tujuan: Mengetahui korelasi antara kekuatan genggam tangan(KGT) dengan kadar FGF-23 pada pasien yang menjalani hemodialisis kronis.

Metode: Penelitianinimerupakanstudipotong lintang. Penelitian ini dilaksanakan di unit Hemodialisis Divisi Ginjal-Hipertensi Departemen Ilmu Penyakit Dalam RSCM Jakarta, pada 74 pasien dialisis 2 kali seminggu. Pengukuran FGF dengan pemeriksaan intactFibroblast Growth Factor-23 (iFGF-23) dan menilai KGT dengan dinamometer hidraulik tangan merek Jamar. Pemilihansubjekdilakukansecaraconsecutivesamplingsampaijumlah subyekyangdiperlukanterpenuhi.

Hasil: Subjek pada penelitian ini sebanyak 74 subjek dengan kadar pemeriksaan iFGF-23 pada laki-laki lebih tinggi dibandingkan dengan perempuan, (3276 [ min-maks; 41-6613]pg/ml dan1585 pg/ml, [min-maks; 21-4820])dan nilai KGT pasien laki-laki adalah 25 kg (min-maks; 11-48) dan perempuan adalah 20 kg (min-maks; 8-26). Setelah dilakukan penyesuaian dengan indeks komorbid charlson modifikasidan indeks massa tubuh, maka tidak didapatkan korelasi antara FGF-23 dengan KGT pada subjek laki-laki (r=-0.053, p=0.7) akan tetapi terdapat korelasi negatif bermakna pada subjek perempuan (r=-0.4, p=0.02). 

Kesimpulan: Kadar iFGF-23 memiliki korelasi negatif bermakna dengan KGT pada perempuan dan hal tersebut tidak ditemukan pada subjek penelitian laki-laki.

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Background: Patients with chronic kidney disease (CKD) face with muscle atrophy, low muscle strength, and low physical activity. One of the main factors involved in bone mineral and skeletal muscle dysfunction in patients with chronic kidney disease (CKD) is Fibroblast Growth Factor-23 (FGF-23). Despite FGF-23 associated left ventricular hypertrophy, there are no prior studies assessing whether FGF-23 level is associated with skeletal muscle strength in hemodialysis patient. 

Objective: To determine the correlation between hand-grip strength (HGS) and FGF-23 levels in patients undergoing twice-weekly hemodialysis patients.

Patient and Method: This is a cross-sectional study, which was conducted on 74 twice-weekly hemodialysis patient at the Hemodialysis Unit at Rumah Sakit Cipto Mangunkusumo, Jakarta. Before dialysis session, intact Fibroblast Growth Factor-23 (iFGF-23) were measured in singlicate from plasma samples and han-grip strength that measured by Jamar hydraulic hand dynamometer. Subject selection was done by consecutive sampling until the required number of subjects was fulfilled. 

Results: There were 74 subjects recruited in this study, which included 7 (18.9%) male and 3 (8.1%) female subject had body mass index (BMI) < 18.5 kg/m2. Level of iFGF23 were significantly higher in males than in females (3276 pg/ml [ min-max, 41-6613] and 1585 pg/ml, [min-max 21-4820], respectively). According to the Asian Working Group for Sarcopenia, the HGS value of male patients was lower than in females (25 kg [min-max; 11-48], (20 kg [min-max; 8-26], respectively). After adjusting to Modified Charlson Comorbidity index (mCCI) and BMI, we found a significant correlation iFGF-23 and HGS in the female subject (r = -0.4, p = 0.02 and no correlation between iFGF-23 and HGS in male subject (r = -0,053, p = 0.7). 

 

Conclusion: In twice-weekly hemodialysis patients, iFGF-23 has a significant correlation with HGS in women and this was not found in male subject.

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"ABSTRAKDewasa ini, jumlah populasi usia lanjut di Indonesia semakin meningkat. Jumlah ini diiringi dengan semakin banyaknya masalah-masalah yang menyertai seseorang dengan usia lanjut, seperti menurunnya mobilitas fungsional. Penurunan mobilitas fungsional ini akan berpengaruh terhadap menurunnya pula kualitas hidup terkait kesehatan HRQoL . Belum ada penelitian yang mengetahui korelasi antara mobilitas fungsional dengan HRQoL, jika diukur menggunakan European Quality of Life-5 Dimension EQ-5D yang memiliki keunggulan. Sebanyak 70 pasien usia lanjut di Poliklinik Geriatri, RSCM dilakukan pengukuran TUGT mengukur mobilitas fungsional dan EQ-5D mengukur HRQoL . Didapatkan nilai median untuk TUGT adalah 12,335 7-30,9 detik, EQ-5D TTO 0,777 0,532-1 , dan EQ-5D VAS 70,0 30-100 . Dengan menggunakan analisis korelasi, didapatkan hasil bahwa terdapat korelasi negative antara TUGT dengan EQ-5D TTO p= 0,006; r= -0,324 dan EQ-5D VAS p= 0,037; r= -0,254 . Dari penelitian ini didapatkan bahwa TUGT orang usia lanjut di Indonesia lebih rendah jika dibandingkan di negara lain. Penelitian ini juga sejalan dengan penelitian-penelitian terkait mobilitas fungsional dan HRQoL. Penelitian lanjutan tentang hubungan kausalitas kedua variabel perlu dilakukan.

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ABSTRACTRecently, total population of eldery in Indonesia is growing in number. This number accompanied by problems among elderly, as decrese in functional mobility. The decrease of functional mobility will affect to health related quality of life HRQoL . There is still no study knowing correlation between functional mobility and HRQoL, if assessed using European Quality of Life 5 Dimension EQ 5D which has its own excellence. As many as 70 elderly patients in Geriatric Policlinic was tested for timed up and go test TUGT for assessing functional mobility and EQ 5D for assessing HRQoL . The median of TUGT was 12,335 7 30,9 second, EQ 5D TTO was 0,777 0,532 1 , and EQ 5D VAS was 70,0 30 100 . From bivariate analysis, there was a correlation between TUGT with EQ 5D TTO p 0,006 r 0,324 and TUGT with EQ 5D VAS p 0,037 r 0,254 . From this study, it is known that TUGT of elderly patient in Indonesia is lower if compared to another counties rsquo references value. This study is also suit with another studies about functional mobility and HRQoL. Advanced study to know causality association between variables needs to be done. "

"ABSTRAK Latar Belakang : Malnutrisi merupakan faktor independen yang berhubungan dengan morbiditas, mortalitas dan tingginya biaya pengobatan sirosis hati. Kekuatan Genggam Tangan (KGT) merupakan suatu metode yang sering digunakan untuk mendeteksi malnutrisi dan menilai prognosis pasien. Hubungan KGT dengan Skor Child Pugh (CP) dan massa otot masih dalam kontroversi. Indonesia sampai saat ini belum memiliki data tersebutMetode : Studi potong lintang pada pasien sirosis hati di poliklinik hepatobilier RSCM dari Februari-Juni 2015. Status nutrisi dinilai berdasarkan KGT. Massa otot diukur menggunakan bioimpedans. Analisis statistik menggunakan uji korelasi spearmanHasil : Terdapat 115 pasien yang kontrol di poliklinik hepatobilier RSCM, 112 pasien memenuhi kriteria penelitian, terdiri dari 79 laki-laki dan 33 perempuan. Usia pasien rata-rata 54,15±10,55 tahun, median skor CP 6(5-13) dengan median KGT 26(11-50) kgF, rata-rata massa otot 44,43±8,12 kg. Median asupan energi 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalensi malnutrisi berdasarkan KGT ditemukan sebanyak 33%. Kekuatan genggam tangan tidak berkorelasi dengan skor CP (p 0,046, r=-0,19) namun berkorelasi dengan massa otot (p <0,001, r= 0,70) Simpulan Terdapat 33% kasus malnutrisi berdasarkan KGT pada pasien sirosis rawat jalan. KGT tidak berkorelasi dengan skor Child Pugh namun berkorelasi dengan massa otot pasien sirosis hati.ABSTRACT Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis."