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"ABSTRAKBackground: the familial nature of type 2 diabetes is manifested by the presence of insulin resistance in non-diabetic first degree relatives. Most of these studies have been performed in middle-aged and there is only few published studies in young age individuals and adolescents. This study aimed to determine the relationship between parents history of type-2 diabetes with metabolic syndrome component and insulin resistance in adolescent non-diabetic subjects. Methods: this was a cross sectional study comparing the metabolic profile, risk of metabolic syndrome and insulin resistance in non-diabetic male adolescents (17-24 years old) whose one or both parents were with type-2 diabetes. We performed anamnesis, physical examination, fasting plasma glucose, lipid profile, fasting insulin level and insulin resistance based on HOMA-IR. Results: metabolic abnormalities were more prevalent in subjects whose parents were with history of type-2 diabetes, especially their waist circumference, fasting plasma glucose, triglyceride, fasting insulin and HOMA-IR (p=0.000). There was increased risk of developing central obesity in adolescents with parental history of 19.3 fold (95%CI 2.46-151.07) and insulin resistance of 10.3 fold (95%CI 3.89-27.23). Parental history of type-2 diabetes together with metabolic syndrome component ie. waist circumference >90 cm and triglyceride ≥150 mg/dl were strong determinat factors for insulin resistance (R2=50.7%). Conclusion: the early multiple metabolic defect can be detected in non-diabetes adolescents with parental history of type-2 diabetes. Cluster of metabolic syndrome component in these subject become a powerful determinat factor for insulin resistance."

"Latar BelakangPeningkatan kasus diabetes melitus tipe 2 (DMT2) dengan berbagai komplikasinya memberikan dampak gangguan fungsional seseorang dalam bentuk gangguan kognitif dan kapasitas fisik. Keduanya masih reversibel dan baru diketahui berhubungan sehingga disebut sebagai PhysioCognitive Decline Syndrome (PCDS). Kondisi PCDS baru dipelajari pada lansia dan belum spesifik pada penyandang DMT2.TujuanMengetahui korelasi antara kendali glikemik dengan komponen physiocognitive decline syndrome pada penyandang DMT2 dewasa usia pertengahan.MetodeStudi potong lintang menggunakan consecutive sampling dari pasien di poliklinik metabolik endokrin dan poli jantung terpadu sejak Januari 202-November 2022. Subjek DMT2 berusia 40-59 tahun diinklusi. Pemeriksaan kekuatan genggam tangan, dan kecepatan berjalan 6-meter diperiksakan di ruangan standar. MoCA-Ina dilakukan oleh dokter yang telah dilatih. Data HbA1c subjek yang diperiksa adalah HbA1c 3 bulan terakhir. Analisis korelasi Pearson’s atau Spearman’s pada SPSS 20.0 dilakukan sesuai sebaran data.HasilSebanyak 133 subjek telah dianalisis. Usia median mencapai 53 tahun dengan proporsi laki-laki dan perempuan serta komplikasi pada masing-masing kateori kendali glikemik (batas HbA1c 7,0%) serupa. Subjek didominasi dengan pendidikan SMA dan Sarjana/Diploma. Median durasi terdiagnosisnya diabetes melitus mencapai 7 tahun dengan HbA1c median 7.6%. Nilai MoCA-Ina pada subjek mencapai nilai median 24 dengan kecepatan berjalan rerata 1.02 + 0.23 m/detik dan median kekuatan genggam tangan 24 kg. Terdapat korelasi bermakna hanya pada HbA1c dengan kekutan genggam tangan (r = -0.24, R2 = 0.06, p value <0.01), terutama pada perempuanKesimpulanTerdapat korelasi bermakna antara kendali glikemik dan kekuatan genggam tangan.

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Background

Increasing cases of type 2 diabetes melitus (T2DM) including its complication have caused functional dysfunction consisted of cognitive decline and physical incapacity. Both cognitive decline and physical incapacity had been just known to be reversible and related to each other, so it is termed as PhysioCognitive Decline Syndrome (PCDS). However, it had been just evaluated in geriatric and not specific to T2DM patient.

Aim

To investigate the correlation between glycaemic correlation and component of physiocognitive decline syndrome in middle-aged adult with T2DM.

Methods

A cross sectional study with consecutive sampling in our metabolic and endocrine clinic and integrated heart centre in January 2021-November 2022 had been conducted. Inclusion criteria was 40-59 years old subjects with T2DM. Measurement of HbA1c in the last 3 month were analysed, while hand grip strength and gait speed were done in standard room. MoCA-Ina had been conducted by trained doctor. Correlation analysis using Pearson’s or Spearman’s in SPSS 20.0 was done according to data distribution.

Result

133 subjects were analysed. Median age was 53 years old with both sex and complication within each glycaemic control category (HbA1c 7,0% cut off) were similar. Subjects were dominated by high school and undergraduate/diploma education level. Most subjects were diagnosed in up to 7 years of T2DM. Median of HbA1c levels in our study was 7.6%. MoCA-Ina score was 24 in median with mean of gait speed was 1.02 + 0.23 m/s. Our median for hand grip was 24 kg. Significant correlation was only found in relationship of HbA1c and hand grip strength (r = -0.24, R2 = 0.06, p value <0.01).

Conclusion

There was significant correlation between glycaemic control and hand grip strength."

"Peningkatan kasus diabetes melitus tipe 2 (DMT2) dengan berbagai komplikasinya memberikan dampak gangguan fungsional seseorang dalam bentuk gangguan kognitif dan kapasitas fisik. Keduanya masih reversibel dan baru diketahui berhubungan sehingga disebut sebagai PhysioCognitive Decline Syndrome (PCDS). Kondisi PCDS baru dipelajari pada lansia dan belum spesifik pada penyandang DMT2.TujuanMengetahui korelasi antara kendali glikemik dengan komponen physiocognitive decline syndrome pada penyandang DMT2 dewasa usia pertengahan.Metode Studi potong lintang menggunakan consecutive sampling dari pasien di poliklinik metabolik endokrin dan poli jantung terpadu sejak Januari 2021 – November 2022. Subjek DMT2 berusia 40 – 59 tahun diinklusi. Pemeriksaan kekuatan genggam tangan, dan kecepatan berjalan 6-meter diperiksakan di ruangan standar. MoCA-Ina dilakukan oleh dokter yang telah dilatih. Data HbA1c subjek yang diperiksa adalah HbA1c 3 bulan terakhir. Analisis korelasi Pearson’s atau Spearman’s pada SPSS 20.0 dilakukan sesuai sebaran data.Hasil Sebanyak 133 subjek telah dianalisis. Usia median mencapai 53 tahun dengan proporsi laki-laki dan perempuan serta komplikasi pada masing-masing kateori kendali glikemik (batas HbA1c 7,0%) serupa. Subjek didominasi dengan pendidikan SMA dan Sarjana/Diploma. Median durasi terdiagnosisnya diabetes melitus mencapai 7 tahun dengan HbA1c median 7.6%. Nilai MoCA-Ina pada subjek mencapai nilai median 24 dengan kecepatan berjalan rerata 1.02 + 0.23 m/detik dan median kekuatan genggam tangan 24 kg. Terdapat korelasi bermakna hanya pada HbA1c dengan kekutan genggam tangan (r = -0.24, R2 = 0.06, p value <0.01), terutama pada perempuanKesimpulanTerdapat korelasi bermakna antara kendali glikemik dan kekuatan genggam tangan.

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Increasing cases of type 2 diabetes melitus (T2DM) including its complication have caused functional dysfunction consisted of cognitive decline and physical incapacity. Both cognitive decline and physical incapacity had been just known to be reversible and related to each other, so it is termed as PhysioCognitive Decline Syndrome (PCDS). However, it had been just evaluated in geriatric and not specific to T2DM patient.

To investigate the correlation between glycaemic correlation and component of physiocognitive decline syndrome in middle-aged adult with T2DM.

A cross sectional study with consecutive sampling in our metabolic and endocrine clinic and integrated heart centre in January 2021 – November 2022 had been conducted. Inclusion criteria was 40 – 59 years old subjects with T2DM. Measurement of HbA1c in the last 3 month were analysed, while hand grip strength and gait speed were done in standard room. MoCA-Ina had been conducted by trained doctor. Correlation analysis using Pearson’s or Spearman’s in SPSS 20.0 was done according to data distribution.

133 subjects were analysed. Median age was 53 years old with both sex and complication within each glycaemic control category (HbA1c 7,0% cut off) were similar. Subjects were dominated by high school and undergraduate/diploma education level. Most subjects were diagnosed in up to 7 years of T2DM. Median of HbA1c levels in our study was 7.6%. MoCA-Ina score was 24 in median with mean of gait speed was 1.02 + 0.23 m/s. Our median for hand grip was 24 kg. Significant correlation was only found in relationship of HbA1c and hand grip strength (r = -0.24, R2 = 0.06, p value <0.01).

There was significant correlation between glycaemic control and hand grip strength.

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"Latar Belakang. Terdapat dua hipotesis mengenai terjadinya diabetes melitus tipe 2 yaitu kegagalan sel beta pankreas dan resistensi insulin. Mengingat pengaruh faktor genetik pada kejadian DM tipe 2 maka diperkirakan resistensi insulin juga dipengaruhi faktor genetik. Sejauh ini data prevalensi resistensi insulin dan gambaran metabolik pads saudara kandung subyek DM tipe 2 di Indonesia belum ada.Tujuan. Mendapatkan angka prevalensi resistensi insulin pada saudara kandung subyek dengan DM tipe 2 dan mendapatkan data profil metabolik (profil lipid, IMT, lingkar perut, konsentrasi asam urat darah), tekanan darah dan distribusinya pads seluruh saudara kandung subyek dengan DM tipe 2Metodologi. Studi pendahuluan dan potong lintang dilakukan pada 30 saudara kandung subyek DM tipe 2 yang datang berobat di Poliklinik Metabolik dan Endokrinologi RSUPN Dr Cipto Mangunkusumo, untuk dilakukan wawancara, pemeriksaan fisik, konsentrasi insulin darah puasa, glukosa puasa, trigliserida, kolesterol HDL dan asam urat. Resistensi insulin ditentukan dari persentil 75 dari HOMA-IR.Hasil. Nilai cut-off HOMA-IR pada penelitian ini sebesar 2,04. Frekuensi resistensi insulin pads saudara kandung subyek DM sebesar 26,67% dengan proporsi di tiap keluarga bervariasi dari 0-75%. Semua subyek dengan resistensi insulin memiliki obesitas sentral dan sebanyak 75% memiliki IMT > 25. Komponen metabolik yang paling banyak ditemukan adalah obesitas sentral (56,7%), menyusul hipertensi (46,7%), hipokolesterol HDL dan hipertrigliseridemia masing-masing 26,6%, dan hiperglikemia (20%).Simpulan. Frekuensi resistensi insulin pada saudara kandung subyek DM tipe 2 sebesar 26,67% dengan proporsi yang bervariasi di setiap keluarga antara 0-75%. Komponen metabolik paling banyak ditemukan adalah obesitas sentral.

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Backgrounds. There are two hypothesis in the pathogenesis of type 2 DM, beta cell failure and insulin resistance. As genetic background has significant role in type 2 DM cases, insulin resistance is also suspected to be influenced by genetic factor. Thus far, there are no insulin resistance prevalence data and metabolic abnormalities among siblings of subjects with type 2 DM available in Indonesia.Objectives. To obtain prevalence figure of insulin resistance among siblings of subjects with type 2 DM and to obtain their metabolic abnormality profiles as measured by their BMI, waist circumference (WC), blood pressure, glucose intolerance, concentration of triglyceride, HDL cholesterol and uric acid.Methods. Cross-sectional study is conducted to 30 siblings of subjects with type 2 DM who are still alive and agree to participate in this study. The subjects are interviewed, physically examined and go through laboratory examination (fasting plasma insulin, plasma glucose, serum triglyceride, HDL cholesterol and uric acid concentration). Insulin resistance is derived from 75 percentile of HOMA-IR.Results. The HOMA-IR cut-off value found in this study is 2,04. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. All of subjects with insulin resistance have central obesity. About 75% subjects with insulin resistance have BMI ? 25. The metabolic components which are frequently found in this study can be ranked as follows; central obesity (56,7%), hypertension (46,7%), hypocholesterol HDL (26,6%), hypertriglyceridemia (26,6%) and hyperglycemia (20%).Conclusion. The frequency of insulin resistance is 26,67% among siblings of subjects with type 2 DM within variation range of 0-75%. Among the metabolic components found in this study, central obesity is the most frequent."

"ABSTRACTCardiovascular disease (CVD) remain a leading cause of death globally. The concept of acute myocardial infarction in young adults was uncommon. Atherosclerosis is the leading cause of CVD, including myocardial infarction, stroke, heart failure and peripheral artery disease. This condition is initiated early in childhood and progressive in nature. CVD risk factors includes hypertension, dyslipidemia and obesity play a role in the development of atherosclerosis and components in insulin resistance syndrome.One of many risk factors for insulin resistance in healthy individuals is a first-degree relative (FDR) of Type 2 Diabetes Mellitus (T2DM) patients. This group shows a higher risk of insulin resistance and pancreatic beta cells disruption even in adolescence, although they often remains asymptomatic. Clinical manifestations of metabolic disorders and atherosclerosis will appear earlier in the FDR T2DM group who have sedentary lifestyles and obesity, when compared to the non-FDR group. Several studies have attempted to detect metabolic disorders and subclinical atherosclerosis that might occur; therefore an early prevention can be carried out in these high-risk groups. Unfortunately, factors that affect the onset and the severity of the prospective clinical manifestations from the previous studies remained inconclusive."

"Latar Belakang. Keluarga derajat pertama (first degree relatives/FDR) dari Diabetes Melitus tipe 2 (DMT2) memiliki kecenderungan untuk memiliki gangguan metabolik dan vaskular lebih dini tanpa melaui resistensi insulin (RI) sebagai perantaranya seperti lebih tebalnya tunika intima media karotis. Penyakit perlemakan hati non-alkoholik (non-alcoholic fatty liver disease/NAFLD) adalah penyakit hati kronik yang banyak ditemukan pada pasien DMT2 yang dependen terhadap RI. Studi tentang hubungan FDR DMT2 dengan NAFLD masih sangat terbatas dan inkonklusif. Hubungan tersebut masih belum jelas apakah kejadian NAFLD pada FDR DMT2 dependen terhadap RI atau karena kerentanan genetik FDR DMT2. Tujuan. Untuk mengetahui hubungan antara FDR DMT2 dengan NAFLD. Metode. Sebanyak 118 dewasa muda (19-39 tahun) dengan toleransi glukosa normal (59 subjek FDR DMT2 dan 59 subjek non-FDR dengan matching usia dan jenis kelamin) diikutsertakan dalam penelitian potong lintang ini. Pengukuran antropometri (tinggi, berat badan, indeks massa tubuh (IMT) dan lingkar perut) dan analisis laboratorium (glukosa darah puasa, HbA1c, profil lipid, serum glutamic pyruvic transaminase (SGPT)), serum glutamic oxaloacetic transaminase (SGOT)) diperiksa pada penelitian ini. Perlemakan hati didiagnosis dengan ultrasonografi (USG) menggunakan kriteria standar. Hasil Penelitian. Dua puluh enam subjek (22,03%) dengan NAFLD terdeteksi dengan USG dalam penelitian ini dengan proporsi yang sama pada kedua kelompok. Pada kelompok FDR DMT2 didapatkan jumlah subjek dengan angka HDL rendah dan sindrom metabolik lebih tinggi dibandingkan dengan kelompok tanpa FDR. Kesimpulan. Pada penelitian ini tidak didapatkan hubungan antara FDR DMT2 dengan NAFLD.

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Background. First degree relatives (FDR) of type 2 diabetes mellitus (T2DM) predisposes individuals to have earlier metabolic and vascular disorders independent of insulin resistance (IR) such as thicker carotid intima media thickness than that of non-FDR. Non-alcoholic fatty liver disease (NAFLD) is the most commonly found chronic liver disease in T2DM which is IR dependent. Studies about NAFLD in FDR of T2DM populations are very limited and inconclusive. It is unclear whether the occurrence of NAFLD in FDR of T2DM is IR dependent or due to genetic vulnerability.

Aim. to determine the association between NAFLD and FDR of T2DM.

Method. A total of 118 young adults (19-39 years old) with normal glucose tolerance (59 FDR of T2DM and age-sex matched 59 non-FDR subjects) were included in this cross-sectional study. Anthropometric measurement (height, weight, BMI and waist circumference) and routine laboratory analysis (fasting blood glucose, HbA1c, lipid profile, alanine aminotransferase (ALT), aspartate transaminase (AST)) were examined. Fatty liver was diagnosed by ultrasonography (US) using standard criteria.

Result. Twenty-six (22,03%) subjects with NAFLD were detected by US with similar proportion for each group. Low HDL level and metabolic syndrome were found higher in FDR group.

Conclusion. we couldn`t prove the association between FDR of T2DM and NAFLD in this research."

"Tujuan Mempelajari keterkaitan antara inflamasi dan resistensi insulin dengan gangguan biogenesis HDL yang menyebabkan rendahnya konsentrasi HDL. Metode Penelitian ini menggunakan desain potong lintang dengan jumlah subyek 163 pria dewasa berusia 25-60 tahun dengan sindroma metabolik (kriteria IDF, 2005), tanpa gangguan fungsi hati dan ginjal. Penelitian ini dilakukan di Jakarta pada tahun 2007-2009. Indikator-indikator yang diukur adalah apolipoprotein A-1 (apoA-1), prebeta-1 HDL, cholesteryl ester transfer protein (CETP), kolesterol HD L, berat badan, tinggi badan, lingkar perut (LP), tekanan darah sistolik (TDS), tekanan darah diastolik (TDD), glukosa darah puasa (GDP), dan trigliserida serum. Rasio apoA-1/HDL-c diambil sebagai indikator maturasi HDL, sedangkan rasio CETP/HDL-c dan CETP/TG menunjukkan katabolisme HDL. high sensitivity-CRP (hsCRP), HOMA-IR digunakan sebagai indikator inflamasi dan resistensi insulin. Data dianalisis dengan menggunakan analisis univariat, bivariat, dan multivariat. Hasil Hasil penelitian menunjukkan bahwa hsCRP berkorelasi positif dengan CETP (rs= 0,200, p= 0,042), dan rasio CETP/HDL-c (rs=0,188, p=0,013); HOMA-IR berkorelasi positif dengan rasio apoA-1/HDL-c (rs=0,190, p=0,016) dan berkorelasi negatif dengan rasio CETP/TG (rs= -0,162, p=0,04). Hasil analisis general linear model (GLM) menunjukkan hsCRP memiliki kontribusi terbesar terhadap rasio CETP/HDL-c, apoA-1, dan CETP (berturut-turut p= 0,009; 0,016; 0,054). Kesimpulan Penelitian ini menyimpulkan adanya hubungan antara inflamasi dan resistensi insulin dengan gangguan biogenesis HDL pada pria dengan SM. Inflamasi berkaitan dengan peningkatan katabolisme kolesterol HDL, sedangkan resistensi insulin berkaitan dengan penurunan maturasi dan peningkatan katabolisme kolesterol HDL, yang akhirnya berkontribusi terhadap rendahnya konsentrasi kolesterol HDL. Inflamasi memiliki kontribusi yang lebih bermakna terhadap faktor biogenesis HDL daripada resistensi insulin.

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Aim To find out the relationship between inflammation and insulin resistance with impaired HDL biogenesis that cause low HDL-c concentration Methods Using a cross-sectional design, this study involved 163 adult men, aged 25-60 years old with metabolic syndrome (IDF criteria, 2005), without liver and kidney dysfunction. This study was undertaken in Jakarta in the year 2007-2009. Measured indicators were serum apolipoprotein A-1 (apoA-1), prebeta-1 HDL, cholesteryl ester transfer protein (CETP), HDL cholesterol (HDL-c), body weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and triglyceride. The apoA-1/HDL-c ratios were taken as indicator of HDL maturation, whereas CETP/HDL-c and CETP/TG ratios were indicated HDL catabolism. high-sensitivity CRP (hsCRP) and HOMA-IR were taken as indicator of inflammation and insulin resistance, respectively. Data were analyzed by using univariate, bivariate, and multivariate analysis. Results Positive correlations were found between hsCRP and CETP (rs= 0.200, p= 0.042), and CETP/HDL-c ratios (rs= 0.188, p= 0.013). HOMA-IR positively correlated with apoA-1/HDL-c ratios (rs= 0.190, p= 0.016) and negatively correlated with the CETP/TG ratios (rs= -0.162, p= 0.04). Results of general linear model analysis showed that serum hsCRP concentration had the highest contribution to CETP/HDL-c ratios, apoA-1, dan CETP (p= 0.009; 0.016; 0.054, respectively). Conclusions Inflammation and insulin resistance related to dysfunction of HDL biogenesis in men with metabolic syndrome. The inflammation correlated with increased HDL catabolism, whereas the insulin resistance correlated with decreased HDL maturation and increased HDL catabolism. These may lead to low HDL-c concentration. Inflammation had higher contribution to HDL biogenesis factors than insulin resistance."

"Latar belakang: Sindrom metabolik merupakan kumpulan gejala abnormalitas metabolik tubuh yang meliputi hipertensi, obesitas sentral, hiperglikemia, resistensi insulin, dan dislipidemia. Hal ini menurunkan kualitas hidup seseorang dan berdampak meningkatnya biaya pengobatan. Salah satu faktor risikonya adalah kebiasaan konsumsi produk instan tinggi fruktosa. Penelitian ini bertujuan membuktikan hubungan antara kebiasaan konsumsi makanan dan/atau minuman yang mengandung fruktosa dengan terjadinya resistensi insulin yang bermanifestasi sindrom metabolik pada subjek di Posyandu Lansia Monjok Kota Mataram.Metode: Penelitian ini merupakan studi cross-sectional. Pengambilan sampel ditetapkan secara consecutive sampling. Subjek penelitian sebanyak 48 orang berusia 45-90 tahun dari Posyandu Lansia Monjok. Data diperoleh dari wawancara subjek, Puskesmas Mataram, dan Posyandu Monjok. Asupan fruktosa dikumpulkan dengan metode food recall 24hour dan dinilai dengan software nutrisurvey. Resistensi insulin ditetapkan dengan metode TyG Index. Sindrom metabolik ditetapkan berdasarkan parameter National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III).Hasil: Hasil penelitian menunjukkan 52.1% subjek di Posyandu Lansia Monjok Kota Mataram mengalami resistensi insulin dan 62.5% sindrom metabolik. Uji Chi-Square menunjukkan terdapat hubungan signifikan antara kebiasaan konsumsi fruktosa dengan terjadinya resistensi insulin (p=0.000) dan sindrom metabolik (p=0.001).Kesimpulan: Sebagian subjek di Posyandu Lansia Monjok Kota Mataram memiliki kebiasaan konsumsi tinggi fruktosa sehingga menyebabkan terjadinya resistensi insulin yang bermanifestasi menjadi sindrom metabolik.

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Introduction: Metabolic syndrome is a collection of symptoms of metabolic abnormalities, including hypertension, central obesity, hyperglycemia, insulin resistance, and dyslipidemia. This matter reduce a person’s quality of life and impact financially due to high treatment costs. One of the risk factors that trigger metabolic syndrome is the habit of consuming instant food or beverages that contain high fructose. This study aims to prove the relationship between the habit of consuming food and/or drinks containing fructose and the occurrence of insulin resistance manifesting metabolic syndrome among subjects at Monjok Elderly Integrated Healthcare Center Mataram.

Method: This study was cross-sectional. Sampling was determined using consecutive sampling. Subjects, as many as 48 people, aged 45-90 years form Monjok Elderly Integrated Healthcare Center Mataram. Data were obtained from subject interviews and data from Mataram Public Health Center and Monjok Integrated Healthcare Center. Fructose intake was collected using a 24-hour food recall method and assessed using NutriSurvey software. Insulin resistance was determined by the TyG Index method. Metabolic syndrome was determined based on the Adult Care Panel of the National Cholesterol Education Program III (NCEP ATP III).

Result: The results showed that 52.1% subjects at Monjok Elderly Integrated Healthcare Center experienced insulin resistance and 62.5% metabolic syndrome. The Chi-Square test showed a significant correlation between fructose consumption habits and the occurrence of insulin resistance (p=0.000) and metabolic syndrome (p=0.001).

Conclusion: Half of the subjects at Monjok Elderly Integrated Healthcare Center had a high fructose consumption habit that cause to insulin resistance manifesting metabolic syndrome."