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"Tujuan : (1) mengetahui perubahan kadar gala darah dalam 5 hari pasca serangan stroke; (2) rengetahui faktor risiko, status gizi, asupan energi dan karbohidrat serta pemberian insulin selama dirawat; (3) mengetahui hubungan antara perubahan kadar gula darah dengan faktor risiko, indeks massa tubuh, asupan energi dan karbohidrat serta pemberian insulin pada pasien hiperglikemia.Tempat : Ruang rawat inap Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo.Metodologi : Sebanyak 103 pasien diambil dengan diagnosa stroke iskemik dan hemoragik yang memenuhi kriteria penerimaan. Dilakukan pengukuran antropometri yaitu berat badan dan tinggi badan. Pemeriksaan laboratorium yang dilakukan yaitu kadar gula darah sewaktu hari 1 dan kadar gula darah puasa hari 2 - 5. HbA1. diperiksa pada pasien hiperglikemia. Data asupan energi dan karbohidrat melalui oral, enteral dan parenteral selama 24 jam pads hari I diambil secara recall dan hari 2 -- 5 secara record, hasil dianalisis dengan program food processor II. Perubahan kadar gula darah di uji dengan uji Friedman I uji Wilcoxon. Hubungan antara perubahan kadar gula darah dengan faktor risiko diuji dengan uji Mann Whitney. Hubungan antara perubahan kadar gula darah dengan indeks massa tubuh diuji dengan uji Kruskal Wallis. Korelasi antara perubahan kadar gula darah dengan asupan energi dan karbohidrat di uji dengan korelasi Spearman rank.Hasil : Hasil penelitian yang diperoleh 51,5% stroke iskernik dan 49,5% stroke hemoragik. Faktor risiko yang di dapat adalah hipertensi, DM, kelainan jantung dan dislipidernia. Faktor risiko dibagi menjadi DM dan non DM. Median asupan energi dan karbohidrat masih dibawah kebutuhan. Pada stroke non DM kadar gula darah puasa tertinggi hari 2, terjadi penurunan bermakna hari 3, dan stabil hari 4 dan 5 sedangkan pads DM tidak ada perbedaan bermakna. Terdapat perbedaan bermakna kadar gula darah antara kelompok stroke iskemik dan hemoragik pads stroke non DM dan tidak bermakna pads DM. Terdapat perbedaan bermakna kadar gula darah puasa antara penderita stroke dengan DM dan non DM. Tidak terdapat perbedaan bermakna antara kadar gula darah puasa dengan indeks massa tubuh.,Terdapat korelasi lemah sampai sedang negatif antara kadar gula darah dengan asupan energi dan karbohidrat pada penderita non DM dan korelasi lemah sampai sedang positif pada DM. Pemberian insulin sesuai dengan pedoman dapat menurunkan kadar gula darah pada beberapa pasien stroke dengan DM.Kesimpulan Penelitian ini menunjukkan terdapat perubahan kadar gula darah pads pasien stroke. Kadar gula darah puasa tertinggi hari 2 menurun bermakna hari 3 dan stabil hari 4 dan 5. Tidak ada perbedaan bermakna antara kadar gula darah dengan indeks massa tubuh. Terdapat korelasi lemah sampai sedang negatif antara kadar gula darah dengan asupan energi dan karbohidrat pada pasien stroke non DM.

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The Changes Of Fasting Glucose And Associated Factors In Stroke Patiens In Ciptomangunkusumo General Hospital 2002Objective : (1) to investigate the changes of blood glucose within 5 days after stroke, (2) to observe the risk factors, body mass index, energy and carbohydrate intake (3) to analyze the correlation between blood glucose with the risk factors, body mass index, energy and carbohydrate intakes and insulin to hyperglycemia patients.

Location: Cipto Mangunkusumo General Hospital, Jakarta.

Subject and methods : One hundred and three patients with acute stroke were recruited as the subjects of the study. Antropometric assessments i.e. body weight and height were assessed in the 1 0 day of admission. Laboratory assessment i.e. blood glucose at the time in the 1 °' day and fasting blood glucose in the 2nd - 5th days, HbAic to patients with hyperglycemia. Energy and carbohydrate intakes from parenteral, enteral and oral route were calculated in the 10 day by recall and 2"d - 5th day by record and analyzed by food processor II program. The changes of fasting blood glucose was tested using Friedman I Wilcoxon test The correlation between changes of blood glucose with risk factors was tested using Mann Whitney U test The correlation between changes of blood glucose with body mass index was tested using Kruskal Wallis test. The correlation between change of blood glucose with energy and carbohydrate intake was tested using Spearman rank correlation.

Results : The type of stroke determined by clinical diagnosis and CT scan were ischemic stroke 51,5% and hemorrhagic stroke 48,5%. Risk factors found were : hypertension, diabetes mellitus, cardiac disease, dislipidemia and unknown risk factors. The risk factors were grouped into 2 categories : DM and non. DM. The median intake of energy and carbohydrate were below the requirement. Fasting blood glucose higher in the 2nd day, significant decrease in the 3`d day, and constant in the 4t- 5th day in non DM patient whereas in DM not significant There were significant difference in changes of fasting blood glucose between ischemic and hemorrhagic stroke in non DM patient whereas DM no significant There were no significant difference between changes of fasting blood glucose with body mass index. There was weak to moderate negative correlation between of fasting blood glucose and energy and carbohydrate intake using Spearman rank correlation in non DM patient. Insulin to decrease blood glucose for several DM stroke patients.

Conclusions : the current study indicates that there was changes of blood glucose in the stroke patients. There were higher in the 2"' day significant decrease in the 3`d day and constant in the 4d' - 5d' day. There was no significant difference in the changes of blood glucose fasting with body mass index. There was weak to moderate negative correlation between fasting blood glucose and energy and carbohydrate intake in non DM stroke patients."

"Menarche dini merupakan salah satu faktor risiko kanker payudara yang berhubungan dengan lama pajanan estrogen. Penelitian mengenai faktor-faktor risiko menarche dini belum banyak dilakukan. Penelitian ini bertujuan untuk mengetahui hubungan antara asupan gizi, antropometri dan komposisi tubuh, serta aktivitas fisik dengan kadar estradiol dan menarche dini. Desain penelitian ini adalah potong lintang dengan subjek remaja putri 13-15 tahun di Jakarta, sejak Januari 2014 sampai Januari 2015. Analisis asupan gizi dilakukan dengan metode 24-hour recall dan Food Frequency Questionnaires (FFQ) semikuantitatif. Variabel antropometrik dan komposisi tubuh meliputi berat badan, tinggi badan, indeks massa tubuh (IMT), dan persentase lemak tubuh. Namun ditambahkan pengukuran lingkar lengan atas (LLA) dan lingkar pinggang (LP). Aktivitas fisik dinilai dengan Physical Activity Questionnaire (PAQ). Kadar estradiol serum diukur pada fase folikuler. Menarche dini adalah usia saat menstruasi pertama kali kurang dari 12 tahun. Terdapat 189 remaja putri usia13-15 tahun yang dilibatkan dari 8 SMP di Jakarta. Asupan gizi remaja putri berdasarkan PUGS cukup karbohidrat, kurang protein, tinggi lemak, dan rendah serat. Berdasarkan kriteria z-score IMT/U dari WHO, ditemukan sebanyak 3,2% gizi kurang, 73,5% normal, 18% mengalami overweight dan 5,3% mengalami obese. Lebih dari 90% subjek penelitian memiliki aktivitas fisik rendah. Proporsi menarche dini pada penelitian ini 22,8%. Kadar estradiol berkorelasi positif dengan asupan energi, protein, dan lemak. Berdasarkan kategori asupan, median estradiol berhubungan dengan asupan karbohidrat dan lemak. Terdapat korelasi negatif antara kadar estradiol dan LLA, LP serta z-score IMT/U. Terdapat hubungan antara menarche dini dan variabel-variabel antropometrik LLA dan LP serta z-score IMT/U. Tidak terdapat hubungan antara menarche dini, asupan gizi, aktivitas fisik, dan kadar estradiol. Faktor determinan kadar estradiol adalah asupan energi, protein, lemak dan zscore IMT/U, sedangkan faktor determinan menarche dini adalah LP. Dari hasil penelitian disimpulkan bahwa untuk menurunkan faktor risiko kanker payudara, perlu memperhatikan faktor-faktor yang terkait kadar estradiol dan menarch. ......Early menarche has been known as a risk factor of breast cancer because its association with the length of exposure time to estrogen. There are not much studies has been done on risk factors of early menarche. The aim of this study was to know the association among nutritional intake, anthropometry and body composition, physical activity, estradiol level and early menarche. This was a cross-sectional study involving adolescent girls aged 13-15 years in Jakarta, between January 2014 and January 2015. Interview on nutritional intakes were done by using the 24-hour recall and semiquantitative Food Frequency Questionnaires (FFQ). The anthropometric and body composition variables included body weight, body height, body mass index (BMI) and body fat percentage; however, additional variables were also measured, i.e. mid-upper arm circumference (MUAC) and waist circumference (WC). Physical activity was assessed by using the Physical Activity Questionnaires (PAQ). Serum estradiol levels was measured during follicular phase. Early menarche was defined if the first menstruation occurred before the age of 12 years. There were 189 adolescent girls enrolled in this study from 8 junior high schools in Jakarta. Based on guidelines of balanced nutrition, nutritiotional intake of adolescent girls were adequate carbohydrate intake, low protein intake, high fat intake, and low fiber intake. based on the WHO z-scores of BMI per age, there was 3,2% underweight, 73,5% normal, 18% overweight and 5,3% obese subjects. More than 90% of the study subjects had mild physical activity. The proportion of early menarche was 22.8%. Estradiol level was positive correlated with the intakes of energy, protein, and fat. Based on the diet intake category, median estradiol level was associate with the intakes of carbohydrate and fat. There was a negative correlation between estradiol level and MUAC, WC, and z-scores BMI per age. There was an association between early menarche and antrophometric measures (MUAC and WC) and z-scores BMI per age. No association was found between early menarche and nutritional intake, physical activity, or estradiol level. Determinant factors of estradiol level were the intakes of energy, protein, fat, and z-score BMI per age; while determinant factor of early menarche was waist circumference. To conclude, in order to reduce breast cancer risk, we should paid attention on factors associated with increased estradiol level and early menarche i.e. fat intake, physical acitivity and normal body weight."