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Abstrak :
Tujuan: Mengetahui status asam folat dan perilaku tentang asupan asam folat pada akseptor KB, sehingga dapat dipertimbangkan perlu tidaknya suplementasi asam folat pada akseptor KB, khususnya akseptor pil. Tempat: RW 014 Kelurahan Pisangan Baru, Kecamatan Matraman, Jakarta Timur. Bahan dan Cara: Penelitian crows-sectional dan subjek penelilian adalah semua akseptor KB yang memenuhi kriteria penelitian. Data yang dikumpulkan meliputi data sosio demografi, pola makan, asupan giri (makro matrial dan asam folat), status kadar asam folat serum dan sel darah merah (SDM). Hasil: Tidak didapatkan kadar asam folat serum < 3 ag/ml. Status asam folat serum subjek tidak berhubungan dengan pemakaian pil, karakteristik demografi, asupan gizi dan status gizi. Persentase kadar asam folat SDM < 160 mg/ml. adalah 3,5%. Kadar asam folat SDM subjek pil tidak berbeda dengan subjek bukan pil, namun ada kecenderungan kadar asam folat SDM subjek pil lebih rendah dari subjek bukan pil. Secara bermakna kadar asam folat SDM subjck bcrhubungan dengan kebiasaan mengkonsumsi sayur hijau dan kelompok umur. Perbedaan dalam mengolah sayur menyebabkan perbedaan bermakna pada jumlah subjek yang mempunyai kadar asam folat SDM < 160 mg/ml. Rata-rata asupan zat-zat gizi subjck penelitian di bawah AKG yang dianjurkan. Subjek pil mempunyai rata-rasa asupan asam folat lebih rendah bermakna dari subjek bukan pil, namun tidak didapatkan korelasi antara asupan asam folat dengan kadar asam folat serum dan SDM subjek penelitian. Kcsimpulan: Status asam folat serum dan SDM subjek penelitian tidak berhubungan dengan pemakaian pil dan bukan pil, sehingga belum diperlukan suplementasi pada subjek penelitian khususnya subjek pil. ...... Objective: To determine the folic acid slates and the behavior of folic acid intake in contraceptive users. This is in order to decide whether folic acid supplemeration is necessary, especially for pill users. Location: RW 014 Kelurahan Pisangan Baru, Kecamatan Matraman, Jakarta Timur. Methods: cross-sectional study and subjects were all contraceptive users who fulfill study criteria. Data ' collected were socio-demographic, eating paucrn, nutritional intake (macro nutrient and folic acid), nutritional status, serum and RISC folic acid level. Results: Serum folic acid level of < 3 mg/ml, was not found, Scrum folic acid level was not associated with using pill or non pill, socio-demographic, eating pattern, nutritional intake and nutritional status. The percentage of RISC folic acid level of N 160 mg/ml, was 3.5%. RISC folic acid level was not associated with using pill or non-pill, but there was a tendency Chef ItBC folic acid level in pill users was lower than non-pill users, There was a significant correlation between R13C folic acid level wish the frequency of green vegetables consumption and age group, 'Ihe difference in the manner of cooking significantly associated with the number of subject with RBC folic acid level of 160 mg/ml. Nutritional intake was under RDl level in almost subjects. Pill users had in average significant lower folic acid intake compare to non-pill users, but there was no correlation between folic acid intake with scrum and RBC folic acid level. Conclusions: Serum and RHC folic acid stains is not associated with using pill or non-pill. From this study it is still not necessary for folic acid supplementation, especially for pill users.

Abstrak :
ABSTRAK
Obesitas merupakan masalah global dengan prevalensi yang semakin meningkat dari tahun ke tahun. Obesitas merupakan salah satu faktor risiko terjadinya defisiensi vitamin D. Hal ini disebabkan karena meningkatnya simpanan vitamin D di jaringan adiposa, yang dapat diperburuk dengan kurangnya pajanan sinar matahari dan asupan vitamin D inadekuat. Defisiensi vitamin D berhubungan dengan resistensi insulin dan dapat meningkatkan risiko terjadinya sindrom metabolik. Peningkatan lingkar pinggang LP dan peningkatan kadar trigliserida TG serum atau hypertriglyceridemic waist dapat digunakan sebagai kriteria sederhana untuk skrining awal identifikasi sindrom metabolik. Penelitian dengan desain potong lintang ini dilakukan di klinik diabetes Rumah Sakit MRCCC Siloam Semanggi, Jakarta, yang bertujuan untuk mengetahui korelasi antara kadar vitamin D serum dengan LP dan kadar TG serum pada penyandang obesitas berusia >18-

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ABSTRACT
Obesity has reached epidemic proportions globally, with increasing prevalence in recent years. Obesity is one of the risk factors in vitamin D deficiency. The low levels of serum vitamin D in obesity has been attributed to multiple factors like excessive storage of vitamin D in the adipose tissue, decreased exposure to sunlight and an inadequate vitamin D intake. Vitamin D deficiency is associated with insulin resistance and increases the risk of developing metabolic syndrome. Increased waist circumference WC and elevated serum triglyceride TG levels or hypertriglyceridemic waist can be used as a simple clinical phenotype for early screening to identify patients with metabolic syndrome. This cross sectional study was conducted at the Diabetes Clinic of MRCCC Siloam Semanggi Hospital, Jakarta, which aims to determine correlation between serum vitamin D levels with WC and serum TG levels in obese individuals aged 18 years to

Abstrak :
ABSTRAK Pendahuluan: Stroke iskemia menyebabkan cedera pada otak yang dapat menyebabkan malnutrisi dan disfagia. Risiko stroke meningkat jika ditemukan hipertensi dan dislipidemia. Tujuan tata laksana nutrisi adalah mencegah malnutrisi, menurunkan faktor risiko, dan mencegah risiko stroke berulang dan komplikasi pada pasien dengan faktor risiko. Presentasi Kasus: Pasien dalam serial kasus terdiri dari tiga pasien laki-laki dan satu pasien perempuan berusia antara 39-54 tahun yang didiagnosis stroke iskemia. Kasus pertama dan kedua memiliki faktor risiko hipertensi, sedangkan kasus kedua dan keempat memiliki faktor risiko dislipidemia. Hasil skrining gizi dengan MST pada pasien pertama adalah skor 2 dan diagnosis khusus, sedangkan tiga kasus lain termasuk dalam diagnosis khusus. Kebutuhan nutrisi dihitung dengan persamaan Harris-Benedict dengan faktor stres 1,5 pada kasus pertama karena terdapat ulkus dekubitus, sedangkan faktor stres tiga kasus lain adalah 1,3. Target pemberian protein adalah 1,3-1,5 g/kg BB/hari. Selama pemantauan, pemberian protein mencapai 1,3-1,4 g/kg BB/hari. Kasus kedua dan keempat mengalami disfagia, tetapi terdapat perbaikan disfagia pada pasien keempat sehingga jalur nutrisi diubah melalui oral, sedangkan pada kasus kedua tidak terdapat perbaikan disfagia sehingga pasien pulang dengan NGT. Terdapat riwayat hiponatremia berulang pada kasus pertama, sehingga dilakukan koreksi natrium dan restriksi cairan. Hasil: Terdapat perbaikan klinis pada keempat kasus dan perbaikan kapasitas fungsional, kecuali kapasitas fungsional kasus pertama. Kesimpulan: Tata laksana nutrisi adekuat pada pasien stroke iskemia dengan mempertimbangkan komorbiditas dapat menunjang perbaikan klinis dan kapasitas fungsional pasien.

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ABSTRACT Background: Ischemic stroke cause cerebral insult results in malnutrition and dysphagia. Risk factors of stroke are hypertension and dyslipidemia. The aim of nutrition management is malnutrition prevention, lowering the risk factors, and preventing of recurrent stroke and complication. Case Presentation: The four patients included in this serial case were three males and one female, 39-54 years old, diagnosed with ischemic stroke. The first and second case had history of hypertension and the third and fourth case had dyslipidemia. The result of MST score of first case was 2 and special diagnosed, whereas the other three cases were special diagnosed. Energy needs was based on Harris-Benedict equation with 1,5 of factor stress for first case (with pressure ulcers) and 1,3 for the other three cases. The target of protein needs is 1,3-1,5 g/kg. The protein intake during monitoring were 1,3-1,4 g/kg. Dysphagia were found at second and fourth case, but then the fourth case had recovery of dysphagia and nutrition route was transitioned to oral, while the second case did not had recovery of dysphagia during monitoring and discharged with NGT. Natrium correction and fluid restriction were done at first case due to history of repeated hyponatremia. Result: There were improvement of clinical outcome and functional capacity, except functional capacity of first case. Conclusion: Adequate nutritional management for ischemic stroke patients could support the recovery of clinical outcome and functional capacity and should consider patients? comorbidities.

Abstrak :
Latar Belakang: Katabolisme pascalaparotomi menyebabkan imbang nitrogen negatif dan diduga tidak dapat dicegah dengan pemberian nutrisi. Nutrisi parenteral dapat meningkatkan faktor anabolisme. Belum diketahui apakah proporsi asupan energi dan protein dari jalur parenteral terhadap asupan total berkorelasi dengan imbang nitrogen pasien pascalaparotomi elektif. Metode: Studi potong lintang dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM) pada pasien pascalaparotomi elektif yang memperoleh supplemental parenteral nutrition (SPN) antara 3 hari pertama pascalaparotomi. Pemeriksaan nitrogen urea urin (NUU) dilakukan terhadap pasien dengan asupan ≥ 12 kkal/kg BB pada hari ketiga pascalaparotomi. Pasien dengan gangguan ginjal dan hati tidak disertakan dalam penelitian. Hasil: Rerata imbang nitrogen hari ketiga pascalaparotomi sebesar -2,8 ± 3,8 g/hari, dengan median asupan energi 19 (12–34) g/kg BB dan protein 0,9 (0,4–1,9) g/kg BB. Proporsi asupan energi dari jalur parenteral sebesar 0,51 ± 0,26 dan protein 0,59 ± 0,28. Tidak ditemukan korelasi signifikan pada proporsi asupan energi dan protein dari jalur parenteral terhadap asupan total dengan imbang nitrogen. Korelasi signifikan ditemukan pada variabel total asupan energi (r = 0,697, p <0,001) dan protein (r = 0,808, p <0,001) dengan imbang nitrogen. Kesimpulan: Pemberian SPN dini penting dalam mencapai total asupan energi dan protein untuk mengimbangi kehilangan nitrogen hari ketiga pascalaparotomi elektif di RSCM meskipun korelasi proporsi asupan nutrisi dengan imbang nitrogen belum tampak pada penelitian ini. ......Background: Post-laparotomy catabolism causes a negative nitrogen balance and is unlikely prevented by nutritional intervention. Parenteral nutrition can increase anabolic factor. It is not known whether the proportion of energy and protein intake from parenteral nutrition to total intake correlates with nitrogen balance in elective post-laparotomy patients. Methods: A cross-sectional study was conducted at Cipto Mangunkusumo Hospital in elective post-laparotomy patients who received supplemental parenteral nutrition (SPN) within first 3 days after laparotomy. Urine urea nitrogen (UUN) examination was performed on patients with intake ≥ 12 kcal/kg BW on the third day after laparotomy. Patients with renal and hepatic impairment were excluded. Results: The mean nitrogen balance on the third day post-laparotomy was -2.8 ± 3.8 g/day, with median energy intake of 19 (12–34) g/kg BW and protein 0.9 (0.4– 1.9) g/kg BW. The proportion of energy intake from the parenteral route was 0.51 ± 0.26 and protein was 0.59 ± 0.28. No significant correlation was found in the proportion of energy and protein intake from the parenteral nutrition to total intake with nitrogen balance. Significant correlations were found for total energy intake (r= 0.697, p <0.001) and protein (r= 0.808, p <0.001) with nitrogen balance. Conclusion: Early administration of SPN is important in achieving total energy and protein intake to compensate nitrogen loss on the third day after elective laparotomy although the association between the proportion of nutrition intake and nitrogen balance has not been observed in this study.

Abstrak :
Latar Belakang: Pegawai kantor dengan obesitas memiliki risiko tinggi mengalami diabetes melitus (DM) tipe 2. Pemeriksaan sensitivitas insulin jarang dilakukan karena kendala teknis dan biaya. Berbagai studi sebelumnya menunjukkan adanya hubungan negatif antara massa lemak tubuh dengan HOMA-IR, namun hasil penelitian di Indonesia menunjukkan hasil yang tidak konsisten. Indeks TyG disebut sebagai penanda resistensi insulin yang lebih akurat jika dibandingkan dengan HOMA-IR pada populasi Asia. Belum ada penelitian yang menilai hubungan massa lemak tubuh dengan Indeks TyG di Indonesia. Metode: Studi potong lintang dilakukan pada 89 pekerja kantor dengan obesitas (IMT ≥25 kg/m2) tanpa riwayat DM di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Agustus hingga Oktober tahun 2022. Dilakukan pengambilan data demografis (usia, jenis kelamin, riwayat DM, kebiasaan merokok), antropometri, analisis asupan menggunakan 24-hour food recall 3x24 jam, serta penilaian tingkat aktivitas fisik berdasarkan Global Physical Activity Questionnaire Score. Pengukuran persentase lemak tubuh total dan massa lemak viseral menggunakan multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Sensitivitas insulin dinilai menggunakan kadar HOMA-IR dan Indeks TyG serum. Analisis korelasi menggunakan uji Spearman dan dilakukan analisis multivariat untuk menilai faktor-faktor yang paling berhubungan dengan sensitivitas insulin. Hasil: Didapatkan sebanyak 89 subjek dengan proporsi perempuan:laki-laki sekitar 2:1, median usia 40 (21-59) tahun, dan mayoritas memiliki tingkat aktivitas sedang, tidak memiliki riwayat DM pada keluarga, tidak merokok, serta memiliki persentase kecukupan asupan melebihi kebutuhan energi individual dengan persentase makronutrien masih masuk dalam rentang normal. Korelasi persentase lemak tubuh total dengan HOMA-IR menunjukkan korelasi positif lemah yang bermakna (r=0,262, p=0,013). Korelasi massa lemak viseral dengan Indeks TyG menunjukkan korelasi positif lemah yang bermakna (r=0,234, p=0,027). Hasil korelasi persentase lemak tubuh total dengan indeks TyG dan korelasi massa lemak viseral dengan HOMA-IR menunjukkan hasil yang tidak signifikan secara statistik. Persentase lemak tubuh total tidak berhubungan signifikan dengan HOMA-IR setelah disesuaikan dengan variabel jenis kelamin, tingkat aktivitas fisik, indeks massa tubuh, lemak viseral, trigliserida, HDL, lingkar pinggang, dan persentase asupan karbohidrat. Massa lemak viseral tidak berhubungan signifikan dengan Indeks TyG setelah disesuaikan dengan variabel usia, jenis kelamin, lemak viseral, persentase asupan protein, dan HDL. Kesimpulan: Didapatkan korelasi positif lemah antara persentase lemak tubuh total dengan HOMA-IR dan korelasi positif lemah antara massa lemak viseral dengan Indeks TyG pada pegawai kantor obesitas di RSUPN Cipto Mangkunsumo. ......Background: Obese office workers have a high risk of developing type 2 diabetes mellitus (DM). Insulin sensitivity tests are rarely performed due to technical and cost constraints. Previous studies have shown a negative relationship between body fat mass and HOMA-IR. However, the results of research in Indonesia have shown inconsistent results. No study has assessed the relationship between body fat mass and the TyG index in Indonesia. In contrast, some research showed that The TyG index is a more accurate marker of insulin resistance in Asian populations. Methods: A cross-sectional study was conducted on 89 office workers with obesity (BMI ≥25 kg/m2) without a history of DM at RSUPN Dr. Cipto Mangunkusumo, Jakarta, on August-October 2022. Demographic data were collected (age, gender, history of DM, smoking habits), anthropometry, analysis of energy intake and macronutrients using a 3- days 24-hour food recall, as well as an assessment of the level of physical activity based on the Global Physical Activity Questionnaire Score. The total body fat percentage and visceral fat mass were measured using a multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Insulin sensitivity was assessed using HOMA-IR levels and serum TyG Index. Correlation analysis used the Spearman test, and multivariate analysis was performed to assess the factors most related to insulin sensitivity. Results: There were 89 subjects with a proportion of women: men around 2:1, the median age was 40 (21-59) years, and the majority had moderate activity levels, had no family history of DM, did not smoke, and had intakes exceeding individual energy needs with the percentage of macronutrients within normal range. The total body fat percentage correlation with HOMA-IR showed a significant positive correlation with weak strength (r=0.262, p=0.013). The correlation of visceral fat mass with the TyG index showed a significant positive correlation with weak strength (r=0.234, p=0.027). The results of the correlation of total body fat percentage with the TyG index and the correlation of visceral fat mass with HOMA-IR showed results that were not statistically significant. The total body fat percentage was not significantly related to HOMA-IR after adjusting for variables such as gender, level of physical activity, body mass index, visceral fat, triglycerides, HDL, waist circumference, and percentage of carbohydrate intake. Visceral fat mass did not have a significant relationship with the TyG index after adjusting for age, sex, visceral fat, percentage of protein intake, and HDL. Conclusion: A weak positive correlation was found between the percentage of total body fat and HOMA-IR and a weak positive correlation between visceral fat mass and the TyG index in obese office workers at Cipto Mangkunsumo General Hospital.