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"Ruang Lingkup dan Cara Penelitian : Survai Kesehatan Rumah Tangga 1992, menunjukkan angka kematian penyakit kardiovaskular di Indonesia telah menduduki urutan pertama. Platelet mempunyai peranan dalam terbentuknya aterosklerosis yang merupakan penyebab terjadinya penyakit kardiovaskular. Asupan asam lemak tak jenuh w-3 dalam makanan sehari-hari dapat mempengaruhi fungsi platelet yang meliputi menurunkan agregasi platelet dan pembentukan Tromboksan A2 (TXA2). Penelitian ini bertujuan untuk menilai pengaruh suplementasi asam lemak tak jenuh w-3 terhadap agregasi platelet dan TXA2 pada orang sehat. Penelitian dilakukan tehadap 11 orang laki-laki sehat, berusia 30-55 tahun dan tidak merokok. Penelitian dilakukan dalam 3 periode yaitu periode pengamatan, periode suplementasi dan periode setelah suplementasi dengan masing-masing periode 21 hari lamanya. Dalam periode suplementasi, setiap subjek penelitian tiap hari mendapat 6 kapsul w-3 yang setara dengan 6 gram asam lemak tak jenuh w-3 dan mengandung 1080 mg EPA dan 720 mg DHA. Pada setiap awal periode dan pada akhir penelitian dilakukan pemeriksaan agregasi platelet dan TX A2. Pada saat yang lama juga dilakukan analisis asupan makanan. Hasil dan Kesimpulan : Nilai rata-rata agregasi platelet pada awal periode pengamatan, awal periode suplementasi, hari pertama dan hari ke 22 periode setelah suplementasi berturut-turut adalah 57,10 ± 7,91; 56,62 ± 10,15; 49,97 ± 10,24 dan 61,12 ± 7,8. Hasil uji t berpasangan terhadap agregasi platelet pada awal periode suplementasi dengan awal periode pengamatan menunjukkan tidak ada perbedaan yang bermakna (p>0,05). Hasil uji t berpasangan terhadap agregasi platelet pada hari pertama periode setelah suplementasi dengan awal periode suplementasi dan pada hari ke 22 dengan hari pertama periode setelah suplementasi ternyata terdapat perbedaan yang bermakna (p<0,05). Dengan demikian dapat disimpulkan bahwa asam lemak tak jenuh w-3 dapat menurunkan agregasi platelet pada orang sehat. Data kadar TXA2 dalam penelitian ini tidak dapat diperoleh dengan lengkap pada ke tiga periode. Hanya tiga data kadar TXA yang lengkap diperoleh dari ke tiga periode tersebut oleh karena itu, tidak dapat dilakukan analisis statistik terhadap kadar TXA2. Dengan demikian pengaruh asam lemak tak jenuh terhadap pembentukan TXA2 dalam penelitian ini belum dapat disimpulkan.

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Scope and Method of Study : Household survey 1992, showed mortality rate of cardiovascular disease in Indonesia has become the highest. Platelets have a role in atherosclerosis formation leading to cardiovascular disease. Dietary intake of w-3 polyunsaturated fatty acids can influence platelet function including the decrease of platelet aggregation and thromboxane A2 (TXA2) formation. The purpose of this study is to evaluate the effect of w-3 polyunsaturated fatty acids supplementation on platelet aggregation and TXA2 in healthy men. The subjects were 11 healthy men, 30 - 55 years of age and non smokers.

The study conducted in three periods ; the run in period, the supplementation period and the post supplementation period, which each of lasted 21 days. During the supplementation period, each subject was administered 6 omega-3 capsules which equal 6 grams of w-3 polyunsaturated fatty acids and containing 1080 mg EPA and 720 mg DHA. Platelet aggregation and TXA2 measurement were conducted at the beginning of each period and the end of the study. At the corresponding points of time dietary intake analysis were also carried out.

Findings and Conclusions : The mean value of platelet aggregation at the beginning of the run in period, the beginning of supplementation period, the first and the twenty second day of the post supplementation period were 57,10 ± 7,91; 56,62 ± 10,15; 49,97 ± 10,24 and 61,12 ± 7,82, respectively. T test dependent statistical analysis on platelet aggregation in the beginning of supplementation period against at the beginning of the run in period showed no significant change (p>0,05). T test dependent statistical analysis on platelet. aggregation at the first day of post supplementation period against at the beginning of supplementation period also at the twenty second day against the first day of the post supplementation period showed that there were significant change (p<0,05).

It can be concluded that in healthy men supplementation of w-3 polyunsaturated fatty acids decreased platelet aggregation. Data of TXA2 levels in this study could not be completely obtained from all the three periods. Since only three datas of TXA2 could be obtained completely, no statistical analysis could be made. The effect of supplementation of w-3 polyunsaturated fatty acids on TXA2 formation in this study is still inconclusive."

"Sampai saat ini sumber utama asam lemak tak jenuh terutama omega-3 masih berasal dari minyak ikan. Pada penelitian ini akan digunakan mikroorganisme fungi kapang jenis Rhizopus oligosporus. Penelitian ini menggunakan metode fermentasi terendam dengan strategi temperature shift yang dimana bertujuan untuk mempelajari pengaruh strategi temperature shift terhadap produksi asam lemak tak jenuh dari R.oligosporus. Pertama, R.oligosporus ditumbuhkan di beberapa variasi suhu yaitu 22, 26, 32, dan 37°C untuk menentukan suhu optimum untuk pertumbuhan R.oligosporus dan pembentukan PUFA. Hasil penelitian menunjukan bahwa R.oligosporus memiliki suhu optimum yang berbeda untuk pertumbuhan biomassa dan pembentukan PUFA (polyunsaturated fatty acids) yaitu 26°C dan 22°C. Berdasarkan hasil ini R.oligosporus difermentasikan dengan strategi temperature shift. Dimana selama lima hari pertama R.oligosporus ditumbuhkan dalam kondisi 26°C, memasuki hari keenam dan ketujuh suhu inkubasi diganti menjadi 22°C untuk akumulasi PUFA yang lebih tinggi. Dengan mengaplikasikan strategi temperature shift biomassa kering mengalami penurunan dari 0,6 g menjadi 0,47 g sementara itu kandungan PUFA mengalami peningkatan dari 19,8 menjadi 21,97.

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Today the main source of unsaturated fatty acids especially omega-3 is still from marine fish oil. In this research, Rhizopus oligosporus will be used to produce PUFA (polyunsaturated fatty acids). This research used submerged fermentation method and temperature shift strategy to optimize the production of PUFA. In this result, batch culture of R.oligosporus for PUFA production at various temperature (22, 26, 32, and 37°C).

Result showed that R.oligosporus has different optimum temperature for growth and PUFA production, 26°C and 22°C respectively. Based on the result temperature-shift strategy was applied, in which the culture temperature was controlled at 26°C at the first 5 days, and then switched to 22°C for two days. By applying such a temperature-shift strategy, the dry cell weight decreased from 0,6 g to 0,47 g and the concentration of PUFA increased from 19,8 to 21,97."

"Penyakit kardiovaskuler merupakan salah satu penyakit mematikan di dunia termasuk di Indonesia. Risiko terserang penyakit ini pun cukup tinggi pada masyarakat bahkan dapat menyebabkan kematian. Penyakit kardiovaskuler dapat dicegah dengan mengkonsumsi asam lemak tak jenuh yang berasal dari minyak ikan. Namun, ketersediaan ikan dan juga kualitas perairan Indonesia yang belakangan ini terpapar pencemar menjadi salah satu tantangan terbesar. Dari masalah tersebut, diperlukan sumber alternatif asam lemak tak jenuh yang dapat memproduksi lipid dalam jumlah besar, tidak membutuhkan lahan yang luas, dan ekonomis. Terdapat berbagai jenis mikroorganisme yang dapat digunakan sebagai sumber alternatif asam lemak. Pada penelitian ini akan digunakan mikroorganisme kapang jenis Rhizopus oligosporus. Kapang digunakan dalam penelitian ini sebab memiliki berbagai keuntungan seperti lebih mudah dalam penanganan, dapat tumbuh dalam pH rendah serta dapat mendegradasi sumber karbon yang kompleks. Penelitian menggunakan metode fermentasi terendam dengan strategi temperature shift dengan variasi konsentrasi glukosa dan laju agitasi. Hasil penelitian menunjukkan bahwa kandungan asam lemak tak jenuh yang didapat dalam kondisi optimum baik dari konsentrasi glukosa 100 g L maupun laju agitasi 120 rpm sebesar 41,77 pada MUFA dan 13,41 pada PUFA dan diperoleh pula asam oleat dan linoleat tertinggi berturut-turut sebesar 41,06 dan 13,41.

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Cardiovascular disease is one of the biggest killing disease in the world especially in Indonesia. The percentage risk of stricken by this disease is so high in community and even causing death. This risk is actually can be prevent with dietary consume of unsaturated fatty acid that often found in fish oil. However, the fish availability and the quality of Indonesias ocean that nowadays polluted becomes the biggest threat.

With the problem above, the alternative sources of omega 3 and omega 6 are needed whereas the source must be able to produce lipid in large number without taking a large amount of land and also economic. There are several kind of microorganism that can be use as an alternative source of fatty acid.

In this research, Rhizopus oligosporus is used as fungi microorganism. Mold is used in this research, because it has a lot of advantages such as ease to handle, easily grow in low pH and able to degradate more complex carbon sources. In this research, the fermentation is processed with submerged fermentation with temperature shift strategy with variation of glucose concentration and agitation rate.

The results showed that the unsaturated fatty acid content obtained in the optimum conditions both from the glucose concentration of 100 g/L and agitation rate of 120 rpm are 41.77 in MUFA and 13.41 in PUFA and the highest highest oleic and linoleic acids were also obtained at 41.06 and 13.41."

"Minyak ikan dikenal sebagai produk yang memiliki khasiat besar karena mengandung PUFA (Polyunsaturated Fatty Acid). Penelitian telah membuktikan bahwa PUFA dapat mencegah penyakit-penyakit berbahaya seperti penyakit kardiovaskular, inflamasi, dan kanker. Ikan sidat (Anguilla sp.) yang digunakan sebagai bahan baku utama memiliki kandungan gizi yang sangat tinggi, baik dari segi protein dan kandungan asam lemaknya. Tujuan penelitian ini adalah untuk menghasilkan minyak ikan Sidat dengan melalui tahap ekstraksi, pemurnian, dan karakterisasi. Metode ekstraksi yang digunakan adalah rendering basah dan proses purifikasi terdiri dari degumming, netralisasi, dan bleaching. Terdapat dua jenis minyak yang dikarakterisasi yakni minyak ikan kasar dan minyak ikan purifikasi. Hasil akhir minyak ikan kasar memiliki kandungan PUFA sebesar 31,81%, sedangakan minyak ikan purifikasi sebesar 18,44%. Minyak ikan kasar memiliki kualitas yang memadai sebagai produk minyak ikan layak konsumsi dengan spesifikasi bilangan asam (2,5), %asam lemak bebas (1,2%), kandungan air (0,15%), tingkat kejernihan (78%), dan asam lamak tak jenuh omega-3 (5,64%), omega-6 (26,17%), dan omega-9 (35,55%).

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Fish oil is known as a very beneficial product because it contains high PUFA (Polyunsaturated Fatty Acid). Various researchs have proven that PUFA is able to prevent many kind of malignancies such as cardiovascular problem, inflammation, and cancer. Sidat fish (Anguilla sp.) which will be used as main raw material has high amount of nutrients, not only in protein, but also in its fatty acid content. The purposes of this research is to produce Sidat fish oil through extraction, purification, and characterization. Wet rendering extraction method is used purification steps are consisted of degumming, neutralization, and bleaching. There are two kinds of fish oil which will be characterizied, crude fish oil and purified fish oil. The final crude sidat fish oil contain PUFA as much as 31.81%, while purified fish oil has 18.44% PUFA. The crude fish oil is known to have better and proper quality as a consumable fish oil product. It has specification as acid value (2.5), %free fatty acid (1.2%), water content (0.15%), clarity (78%), omega 3 unsaturated fatty acid (5.64%), omega 6 (26,16%), and omega 9 (35.55%)."

"Aspergillus oryzae dilakukan kultivasi pada medium limbah berupa onggok dan ampas tahu dengan menggunakan metode submerged fermentation dan ekstraksi sonikasi dengan pelarut etanol untuk menghasilkan asam lemak tak jenuh. Ekstraksi etanol merupakan salah satu ekstraksi yang aman, sehingga asam lemak yang dihasilkan dalam penelitian ini dapat diaplikasikan pada industri pangan. Hasil penelitian ini menunjukkan bahwa suhu optimum dalam produksi asam lemak tak jenuh berada pada suhu 300C dengan menghasilkan 65,88 % asam lemak tak jenuh terdiri dari 1,28% MUFA dan 64,6 % PUFA, serta pH 4 menghasilkan asam lemak tak jenuh tertinggi sebesar 54,44% dengan 1,84% MUFA dan 52,6% PU.

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Aspergillus oryzae is cultivated in medium based on onggok and tofu?s solid waste by using submerged fermentation and extraction of sonication with ethanol solvent to produce unsaturated fatty acid. Ethanol extraction is one of the safe extraction methods, so the fatty acid can be applied to the food industry.

The result showed the optimum incubation temperature in the production of unsaturated fatty acid at 300C with 65.88% unsaturated fatty acids that consist of 1.28% MUFA and 64.6% PUFA. And also pH 4 result the highest unsaturated fatty acid of 54.44 with 1.84% MUFA and 52.6% PUFA."

"Lemak menjadi nutrisi yang berperan penting dalam proses metabolisme. Sekitar 60% nutrisi yang dibutuhkan untuk perkembangan otak adalah berupa lemak. Polyunsaturated Fatty Acid (PUFA) yang terdiri dari omega-3 (linoleate) dan omega-6 (linolenat), merupakan asam lemak esensial yang digunakan untuk menjaga bagian-bagian struktural dari membran sel, serta mempunyai peran penting dalam perkembangan otak. Kapang adalah salah satu mikroorganisme oleaginous yang potensial sebagai sumber alternatif peghasil PUFA. Peneliti akan menggunakan Aspergillus oryzae sebagai mikroorganisme penghasil PUFA. Namun produksi single cell oil (SCO) dari mikroorganisme terhambat pada biaya operasional yang mahal, sehingga perlu adanya pemanfaatan limbah untuk menekan biaya operasional. Oleh karena itu, dalam penelitian ini digunakan limbah industri yaitu onggok tapioka dan ampas tahu sebagai medium kultivasi. Hasil penelitian menunjukkan bahwa kandungan PUFA dalam lipid A. oryzae meningkat seiring peningkatan konsentrasi karbon. Persentase PUFA tertinggi berada pada konsentrasi karbon 6% (w/w), yaitu sebesar 60,8% (w/w). Pada variasi rasio C/N, persentase PUFA dalam lipid A. oryzae relatif menurun seiring dengan peningkatan rasio C/N. Persentase PUFA tertinggi berada pada rasio 30:1, yaitu sebesar 56,1% (w/w).

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Fat is nutrients that play an important role in the metabolism process. About 60% of the nutrients needed for brain development is in the form of fat. Polyunsaturated Fatty Acids (PUFAs), which consists of omega-3 (linoleate) and omega-6 (linolenic acid), is an essential fatty acid that is used to maintain the structural parts of the cell membrane, and has an important role in brain development. Fungus is one of oleaginous microorganisms as a potential alternative source of PUFA producer. We will use the Aspergillus oryzae as PUFA-producing microorganisms. However, the production of single cell oil (SCO) of microorganisms is inhibited at high operational cost, thus we need for waste utilization to reduce the operational cost. Therefore, in this study, we used industrial waste, they are production waste of tapioca powder and tofu as cultivation medium. The result showed that the content of PUFAs in lipid A. oryzae increases with the concentration of carbon. The highest percentage of PUFA is at the carbon concentration of 6% (w/w), which amounted to 60.8% (w/w). In variations of C/N ratio, the percentage of PUFAs in lipid A. oryzae relatively decr"

"Gangguan spectrum autisma GSA merupakan gangguan perkembangan neurologis pada anak di mana terdapat perubahan dalam metabolisme asam lemak tak Jenuh dengan rasio EPA Eicosapentaenoic Acid dan AA Arachidonic Acid yang tinggi yang menurunkan produksi ceruloplasmin Cp yang menyebabkan gejala-gejala perilaku dalam individu GSA. Oleh karena itu, gangguan sosial pada penderita GSA dapat ditangani dengan suplementasi AA. Dalam penilitian ini, akan dilihat kemampuan Aspergillus oryzae dalam memproduksi asam lemak dan PUFA dengan fokus pada AA dengan metode fermentasi tiga tahap serta konsentrasi glukosa optimum untuk propagasi miselium pada medium tahap satu dan akumulasi lipid pada medium tahap dua. Ekstraksi dlakukan dengan menggunakan klroform dan metanol. Hasil penelitian konsentrasi glukosa optimum untuk propagasi miselium adalah 60 g/L dengan berat biomassa kering 1,079 g. Sedangkan, untuk medium tahap dua konsentrasi glukosa yang optimum adalah 40 g/L dengan perbandingan berat lipid dan biomassa kering 17,18. Dengan metode fermentasi tiga tahap kadar asam lemak tak jenuh yang terbaik mencapai 64,43 dengan 31,67 asam lemak jenuh. Sedangkan produksi AA terbaik didapatkan pada kultur dengan konsentrasi glukosa 60 g/L pada medium tahap dua dengan 0,06.

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Acid to AA Arachidonic Acid ratio, this decreases the production of ceruloplasmin Cp that can be cured from AA supplementation. The main source PUFA is fish oil, which is limited, thus an alternative source is needed. A possible source can be found in microorganisms.

In this paper Aspergillus oryzae is evaluated for its ability to produce fatty acids and AA with the three stage fermentation method as well as the optimum glucose concentration for the first and second stage of fermentation. The extraction of lipids is done with a mixtrure of chloroform and methanol.

The results of this research find the optimum glucose concentration for miscellium propagation in the first stage medium is 60 g L resulting in 1,079 g of dry biomass. On the other hand, the optimum glucose concentration for the second stage, which is the lipid accumulation stage is 40 g L resulting in 17,18 of lipid compared to the dry biomass. With the three stage fermentation method, the best unsaturated fatty acid content in the lipid produced is 64,43 with 31,67 of saturated fatty acid. While the highest amount of AA produced is 0,06 with 60g L of glucose in the second stage medium."

"Bekatul merupakan salah satu produk samping dari proses penggilingan padi yang memiliki manfaat. Salah satu manfaatnya, bekatul berpotensi menjadi sumber asam lemak esensial. Hal ini dikarenakan kandungan minyak pada bekatul mengandung asam lemak tak jenuh sebanyak 80%. Ekstrak minyak bekatul memiliki banyak manfaat bagi manusia terutama pada bidang kesehatan. Salah satu manfaat dari asam lemak tak jenuh yaitu dapat menurunkan risiko penyakit kardiovaskular seperti menurunkan risiko jantung koroner. Pengayaan asam lemak tak jenuh pada bekatul dilakukan dengan menggunakan metode fermentasi padat dengan menggunakan bantuan mikroorganisme. Mikroorganisme yang digunakan pada penelitian ini yaitu kapang Aspergillus terreus. Kandungan asam lemak tak jenuh yang dihasilkan oleh Aspergillus terreus lebih tinggi dibandingkan Aspergillus lain. Penelitain ini mengkaji pengaruh volume inokulum terhadap pengayaan asam lemak tak jenuh pada minyak bekatul dari hasil fermentasi menggunakan kapang Aspergillus terreus. Metode fermentasi yang digunakan yaitu metode fermentasi padat dengan dengan ekstraksi Bligh-Dyer termodifikasi dan instrumen Gas Chromatography/Mass Spectrometry (GC/MS) untuk mengetahui kandungan dari asam lemak tak jenuh pada minyak bekatul. Hasil penelitian ini menunjukan bahwa volume inokulum optimum untuk memperkaya asam lemak tak jenuh pada minyak bekatul, yaitu volume inokulum sebanyak 7 mL dengan kandungan asam lemak tak jenuh meningkat dari 37,90% menjadi 41,39%.

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Bran is a by-product of the rice milling process which has benefits. One of its benefits, bran has the potential to be a source of essential fatty acids. This is because the oil content in bran contains 80% unsaturated fatty acids. Bran oil extract has many benefits for humans, especially in the health sector. The benefits of unsaturated fatty acids can reduce the risk of cardiovascular disease like reducing the risk of coronary heart disease. Enrichment of unsaturated fatty acids in bran is using the solid fermentation method using the help of microorganisms. The microorganisms used in this study were Aspergillus terreus molds. The content of unsaturated fatty acids produced by Aspergillus terreus is higher than another Aspergillus. This study examines the effect of inoculum volume on the enrichment of unsaturated fatty acids in bran oil from fermentation using Aspergillus terreus molds. The fermentation method used is solid fermentation method with modified Bligh-Dyer extraction and (GC/MS) instruments to determine the content of unsaturated fatty acids in bran oil. The results of this study indicate that the optimum inoculum volume to enrich unsaturated fatty acids in bran oil, is 7 mL with unsaturated fatty acid content increased from 37.90% to 41.39%."

"ABSTRAKProses penggilingan padi akan menghasilkan produk samping, salah satunya yaitu bekatul yang memiliki potensi yang sangat besar baik dari segi ekonomi maupun kesehatan tubuh jika diolah lebih lanjut, namun hingga saat ini pemanfaatan bekatul masih sangat terbatas. Bekatul mengandung kadar minyak yang cukup tinggi yaitu sekitar 10-23% yang terdiri atas 80% asam lemak tak jenuh dan 20% asam lemak jenuh. Asam lemak tak jenuh umumnya diperoleh dari minyak ikan, namun minyak ikan mempunyai harga yang mahal dan berbau amis. Kandungan asam lemak tak jenuh pada bekatul dapat diperkaya dengan memanfaatkan kapang Aspergillus terreus, karena kapang tersebut dapat menghasilkan asam lemak tak jenuh lebih tinggi dibanding jenis kapang Aspergillus lainnya. Penelitian ini mengkaji pengaruh variasi pH medium terhadap peningkatan kadar asam lemak tak jenuh pada minyak bekatul hasil fermentasi menggunakan kapang Aspergillus terreus. Metode fermentasi yang digunakan adalah metode fermentasi padat dengan metode ekstraksi Bligh-Dyer termodifikasi dan instrumen Gas Chromatography/Mass Spectrometry (GC-MS) digunakan untuk mengetahui komposisi dan kandungan dari asam lemak tak jenuh dalam minyak bekatul. Hasil penelitian menunjukkan bahwa pH medium optimum untuk peningkatan kadar asam lemak tak jenuh dalam minyak bekatul dengan menggunakan Aspergillus terreus, yaitu pada pH 5 dengan kadar asam lemak tak jenuh semula 74,835% menjadi 76,719%.

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ABSTRACT

The rice milling process will produce side products, one of them is rice bran which has enormous potential both in terms of economy and health if it is further processed, but until now the use of rice bran is still very limited. Rice bran contains a fairly high oil content, which is around 10-23% consisting of 80% unsaturated fatty acids and 20% saturated fatty acids. Unsaturated fatty acids are generally obtained from fish oil, but fish oil has a high price and smells fishy. The content of unsaturated fatty acids in rice bran can be enriched by using Aspergillus terreus, because these molds can produce unsaturated fatty acid higher than other types of Aspergillus. This study examines the effect of pH of the medium variations on increasing unsaturated fatty acid content in fermented rice bran oil using Aspergillus terreus. The fermentation method used is solid-state fermentation with modified Bligh-Dyer extraction method and Gas Chromatography/Mass Spectrometry (GC-MS) instrument is used to determine the composition and content of unsaturated fatty acids in bran oil. The result showed that the optimum pH of the medium for increasing the unsaturated fatty acid contents in rice bran oil using Aspergillus terreus, which is at pH 5 with the initial unsaturated fatty acid content of 74.835% to 76.719%."

"[ABSTRAK

Latar balakang. Sekitar 75% kanker leher rahim datang ke rumah sakit dalam stadium lanjut. Terapi utama kanker serviks stadium lanjut adalah radioterapi. Kombinasi terapi radiasi dengan kemoterapi ternyata tidak menghasilkan respons terapi yang lebih baik, tetapi bahkan menimbulkan efek samping yang lebih berat dibandingkan terapi radiasi saja. Perubahan pola makan saat ini, diduga berpengaruh pada respons terapi. Rasio asupan Polyunsaturated Fatty Acids (PUFA) n-6 : n-3 sekitar 1-2 : 1 dapat melawan pertumbuhan kanker. Beberapa publikasi melaporkan bahwa PUFA n-3 (AL n-3) mempunyai efek pro-apoptosis, anti-inflamasi, anti-proliferatif dan anti-angiogenik. Penelitian ini bertujuan untuk mengetahui apakah suplementasi nutrisi tinggi PUFA bersamaan dengan terapi radiasi dapat meningkatkan respons tumor pada kanker serviks stadium lanjut. Metode. Penelitian ini merupakan Randomized Clinical Trial, double blind pada pasien kanker serviks stadium lanjut, jenis karsinoma sel skuama yang hanya mendapat terapi radiasi di Departemen Radioterapi, Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta. Subjek penelitian diambil secara konsekutif, melalui randomisasi dibagi dua kelompok, yaitu kelompok perlakuan dan kontrol. Selama radiasi subjek penelitian mendapat suplementasi nutrisi mengandung isokalori dan isoprotein dengan rasio AL n-6 : n-3 = 1,27 : 1 dan kontrol. Selama perlakuan dilakukan evaluasi setiap lima kali radiasi, meliputi BB dan efek samping radiasi akut. Parameter yang dinilai adalah respons klinis, respons histopatologis serta perubahan kadar PGE2 dan VEGF serum.

Hasil. Sebanyak 31 subjek dari 45 subjek dapat menyelesaikan penelitian. Sebelum perlakuan, status sosio-demografi, pola asupan AL n-6 dan n-3, status gizi dan klinis tidak didapatkan perbedaan bermakna. Setelah perlakuan, didapatkan penurunan kadar PGE2 serum pada kelompok perlakuan, sedangkan kelompok kontrol mengalami kenaikan (p = 0,127). Penurunan kadar VEGF kelompok perlakuan lebih besar dibanding kontrol (p = 0,626). Respons klinis dan respons histopatologis kelompok perlakuan lebih baik dibanding kontrol, dengan kemaknaan masing-masing p = 0,172 dan p = 0,169. Secara statistik belum didapatkan perbedaan yang bermakna pada penurunan kadar PGE2 dan VEGF serum, respons klinis dan respons histopatologis, tetapi didapat kemaknaan klinis yang nyata pada kelompok perlakuan dibanding kontrol. Analisis statistik gabungan dari respons klinis, respons histopatologis, kadar PGE2 dan VEGF serum didapatkan respons tumor total yang bermakna (p = 0,048).

Kesimpulan. Suplementasi nutrisi tinggi PUFA dengan rasio asam lemak n-6 : n- 3 = 1,27 : 1 pada kanker serviks stadium lanjut bersama terapi radiasi memberikan respons tumor total yang lebih baik.;

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ABSTRACT

Background . Approximately 75% of uterine cervical cancer came to the hospital in an advanced stage. Primary therapy of advanced cervical cancer is radiotherapy. The combination of radiotherapy with chemotherapy did not give better outcomes, but even cause more severe side effects than radiotherapy. Changes in dietary intake at this time, are supposed to influence the response to therapy. The ratio of n-6 to n-3 polyunsaturated fatty acids (PUFA) about 1-2: 1 can fight cancer growth. Several publications stated that n-3 PUFA has pro- apoptotic effect, anti-inflammatory, anti-proliferative and anti-angiogenic. This study aimed to examine whether radiotherapy combined with daily nutritional supplements enriched PUFA enhance tumor response in advanced cervical cancer.

Method. This study was a double-blind Randomized Clinical Trial (RCT) in patients with advanced squamous cell cervical cancer, received radiation only as control group, and those who received nutritional supplementation containing isocaloric and isoprotein with ratio of n-6 : n-3 PUFA = 1.27: 1 as treatment group. This study was performed in the Department of Radiotherapy Dr. Cipto Mangunkusumo General Hospital (RSUPNCM), Jakarta. Evaluation was done every five times radiation, including Karnofsky Perfomance Scale, body weight and side effects of acute radiation. Parameters assessed were clinical and hematological response, histopathological response and changes in the levels of PGE2 and VEGF serum,

Results. A total of 31 subjects from 45 subjects participated the study completely. Prior to treatment, socio-demographic status, patterns of n-6 and n-3 PUFA, clinical and nutritional status were analyzed, no significant differences were noted. After treatment, a decrease in serum PGE2 levels in the treatment group was found, while in the control group increased (P = 0.127). VEGF in the treatment group declined higher than controls (P = 0.626). Treatment group showed significant better clinical response and histopathological responses compared to the control group (p = 0.172 and p = 0.169). No significant differences were found in the reduction of PGE2 and VEGF serum levels, clinical response and histopathological response, although from clinical standpoint there is a better significant response in the treatment group than the control. The combined statistical analysis of clinical response, histopathological response, PGE2 and VEGF serum levels obtained total tumor response (P = 0.048). Conclusion. Nutritional supplementation enriched PUFA (ratio of n-6: n-3 PUFA = 1.27 : 1) in advanced cervical cancer receiving radiotherapy gives better total tumor response.;Background . Approximately 75% of uterine cervical cancer came to the hospital in an advanced stage. Primary therapy of advanced cervical cancer is radiotherapy. The combination of radiotherapy with chemotherapy did not give better outcomes, but even cause more severe side effects than radiotherapy. Changes in dietary intake at this time, are supposed to influence the response to therapy. The ratio of n-6 to n-3 polyunsaturated fatty acids (PUFA) about 1-2: 1 can fight cancer growth. Several publications stated that n-3 PUFA has pro- apoptotic effect, anti-inflammatory, anti-proliferative and anti-angiogenic. This study aimed to examine whether radiotherapy combined with daily nutritional supplements enriched PUFA enhance tumor response in advanced cervical cancer.

Method. This study was a double-blind Randomized Clinical Trial (RCT) in patients with advanced squamous cell cervical cancer, received radiation only as control group, and those who received nutritional supplementation containing isocaloric and isoprotein with ratio of n-6 : n-3 PUFA = 1.27: 1 as treatment group. This study was performed in the Department of Radiotherapy Dr. Cipto Mangunkusumo General Hospital (RSUPNCM), Jakarta. Evaluation was done every five times radiation, including Karnofsky Perfomance Scale, body weight and side effects of acute radiation. Parameters assessed were clinical and hematological response, histopathological response and changes in the levels of PGE2 and VEGF serum,

Results. A total of 31 subjects from 45 subjects participated the study completely. Prior to treatment, socio-demographic status, patterns of n-6 and n-3 PUFA, clinical and nutritional status were analyzed, no significant differences were noted. After treatment, a decrease in serum PGE2 levels in the treatment group was found, while in the control group increased (P = 0.127). VEGF in the treatment group declined higher than controls (P = 0.626). Treatment group showed significant better clinical response and histopathological responses compared to the control group (p = 0.172 and p = 0.169). No significant differences were found in the reduction of PGE2 and VEGF serum levels, clinical response and histopathological response, although from clinical standpoint there is a better significant response in the treatment group than the control. The combined statistical analysis of clinical response, histopathological response, PGE2 and VEGF serum levels obtained total tumor response (P = 0.048). Conclusion. Nutritional supplementation enriched PUFA (ratio of n-6: n-3 PUFA = 1.27 : 1) in advanced cervical cancer receiving radiotherapy gives better total tumor response., Background . Approximately 75% of uterine cervical cancer came to the hospital in an advanced stage. Primary therapy of advanced cervical cancer is radiotherapy. The combination of radiotherapy with chemotherapy did not give better outcomes, but even cause more severe side effects than radiotherapy. Changes in dietary intake at this time, are supposed to influence the response to therapy. The ratio of n-6 to n-3 polyunsaturated fatty acids (PUFA) about 1-2: 1 can fight cancer growth. Several publications stated that n-3 PUFA has pro- apoptotic effect, anti-inflammatory, anti-proliferative and anti-angiogenic. This study aimed to examine whether radiotherapy combined with daily nutritional supplements enriched PUFA enhance tumor response in advanced cervical cancer.

Method. This study was a double-blind Randomized Clinical Trial (RCT) in patients with advanced squamous cell cervical cancer, received radiation only as control group, and those who received nutritional supplementation containing isocaloric and isoprotein with ratio of n-6 : n-3 PUFA = 1.27: 1 as treatment group. This study was performed in the Department of Radiotherapy Dr. Cipto Mangunkusumo General Hospital (RSUPNCM), Jakarta. Evaluation was done every five times radiation, including Karnofsky Perfomance Scale, body weight and side effects of acute radiation. Parameters assessed were clinical and hematological response, histopathological response and changes in the levels of PGE2 and VEGF serum,

Results. A total of 31 subjects from 45 subjects participated the study completely. Prior to treatment, socio-demographic status, patterns of n-6 and n-3 PUFA, clinical and nutritional status were analyzed, no significant differences were noted. After treatment, a decrease in serum PGE2 levels in the treatment group was found, while in the control group increased (P = 0.127). VEGF in the treatment group declined higher than controls (P = 0.626). Treatment group showed significant better clinical response and histopathological responses compared to the control group (p = 0.172 and p = 0.169). No significant differences were found in the reduction of PGE2 and VEGF serum levels, clinical response and histopathological response, although from clinical standpoint there is a better significant response in the treatment group than the control. The combined statistical analysis of clinical response, histopathological response, PGE2 and VEGF serum levels obtained total tumor response (P = 0.048). Conclusion. Nutritional supplementation enriched PUFA (ratio of n-6: n-3 PUFA = 1.27 : 1) in advanced cervical cancer receiving radiotherapy gives better total tumor response.]"