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"Many persons have a constellation of major risk/actors, life-habit risk factors, and emerging risk factors that constitute a condition called the Metabolic Syndrome. Eight components characteristic of the Metabolic Syndrome are: I. insulin resistance (with or without glucose intolerance), 2. hyperinsulinemia, 3. abdominal obesity, 4. raised blood pressure, 5. atherogenic dyslipidemia (T Triglyceride, T Postprandial lipemia, Small dense LDL or Type B pattern), 6. procoagulant state (t Fibrinogen, T PAI-1), 7. hyperuricemia, 8. endothelial dysfunction ft Albumin excretion rate, etc).Among the single etiologic factors being considered are: 1. a genetic defect in one or more components of the insulin action cascade leading to insulin resistance, 2. malnutrition during fetal development, and 3. abdominal obesity. It is possible that these three factors could be in some way interrelated. Several mechanisms implicated in the development of insulin resistance in obesity can be shortly postulated below. TNF-a oversecreted by the enlarged fat cells impairs insulin action by inhibiting insulin receptor signaling, possibly by increasing IRS-l serine phosphorylation GLUT-4 expression and translocation to the cell surface will be impaired by TNF-a.Leptin released from visceral adipocytes may inhibit insulin action in the liver by impairing insulin receptor signaling, leading to reduced down-regulation of PEPCK, the rate-limiting enzyme in gluconeogenesis. Glucose-stimulated insulin released from pancreatic fi-cell is also impaired by leptin through STAT-3 production stimulated by leptin via leptin receptor on the surface membrane of fl-cell, and then STAT-3 stimulates the opening of K+Arp-channels, and consequently insulin release will be inhibited.Resistin, as well as TNF-a and leptin released by adipocytes, decrease insulin sensitivity and to be suggested to inhibit adipogenesis; insulin administration rapidly increases resistin levels to normal in adipose tissue. Potential therapeutic beneficial effects of metformin for obesity and insulin resistance may be selectively categorized into 3 groups. In carbohydrate metabolism, metformin prevents pancreatic j3-cellfrom gluco-and lipotoxicity, increases insulin receptor binding, and increases insulin receptor tyrosine kinase (IRTK) activity.Metformin increases oral glucose-induced GLP-l amide levels in obese non-diabetic subjects; metformin is able to inhibit GLP-l degradation induced by dipeptidyl-peptidase IV. GLP-l is a gastrointestinal hormone, which stimulates insulin secretion and promotes satiety, and hence GLP-l and dipeptyl-peptidase IV-inhibitor can be proposed as therapeutic goals for the treatment of patients with Type 2-DM (T2DM) and obesity.In lipid metabolism, metformin may improve lipid profile. Several vasoprotective effects also belong to Metformin, f.e. 4. Hyperinsulinemia, J- Fibrinogen, -I PAl-I, -I FactorXHIa which functions to stabilize fibrin, 4- Platelet aggregation, i Capillary permeability, -I SMC-Fibroblast activity, and i Carbonyl stress (pathway to AGE formation).Conclusion: Obesity and insulin resistance are two major components of the metabolic syndrome, which predispose individuals to the development of T2DM and coronary heart disease. TNF-a and leptin, which are oversecreted by enlarged fat cells, play pivotal roles in the molecular defects of insulin action in obesity-linked insulin resistance. Pleio-tropic properties (vasoprotective effects) of metformin beyond carbohydrate and lipid effects may contribute to the beneficial therapeutic tools for obesity-linked insulin resistance."

"ABSTRAKSindrom metabolik MetS adalah kumpulan faktor yang kompleks dan saling berhubungan, yang meningkatkan risiko penyakit jantung dan diabetes mellitus tipe 2. Resistensi insulin dan obesitas sentral dianggap sebagai penyebab utama dari sindrom metabolik, sehingga penurunan resistensi insulin menjadi tujuan klinis yang penting saat ini. Beberapa studi menyimpulkan bahwa akupunktur dapat meningkatkan sensitivitas insulin, karena itu efektif untuk mengatasi gangguan metabolik Uji klinis acak tersamar tunggal dengan pembanding dilakukan pada 50 penderita sindrom metabolik yang dibagi secara acak ke dalam dua kelompok, kelompok elektroakupunktur dan medikamentosa n = 25 serta kelompok elektroakupunktur sham dan medikamentosa n=25 . Elektroakupunktur dilakukan 2 kali seminggu sebanyak 10 kali tindakan di titik CV12 Zhongwan, CV4 Guanyuan, ST25 Tianshu, ST36 Zusanli, ST40 Fenglong, SP6 Sanyinjiao, dan MA-IC3 Endokrin. Dilakukan pemeriksaan gula darah puasa dan insulin puasa untuk mengukur HOMA-IR sebagai luaran primer. Hasilnya terdapat perbedaan bermakna secara statistik perubahan HOMA-IR antara kelompok elektroakupunktur dan medikamentosa dengan kelompok elektroakupunktur sham dan medikamentosa -1,66 2,187 dan -0,29 2,388, p = 0,044 . Terapi kombinasi elektroakupunktur dan medikamentosa efektif untuk menurunkan resistensi insulin pada penderita sindrom metabolik.

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ABSTRACTThe metabolic syndrome is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular diseases and diabetes mellitus type 2. Insulin resistance and central obesity are considered significant factors as the underlying cause of the metabolic syndrome, since reduction of insulin resistance is an important clinical goal today. Several studies have concluded that acupuncture can improve insulin sensitivity, as it is effective against metabolic disturbances. A single blind randomized controlled trial involved 50 patients randomly allocated into two groups electroacupuncture with medication group n 25 or sham electroacupunture with medication group n 25 . Electroacupuncture therapy was given twice a week for ten times at CV12 Zhongwan, CV4 Guanyuan, ST25 Tianshu, ST36 Zusanli, ST40 Fenglong, SP6 Sanyinjiao, and MA IC3 Endocrine. Fasting blood glucose and fasting insulin serum were assessed to measure HOMA IR as the primary outcome. There was a statistically significant difference in changing of HOMA IR between electroacupuncture with medication group and sham electroacupunture with medication group 1,66 2,187 and 0,29 2,388, p 0.044 . Electroacupuncture with medical treatment effectively decreased insulin resistance of metabolic syndrome patients."

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Studi diagnostik ini bertujuan untuk menghasilkan kuesioner skor risiko resistensi insulin, yang merupakan alat skrining untuk membedakan seseorang dengan dan tanpa risiko resistensi insulin. Alat skrining diperlukan untuk pencegahan dini diabetes mellitus tipe 2. Model prediksi resistensi insulin ini dikembangkan melalui analisis regresi logistik multivariat menggunakan indikator diet dan non-diet untuk memprediksi kejadian resistensi insulin yang didefinisikan sebagai HOMA-IR ≥ 0.97. Asupan rata-rata harian dari nasi, telur, ikan dan udang, ayam, bersama dengan indeks massa tubuh (IMT) dipilih sebagai komponen model prediksi terbaik untuk menghitung risiko resistensi insulin. Skor risiko dari penelitian ini memiliki validitas yang baik untuk membedakan orang dengan resistensi insulin, Area Under Curve (AUC) 0.779 (0.721-0.838), sensitivitas 0.806, dan spesifisitas 0.577.

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This diagnostic study aimed to generate an insulin resistance risk score questionnaire, which was a screening tool to discriminate someone with and without insulin resistance risk. The screening tool was needed for early prevention of type 2 diabetes mellitus. Insulin resistance prediction models were developed from multivariate logistic regression analysis using dietary and non dietary indicators to predict insulin resistance incidence defined as HOMA-IR ≥ 0.97.  Daily average intake of steamed rice, egg, fish and shrimp, chicken, together with body mass index (BMI), were selected as the components of the best prediction model to calculate insulin resistance risk. The risk score from this study had good validity to discriminate people with insulin resistance, with  Area Under Curve (AUC) of  0.779  (0.721-0.838), sensitivity of 0.806 dan specivicity of 0.577.

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"Latar belakang Hiperglikemia pada anak sepsis dan syok septik merupakan keadaan yang sering ditemukan serta mempunyai luaran yang buruk. Patofisiologinya belum jelas mungkin berbeda dengan dewasa yaitu terdapatnya hipofungsi sel beta pankreas dibandingkan dengan resistensi insulin.Tujuan Mengetahui adanya hipofungsi sel beta pankreas dengan didapatnya penurunan kadar insulin melalui pemeriksaan kadar C peptida pada anak sepsis dan syok septik dengan hiperglikemiaMetode. Penelitian dilakukan di PICU Pediatric Intensive Care Unit dan IGD Instalasi Gawat Darurat. Penelitian ini merupakan suatu uji deskriptif analitik dengan memeriksa kadar C peptida pada anak sepsis dan syok septik dengan hiperglikemia Kadar gula darah dan C peptida diperiksa secara periodik selama 48 jamHasil Hiperglikemia dan penurunan kadar C peptida ditemukan pada 59 dan 52 pasien anak dengan sepsis dan syok septik Keadaan hiperglikemia hanya ditemukan pada 12 jam pertama perawatan. Perbedaan kadar gula darah dan C peptide tampak pada 1 jam pertama yaitu 229 vs 192 mg dl dan 0 5 vs 1 5 ng ml nilai p 0 409 p 0 025 Skor PELOD lebih tinggi pada kadar C peptida rendah 11 vs 1. Penggunaan ventilator inotrops kortikosteroid dan lama rawat PICU tidak terdapat perbedaan pada kedua kelompok.Simpulan Terdapat penurunan kadar C peptida di bawah normal pada anak sepsis dan syok septik dengan hiperglikemia dan meningkat ke normal dalam 48 jam Penurunan gula darah terjadi 12 jam pertama hal ini menunjukkan perlunya infus glukosa pada keadaan akut sepsis. Apakah hiperglikemia merupakan respons normal tubuh dan hipofungsi sel beta pankreas akibat beratnya penyakit pada anak sepsis perlu dilakukan penelitian lebih lanjut

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Background Hyperglycemia in children sepsis is a condition that is often found Pathophysiology is unclear may differ from the adult that the presence of hypofunction of pancreatic beta cells compared with insulin resistance.Objective To determine the hypofunction pancreatic beta cells with decreased levels of C peptide insulin in children with sepsis hyperglycemiaMethods The study was conducted in the PICU and ER. This study was a descriptive analytic test by examining the levels of C peptide in children with sepsis hyperglycemia Checked blood sugar levels and C peptide during 48 hours on a periodic basis.Results Hyperglycemia and decreased levels of C peptide were 59 and 52 in children with sepsis respectively Hyperglycemia was found only in the first 12 hours Differences in blood sugar levels 229 vs 192 mg dl p value 0 409 and C peptide 0 5 vs 1 5 ng ml p value 0 025 appeared at the first 1 hour. Further analysis between normal and low C peptide showed PELOD score was higher in low C peptide level 11 vs 1. Ventilators inotrops corticosteroids and PICU LOS was should no difference in the two groups.Conclusions There was a decrease in C peptide level below normal in children with sepsis hyperglycemia and increased to normal within 48 hour. The decrease in blood sugar occurs in the first 12 hours which demonstrates the need for infusions of glucose in acute sepsis Further research whether hyperglycemia was a normal response of the body and hypofunction pancreatic beta cells due to the severity of the disease in children sepsis."

"Latar Belakang: Keadaan resistensi insulin dipicu oleh berbagai faktor, salah satunya adalah inflamasi kronik yakni periodontitis. Hubungan antara periodontitis dengan resistensi insulin yang dinilai dengan HOMA-IR telah dilaporkan sebelumnya, namun belum ada data hubungan antara derajat periodontitis dengan resistensi insulin pada populasi umum, khususnya di Indonesia.Tujuan: Mendapatkan perbandingan nilai HOMA-IR pada berbagai derajat periodontitis pada populasi umumMetode: Studi potong-lintang dilakukan pada 68 pasien Periodontitis di Poliklinik Periodontologi RSUPN CiptoMangunkusumo dan RSGM FKG-Universitas Indonesia, pada bulan April-Desember 2017. Anamnesis dan pemeriksaan fisik, serta pemeriksaan gigi dilakukan berdasarkan kriteria dan standar pelayanan medik. Pemeriksaan resistensi insulin dilakukan dengan metode pemeriksaan HOMA-IR. Analisis komparatif tidak berpasangan dilakukan untuk menemukan beda rerata pada berbagai derajat periodontitis..Hasil: Didapatkan bahwa nilai median HOMA-IR pada kelompok yang mengalami periodontitis berat lebih tinggi secara bermakna dibanding periodontitis tidak berat [2,85 1,1 ndash; 9 vs. 1,94 0,4-8 , p=0,038 ]. Nilai median HOMA-IR pada kelompok yang mengalami periodontitis menyeluruh juga lebih tinggi secara klinis dibanding kelompok yang mengalami periodontitis lokal [2,9 0,4 ndash; 9 vs. 2,15 0,4-7,6 , p=0,51] meskipun secara statistik tidak bermakna.Kesimpulan: Nilai HOMA-IR lebih tinggi secara bermakna pada periodontitis berat dibandingkan dengan periodontitis tidak berat. Nilai HOMA-IR tidak memberikan perbedaan nilai secara bermakna pada periodontitis lokal dibandingkan dengan periodontitis menyeluruh.

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Background Insulin resistance induced by various factors, including chronic inflammation such as periodontitis. The correlation between periodontitis and insulin resistance assessed with HOMA IR has been reported before, but data about the correlation between degree of periodontitis with insulin resistance in general population, especially in Indonesia.Objective To compare HOMA IR score in various degree of periodontitis in general populationMethod A cross sectional study was performed on 68 periodontitis patients at Periodontology Clinic of Cipto Mangunkusumo National General Hospital and Dental Hospital of Faculty of Dentistry University of Indonesia during April December 2017. Anamnesis, physical examination, and dental examination were done according to medical service criteria and standards. Insulin resistance examination was done using HOMA IR method. Unpaired comparative analysis was done to find the mean difference among various degree of periodontitis.Result It was found that the median HOMA IR score of severe periodontitis group is significantly higher that non severe periodontitis group 2.85 1.1 ndash 9 vs. 1.94 0.4 8 , p 0.038 . Median HOMA IR score in general periodontitis group is also clinically higher compared to local periodontitis group 2.9 0.4 ndash 9 vs. 2.15 0.4 7.6 , p 0.51 although not statistically significant.Conclusion HOMA IR score is significantly higher in severe periodontitis compared to severe periodontitis. HOMA IR score is not significantly different between general and local periodontitis."

"Latar Belakang: Keadaan resistensi insulin dipicu oleh berbagai faktor, salah satunya adalah inflamasi kronik yakni periodontitis. Hubungan antara periodontitis dengan resistensi insulin yang dinilai dengan HOMA-IR telah dilaporkan sebelumnya, namun belum ada data hubungan antara derajat periodontitis dengan resistensi insulin pada populasi umum, khususnya di Indonesia. Tujuan: Mendapatkan perbandingan nilai HOMA-IR pada berbagai derajat periodontitis pada populasi umum Metode: Studi potong-lintang dilakukan pada 68 pasien Periodontitis di Poliklinik Periodontologi RSUPN CiptoMangunkusumo dan RSGM FKG-Universitas Indonesia, pada bulan April-Desember 2017. Anamnesis dan pemeriksaan fisik, serta pemeriksaan gigi dilakukan berdasarkan kriteria dan standar pelayanan medik. Pemeriksaan resistensi insulin dilakukan dengan metode pemeriksaan HOMA-IR. Analisis komparatif tidak berpasangan dilakukan untuk menemukan beda rerata pada berbagai derajat periodontitis.Hasil: Didapatkan juga bahwa nilai median HOMA-IR pada kelompok yang mengalami periodontitis berat lebih tinggi secara bermakna dibanding periodontitis tidak berat [2,85 (1,1-9) vs. 1,94 (0,4-8), p=0,038). Nilai median HOMA-IR pada kelompok yang mengalami periodontitis menyeluruh juga lebih tinggi secara klinis dibanding kelompok yang mengalami periodontitis lokal [2,9 (0,4-9) vs. 2,15 (0,4-7,6), p=0,51) meskipun secara statistik tidak bermakna. Kesimpulan: Nilai HOMA-IR lebih tinggi secara bermakna pada periodontitis berat dibandingkan dengan periodontitis tidak berat. Nilai HOMA-IR tidak memberikan perbedaan nilai secara bermakna pada periodontitis lokal dibandingkan dengan periodontitis menyeluruh.

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Background: Insulin resistance induced by various factors, including chronic inflammation such as periodontitis. The correlation between periodontitis and insulin resistance assessed with HOMA-IR has been reported before, but data about the correlation between degree of periodontitis with insulin resistance in general population, especially in Indonesia. Objective: To compare HOMA-IR score in various degree of periodontitis in general population. Method: A cross-sectional study was performed on 68 periodontitis patients at Periodontology Clinic of Cipto Mangunkusumo National General Hospital and Dental Hospital of Faculty of Dentistry University of Indonesia during April-December 2017. Anamnesis, physical examination, and dental examination were done according to medical service criteria and standards. Insulin resistance examination was done using HOMA-IR method. Unpaired comparative analysis was done to find the mean difference among various degree of periodontitis. Result: It was also found that the median HOMA-IR score of severe periodontitis group is significantly higher that non-severe periodontitis group [2.85 (1.1-9) vs. 1.94 (0.4-8), p=0.038). Median HOMA-IR score in general periodontitis group is also clinically higher compared to local periodontitis group [2.9 (0.4-9) vs. 2.15 (0.4-7.6), p=0.51) although not statistically significant. Conclusion: HOMA-IR score is significantly higher in severe periodontitis compared to-severe periodontitis. HOMA-IR score is not significantly different between general and local periodontitis."

"Penelitian ini bertujuan untuk menilai efek suplementasi probiotik pada masa kanak-kanak terhadap indeks resistensi insulin pada masa remaja. Studi ini merupakan studi tindak lanjut tahun ke-10 dari uji klinis pemberian probiotik dan kalsium pada anak-anak yang tinggal di daerah sosioekonomi rendah di Jakarta Timur, yang diadakan pada bulan Januari hingga Maret 2019. Studi ini melibatkan 154 remaja berusia 11-17 tahun, yang terbagi menjadi 3 kelompok berdasarkan intervensi terdahulu (kalsium regular (KR) sebagai kelompok kontrol, kelompok reuteri, dan kelompok casei). Luaran utama berupa perbedaan resistensi insulin yang dinilai dengan homeostatic model assessment for insulin resistance (indeks HOMA-IR) diantara ketiga kelompok sesudah dilakukan penyesuaian terhadap faktor perancu, seperti usia, jenis kelamin, status pubertas, status nutrisi, aktivtas fisik, dan pola asupan makanan. Studi ini memperoleh karakteristik subjek tidak berbeda bermakna diantara kelompok KR, casei, dan reuteri. Pola asupan makanan subjek juga tidak berbeda bermakna diantara kelompok RC, casei, dan reuteri. Rerata indeks HOMA-IR pada kelompok casei, reuteri, dan KR berturut-turut adalah 3,5 ± 1,9; 3,2 ± 1,7; 3,2 ± 1,6. Rerata indeks HOMA-IR tidak berbeda bermakna diantara kelompok casei dan RC (mean differences (MD): 1,10 [95% CI: 0.9-1.33]), diantara kelompok reuteri dan RC (MD:0.99 [95% CI: 0.82-1.22]) sesudah penyesuaian terhadap usia, jenis kelamin, status gizi, asupan serat, dana asupan lemak. Suplementasi probiotik selama 6 bulan pada masa kanak-kanak diduga tidak memengaruhi indeks resistensi insulin pada masa remaja.

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Objective: To investigate the effect of probiotic supplementation in the childhood toward insulin resistance index in adolescence.

Methods: This study was a 10-year follow-up study on probiotic and calcium trial in children living in low-socioeconomic urban area of East Jakarta between January and March 2019. This study involved 154 adolescents aged 11-17 years, divided into 3 groups based on previous intervention (regular calcium as a control group, reuteri group, and casei group). Primary outcome was differences in insulin resistance that measured by homeostatic model assessment for insulin resistance (HOMA-IR index) between the three groups after adjustment of the confounding factor, such as age, gender, pubertal status, nutritional status, physical activity, and dietary intake patterns.

Results: Subjects' characteristics were not significantly different among casei, reuteri, and RC. Subjects' dietary intake patterns also were not significantly different among casei, reuteri, and RC. The mean HOMA-IR in casei, reuteri, and RC were 3.5 ± 1.9, 3.2 ± 1.7, 3.2 ± 1.6, irrespectively. The mean HOMA-IR index were no significantly different between casei and RC (mean differences (MD): 1,10 [95% CI: 0.9-1.33]), between reuteri and RC (MD:0.99 [95% CI: 0.82-1.22]) after adjusted with age, gender, nutritional status, fiber intake, and fat intake.

Conclusion: Probiotic supplementation for 6 months in childhood may not affect insulin resistance index in adolescence."

"Latar belakang: Prediabetes didefinisikan sebagai keadaan hiperglikemia dengan kadar glukosa di atas normal dan dapat berkembang menjadi keadaan diabetes. Beberapa studi membuktikan keadaan defisiensi vitamin D berhubungan dengan keadaan resistensi insulin. Penelitian ini bertujuan untuk menganalisis efek modulasi suplementasi vitamin D terhadap mekanisme molekular pada kondisi resistensi insulin melaluli regulasi persinyalan jalur inflamasi dan mikrobiota usus pada tikus prediabetes.Metode: Penelitian ini dilakukan pada tahun 2019-2021 di Fakultas Kedokteran Universitas Indonesia dan Medica Satwa Laboratory Bogor. Eksperimen dilakukan pada tikus Wistar jantan berumur 4 minggu. Tikus akan dibagi secara acak, yaitu tikus yang menerima diet normal dan diet tinggi lemak dan tinggi glukosa (DTL-G)yang dikombinasi dengan dosis rendah injeksi streptozotocin 30 mg/kgBB intraperitoneal pada minggu ketiga. Setelah itu dilakukan tes toleransi glukosa oral (TTGO) dengan dosis 2 gram/kgBB pada tikus. Jika telah terjadi resistensi insulin (model tikus prediabetes) maka tikus prediabetes dibagi dalam tiga kelompok secara acak yaitu: (1) kelompok yang tidak diberi terapi, (2) kelompok yang diterapi vitamin D3 dosis 100 IU/kg/hari, (3) kelompok yang diterapi vitamin D3 dosis 1000 IU/kgBB/hari bersamaan dengan induksi DTL-G 12 minggu. Setelah itu akan dilakukan pengukuran kadar glukosa darah puasa (GDP), kadar glukosa darah 2 jam pasca-bebas glukosa, nilai HOMA-IR, kadar Glycated albumin, profil hematologi, kadar 25(OH)D3,pengamatan histopatologi pankreas, kadar TNF-alpha, IL-6, IL-10, NF-κB, TLR2, TLR4, PPARg, IRS1, dan komposisi mikrobiota usus.Hasil: Pada tikus prediabetes terjadi peningkatan nilai glukosa darah puasa, kadar glukosa darah 2 jam pasca-bebas glukosa, nilai HOMA-IR, kadar Glycated albumin, serta perubahan profil hematologi. Pemberian vitamin D 1000 IU mampu menurunkan nilai GDP, TTGO, Glycated albumin, HOMA-IR, serta mampu mengurangi degenerasi pada pulau Langerhans. Vitamin D 1000 IU mampu meningkatan sitokin anti-inflamasi IL-10, menurunkan ekspresi TLR2 dan TLR4, mengembalikan ekspresi IRS seperti kelompok normal, serta dapat meningkatkan keragaman mikrobiota. Suplementasi vitamin D berkorelasi dengan kadar PPARg, IRS1, TLR2, TLR4, dan sel beta pankreas.Kesimpulan: Pemberian vitamin D 1000 IU bersamaan dengan DTL-G pada tikus prediabetes dapat memberikan perbaikan kondisi resistensi insulin, meningkatkan sitokin anti-inflamasi, mengembalikan nilai ekspresi PPARg, meningkatkan ekspresi protein IRS1 kembali seperti kelompok normal, serta meningkatkan keragaman mikrobiota yang berkorelasi dengan regulasi persinyalan sitokin inflamasi.

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Introduction: Prediabetes is defined as a state of intermediate hyperglycemia and can lead to type 2 diabetes. Several studies have shown that vitamin D deficiency is associated with insulin resistance. This study aimed to analyze the modulating effect of vitamin D supplementation on the molecular mechanisms of insulin resistance through signaling regulation pathways of inflammation and gut microbiota in prediabetic rats.

Methods: The study was conducted during 2019-2021 at the Faculty of Medicine, Universitas Indonesia and Medica Satwa Laboratory Bogor. The experiments was conducted on male Wistar rats of 4 weeks. Rats were divided randomly into control and a high-fat and high-glucose (HFD-G) diet combined with 30 mg/kg intraperitoneal injection of streptozotocin in the third week. Oral glucose tolerance test (OGTT) was performed at 2 grams/kgBW gluocose. If insulin resistance has occurred (prediabetic rat model) then rats were randomly divided into three groups, namely: (1) the group that was not given therapy, (2) the group with vitamin D3 at a dose of 100 IU/kgBW/day, (3) the group with vitamin D3 at a dose of 1000 IU/kgBW/day together with HFD-G in 12 weeks. Fasting blood glucose (FBG) levels, OGTT, HOMA-IR, Glycated albumin levels, hematological profiles, 25(OH)D3 levels, pancreatic histopathological observations, TNF-alpha, IL-6, IL-10, NF-B, TLR2, TLR4, PPARg, IRS1, and gut microbiota composition was evaluated.

Results: In prediabetic rats there was an increase in FBG, OGTT, HOMA-IR, Glycated albumin levels, and changes in hematological profiles. The administration of vitamin D 1000 IU could reduce the levels of FBG, OGTT, Glycated albumin, HOMA-IR, and could reduce degeneration of the islets of Langerhans. Vitamin D 1000 IU increased the anti-inflammatory cytokine IL-10, decreased the expression of TLR2 and TLR4, increased IRS1 expression like the normal group, and increased the diversity of gut microbiota. Vitamin D supplementation correlated with levels of PPARg, IRS1, TLR2, TLR4, and pancreatic beta cells.

Conclusion: Vitamin D 1000 IU vitamin D together with HFD-G in prediabetic rat could reduce insulin resistance, increased anti-inflammatory cytokines, increased PPARg expression level, increased IRS1 protein expression, and increased diversity of gut microbiota which correlates with signaling regulation of Inflammatory Pathways."

"Latar Belakang: Dermatitis seboroik (DS) merupakan kelainan inflamasi kronik pada area kulit yang kaya kelenjar sebasea. Hingga saat ini patogenesis DS terus berkembang, termasuk dikaitkan dengan kejadian sindrom metabolik. Oleh karena sindrom metabolik terjadi akibat resistensi insulin yang diperankan oleh jaringan lemak viseral, maka diduga kedua hal tersebut juga memiliki peran terhadap kejadian DS.Tujuan: mengetahui rerata HOMA-IR dan skala jaringan lemak viseral pada pasien DS, serta menilai perbedaannya dibandingkan dengan kontrol.Metode: Penelitian kasus-kontrol berpasangan ini dilakukan di Poliklinik Dermato-venereologi RSCM selama Juli-Agustus 2022. Kelompok kasus ialah pasien berusia ≥18 tahun, tidak hamil, IMT ≥18,5 kg/m2 yang terdiagnosis DS secara klinis, serta tidak memiliki penyakit imunokompromais, infeksi kronis, kanker, autoimun, atau degeneratif lainnya. Kelompok kontrol ialah pasien non-DS yang match berdasarkan usia, jenis kelamin, dan kategori IMT. Seluruh subjek menjalani pemeriksaan klinis, laboratorium, dan pengukuran skala lemak viseral menggunakan alat BIA TANITA® SC330.Hasil: Masing-masing kelompok DS dan kontrol berjumlah 36 subjek pada studi ini. Median(min-maks) usia kelompok DS ialah 26,5(20-45) tahun, jenis kelamin laki-laki 52,8%, dan median(min-maks) IMT sebesar 24,2(18,5-38,8) kg/m2. Median HOMA-IR ditemukan lebih tinggi pada kelompok DS dibandingkan kontrol (1,54[0,72-4,09] VS. 1,22[0,53-2,73]; p=0,031). Namun, tidak terdapat perbedaan yang bermakna secara statistik untuk skala lemak viseral antara kelompok DS dengan kontrol (6,5[1-14] VS. 6,0[1-12]; p=0,149).Kesimpulan: Nilai median HOMA-IR dan skala jaringan lemak viseral pada pasien DS adalah masing-masing 1,54 (IK95% 0,72-4,09) dan 6,5 (IK95% 1-14). Nilai HOMA-IR pada pasien DS lebih tinggi dibandingkan dengan kontrol dan bermakna secara statistik, tetapi tidak terdapat perbedaan bermakna secara statistik untuk skala lemak viseral.

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Background: Seborrheic dermatitis (SD) is a chronic inflammatory disorder in sebaceous gland-rich skin. Until today the pathogenesis of SD continues to develop, including investigation about the link association between SD and metabolic syndrome. Metabolic syndrome is a disease caused by insulin resistance in which visceral fat tissue may play important role, therefore insulin resistance and visceral fat tissue are hypothesized to influence the development of SD.

Objective: To measure the HOMA-IR and visceral fat rating scale in SD patients, and to investigate the differences compared to the control group.

Methods: A matched case-control study was conducted in Dermatovenereology Clinic Cipto Mangunkusumo General Hospital in July-August 2022. Case group was non-pregnant patients aged ≥18 years old and BMI ≥18,5 kg/m2 which were clinically diagnosed with SD, and did not have any of immunocompromise, chronic infection, cancer, autoimmune, or degenerative disease. Control group was non-SD patients that were matched according to the age, gender, and BMI categories. All the subjects assigned for clinical and laboratory examination, and visceral fat measurement using BIA TANITA® SC330.

This study involved 36 subjects in each SD and control group. Median(min-max) of age in SD group was 26.5(20-45) yo, male 52.8%, and median(min-max) of BMI was 24.2(18.5-38.8) kg/m2. Median HOMA-IR was significantly higher in SD group compared to the control group (1.54[0.72-4.09] VS. 1.22[0.53-2.73]; p=0.031). However, there was no significant difference for visceral fat rating scale between SD and control group (6.5[1-14] VS. 6.0[1-12]; p=0.149).

Conclusion: The median HOMA-IR and visceral fat rating scale in SD were 1.54 (95%CI 0.72-4.09) and 6.5 (95%CI 1-14). HOMA-IR in SD group is higher to the control group and statistically significant, but there is no significant difference for visceral fat rating scale."

"Rekomendasi pemberian cairan karbohidrat sebelum operasi pada populasi diabetes melitus tipe 2 (DMT2) masih lemah. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian CHO terhadap profil gula darah perioperatif dan resistensi insulin pada populasi DMT2. Penelitian ini merupakan uji klinis acak tersamar ganda yang melibatkan 44 pasien dewasa dengan DMT2 yang menjalani operasi elektif kategori minor. Subjek dibagi menjadi kelompok kontrol dan kelompok CHO. Pencatatan terhadap kadar gula darah (GD) pada empat titik waktu pengukuran, yaitu prabedah, intrabedah, pascabedah, dan 1 hari pascabedah, serta kadar insulin sebelum dan sesudah operasi. Komplikasi yang direkam meliputi kejadian mual, muntah, aspirasi, infeksi, serta pemajangan lama rawat. Kelompok CHO memiliki profil gula darah yang lebih stabil dibandingkan kelompok kontrol (p=0,003) terutama 1 hari pascabedah dengan median lebih rendah (137,5 (79–248) vs. 147,0 (88­–228)). Kelompok kontrol memiliki fluktuasi gula darah signifikan. Resistensi insulin kelompok CHO menurun signifikan dari nilai prabedah (p=0,01). Insiden hiperglikemi sebesar 65% pada kelompok CHO dibanding 45% pada kontrol dengan insiden hipoglikemia 10% pada kelompok kontrol. Tidak ada komplikasi dalam penelitian ini. Pasien DMT2 yang mendapat CHO memiliki profil GD lebih stabil dan penurunan resistensi insulin pascabedah.

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Preoperative carbohydrate loading (CHO) recommendations in type 2 diabetes (T2DM) patients are still controversial. This study aimed to evaluate the effects of CHO towards perioperative blood glucose (BG) and insulin resistance in T2DM underwent elective surgery. Forty-four patients were allocated randomly to control group and CHO group. Blood glucose was examined at four time points: preloading, intraoperative, end of surgery and 1-day post-surgery. Insulin was examined at preloading and end of surgery. Complications recorded including nausea, vomiting, aspiration, infection and prolong hospital stay. The CHO group had a more stable BG compared to control (p=0,003) notably at 1-day post-surgery with lower BG median in CHO (137,5 (79–248) vs. 147,0 (88­–228) while control group had significant BG fluctuation. Insulin resistance trend between group were not statistically significant (p=0,34), however insulin resistance in CHO group was significantly lower compared to preloading (p=0,01). About 65% subjects in CHO group had hyperglycemia compared to 45% in control group. There were 10% subjects with hypoglycemia in control group. There were no complications observed during this study. T2DM patients receiving CHO had more stable perioperative BG profile and could lower insulin resistance due to surgery."