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"Tujuan : Mengetahui pengaruh suplementasi vitamin B6, B12 dan asam folat terhadap kadar homosistein plasma pada lansia dalam rangka mengurangi risiko terjadinya aterosklerosis.Tempat : Panti werdha Santa Anna - Jakarta.Bahan dan cara : penelitian eksperimental pra dan pasca suplementasi vitamin B6 (10 mg), B12 (400 µg) dan asam folat (1 mg) yang diberikan per oral, sekali sehari selama 6 minggu, terhadap 10 subyek lansia (60 tahun) yang telah memenuhi kriteria penerimaan dan penolakan. Data yang dikumpulkan meliputi data non nutrisi, data nutrisi, data antropametri, status vitamin B6, kadar vitamin B12 serum dan asam folat serum dan kadar homosistein plasma.Hasil : Pada pra suplementasi, diketahui prevalensi subyek dengan hiperhomosisteinemia tipe ringan sebesar 70%. Prevalensi defisiensi vitamin B6 (KA ASATE>I,40), 812 (<258 pmol/L) dan asam folat (<15 nmo/L) adalah 30%,30% dan 90%. Prevalensi defisiensi vitamin B6, B12 dan asam folat pada subyek dengan hiperhomosisteinemia adalah 14%, 43% dan 85%. Pada pasca suplementasi didapatkan perbaikan pada seluruh hasil pemeriksaan laboratorium secara bermakna (p<0,05) yaitu penurunan KA ASATE 11,68%, kenaikan kadar vitamin B12 serum 111,75%, kenaikan kadar asam folat serum 139,05% dan penurunan kadar homosistein plasma 36,68%.Kesimpulan : Suplementasi vitamin B6, B12 dan asam folat terbukti secara efektif dan elision dapat memperbaiki status vitamin dan menurunkan kadar homosistein plasma secara bermakna pada seluruh subyek penelitian.

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Objective : To identify the effect of vitamin B6, B12 and folate supplementation to plasma homocysteine concentration of elderly people in respect of minimizing atherosclerosis risks.Place :Panri werdha Santa Anna - Jakarta.Materials and Methods :Experimental study of pre and post oral supplementation of vitamin B6 (10 mg), B12 (400 }1g) and folate (1 mg), once a day for 6 weeks continuously applied to 10 elderly subjects NO years) passing through pre-defined inclusion criteria. Relevant information and data was collected through questionnaire, field observation and laboratory measurement which comprise of ages, sex, education, anthropometrics, dietary intake, food frequency amount, food habits, vitamin B6, B12 and folate status and finally plasma homocysteine concentration.Results :During pre-supplementation, 70% of subjects was classified as moderate hyperhomocysteinemia. Cut off points to define deficiency vitamin status are erytrocyte aspartate aminotransferase activity coefficient (EAST-AC) >1,40 for vitamin B6 , serum vitamin B12 and folate concentrations were <258 pmol/L and <15 nmol/L respectively. The overall prevalence of deficiencies vitamin B6, B12 and folate status were 30%, 30% and 90% respectively. The prevalence of deficiencies vitamin B6, B12 and folate status in hyperhomocysteinemia subjects were 14%, 43% and 85% respectively. During post supplementation, no more vitamins deficiencies subjects was detected. Post supplementation laboratory measurement indicate the following significant improvement (p<0,05) on EAST-AC reduction 11,68%, serum vitamin B12 concentration improvement to 111,75%, serum folate concentration improvement to 139,05% and reduction of plasma homocysteine concentration of 36,68%.Conclusion :Supplementation of vitamin B6, B12 and folate are effectively and significantly improve both vitamin status and plasma homocysteine concentration level of all subjects."

"Anak sakit kritis pascabedah memiliki risiko mengalami malnutrisi. Terapi nutrisi optimal mampu mencegah morbiditas dan menurunkan mortalitas. Asupan protein yang adekuat mempercepat tercapainya anabolisme. Saat ini belum ada data yang tersedia mengenai pengaruh suplementasi protein enteral terhadap imbang nitrogen dan kadar Intestinal Fatty Acid Binding Protein (I-FABP). Penelitian ini bertujuan untuk menganalisis apakah peningkatan asupan protein nutrisi enteral berhubungan dengan perbaikan imbang nitrogen dan penurunan kadar serum I-FABP pada anak sakit kritis pascabedah. Penelitian ini merupakan uji klinis acak terkontrol dengan penyamaran ganda, melibatkan anak sakit kritis pascabedah usia 1-5 tahun yang mendapat nutrisi enteral dini. Total 76 subjek dibagi menjadi dua kelompok: kelompok dengan protein standar (3,0 g/100 mL) dan kelompok dengan protein tinggi (4,35 g/100 mL). Penilaian imbang nitrogen dilakukan 24 jam pertama dan ketiga setelah pemberian nutrisi enteral, sedangkan kadar I-FABP diperiksa sebelum dan sesudah 72 jam nutrisi enteral. Terjadi peningkatan signifikan rerata imbang nitrogen pada kelompok protein tinggi 283,4 (SB 82,5) mg/kg/hari, dibandingkan kelompok protein standar dengan nilai 114,7 (SB 53) mg/kg/hari (p<0,0001). Tidak terjadi penurunan signifikan kadar I-FABP pada kelompok peningkatan imbang nitrogen di atas rerata dibandingkan kelompok peningkatan imbang nitrogen di bawah rerata. Pemberian suplementasi enteral protein tinggi meningkatkan imbang nitrogen pada anak sakit kritis pascabedah tanpa efek samping yang merugikan.

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Critically ill post-surgical children are at risk of malnutrition. Optimal nutritional therapy can prevent morbidity and reduce mortality. Adequate protein intake accelerates the achievement of anabolism. Currently, no data is available regarding the effect of enteral protein supplementation on nitrogen balance and levels of Intestinal Fatty Acid Binding Protein (I- FABP). This study aims to analyze whether increasing protein intake in enteral nutrition is associated with improved nitrogen balance and reduced serum I-FABP levels in critically ill post-surgical children. This was a double-blind, randomized controlled trial involving critically ill post-surgical children aged 1 to 5 years who were receiving early enteral nutrition. A total of 76 subjects were divided into two groups: the standard protein group (3.0 g/100 mL) and the high-protein group (4.35 g/100 mL). Nitrogen balance was assessed on the first and third days, while I-FABP levels were examined before and after 72 hours of enteral feeding. There was a significant increase in the average nitrogen balance in the high protein group, 283.4 (SD 82.5) mg/kg/day, compared to the standard protein group, 114.7 (SD 53) mg/kg/day, with p<0.0001. There was no significant decrease in I-FABP levels in the group with nitrogen balance improvement above the average compared to the group with nitrogen balance improvement below the average. High-protein enteral supplementation improves nitrogen balance in critically ill post-surgical children without adverse side effects."