Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 12 dokumen yang sesuai dengan query
cover
Nita
Abstrak :

Penurunan massa otot pada usia lanjut menimbulkan sarkopenia,salah satu penyebabnya adalah proses inflamasi. Rasio asam lemak omega-3/omega-6 dapat memengaruhi proses inflamasi, namun hubungannya dengan massa otot masih menunjukkan hasil yang beragam. Penelitian potong lintang ini bertujuan untuk mengeksplorasi korelasi rasio asupan asam lemak omega-3/omega-6 dan kadar asam lemak omega-3 dengan massa otot pada usia lanjut di lima panti wreda yang terdaftar di Kota Tangerang Selatan. Penelitian ini melibatkan 101 usila yang didapatkan menggunakan proportional random sampling. Rasio asupan asam lemak omega-3 dan omega-6 dinilai menggunakan food record 3x24 jam dan food frequency questionnaire semikuantitatif, kadar asam lemak omega-3 membran eritrosit diukur menggunakan gas chromatography-mass spectrometry, dan pemeriksaan massa otot menggunakan bioelectrical impedance analysis. Analisis korelasi menggunakan uji Spearman. Didapatkan rerata usia subjek adalah 75.5 ± 7.6 tahun dengan 73.3% subjek adalah perempuan. Rasio asupan asam lemak omega-3/omega-6 subjek menggunakan food record adalah 0,09 (0,05-0,22) dan 0,08 (0,05-0,23) menggunakan FFQ semikuantitatif. Nilai tengah kadar asam lemak omega-3 membran eritrosit subjek untuk ALA=10,06 (4,9-24,9) µg/mL, EPA=14,6 (5,06-81,02) µg/mL, DHA=115,5 (20,6-275,09) µg/mL, dan total omega-3=144,1 (89,3-332,1) µg/mL. Nilai tengah massa otot subjek adalah 35,5 (22,8-63,5) kg. Hasil penelitian ini menunjukkan tidak terdapat korelasi antara rasio asupan asam lemak omega-3/omega-6 dengan massa otot baik menggunakan food record (r = -0.2, p = 0.07), maupun FFQ semikuantitatif (r = 0.01, p = 0.9), dan tidak terdapat korelasi antara kadar ALA, EPA, DHA, total asam lemak omega-3 membran eritrosit dengan massa otot berturut-turut (r = -0.03, p = 0.8; r = 0.01, p = 0.9; r = -0.06, p = 0.5; dan r = -0.02, p = 0.8).


The phenomenon of muscle mass deterioration appeared in the elderly called sarcopenia, one of the reasons was the inflammatory process. The ratio of omega-3 and omega-6 fatty acids are known to influence the inflammatory process. However, the relationship of this ratio with muscle mass are still conflicting. This cross-sectional study aimed to explore the correlations of omega-3/omega-6 fatty acids intake ratio and omega-3 fatty acids erythrocyte membrane levels with muscle mass among the elderly in five registered nursing homes in South Tangerang City. This study involved 101 elderly from the proportional random sampling method. The ratio of omega-3 and omega-6 fatty acids intake was assessed using 3-days food records and semi-quantitative food frequency questionnaire (SQ-FFQ). Moreover, omega-3 fatty acid erythrocyte membrane levels were measured using gas chromatography-mass spectrometry and muscle mass were examined using bioelectrical impedance analysis. We used Spearman analysis to investigate the correlation. The mean age of the participants was 75.5 ± 7.6 years and most of the participants were female (73.3%). Furthermore, the median value of omega-3 and omega-6 fatty acid intake ratio was 0.09 (0.05 – 0.22) using 3-days food records and 0.08 (0.05 – 0.23) using SQ-FFQ, the median value of omega-3 erythrocyte membrane levels for ALA = 10.06 (4.9-24.9) µg/mL, EPA = 14.6 (5.06 – 81.02) µg/mL, DHA = 115.5 (20.6 – 275.09) µg/mL, total omega-3 = 144.1 (89.3 – 332.1) µg/mL, and the median value of muscle mass were 35.5 (22.8 – 63.5) kg. We did not find strong correlation between omega-3/omega-6 fatty acids intake ratio and muscle mass using either 3-days food records (r = -0.2, p = 0.07), or SQ-FFQ (r = 0.01, p = 0.9), and no strong correlations found between ALA, EPA, DHA, total omega-3 fatty acids erythrocyte membrane levels and muscle mass (r = -0.03, p = 0.8; r = 0.01, p = 0.9; r = -0.06, p = 0.5; and r = -0.02, p = 0.8), respectively.

Depok: Fakultas Kedokteran Universitas Indonesia, 2020
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Siti Hapsari Mitayani
Abstrak :
Latar Belakang: Sarkopenia merupakan salah satu sindrom geriatri yang dapat menyebabkan luaran yang buruk. Dibutuhkan pemeriksaan yang lebih sederhana dibandingkan Bioelectrical Impedance Analysis (BIA) atau Dual energy X- ray Absorptiometry (DXA) untuk mengukur massa otot sebagai komponen penting sarkopenia. Namun, belum ada studi di Indonesia yang meneliti perannya dalam memprediksi massa otot pada pasien usia 60 tahun atau lebih. Tujuan: Mengetahui performa diagnostik lingkar betis untuk estimasi massa otot sebagai komponen sarkopenia pada pasien usia 60 tahun atau lebih. Metode: Penelitian ini merupakan suatu uji diagnostik menggunakan desain uji potong lintang yang dilakukan di poliklinik geriatri Departemen Ilmu Penyakit Dalam FKUI-RSCM selama bulan April-Juni 2018. Pengukuran massa otot menggunakan DXA dan penentuan titik potong berdasarkan Asian Working Group of Sarcopenia (AWGS). Hasil: Dari 120 subjek didapatkan 46 lelaki (38,3%) dan 74 perempuan (61,7%). Didapatkan titik potong lingkar betis kelompok lelaki dibawah 34 cm (sensitivitas 64.7%, spesifitas 79.3%, NDP 64.7%, NDN 79.3%, AUC 73.1%) dan 29 cm untuk perempuan (sensitivitas 71.4%, spesifitas 95.5%, NDP 62.5%, NDN 97.0%, AUC 96.4%). Simpulan: Akurasi diagnostik lingkar betis cukup baik sebagai prediktor massa otot pada pasien perempuan usia 60 tahun atau lebih.
Background: Sarcopenia is one of the geriatric syndromes that lead to poor outcomes. A simpler method than Bioelectrical Impedance Analysis (BIA) or Dual energy X- ray Absorptiometry (DXA) is needed to measure muscle mass as essential component of sarcopenia. Previous studies have shown calf circumference (CC) as surrogate marker of muscle mass. However there has been no study on the role of CC in predicting muscle mass in both gender of elderly outpatient. Objectives: To investigate the diagnostic performance of CC to estimate muscle mass in elderly outpatient. Methods: A cross sectional study was conducted at Geriatric Outpatient Clinic of Cipto Mangunkusumo Hospital Jakarta during April-June 2018, using DXA as a reference test for measuring muscle mass. Asian Working Group of Sarcopenia (AWGS) criteria was used to classify muscle mass as normal or low. Results: Of the 120 subjects, 46 subjects were male (38.3%) and 74 were female (61.7%).The optimal Cut-off for CC that indicate low muscle mass was 34 cm for (sensitivity 64.7%, specificity 79.3%, PPV 64.7%, NPV 79.3%, AUC 73.1%) and 29 cm for female (sensitivity 71.4%, specificity 95.5%, PPV 62.5%, NPV 97.0%, AUC 96.4%). Conclusion: CC can be used to estimate muscle mass in female elderly outpatient, with good diagnostic performance.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Cipuk Muhaswitri
Abstrak :
Malnutrisi pada kanker nasofaring (KNF) disebabkan oleh peradangan, sel tumor dan efek kemoradioterapi. Malnutrisi dikaitkan dengan penurunan kualitas hidup, fungsi fisik, dan kelangsungan hidup. Pemberian nutrisi pasien KNF yang menjalani radioterapi (RT) memperbaiki status gizi, kapasitas fungsional, dan prognosis keseluruhan. Pasien KNF dengan kaheksia, usia 29 - 67 tahun, tiga pria dan satu wanita yang menjalani kemoradioterapi. Diberikan nutrisi sesuai kebutuhan energi, makronutrien, mikronutrien, dan nutrien spesifik. Pemantauan pasien di awal, hingga RT selesai, pada keluhan terkait terapi, analisis asupan, antropometri, komposisi tubuh, kapasitas fungsional, dan pemeriksaan CRP. Didapatkan penurunan asupan pada empat pasien saat RT, tetapi meningkat lagi pada tiga pasien setelah pemasangan NGT. Satu pasien dengan peningkatan berat badan (BB), sedangkan 3 pasien lainnya BB menurun 2,2-13% pasca RT. Tiga pasien dengan CRP meningkat pada awal RT, tetapi hanya 1 pasien dengan CRP kembali normal. Massa otot meningkat pada 3 pasien setelah RT. Tiga pasien mengalami perbaikan skor ECOG pasca RT, dan satu pasien dengan skor ECOG tetap stabil. Pemasangan NGT dapat mempertahankan asupan pasien. Terapi nutrisi memperbaiki penurunan BB, tetapi tidak terlihat kaitan dengan CRP, massa otot dan kapasitas fungsional karena faktor lain. ......Malnutrition in nasopharyngeal carcinoma (NPC) is induced by inflammation, tumor cells and the effects of chemoradiotherapy. Malnutrition is associated with decrease in quality of life, physical function and survival. Nutritional therapy to NPC who underwent radiotherapy (RT) improves nutritional status, functional capacity, and prognosis. NPC cachexic patients, ages 29 - 67 years, three male and one female, all underwent chemoradiotherapy. Nutrition therapy start with planning of energy, macronutrient, micronutrient and specific nutrients needs. Patients monitoring start from the the beginning, until completed RT, related to therapy, intake analysis, anthropometry, body composition, functional capacity, and C-Reactive Protein (CRP) examination. Decrease intake in four patients during RT, but it increased in three patients after NGT insertion. One patient increase body weight (BW), while other 3 patients dropped BW 2.2-13% post-RT. Three patients increase in CRP at the start of RT, but only 1 CRP patient returned to normal. Muscle mass increased in 3 patients after RT. Three patients had improved ECOG scores after RT, and one patient with ECOG scores remained stable. Insertion of NGT can maintain patient intake. Nutritional therapy maintains BW, but does not appear to be related to CRP, muscle mass and functional capacity due to other factors.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T57667
UI - Tesis Membership  Universitas Indonesia Library
cover
Amanda Trixie Hardigaloeh
Abstrak :
ABSTRAK
Latar Belakang : Malnutrisi merupakan faktor independen yang berhubungan dengan morbiditas, mortalitas dan tingginya biaya pengobatan sirosis hati. Kekuatan Genggam Tangan (KGT) merupakan suatu metode yang sering digunakan untuk mendeteksi malnutrisi dan menilai prognosis pasien. Hubungan KGT dengan Skor Child Pugh (CP) dan massa otot masih dalam kontroversi. Indonesia sampai saat ini belum memiliki data tersebut

Metode : Studi potong lintang pada pasien sirosis hati di poliklinik hepatobilier RSCM dari Februari-Juni 2015. Status nutrisi dinilai berdasarkan KGT. Massa otot diukur menggunakan bioimpedans. Analisis statistik menggunakan uji korelasi spearman

Hasil : Terdapat 115 pasien yang kontrol di poliklinik hepatobilier RSCM, 112 pasien memenuhi kriteria penelitian, terdiri dari 79 laki-laki dan 33 perempuan. Usia pasien rata-rata 54,15±10,55 tahun, median skor CP 6(5-13) dengan median KGT 26(11-50) kgF, rata-rata massa otot 44,43±8,12 kg. Median asupan energi 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalensi malnutrisi berdasarkan KGT ditemukan sebanyak 33%. Kekuatan genggam tangan tidak berkorelasi dengan skor CP (p 0,046, r=-0,19) namun berkorelasi dengan massa otot (p <0,001, r= 0,70) Simpulan Terdapat 33% kasus malnutrisi berdasarkan KGT pada pasien sirosis rawat jalan. KGT tidak berkorelasi dengan skor Child Pugh namun berkorelasi dengan massa otot pasien sirosis hati.ABSTRACT
Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.

Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test.

Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.

Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test.

Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.

Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test.

Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Purwita W Laksmi
Abstrak :
ABSTRACT
Background: the use of bioelectrical impedance analysis (BIA) is affected by the population setting, the type of BIA, and the cut-off point being used. The aim of this study was to determine the diagnostic performance of BIA to measure muscle mass in Indonesian elderly outpatients aged 60 years or more. Methods: a cross-sectional study was conducted at the Geriatric Clinic of Cipto Mangunkusumo Hospital from April to June 2018. The muscle mass was measured using BIA Tanita MC-780MA (Tokyo, Japan) with dual-energy x-ray absorptiometry (DXA) as the reference test. Analysis on the cut-off point was performed based on the Asian Working Group of Sarcopenia (AWGS) criteria and the new cut-off point. Results: from 120 subjects, 74 were female (61.7%). The diagnostic performance of BIA based on AWGS criteria only showed sensitivity and specificity of 79.2% and 66.7%. The diagnostic performance of BIA based on the new cut-off point showed sensitivity and specificity of 75% and 92.7%. The new cut-off point using BIA was found to be <6.9 kg/m2 in males (sensitivity 70.6%; specificity 82.8%) and <5 kg/m2 in females (sensitivity 85.7%; specificity 97%). Conclusion: the diagnostic performance of BIA Tanita MC-780MA (Tokyo, Japan) was good to measure muscle mass in Indonesian elderly outpatients using a new cut-off point of <6.9 kg/m2 for males and <5 kg/m2 for females.
Jakarta: University of Indonesia. Faculty of Medicine, 2019
610 UI-IJIM 51:2 (2019)
Artikel Jurnal  Universitas Indonesia Library
cover
Dian Novianti
Abstrak :
Latar Belakang: Obesitas merupakan kondisi inflamasi kronik yang dapat mengakibatkan penurunan massa otot dan kekuatan genggam tangan. Salah satu nutrisi yang berperan untuk meningkatkan sintesis protein dan menurunkan degradasi protein, yaitu eicosapentaenoic acid (EPA). Penelitian ini bertujuan untuk melihat korelasi antara asupan EPA dengan massa otot dan kekuatan genggam tangan pada karyawan kantoran dengan obesitas. Metode: Penelitian potong lintang ini dilakukan pada subjek karyawan kantoran dengan obesitas. Asupan EPA dinilai dengan food frequency questionnaire semi kuantitatif. Massa otot diukur dengan menggunakan multifrequency bioelectrical impedance analysis. Sedangkan, kekuatan genggam tangan diukur menggunakan electric dynamometer. Hasil: Penelitian ini mencakup 41 subjek penelitian yang memiliki median usia 35 (21-56) tahun dengan jumlah subjek perempuan lebih banyak dibandingkan dengan subjek laki-laki. Subjek penelitian dengan obesitas derajat 1 sebanyak 16 orang (39%) dan obesitas derajat 2 sebanyak 25 orang (61%). Subjek memiliki rerata asupan EPA sebesar 152,3±64,64 mg. Subjek penelitian memiliki median massa otot sebesar 19,8 (15,3-46,5) kg dan median kekuatan genggam tangan sebesar 24,5 (17,8-42,9) kg. Penelitian ini mendapatkan nilai koefisien korelasi cukup dan signifikan antara asupan EPA dengan massa otot (r=0,335, p=0,032). Sedangkan, tidak didapatkan korelasi yang bermakna antara asupan EPA dengan kekuatan genggam tangan. Kesimpulan: Terdapat korelasi bermakna antara asupan EPA dengan massa otot pada karyawan kantoran dengan obesitas. Namun, tidak didapatkan korelasi antara asupan EPA dengan kekuatan genggam tangan. ......Background: Obesity is a chronic inflammatory condition that can lead to decrease muscle mass and handgrip strength. One of the nutrients that plays role in increasing protein synthesis and reducing protein degradation is eicosapentaenoic acid (EPA). This study aims to investigate the correlation between EPA intake with muscle mass and handgrip strength in office workers with obesity. method: This cross-sectional study was conducted on the subject of office workers with obesity. EPA intake was assessed with semi-quantitative food frequency questionnaire. Muscle mass was measured using a multifrequency bioelectrical impedance analysis. Meanwhile, handgrip strength was measured using a electric dynamometer Results: This study included fourty one subjects with a median age of 35 (21-56) years old, mostly were female subjects. There were 16 people with obesity grade 1 (39%) and 25 people with obesity grade 2 (61%). Average EPA intake was 152,3±64,64 mg. The subjects had a median muscle mass of 19,8 (15,3-46,5) kg and median handgrip strength of 24,5 (17,8-42,9) kg. There was adequate correlation between EPA intake and muscle mass (r=0,335, p=0,032). There was no significant correlation between EPA intake and handgrip strength Conclusion: There was a significant correlation between EPA intake muscle mass in office workers with obesity. However, there was no correlation between EPA intake and handgrip strength.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Karina Rahmah Ayu Anggrenani
Abstrak :
Kanker kolorektal diketahui berhubungan dengan massa otot yang rendah. Massa otot yang rendah dihubungkan dengan luaran klinis yang buruk. Telah diketahui bahwa asupan protein adalah salah satu faktor yang berperan dalam mempertahankan massa otot. Namun, studi-studi yang ada mengenai efek pemberian protein tinggi pada pasien kanker kolorektal terhadap massa otot belum dapat disimpulkan karena kurangnya bukti dari penelitian berkualitas baik dan intervensi pada studi yang berbeda-beda. Tujuan dari penelitian ini adalah untuk mengetahui korelasi antara asupan protein dengan indeks massa otot skelet pada pasien kanker kolorektal yang dirawat inap di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo (RSCM). Penelitian menggunakan desain potong lintang pada subjek dewasa kanker kolorektal yang dirawat inap di RSCM. Asupan protein dinilai menggunakan multiple 24 hour recall. Indeks massa otot skelet didapatkan dari pengukuran massa otot skelet dalam kilogram menggunakan BIA multifrequency, lalu dibagi dengan tinggi badan dalam meter yang dikuadratkan. Sebanyak 52,5% subjek berjenis kelamin perempuan dan 50% subjek berada pada stadium IV. Terapi yang paling banyak telah dijalani subjek adalah kombinasi pembedahan dan kemoterapi (n=16, 40%). Tidak ditemukan korelasi antara asupan protein dan indeks massa otot skelet (r = -0,04, P=0,795). ......Colorectal cancer is known to be associated with low muscle mass. Low muscle mass is associated with poor clinical outcome. It is known that protein intake is one of the factors that play a role in maintaining muscle mass. However, the existing studies on the effect of administering high protein in colorectal cancer patients on muscle mass have not been definitively concluded due to the lack of evidence from good quality studies and differences of intervention in existing studies. The purpose of this study was to determine the correlation between protein intake and skeletal muscle mass index in colorectal cancer patients who were hospitalized at the RSUPN Dr. Cipto Mangunkusumo (RSCM). The study used a cross-sectional design on adult subjects with colorectal cancer who were hospitalized at RSCM. Protein intake was assessed using multiple 24 hour recalls. Skeletal muscle mass index was obtained from the measurement of skeletal muscle mass in kilograms using BIA multifrequency, then divided by height in meters squared. A total of 52.5% of the subjects were female and 50% of the subjects were in stage IV. The most common therapy that the subject had undergone was a combination of surgery and chemotherapy (n=16, 40%). No correlation was found between protein intake and skeletal muscle mass index (r = -0.04, P=0.795).
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Prasetya Ismail Permadi
Abstrak :
Latar belakang: Pasien Talasemia Mayor (TM) anak menderita defisiensi nutrisi karena asupan nutrisi yang tidak mencukupi. Penghindaran makanan kaya zat besi seringkali bersamaan dengan pembatasan asupan protein. Asupan mikronutrien termasuk magnesium lebih rendah dibandingkan anak normal. Fungsi otot lebih awal terganggu akibat defisiensi nutrisi daripada massa otot. Penilaian massa otot dan Hand Grip Strength (HGS) menjadi penting untuk mengevaluasi status gizi. Hingga saat ini belum ada penelitian di Indonesia yang mengevaluasi hubungan antara HGS dengan asupan kalori, protein dan magnesium, LILA dan massa otot pasien anak TM. Metode: Penelitian dengan desain studi potong lintang melibatkan 70 pasien TM anak, berusia 6-18 tahun di Pusat Talasemia RSUPN Cipto Mangunkusumo. Status gizi dievaluasi disertai pengukuran lingkar lengan atas (LILA). Asupan kalori, protein dan magnesium diperoleh melalui metode analisis diet semi-kuantitatif Food Frequency Questionnaires (FFQ) dan Magnesium FFQ (MgFFQ). Kadar Mg serum dinilai dengan menggunakan metode enzimatik-kalorimetri. Massa otot diukur menggunakan Bioelectrical Impedance Analysis (BIA) dan HGS dinilai menggunakan Dinamometer tangan Jamar Hasil: Status gizi berdasarkan LILA/U sebagian besar berstatus gizi baik 42,9% dan malnutrisi 57,1% yakni gizi kurang (30,0%), gizi buruk (25,7%), dan obesitas (1,4%). Rerata kecukupan energi pada anak TM lelaki 100% (SB 17), sedangkan anak perempuan sebesar 112% (SB 27). Rerata asupan protein dan magnesium pada kedua kelompok lebih tinggi dibanding kebutuhan AKG. HGS berkorelasi kuat dengan massa otot (r=0,82), berkorelasi sedang dengan LILA (r=0,60), dan berkorelasi lemah dengan asupan kalori (r=-0,27), protein (r=-0,33) dan magnesium (r=-0,23), serta kadar magnesium (r=0,26). Hipermagnesemia dijumpai pada 23% subyek penelitian. Simpulan: Lebih dari separuh anak Talasemia mengalami malnutrisi walaupun asupan cukup. HGS berkorelasi dengan asupan nutrisi, LILA, dan massa otot. ......Background: Pediatric Thalassemia Major (TM) patients suffer from nutritional deficiencies due to insufficient nutritional intake. Avoidance of iron-rich foods often coincides with limiting protein intake. Micronutrient intake including magnesium is lower than in normal children. Muscle function is impaired earlier due to nutritional deficiencies than muscle mass. Assessment of muscle mass and Hand Grip Strength (HGS) is important for evaluating nutritional status. Until now there has been no research in Indonesia that evaluates the relationship between HGS and calorie, protein, and magnesium intake, LILA, and muscle mass in pediatric TM patients. Methods: This research with a cross-sectional study design involved 70 pediatric TM patients, aged 6-18 years at the Thalassemia Center of RSUPN Cipto Mangunkusumo. Nutritional status is evaluated by measurement of mid-upper arm circumference (MUAC). Calorie, protein, and magnesium intake was obtained through semi- quantitative dietary analysis methods Food Frequency Questionnaires (FFQ) and Magnesium FFQ (MgFFQ). Serum Mg levels were assessed using the enzymatic calorimetric method. Muscle mass was measured using Bioelectrical Impedance Analysis (BIA) and HGS was assessed using a Jamar hand dynamometer. Results: Nutritional status based on LILA/U was mostly good nutritional status 42.9% and malnutrition 57.1%, namely undernutrition (30.0%), poor nutrition (25.7%), and obesity (1.4%). The average energy adequacy for TM boys is 100% (SD 17), while for girls it is 112% (SD 27). The average intake of protein and magnesium in both groups was higher than the RDA requirements. HGS is strongly correlated with muscle mass (r=0.82), moderately correlated with LILA (r=0.60), and weakly correlated with calorie intake (r=-0.27), protein (r=-0.33), and magnesium (r=-0.23), as well as magnesium levels (r=0.26). Hypermagnesemia was found in 23% of study subjects. Conclusion: More than half of Thalassemia children experience malnutrition despite adequate intake. HGS correlates with nutritional intake, MUAC, and muscle mass.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Rizka Hanifa
Abstrak :
Latar Belakang: Diperkirakan 20-40% pasien kanker mengalami metastasis ke sistem saraf pusat (SSP). Kondisi inflamasi sistemik pada kanker yang dimediasi sitokin berkaitan dengan penurunan massa otot. Pada kondisi inflamasi, sel hepatosit terstimulasi untuk memproduksi protein fase akut c-reative protein (CRP). Kadar CRP di sirkulasi mengalami peningkatan pada lebih dari 50% pasien keganasan. CRP diperkirakan berhubungan dengan penurunan massa otot dan menjadi prediktor dini dalam kehilangan jaringan lean. Penelitian ini dilakukan untuk mengetahui hubungan kadar CRP dengan indeks massa otot skeletal (skeletal muscle mass index, SMI) pada pasien metastasis SSP. Metode: Penelitian ini adalah studi potong lintang pada pasien kanker dengan metastasis SSP di RSCM. Karakteristik subjek berupa usia, jenis kelamin, tipe metastasis, lokasi tumor primer, defisit neurologis, status performa Karnofsky, penyakit komorbid, penyakit infeksi, terapi glukokortikoid, sedang menjalani kemoterapi, radioterapi, dan tindakan bedah, indeks massa tubuh (IMT), status gizi berdasarkan IMT dan kriteria ASPEN, asupan energi, asupan protein, kadar CRP, dan nilai SMI. Dilakukan analisis hubungan kadar CRP dengan SMI. Hasil: Terdapat 57 pasien yang mengalami metastasis SSP. Mayoritas subjek perempuan (56,1%). Median usia 47 tahun. Lokasi metastasis lebih banyak ditemukan di otak (56,1%), tipe metastasis berdasarkan lokasi susunan saraf terbanyak adalah sinkronus (86%), seluruh subjek merupakan oligometastasis, dan lokasi tumor primer mayoritas berasal dari nasofaring (17,5%), payudara (15,8%), dan paru (14%). Defisit neurologis terbanyak yaitu nyeri kanker (68,4%), nyeri kepala (56,1%), dan kelemahan anggota gerak (43,9%). Kelemahan anggota gerak mayoritas hemiparesis (22,8%). Sebagian besar status performa Karnofsky pasien terganggu sedang (45,6%), 63,2% subjek tidak memiliki penyakit komorbid, 68,4% tidak memiliki penyakit infeksi, 52,6% tidak dalam terapi glukokortikoid, 75,4% subjek tidak sedang menjalani kemoterapi, masing-masing 1,8% subjek sedang menjalani radioterapi dan tindakan bedah. Rerata IMT estimasi 21,28 kg/m2 dan mayoritas status gizi berdasarkan IMT estimasi adalah berat badan normal (43,9%). Berdasarkan kriteria ASPEN, mayoritas termasuk malnutrisi sedang (49,1%) dan berat (31,6%). Rerata asupan energi 19 kkal/kgBB dan median asupan protein 0,6 g/kgBB. Median kadar CRP 46,6 mg/L dan 96,5% subjek mengalami peningkatan kadar CRP. Rerata SMI seluruh subjek yaitu 6,17 kg/m2, rerata SMI laki-laki 7,2 kg/m2 sedangkan rerata SMI perempuan 5,4 kg/m2. Terdapat korelasi negatif lemah (r=-0,373) yang bermakna secara statistik (p=0,005) antara kadar CRP dengan SMI pasien metastasis SSP . Kesimpulan: Terdapat korelasi yang bermakna antara kadar CRP dengan SMI pada pasien metastasis SSP. ......Background: It is estimated that 20-40% of cancer patients experience metastases to the central nervous system (CNS). Systemic inflammatory conditions in cancer mediated by cytokines are associated with a decrease in muscle mass. In inflammatory conditions, hepatocyte cells are stimulated to produce the acute-phase protein called c-reactive protein (CRP). Circulating CRP levels increase in over 50% of cancer patients. CRP is believed to be related to a decrease in muscle mass and serves as an early predictor in lean tissue loss. This study was conducted to determine the relationship between CRP levels and the skeletal muscle mass index (SMI) in patients with CNS metastases. Methods: This study is a cross-sectional study on cancer patients with CNS metastases at RSCM. Subject characteristics include age, gender, metastases type, primary tumor location, neurological deficits, Karnofsky performance status, comorbidities, infectious diseases, glucocorticoid therapy, undergoing chemotherapy, radiotherapy, and surgery, body mass index (BMI), nutritional status based on BMI and ASPEN criteria, energy intake, protein intake, CRP levels, and skeletal muscle mass index (SMI). An analysis of the relationship between CRP levels and SMI was conducted. Results: There were 57 patients with CNS metastases. Most subjects were female (56.1%). The median age was 47 years. Metastases was more commonly found in the brain (56.1%), and the most common type of metastasis based on the nervous system location was synchronous (86%). All subjects had oligometastasis, and most primary tumor locations were in the nasopharynx (17.5%), breast (15.8%), and lungs (14%). The most common neurological deficits were cancer pain (68.4%), headaches (56.1%), and limb weakness (43.9%). Most limb weakness was hemiparesis (22.8%). Most Karnofsky performance status was moderately impaired (45.6%), 63.2% had no comorbidities, 68.4% had no infectious diseases, 52.6% were not on glucocorticoid therapy, 75.4% were not undergoing chemotherapy, and 1.8% each were undergoing radiotherapy and surgery. The estimated mean BMI was 21.28 kg/m2, with the majority having a normal weight (43.9%). According to ASPEN criteria, the majority were moderately malnourished (49.1%) and severely malnourished (31.6%). The mean energy intake was 19 kcal/kgBW, and the median protein intake was 0.6 g/kgBW. The median CRP level was 46.6 mg/L, with 96.5% of subjects experiencing an increased CRP level. The mean SMI for all subjects was 6.17 kg/m2, with male subjects having a mean SMI of 7.2 kg/m2 and female subjects having a mean SMI of 5.4 kg/m2. There was a weak negative correlation (r=- 0.373) that was statistically significant (p=0.005) between CRP levels and SMI in patients with CNS metastases. Conclusion: CRP levels are correlated with SMI in patients with CNS metastasis. Higher CRP levels are associated with lower SMI in patients with CNS metastases.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Prasetya Ismail Permadi
Abstrak :
Latar belakang: Pasien Talasemia Mayor (TM) anak menderita defisiensi nutrisi karena asupan nutrisi yang tidak mencukupi. Penghindaran makanan kaya zat besi seringkali bersamaan dengan pembatasan asupan protein. Asupan mikronutrien termasuk magnesium lebih rendah dibandingkan anak normal. Fungsi otot lebih awal terganggu akibat defisiensi nutrisi daripada massa otot. Penilaian massa otot dan Hand Grip Strength (HGS) menjadi penting untuk mengevaluasi status gizi. Hingga saat ini belum ada penelitian di Indonesia yang mengevaluasi hubungan antara HGS dengan asupan kalori, protein dan magnesium, LILA dan massa otot pasien anak TM. Metode: Penelitian dengan desain studi potong lintang melibatkan 70 pasien TM anak, berusia 6-18 tahun di Pusat Talasemia RSUPN Cipto Mangunkusumo. Status gizi dievaluasi disertai pengukuran lingkar lengan atas (LILA). Asupan kalori, protein dan magnesium diperoleh melalui metode analisis diet semi-kuantitatif Food Frequency Questionnaires (FFQ) dan Magnesium FFQ (MgFFQ). Kadar Mg serum dinilai dengan menggunakan metode enzimatik-kalorimetri. Massa otot diukur menggunakan Bioelectrical Impedance Analysis (BIA) dan HGS dinilai menggunakan Dinamometer tangan Jamar. Hasil: Status gizi berdasarkan LILA/U sebagian besar berstatus gizi baik 42,9% dan malnutrisi 57,1% yakni gizi kurang (30,0%), gizi buruk (25,7%), dan obesitas (1,4%). Rerata kecukupan energi pada anak TM lelaki 100% (SB 17), sedangkan anak perempuan sebesar 112% (SB 27). Rerata asupan protein dan magnesium pada kedua kelompok lebih tinggi dibanding kebutuhan AKG. HGS berkorelasi kuat dengan massa otot (r=0,82), berkorelasi sedang dengan LILA (r=0,60), dan berkorelasi lemah dengan asupan kalori (r=-0,27), protein (r=-0,33) dan magnesium (r=-0,23), serta kadar magnesium (r=0,26). Hipermagnesemia dijumpai pada 23% subyek penelitian. Simpulan: Lebih dari separuh anak Talasemia mengalami malnutrisi walaupun asupan cukup. HGS berkorelasi dengan asupan nutrisi, LILA, dan massa otot. ......Background: Pediatric Thalassemia Major (TM) patients suffer from nutritional deficiencies due to insufficient nutritional intake. Avoidance of iron-rich foods often coincides with limiting protein intake. Micronutrient intake including magnesium is lower than in normal children. Muscle function is impaired earlier due to nutritional deficiencies than muscle mass. Assessment of muscle mass and Hand Grip Strength (HGS) is important for evaluating nutritional status. Until now there has been no research in Indonesia that evaluates the relationship between HGS and calorie, protein, and magnesium intake, LILA, and muscle mass in pediatric TM patients. Methods: This research with a cross-sectional study design involved 70 pediatric TM patients, aged 6-18 years at the Thalassemia Center of RSUPN Cipto Mangunkusumo. Nutritional status is evaluated by measurement of mid-upper arm circumference (MUAC). Calorie, protein, and magnesium intake was obtained through semi- quantitative dietary analysis methods Food Frequency Questionnaires (FFQ) and Magnesium FFQ (MgFFQ). Serum Mg levels were assessed using the enzymatic calorimetric method. Muscle mass was measured using Bioelectrical Impedance Analysis (BIA) and HGS was assessed using a Jamar hand dynamometer. Results: Nutritional status based on LILA/U was mostly good nutritional status 42.9% and malnutrition 57.1%, namely undernutrition (30.0%), poor nutrition (25.7%), and obesity (1.4%). The average energy adequacy for TM boys is 100% (SD 17), while for girls it is 112% (SD 27). The average intake of protein and magnesium in both groups was higher than the RDA requirements. HGS is strongly correlated with muscle mass (r=0.82), moderately correlated with LILA (r=0.60), and weakly correlated with calorie intake (r=-0.27), protein (r=-0.33), and magnesium (r=-0.23), as well as magnesium levels (r=0.26). Hypermagnesemia was found in 23% of study subjects. Conclusion: More than half of Thalassemia children experience malnutrition despite adequate intake. HGS correlates with nutritional intake, MUAC, and muscle mass.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
<<   1 2   >>