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Andriyani
Efek α-mangostin terhadap fungsi ginjal dan kadar asam urat dalam plasma darah tikus model resistensi insulin: Kajian pada ekspresi transporter URAT1, GLUT9 dan SGLT2 = Effect of α-mangostin on kidney function and plasma uric acid level of insulin resistance rat model: Focus on URAT1, GLUT9 and SGLT2 transporters expression.
"Pendahuluan: Hiperurisemia sering terjadi pada pasien DM tipe 2, hal ini disebabkan adanya penurunan ekskresi asam urat yang berkaitan dengan resistensi insulin (RI) dan hiperinsulinemia. Tujuan dari penelitian ini adalah untuk mengetahui efek α-mangostin terhadap fungsi ginjal dan kadar asam urat dalam plasma darah tikus model resistensi insulin.
Metode: Tikus jantan galur wistar dibagi menjadi 6 kelompok secara acak: normal, normal yang diberi α-mangostin 200 mg/kgBB, RI, RI yang diberi metformin 200 mg/kgBB, RI yang diberi α-mangostin 100 mg/kgBB dan RI yang diberi α- mangostin 200 mg/kgBB. Pemberian α-mangostin dan metformin dilakukan selama 8 minggu dan diberikan secara peroral. Kelompok perlakuan diberi diet tinggi lemak, glukosa 20% dan induksi STZ dosis rendah. Pada akhir penelitian, sampel urin, darah dan ginjal diambil dan diukur proteinuria, BUN, klirens kreatinin, asam urat plasma, transporter URAT1, GLUT9, SGLT2 dan histopatologi ginjal.
Hasil: α-mangostin 100 mg/kgBB dan 200 mg/kgBB mampu menurunkan BUN dan asam urat plasma secara signifikan, α-mangostin 100 mg/kgBB dan 200 mg/kgBB cenderung menurunkan proteinuria, meningkatkan klirens kreatinin, menurunkan ekspresi URAT1, GLUT9, SGLT2 serta memperbaiki kerusakan ginjal dibandingkan dengan kelompok RI tanpa pengobatan.
Kesimpulan: α-mangostin 100 mg/kgBB dan 200 mg/kgBB mampu menurunkan kadar asam urat plasma dan cenderung memperbaiki fungsi ginjal pada tikus model RI.
......Background: Hyperuricemia often occurs in type 2 diabetes mellitus, this is due to a decrease in uric acid excretion associated with insulin resistance (IR) and hyperinsulinemia. The aim of this study was to analyze the effects of α-mangostin on kidney function and plasma uric acid level of insulin resistance rat model.
Method: Wistar male rats were divided into 6 groups, such as normal, normal + α- mangostin 200 mg/kgBW, IR, IR + metformin 200 mg/kgBW, IR + α-mangostin 100 mg/kgBW and IR + 200 mg/kgBW. -mangostin and metformin were administered by gavage for 8 weeks. To induce IR, treatment groups were given a high-fat diet, glucose 20%, and low-dose injection of STZ. At the end of the study, urine, blood, and kidney tissue were taken and measured proteinuria, BUN, creatinine clearance, plasma uric acid, expressions of URAT1, GLUT9, and SGLT2 as well as kidney histopathology
Results: -mangostin 100 mg/kgBW and 200 mg/kgBW were able to significantly reduce BUN and plasma uric acid levels. -mangostin 100 mg/kgBW and 200 mg/kgBW tended to reduce proteinuria, increase creatinine clearance, reduce the expression of URAT1, GLUT9, SGLT2, as well as improve renal damage compared to that of IR untreated group.
Conclusion: -mangostin 100 mg/kgBW and 200 mg/kgBW were able to reduce plasma uric acid levels dan tended to alleviate renal dysfunction in IR rat model."
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tesis Membership  Universitas Indonesia Library
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Zaenal Hakiki Fiantoro
Hubungan Resistensi Insulin dengan Kejadian Metastasis pada Kanker Payudara = Corelation between Insulin Resistance and the Event of Metastasis in Breast Cancer.
"Latar Belakang/Tujuan. Angka kematian dan kejadian metastasis kanker payudara cukup tinggi. Faktor metabolik termasuk resistensi insulin mempunyai peranan terhadap progresivitas kanker payudara namun terdapat hanya sedikit penelitian yang menilai hubungan resistensi insulin dengan kejadian metastasis kanker payudara. Terdapat hubungan yang erat antara beberapa variabel dalam kelompok pasca-menopause terhadap kejadian metastasis, pemberian terapi hormonal aromatase inhibitor dan kemoterapi terhadap nilai HOMA-IR. Mengetahui hubungan resistensi insulin yang dinilai menggunakan nilai homeostatic model assessment for insulin resistance (HOMA-IR) dengan kejadian metastasis kanker payudara.
Metode. Studi potong lintang yang meneliti 150 pasien kanker payudara di Rumah Sakit Cipto Mangunkusumo (RSCM) dan Rumah Sakit Siloam Mochtar Riady Comprehensive Cancer Centre (MRCCC) Jakarta dalam rentang waktu agustus 2019-april 2020. Terdapat 150 subjek penelitian, nilai titik potong HOMA-IR ditentukan dengan kurva receiver operating curve (ROC). Dilakukan analisis subgrup kelompok pasca menopause terhadap metastasis, terapi hormonal dan kemoterapi terhadap HOMA-IR.
Hasil. Tidak didapatkan nilai titik potong optimal HOMA-IR terhadap kejadian metastasis (Area under curve (AUC) 0,50, P : >0,05, interval kepercayaan (IK) 95% : 0,406-0,593). Tidak terdapat hubungan bermakna variabel pasca-menopause dengan kejadian metastasis dan kemoterapi terhadap nilai HOMA-IR. Terdapat hubungan bermakna pemberian terapi hormonal aromatase inhibitor terhadap peningkatan nilai HOMA-IR, P : <0,01
Simpulan. Tidak terdapat hubungan yang bermakna antara resistensi insulin dengan kejadian metastasis pada pasien kanker payudara.
......Background/Purpose. Mortality and incidence rate of metastatic breast cancer is quite high.
Metabolic factors including insulin resistance have a role in the progression of breast cancer,
but there are only a few studies that assess the relationship of insulin resistance with the incidence of breast cancer metastases. There is a close relationship between variables in the postmenopausal group for the occurrence of metastases, administration of hormonal aromatase inhibitors and chemotherapy to the value of HOMA-IR. Knowing the relationship of insulin resistance which was assessed using the value of
the homeostatic model assessment for insulin resistance (HOMA-IR) with the incidence of metastatic breast cancer.
Method. A cross-sectional study examining 150 breast cancer patients at Cipto Mangunkusumo General Hospital and Siloam Hospital Mochtar Riady Comprehensive Cancer Center Jakarta in August 2019-April 2020. There are 150 subjects research, the HOMA-IR cutoff value is determined by the receiver operating curve (ROC) curve. Postmenopausal subgroups were analyzed for metastases, hormonal therapy and chemotherapy for HOMA-IR.
Results. There was no optimal HOMA-IR cut off value for metastatic events (Area under curve (AUC) 0.50,
P:> 0.05, 95% confidence interval (IK): 0.406-0.593). There was no significant relationship between postmenopausal variables with the incidence of metastasis and chemotherapy on the value of HOMA-IR. There was a significant
relationship between the administration of hormonal aromatase inhibitor therapy to the increase of HOMA-IR value, P: <0.01"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tesis Membership  Universitas Indonesia Library
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Irena Ujianti
Dampak restriksi vitamin B12 terhadap kadar homosistein, homa-ir dan gambaran histopatologi perlemakan hati non alkoholik pada tikus = Impact of vitamin B12 restriction on homocysteine levels, insulin resistance and nafld on rats
"Nama : Irena UjiantiProgram Studi : Program Magister Ilmu BiomedikJudul Tesis :Dampak Restriksi Vitamin B12 Terhadap Kadar Homosistein, Resistensi Insulin Dan Gambaran NAFLDPembimbing : dr. Imelda Rosalyn Sianipar, M.Biomed, Ph.D dan Dr. dr. Dewi Irawati Soeria Santoso, MS Latar Belakang: Perlemakan hati merupakan penyakit hati kronik terbesar di dunia. Kondisi yang mendasari terjadinya perlemakan hati dimulai dari kondisi resistensi insulin. Salah satu patogenesis terjadinya resistensi insulin adalah gangguan pada pensinyalan insulin oleh zat toksik tertentu yang akan berinteraksi dengan protein yang menyusun jalur pensinyalan insulin. Peningkatan homosistein dikaitkan dengan resistensi insulin. Homosistein akan meningkat sejalan dengan terganggunya jalur metilasi dari siklus metionin. Pemberian diet restriksi vitamin B12 akan memicu terjadinya resistensi insulin lewat jalur stres oksidatif yang ditimbulkan oleh homosistein.Bahan dan Metode: Penelitian ini menggunakan metode eksperimental terhadap 24 tikus Sprague Dawley jantan Rattus norvegicus, 300-350 gram, usia 35-40 minggu , terbagi ke dalam 4 kelompok yaitu kontrol K , Kelompok perlakuan 4 minggu P-1 , Kelompok Perlakuan 8 minggu P-2 dan kelompok perlakuan 12 minggu P-3 . Pada Kelompok kontrol, diberikan diet standar AIN-93M sedangkan kelompok perlakuan diberikan pakan modifikasi restriksi vitamin B12 AIN-93 sesuai usia perlakuan.Hasil: Kelompok perlakuan 8 minggu paling baik dalam menggambarkan kondisi perlemakan hati dibandingkan kelompok kontrol dan perlakuan 4 minggu, sedangkan kelompok perlakuan 12 minggu telah mempresentasikan kondisi NASH Non Alcoholic Steatohepatitis . Hasil ini sejalan dengan kondisi peningkatan homosistein plasma pada kelompok kontrol dan masing-masing usia perlakuan.Kesimpulan: Peningkatan homosistein akibat diet restriksi vitamin B12 mengakibatkan kondisi steatosis dan steatohepatitits pada hati, sebagai akibat dari kondisi resistensi insulin dan kerusakan sebagian dari sel beta pankreas. Kata kunci: Homosistein, Restriksi vitamin B12, NAFLD, Resistensi Insulin
ABSTRACT Name Irena UjiantiStudy Program Master Program of Biomedical SciencesThesis Title Impact of Vitamin B12 Restriction on Homocysteine Levels, Insulin Resistance and NAFLDCounselor dr. Imelda Rosalyn Sianipar, M.Biomed, Ph.D. dr. Dewi Irawati Soeria Santoso, MS Background The fatty liver is the biggest chronic liver disease in the world. The underlying condition of fatty liver starts from the condition of insulin resistance. One of the pathomechanisms of insulin resistance is the disturbance in insulin signaling by certain toxic substances that will interact with one of the proteins that make up the insulin signaling pathway. Increased homosisteine is associated with insulin resistance. Homosisteine will increase in line with the disruption of the methionin metionin pathway. Dietary vitamin B12 deficiency will trigger insulin resistance through the path of oxidative stress generated by homocysteine.Materials and Methods This study used an experimental method of 24 male Sprague Dawley rats Rattus norvegicus, 300 400 gram, age 7 8 months , divided into 4 groups kontrol K , 4 weeks treatment group P 1 , 8 weeks treatment group P 2 and 12 week treatment group P 3 . In the kontrol group, a standard AIN 93 diet was administered while the feeding group was administered vitamin A deficiency deficiency AIN 93M according to treatment age.Results The best 8 weeks treatment group described the conditions of fatty liver compared to the 4 week kontrol and treatment group, while the 12 week treatment group presented the NASH condition. These results are consistent with the elevated plasma homocysteine conditions in the kontrol group and each treatment age.Conclusion Increased homocysteine due to dietary vitamin B12 deficiency is able to induce the condition of steatosis and steatohepatitits in the liver, as a result of the condition of insulin resistance and beta cell pancrease damage as the underlying patomechanism. Keywords Homocysteine, vitamin B12 Deficiency, NAFLD, Insulin Resistance "
2018
T55512
UI - Tesis Membership  Universitas Indonesia Library
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Iqbal Kevin Kyle
Efek Pemberian Alpha-Mangostin Pada IRS-1 Jaringan Hati di Model Tikus Resisten Insulin = The Effects of Alpha-Mangostin Administration on Hepatic IRS- 1 in Insulin Resistant Rat Model
"Latar Belakang: Resistensi insulin adalah ketidaknormalan sel yang ada pada banyak gangguan metabolic, terutama diabetes tipe-2. Kondisi ini berkaitan erat dengan penurunan Insulin receptor substrate 1 (IRS-1.). Penelitian ini bertujuan untuk mengevaluasi efek dari alfa-mangostin (α-MG), senyawa aktif yang ada di kulit buah manggis, pada kemampuannya meningkatkan konsenstrasi IRS-1 pada jaringan hati tikus model resistensi insulin Metode: 36 tikus Sprague-Dawley dibagi ke dalam 6 kelompok; kelompok 1: control (diberikan diet normal selama 8 minggu), kelompok 2; control + alfa-mangostin 200 (200 mg/kg/hari), kelompok 3; resisten insulin (diberikan diet tinggi lemak dan gula selama 3 minggu dan diinjeksi dengan streptozotocin intra peritoneal dosis rendah pada minggu ke 3), kelompok 4: resisten insulin + metformin, kelompok 5: resisten insulin + alfa-mangostin 100, kelompok 6: resisten insulin + alfa-mangostin 200. Pada masing-masing kelompok dipilih 4 sampel secara acak yang kemudian dikorbankan setelah 8 minggu. Kemudian jaringan hati diambil, diisoloasi, dan di ukur konsentrasi IRS-1 menggunakan ELISA. Data yang didapat kemudian dianalisa menggunakan SPSS versi 26. Hasil: Analisis dilakukan dengan uji Welch’s ANOVA dan Games-Howell post hoc. Tidak ditemukan adanya perbedaan signifikan antara perbedaan konsentrasi IRS-1 hati pada kelompok 3 (resisten insulin) dan kelompok 5 dan 6 (α-ΜG 100, p = 1 (>0.05) dan α-MG 200, p = 0.677 (>0.05)). Kelompok 6 memiliki konsenstrasi IRS-1 lebih tinggi dari kelompok 5, meskipun tidak secara signifikan (p = 0.558, (>0.05)). Kesimpulan: Pemberian alpha-mangostin 100 mg dan 200 mg tidak dapat meningkatkan konsentrasi IRS-1 pada hati.
......Background: Insulin resistance (IR) is an abnormal cellular mechanism that is present in various metabolic disorder, particularly type-2 diabetes mellitus. This condition is closely related to downregulation of Insulin Receptor Substrate-1 (IRS-1). T2DM ranks seventh highest cause of disability and ninth in mortality worldwide. This research project was conducted to provide further understanding on the effects of alpha- mangostin, a bioactive compound found in pericarp of mangosteen fruit, on its therapeutic effect by increasing hepatic IRS-1 concentration. Method: This experiment is done by analyzing hepatic IRS-1 concentration of 36 Sprague-Dawley rats that were divided into 6 groups; group 1: control (given 8 weeks of standard diet), group 2: control + α-ΜG 200 (200 mg/kg/day), group 3: IR (given high fat and high glucose diet for 3 weeks and injected by streptozotocin i.p at fourth week), group 4: IR + metformin 200, group 5: IR + α-ΜG 100, group 6: IR + α-ΜG 200. Through random sampling, 4 samples from each group are chosen and each sample’s hepatic IRS-1 are measured using ELISA method. Data analysis were done using SPSS software version 26. Result: The analysis done utilizing Welch’s ANOVA test with Games-Howell post hoc. No significant difference of IRS-1 concentration found between group 3 (IR) and group 5 (IR + α-MG 100, p = 1 (>0.05)) and group 6 (IR + α-MG 200, p = 0.558)). Group 6 (IR + α-MG 200, p = 0.558) shown to have a higher IRS-1 compared to group 5 (IR + α-MG 100) although not significant. Conclusion: Alpha-mangsotin administration unable to increase IRS-1 concentration in insulin resistant mouse."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Vita Silvana
Penentuan titik potong optimal kadar serum Retinol Binding Protein-4 untuk memprediksi risiko kejadian resistensi insulin pada sindrom ovarium poli kistik dengan indeks masa tubuh normal = Serum Retinol Binding Protein-4 cut off level to predict the risk of insulin resistance on polycystic ovarian syndrome with normal body mass index
"ABSTRAK
Latar Belakang: Sindrom Ovarium Polikistik (SOPK) merupakan penyebab 40%
infertilitas pada wanita usia reproduksi. Resistensi insulin sebagai salah satu
patofisiolofi yang mendasari SOPK, berkaitan erat dengan jaringan adiposa
viseral dan ditemukan pada 30-50% pasien SOPK dengan indeks masa tubuh
normal serta lingkar pinggang kurang dari 80 cm. Retinol Binding Protein-4
(RBP-4) yang disekresi oleh jaringan adiposa viseral diketahui sebagai salah satu
adipokin yang menyebabkan resistensi insulin. Pengukuran IMT dan lingkar
pinggang tidak dapat mewakili akumulasi jaringan adiposa viseral pada SOPK
dengan IMT normal serta lingkar pinggang kurang dari 80 cm. Dengan
diketahuinya titik potong optimal kadar serum RBP-4 sebagai penanda jaringan
adiposa viseral, diharapkan dapat memprediksi risiko kejadian resistensi insulin
yang bermanfaat dalam menentukan penatalaksanaan kasus SOPK dengan IMT
normal terkait strategi pengurangan akumulasi jaringan adiposa viseral.
Tujuan: Diketahuinya titik potong optimal kadar serum RBP-4 sebagai penanda
jaringan adiposa viseral untuk memprediksi risiko kejadian resistensi insulin pada
penderita SOPK dengan IMT normal.
Metode: Studi observasional dengan desain potong lintang selama periode Juli
2014 hingga Maret 2015 di Poliklinik Yasmin, RSCM, Jakarta.
Hasil: Sejumlah 40 subjek SOPK dengan IMT normal yang memenuhi kriteria
inklusi didapatkan 16 subjek (40%) yang mengalami resistensi insulin dan 24
subjek (60%) nir resistensi insulin. Sejumlah 23 subjek (57.5%) memiliki lingkar
pinggang kurang dari 80 cm, dimana 6 subjek (26%) diantaranya mengalami
resistensi insulin. Kadar serum RBP-4 pada kelompok resistensi insulin bermakna
lebih tinggi dibandingkan nir resistensi insulin (p 0.008). Dengan analisis ROC
didapatkan AUC kadar serum RBP-4 78.8% (IK 95% -8445.59 ? -1447.98)
dengan nilai p 0.002. Titik potong optimal kadar serum RBP-4 adalah 24133
ng/mL dengan sensitivitas sebesar 75% dan spesifisitas sebesar 75%. Dengan
analisis regresi logistik biner didapatkan pemeriksaan serum RBP-4 menambah
nilai diagnostik dari parameter demografis dan klinis AUC 85.7% menjadi 91.1%.
Kesimpulan: Kadar serum RBP-4 sebagai penanda jaringan adiposa viseral dapat digunakan untuk memprediksi risiko kejadian resistensi insulin pada penderita SOPK dengan IMT normal. ABSTRACT Background: Polycystic ovarian syndrome (PCOS) contributes to fourty percent
of infertility?s issues on reproductive women. Insulin resistance as one of
important pathophysiology in PCOS, correlates with visceral adipose tissue and is
found on 30-50% PCOS patients with normal body mass index and waist
circumference less than 80 cm. Retinol Binding Protein-4 (RBP-4), which is
secreted by visceral adipose tissue, known as one of adipokines that cause insulin
resistance. The measurement of body mass index and waist circumference could
not represent visceral adiposity on PCOS with normal body mass index and waist
circumference less than 80 cm. Determination of serum RBP-4 cut off level as
visceral adipose tissue marker hopefully could predict the risk of insulin
resistance on polycystic ovarian syndrome with normal body mass index,
therefore it will be useful on its management related to reduction of visceral
adiposity.
Objective: To obtain serum RBP-4 cut off level as visceral adipose tissue marker
to predict the risk of insulin resistance on PCOS with normal body mass index.
Method: This was an observational study with cross sectional design conducted at
Yasmin Clinic, RSCM, Jakarta during a period of July 2014 until March 2015.
Result: Fourty PCOS patients with normal body mass index were participated on
this study. There were 16 subjects (40%) who were insulin resistance and 24
subjects (60%) who were not insulin resistance. There were 23 subjects (57.5%)
who had waist circumference less than 80 cm, where 6 of them (26%) were
insulim resistance. Serum RBP-4 level was significantly higher on insulin
resistance group (p 0.008). After ROC analysis was performed, AUC of serum
RBP-4 was 78.8% (CI 95% -8445.59 ? -1447.98, p 0.002). The cut off level of
serum RBP-4 was 24133 ng/mL with sensitivity 75% and specificity 75%. After
logistic regression analysis was performed, it was found that serum RBP-4 increase diagnostic value of demographic and clinical parameter with AUC 85.7% to 91.1%. ;Background: Polycystic ovarian syndrome (PCOS) contributes to fourty percent
of infertility?s issues on reproductive women. Insulin resistance as one of
important pathophysiology in PCOS, correlates with visceral adipose tissue and is
found on 30-50% PCOS patients with normal body mass index and waist
circumference less than 80 cm. Retinol Binding Protein-4 (RBP-4), which is
secreted by visceral adipose tissue, known as one of adipokines that cause insulin
resistance. The measurement of body mass index and waist circumference could
not represent visceral adiposity on PCOS with normal body mass index and waist
circumference less than 80 cm. Determination of serum RBP-4 cut off level as
visceral adipose tissue marker hopefully could predict the risk of insulin
resistance on polycystic ovarian syndrome with normal body mass index,
therefore it will be useful on its management related to reduction of visceral
adiposity.
Objective: To obtain serum RBP-4 cut off level as visceral adipose tissue marker
to predict the risk of insulin resistance on PCOS with normal body mass index.
Method: This was an observational study with cross sectional design conducted at
Yasmin Clinic, RSCM, Jakarta during a period of July 2014 until March 2015.
Result: Fourty PCOS patients with normal body mass index were participated on
this study. There were 16 subjects (40%) who were insulin resistance and 24
subjects (60%) who were not insulin resistance. There were 23 subjects (57.5%)
who had waist circumference less than 80 cm, where 6 of them (26%) were
insulim resistance. Serum RBP-4 level was significantly higher on insulin
resistance group (p 0.008). After ROC analysis was performed, AUC of serum
RBP-4 was 78.8% (CI 95% -8445.59 ? -1447.98, p 0.002). The cut off level of
serum RBP-4 was 24133 ng/mL with sensitivity 75% and specificity 75%. After
logistic regression analysis was performed, it was found that serum RBP-4 increase diagnostic value of demographic and clinical parameter with AUC 85.7% to 91.1%. "
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Dian Araminta Ramadhania
Kadar seng serum dan korelasinya dengan resistensi insulin pada ibu laktasi di Jakarta = Zinc serum level and its correlation with insulin resistance among lactating mothers in Jakarta.
"ABSTRAK
Resistensi insulin adalah kondisi yang mendasari terjadinya diabetes melitus. Prevalensi diabetes melitus kian meningkat dari tahun ke tahun, termasuk di Indonesia. Proporsi penderita diabetes melitus ditemukan lebih tinggi pada perempuan. Perubahan fisiologis yang terjadi selama kehamilan merupakan salah satu penyebab terjadinya resistensi insulin dan resistensi insulin ini dapat bertahan hingga masa postpartum. Laktasi serta nutrien salah satunya seng, dapat memengaruhi resistensi insulin. Penelitian dengan desain potong lintang ini bertujuan menilai kadar seng serum dan korelasinya dengan resistensi insulin pada ibu laktasi di Jakarta. Pengambilan subjek dilakukan di Puskesmas Kecamatan Cilincing, Jakarta Utara dan Grogol Petamburan, Jakarta Barat pada bulan Februari-April 2019. Sebanyak 75 orang ibu laktasi pada 3-6 bulan postpartum yang berusia 20-40 tahun direkrut menjadi subjek penelitian ini. Sekitar 76% (n=57) subjek memiliki kadar seng rendah dengan rerata sebesar 62,33±11,89 µg/dL. Resistensi insulin dinilai dengan menggunakan HOMA-IR (homeostasis model assessment-insulin resistance). Median HOMA-IR adalah 0,54 (0,22-2,21). Sebanyak 13,3% (n=10) subjek diprediksi mengalami resistensi insulin. Dilakukan uji korelasi antara kadar seng serum dengan HOMA-IR. Tidak ditemukan adanya korelasi bermakna antara kadar seng serum dengan HOMA-IR (r=0,003, p=0,977).
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T58660
UI - Tesis Membership  Universitas Indonesia Library
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Anni Rahmawati
Pengaruh puasa intermiten 5:2 terhadap lingkar pinggang dan resistensi insulin pada karyawan dengan obesitas di Jakarta = The effect of intermittent fasting 5:2 on waist circumference and insulin resistance in obese employees in Jakarta.
"Latar belakang: Prevalensi penduduk dewasa di Indonesia yang obesitas mengalami peningkatan dari tahun ke tahun, demikian juga dengan angka obesitas pada karyawan. Puasa intermiten dapat menjadi alternatif solusi dalam tatalaksana obesitas, terutama terhadap ukuran lingkar pinggang dan resistensi insulin yang diketahui melalui nilai HOMA-IR.
Tujuan: Penelitian ini bertujuan untuk mengetahui efek puasa intermiten 5:2 terhadap lingkar pinggang dan resistensi insulin pada karyawan obesitas di Jakarta.
Metode: Penelitian uji klinis acak terkontrol ini dilakukan pada 50 karyawan obesitas berusia 19-59 tahun, dan memiliki lingkar pinggang ≥ 90 cm. Sampel dibagi menjadi kelompok intervensi dan kelompok kontrol. Kelompok intervensi diminta untuk berpuasa pada hari senin dan kamis selama 8 minggu, sementara kelompok kontrol melanjutkan pola makan seperti biasa. Tidak terdapat pembatasan kalori pada kedua kelompok. Data dikumpulkan melalui kuesioner, food recall 2x24 jam, pengukuran antropometri, dan pemeriksaan resistensi insulin yang diketahui melalui nilai HOMA-IR. Analisis menggunakan uji t tidak berpasangan atau uji Mann-Whitney, dan uji t berpasangan atau Wilcoxon.
Hasil: Setelah 8 minggu intervensi, perubahan lingkar pinggang pada kelompok intervensi ialah 0,00 (-5,0-8,0) cm dan pada kelompok kontrol 1 (-4,0 – 4) cm. Sementara perubahan kadar HOMA-IR pada kelompok intervensi ialah 0,29 (-17,78 – 6,84) dan kelompok kontrol -0,46 (-18,94 – 10,55).
Kesimpulan: Tidak terdapat perbedaan bermakna perubahan lingkar pinggang dan resistensi insulin pada kelompok yang berpuasa dibandingkan kelompok yang tidak melakukan puasa (p>0,05).
......Introduction: The prevalence of the obese adult population in Indonesia has increased from year to year. So is the obesity rate in employees. Intermittent fasting could be an alternative solution in managing of obesity, especially for waist circumference and insulin resistance levels.
Objective: This study aims to determine the effects of intermittent fasting 5:2 on waist circumference and insulin resistance in obese employees in Jakarta.
Method: This randomized controlled clinical trial was conducted on 50 obese employees aged 19-59 years, and had a waist circumference ≥ 90 cm. The subjects were divided into intervention groups and control groups. The intervention group was asked to fast on Mondays and Thursdays for eight weeks, while the control group continued their usual diet. There were no calorie restrictions in either group. Data is collected through the interview, food recall 2x24 hours, anthropometry asssessment and measurement of insulin resistance by HOMA-IR index. The data were analyzed using t-test or a Mann-Whitney test, and a paired t-test or Wilcoxon.
Results: After 8 weeks of intervention, the change in waist circumference in the intervention group was 0.00 (-5.0-8.0) cm and in the control group 1 (-4.0 - 4) cm. While the change in HOMA-IR levels in the intervention group was 0.29 (-17.78 - 6.84) and the control group was -0.46 (-18.94 - 10.55).
Conclusion: There was no significant difference in waist circumference and insulin resistance in the fasting group compared to the control group (p>0.05)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tesis Membership  Universitas Indonesia Library
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Callista Qonita Putri Nabila
Hubungan Kebiasaan Konsumsi Fruktosa terhadap Resistensi Insulin dengan Biomarker TyG Index yang Bermanifestasi Sindrom Metabolik di Posyandu Lansia Monjok = Relationship between Fructose Consumption Habits and Insulin Resistance with TyG Index Biomarker Manifesting Metabolic Syndrome at Monjok Elderly Integrated Healthcare Center
"Latar belakang: Sindrom metabolik merupakan kumpulan gejala abnormalitas metabolik tubuh yang meliputi hipertensi, obesitas sentral, hiperglikemia, resistensi insulin, dan dislipidemia. Hal ini menurunkan kualitas hidup seseorang dan berdampak meningkatnya biaya pengobatan. Salah satu faktor risikonya adalah kebiasaan konsumsi produk instan tinggi fruktosa. Penelitian ini bertujuan membuktikan hubungan antara kebiasaan konsumsi makanan dan/atau minuman yang mengandung fruktosa dengan terjadinya resistensi insulin yang bermanifestasi sindrom metabolik pada subjek di Posyandu Lansia Monjok Kota Mataram.
Metode: Penelitian ini merupakan studi cross-sectional. Pengambilan sampel ditetapkan secara consecutive sampling. Subjek penelitian sebanyak 48 orang berusia 45-90 tahun dari Posyandu Lansia Monjok. Data diperoleh dari wawancara subjek, Puskesmas Mataram, dan Posyandu Monjok. Asupan fruktosa dikumpulkan dengan metode food recall 24hour dan dinilai dengan software nutrisurvey. Resistensi insulin ditetapkan dengan metode TyG Index. Sindrom metabolik ditetapkan berdasarkan parameter National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III).
Hasil: Hasil penelitian menunjukkan 52.1% subjek di Posyandu Lansia Monjok Kota Mataram mengalami resistensi insulin dan 62.5% sindrom metabolik. Uji Chi-Square menunjukkan terdapat hubungan signifikan antara kebiasaan konsumsi fruktosa dengan terjadinya resistensi insulin (p=0.000) dan sindrom metabolik (p=0.001).
Kesimpulan: Sebagian subjek di Posyandu Lansia Monjok Kota Mataram memiliki kebiasaan konsumsi tinggi fruktosa sehingga menyebabkan terjadinya resistensi insulin yang bermanifestasi menjadi sindrom metabolik.
......Introduction: Metabolic syndrome is a collection of symptoms of metabolic abnormalities, including hypertension, central obesity, hyperglycemia, insulin resistance, and dyslipidemia. This matter reduce a person’s quality of life and impact financially due to high treatment costs. One of the risk factors that trigger metabolic syndrome is the habit of consuming instant food or beverages that contain high fructose. This study aims to prove the relationship between the habit of consuming food and/or drinks containing fructose and the occurrence of insulin resistance manifesting metabolic syndrome among subjects at Monjok Elderly Integrated Healthcare Center Mataram.
Method: This study was cross-sectional. Sampling was determined using consecutive sampling. Subjects, as many as 48 people, aged 45-90 years form Monjok Elderly Integrated Healthcare Center Mataram. Data were obtained from subject interviews and data from Mataram Public Health Center and Monjok Integrated Healthcare Center. Fructose intake was collected using a 24-hour food recall method and assessed using NutriSurvey software. Insulin resistance was determined by the TyG Index method. Metabolic syndrome was determined based on the Adult Care Panel of the National Cholesterol Education Program III (NCEP ATP III).
Result: The results showed that 52.1% subjects at Monjok Elderly Integrated Healthcare Center experienced insulin resistance and 62.5% metabolic syndrome. The Chi-Square test showed a significant correlation between fructose consumption habits and the occurrence of insulin resistance (p=0.000) and metabolic syndrome (p=0.001).
Conclusion: Half of the subjects at Monjok Elderly Integrated Healthcare Center had a high fructose consumption habit that cause to insulin resistance manifesting metabolic syndrome."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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Clark Christensen Matheos
Efek anti-inflamasi dari alfa-mangostin pada liver model tikus resistensi insulin: fokus pada ekspresi IL-1B = Anti-inflammatory effect of alpha-mangostin in liver of insulin resistance rat model: focus on IL-1B expression
"Resistensi insulin (IR) menyebabkan rusaknya respons biologis pada hati. Jika tidak dikontrol, resistensi insulin dapat memicu inflamasi, penumpukan lemak dan lipotoxicity, mengakibatkan cepatnya progresi penyakit perlemakan hati non-alkoholik. Inflamasi pada hati ditandai oleh munculnya sitokin proinflamasi pada respon imun bawaan, contohnya IL-1B. Obat insulin sensitizer seperti metformin dapat dipakai untuk mengontrol resistensi insulin dan mencegah progresi penyakit, akan tetapi mekanisme efek anti-inflamasi metformin pada hati masih belum diketahui. Studi terbaru menyebutkan alfa-mangostin mempunyai potensi untuk menekan inflamasi dan bisa menjadi obat alternatif untuk penyakit perlemakan hati. Tujuan dari penelitian ini adalah untuk meneliti efek anti-inflamasi pada model tikus IR memakai ekspresi mRNA IL-1b sebagai marker. Penelitian dilakukan secara in vivo experimental research memakai hati tikus Wistar jantan berusia 10-12 minggu. Sampel dibagi menjadi enam kelompok: 1) kontrol, 2) kontrol dengan pemberian alfa-mangostin 200 mg, 3) diet tinggi lemak, 4) diet tinggi lemak dengan pemberian metformin 200 mg, 5) diet tinggi lemak dengan pemberian alfa-mangostin 100 mg, 6) diet tinggi lemak dengan pemberian alfa-mangostin 200 mg. Ekspresi mRNA IL-1B dianalisa memakai qRT-PCR. Dari data yang diambil, ditemukan bahwa pemberian alfa-mangostin mengurangi ekspresi IL-1B secara signifikan (p <0.05) dan juga dose-dependent. Pemberian metformin juga mengurangi ekspresi IL-1B tetapi perbedaannya tidak signifikan. ......Insulin resistance (IR) causes impaired biological response to the liver. If untreated, insulin resistance causes inflammatory change and lipotoxicity, leading to the progression of non-alcoholic fatty liver disease. Inflammation in liver is marked by proinflammatory cytokines produced during innate immune response, such as IL-1B. Insulin sensitizer drug metformin may be used to treat insulin resistance and prevent disease progression, however, it’s unknown if metformin has a direct anti-inflammatory effect of alpha-mangostin in an IR rat model, using IL-1B mRNA expression as a marker. In vivo experimental laboratory research was done using liver of 10-12 weeks old male Wistar rats. We categorized the sample into six groups: 1) control, 2) control treated with alpha-mangostin 200 mg, 3) high fat diet, 4) high fat diet treated with metformin 200 mg, 5) high fat diet treated with alpha-mangostin 100 mg, 6) high fat diet treated with alpha- mangostin 200 mg. IL-1B mRNA expression was analyzed using qRT-PCR. Alpha- mangostin reduced IL-1B expression significantly (p <0.05) and was dose dependent. Metformin reduced IL-1B expression but wasn’t significantly different."
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Skripsi Membership  Universitas Indonesia Library
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Atikah Isna Fatya
Perbedaan rerata kadar Intestinal Fatty Acid Binding Protein (I-FABP) pada penyandang obesitas dengan dan tanpa diabetes melitus tipe 2 di Indonesia = The mean difference of Intestinal Fatty Acid Binding Protein (I-FABP) in obesity with and without type 2 diabetes melitus in Indonesia
"Latar Belakang: Terdapat dua jenis obesitas berdasarkan risiko kardiometaboliknya, yaitu metabolically healthy obese (MHO) dan metabolically unhealthy obese (MUO). Kelompok MUO lebih berisiko mengalami DM tipe 2 karena terdapat resistensi insulin yang dicetuskan endotoksemia metabolik akibat disbiosis usus, melalui peningkatan permeabilitas usus. Belum ada data mengenai perbedaan permeabilitas usus, yang diwakili oleh kadar intestinal fatty acid binding protein (I-FABP), pada penyandang obesitas dengan dan tanpa DM tipe 2 di Indonesia.
Tujuan: Mengetahui perbedaan rerata kadar I-FABP pada penyandang obesitas dengan dan tanpa DM tipe 2 di Indonesia.
Metode: Studi potong lintang menggunakan data sekunder dari penelitian Divisi Endokrin, Metabolik, Diabetes FKUI-RSUPN Dr. Cipto Mangunkusumo, Jakarta yang berjudul “Profil Mikrobiota Usus, Mikrobiota Rongga Mulut, Inflamasi, dan Resistensi Insulin pada Berbagai Spektrum Disglikemia” periode Juli 2018-Agustus 2019. Sebanyak 63 subjek obesitas berdasarkan kriteria WHO untuk Asia (IMT ≥25 kg/m2) dibagi menjadi 2 kelompok berdasarkan kriteria ADA: dengan dan tanpa DM tipe 2. Kadar I-FABP diperiksa dengan metode Enzyme-linked immunosorbent assay. Analisis data dengan uji T tidak berpasangan untuk perbedaan rerata I-FABP. Uji regresi logistik dilakukan untuk faktor perancu.
Hasil: Mayoritas subjek ialah perempuan (82,53%), usia >45 tahun (63,50%), obesitas grade I (54,00%), obesitas sentral (93,70%). Rerata I-FABP pada kelompok dengan DM tipe 2 lebih tinggi, yaitu 2,82 (1,23) ng/mL vs. 1,78 (0,81) ng/mL (p<0,001; IK95% 0,51-1,55).
Simpulan: Rerata kadar I-FABP lebih tinggi pada kelompok obesitas dengan DM tipe 2 dan independen terhadap faktor usia.
......Background: There are two types of obesity based on its cardiometabolic risk, which are metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). The MUO exerts higher risk to develop type 2 DM because of higher state of insulin resistance due to metabolic endotoxemia through gut dysbiosis and increased intestinal permeability. There is no study regarding the difference of intestinal permeability, using intestinal fatty acid binding protein (I-FABP), in obese people with and without type 2 DM in Indonesia.
Objective: To know the mean difference of I-FABP in obese people with and without T2DM in Indonesia.
Method: A cross-sectional study using secondary data from the study of Division of Endocrine, Metabolism and Diabetes FMUI-RSUPN Dr. Cipto Mangunkusumo, Jakarta entitled "Profile of the Intestinal Microbiota, Oral Cavity Microbiota, Inflammation, and Insulin Resistance in Various Spectrums of Dysglycemia" for the period July 2018-August 2019. A total of 63 obese subjects based on WHO criteria for Asia (BMI ≥25 kg/m2) were divided into 2 groups based on ADA criteria for diabetes: with and without T2DM. The I-FABP levels were checked using enzyme-linked immunosorbent assay method. Data was analyzed using unpaired T test for mean difference of I-FABP while logistic regression test was performed for confounding factors.
Results: The majority of the subjects were women (82.53%), age >45 years (63.50%), obesity grade I (54.00%) and central obesity (93.70%). The I-FABP level of T2DM group was higher compared to without T2DM group, namely 2.82 (1.23) ng/mL vs. 1.78 (0.81) ng/mL (p<0.001; 95% CI 0.51-1.55).
Conclusion: The mean level of I-FABP was higher in the obese group with T2DM which is independent of age."
Depok: Fakultas Kedokteran Univesitas Indonesia, 2021
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