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Abstrak :
Albumin serum, berat badan dan kekuatan genggaman merupakan parameter penilaian status gizi yang berhubungan dengan kadar protein tubuh. Penelitian ini dilakukan untuk mengetahui korelasi antara kadar albumin serum terhadap persentase penurunan berat badan dan kekuatan genggaman. Penelitian dengan desain potong lintang pada pasien kanker kepala leher dengan usia ≥18–65 tahun yang telah menjalani radiasi ≥25 kali di Departemen Radioterapi RSUPNCM. Hasil penelitian menunjukkan sekitar 55,76% subjek memiliki kadar albumin <3,4 g/dL. Rerata penurunan berat badan selama radiasi – 9,42 ± 7,76%, dengan 79,6% subyek mengalami penurunan berat badan ≥5%. Rerata kekuatan genggaman tangan dominan 39,48 ± 9,15 kg. Tidak terdapat korelasi antara kadar albumin serum dengan persentase penurunan berat badan (r = - 0,129; p = 0,364) dan kekuatan genggaman tangan (r = 0,048; p = 0,733). Kesimpulan, kadar albumin serum tidak memengaruhi penurunan berat badan dan kekuatan genggaman selama radiasi. Sangat penting untuk mempertahankan status gizi selama menjalani radioterapi salah satunya dengan pemakaian NGT di awal radiasi. Diperlukan penelitian lebih lanjut dengan desain kohort prospektif untuk mendapatkan data yang lebih konklusif. ......Serum albumin, body weight and hand grip strength is a parameter of assessment of nutritional status related to body protein. This study was conducted to determine the correlation between serum albumin levels with the percentage of weight loss and hand grip strength. A cross sectional study design in the head neck cancer patients with ge 18 65 years of age who have undergone radiation at least 25 times in the Department of Radiotherapy RSUPNCM. The results showed approximately 55,76 of the subjects had levels of albumin below 3,4 g dL. Mean weight loss during radiation ndash 9,42 7,76 , with 79,6 of subjects experienced weight loss ge 5 . Mean dominant hand grip strength 39,48 9,15 kg. There is no correlation between serum albumin levels with percentage of body weight loss r 0,129 p 0,364 and hand grip strength r 0,048 p 0,733 . Conclussion, serum albumin levels did not affect body weight loss and handgrip strength during radiation. It is essential for head and neck cancer patients undergoing radiotherapy to maintain nutritional status with NGT in the initial radiation. Further research with prospective cohort design is needed to obtain more conclusive data. Keywords Serum albumin, weight loss percentage, handgrip strength, head and neck cancer, radiotherapy

Abstrak :
Penelitian ini merupakan penelitian potong lintang di Departemen Radioterapi Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta, yang bertujuan untuk mengetahui korelasi antara kadar asam lemak omega-3 terhadap massa otot dan kekuatan genggam pada subjek kanker kepala leher yang mendapatkan radioterapi. Kaheksia kanker sering terjadi pada kanker kepala leher akibat peningkatan sitokin proinflamasi yang menyebabkan hipermetabolisme, peningkatan kebutuhan nutrisi, anoreksia, penurunan massa otot dan berat badan. Asam lemak omega-3 berperan dalam menurunkan inflamasi, meningkatkan massa otot, dan kekuatan genggam. Dari 52 subjek yang sudah mendapatkan radioterapi ge;25 kali, 57 adalah laki-laki dengan rerata usia di atas 50 tahun. Lokasi kanker paling banyak di area nasofaring, sebagian besar sudah berada pada stadium IV dan mendapatkan kombinasi radioterapi dan kemoterapi. Sebesar 38,5 dan 32,7 subjek berada pada kategori indeks massa tubuh normal dan kurang. Data yang diperoleh dari penelitian ini dapat memberikan gambaran kurangnya asupan energi, protein, lemak, dan asam lemak omega-3, serta massa otot sebagian besar subjek yang tergolong kecil 28,4 4,7 , dengan kekuatan genggam sebagian besar subjek tergolong normal, dan kadar asam lemak omega-3 plasma seluruh subjek yang tergolong rendah 2,5 0,8 . Data tersebut menunjukkan adanya masalah nutrisi pada pasien kanker kepala leher. Terdapat korelasi yang kuat antara kadar asam lemak omega-3 plasma terhadap massa otot r =0,6, p 50?60 Gy dan 50 Gy. ......This cross sectional study conducted in the Department of Radiotherapy Dr. Cipto Mangunkusumo Hospital, aimed to investigate the correlation between omega 3 fatty acids plasma levels with muscle mass and hand grip muscle strength in subjects with head and neck cancer undergoing radiotherapy. Cancer cachexia is common in head and neck cancer as a result of the increasing of proinflammatory cytokines that cause hipermetabolisme, increased nutritional needs, anorexia, decreased muscle mass and body weight. Omega 3 fatty acids play a role in reducing inflammation, as well as improving muscle mass and hand grip. There were 52 subjects who had received radiotherapy ge 25 times, 57 were male with a mean age of 50 years. Most cancer sites were at nasopharynx area, mostly in stage IV and received a combination of radiotherapy and chemotherapy. There were 38,5 of the subjects in the normal body mass index and 32,7 were in low body mass index. The data from this study showed inadequate intake of energy, protein, fat, and omega 3 fatty acids, as well as muscle mass majority was small 28,4 4,7 , with most of the hand grip classified as normal, and the plasma levels of omega 3 fatty acids all of the subjects were low 2,5 0,8 . The data showed that there were nutritional problems in patients with head and neck cancer. There was strong correlation of plasma levels of omega 3 fatty acids with muscle mass r 0,8, p 50 60 Gy and 50 Gy.

Abstrak :
Uji klinis acak tersamar ganda paralel ini merupakan penelitian pendahuluan, bertujuan mengetahui pengaruh suplementasi serat larut dan diet rendah kalori seimbang (DRKS) selama 4 minggu terhadap kadar kolesterol low-density lipoprotein (LDL) serum pada obes I usia 30−50 tahun. Sejumlah 31 subyek dipilih dengan kriteria tertentu dan dibagi menjadi dua kelompok dengan randomisasi blok, 15 orang kelompok perlakuan (KP) dan 16 orang kelompok kontrol (KK). Subyek KP mendapat serat larut psyllium husk (PH) 8,4 g/hari dan DRKS 1200 kkal/hari, sedangkan subyek KK mendapat plasebo dan DRKS 1200 kkal/hari. Data terdiri atas usia, indeks massa tubuh (IMT), asupan zat gizi, serta kadar kolesterol LDL serum. Pemeriksaan kolesterol LDL dilakukan pada awal dan akhir penelitian. Analisis data menggunakan uji t tidak berpasangan dan Mann-Whitney, batas kemaknaan 5%. Karakteristik data dasar dan sebaran subyek kedua kelompok sebanding. Analisis lengkap dilakukan pada 28 subyek (KP dan KK masing-masing 14 subyek). Suplementasi ditoleransi baik dan tidak ditemukan efek samping serius. Median usia subyek KP dan KK berturut-turut 35,0 (30−45) tahun dan 34,50 (30−48) tahun serta rerata IMT 28,0 ± 1,1 kg/m2 dan 27,2 ± 1,4 kg/m2. Rerata kadar kolesterol LDL serum awal KP 137,0 ± 37,0 mg/dL dan KK 134,4 ± 29,1 mg/dL. Defisit energi KP lebih rendah tidak signifikan (p = 0,62) dibandingkan KK, berturut-turut -282,0 ± 482,6 kkal/hari dan -331,8 ± 578,3 kkal/hari. Persentase asupan energi terhadap anjuran KP (94,2 ± 18,5%) lebih tinggi signifikan (p = 0,02) daripada KK (85,4 ± 22,9%). Asupan karbohidrat (KH) total KP (613,1 ± 134,5 kkal/hari) lebih tinggi signifikan (p = 0,02) dibandingkan KK (545,4 ± 161,1 kkal/hari). Asupan protein, lemak total, dan kolesterol KP dan KK sesuai rekomendasi NCEP-ATP III. Pada kedua kelompok, asupan asam lemak jenuh cenderung tinggi, tetapi asupan asam lemak tak jenuh tunggal dan jamak rendah. Asupan serat subyek KP 17,2 ± 2,8 g/hari dan KK 8,6 (5,2−15,2) g/hari. Dengan suplementasi PH tidak tercapai rekomendasi asupan serat. Persentase asupan KH sederhana terhadap energi total KP 11,5±5,4% lebih tinggi signifikan (p = 0,00) dibandingkan KK 6,0 (1,2524,2)%. Penurunan kadar kolesterol LDL serum KP -2,1 ± 16,2 mg/dL lebih sedikit tidak signifikan (p = 0,15) dibandingkan pada KK -10,9 ± 15,3 mg/dL. Penelitian ini belum dapat membuktikan suplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari selama 4 minggu lebih baik dalam menurunkan kadar kolesterol LDL serum dibandingkan plasebo pada subyek obes I. ...... This parallel double blind randomized clinical trial is a preliminary study that aims to investigate the effect of soluble fiber supplementation 8.4 g/day and lowcalorie balanced diet (LCBD) for 4 weeks on serum low-density lipoprotein (LDL) cholesterol level in obese I, aged 30−50 years old. A total of 31 subjects were selected using certain criteria and randomly allocated to one of two groups using block randomization; 15 subjects for treatment (T) group and 16 subjects for control (C) group, respectively. The T group received psyllium husk (PH) 8.4 g/day and LCBD 1200 kcal/day, and the C group received placebo and LCBD 1200 kcal/day. Data include age, body mass index (BMI), intake of energy, macronutrient, and fiber, as well as serum LDL cholesterol level. Serum LDL cholesterol level was examined before and after treatment. Statistical analyses include independent t-test and Mann-Whitney with significance level of 5%. Subjects characteristics of the two groups at baseline was not statistically different. Twenty eight subjects (14 subjects in each group) completed the intervention. Supplementation was well tolerated and there were no serious adverse events. The mean age in T and C group was 35.0 (30.0−45.0) and 34.5 (30.0−48.0) years, respectively, and BMI was 28.0 ± 1.1 and 27.2 ± 1.4 kg/m2, respectively. The pretreatment serum LDL cholesterol level in T and C group was 137.0 ± 37.0 and 134.4 ± 29.1 mg/dL, respectively. Energy deficit in T group was insignificantly lower (p = 0.62) than in C group; -282.0 ± 482.6 and -331.8 ± 578.3 kcal/day, respectively. Percentage of energy intake to recommendation in T group (94.2 ± 18.5%) was significantly higher (p = 0.02) than that in C group (85.4 ± 22.9%). Total carbohydrate (CHO) intake in T group (613.1 ± 134.5 kcal/day) was significantly higher (p = 0.02) than in C group (545.4 ± 161.1 kcal/day). Total protein, fat, and cholesterol intake were similar to the NCEP-ATP III recommendation in both groups. Intake of SAFA was higher than recommended, meanwhile PUFA and MUFA intake were lower than those recommended in both groups. Dietary fiber intake in T and C group was 17.2 ± 2.8 and 8.6 (5.2−15.2) g/day, respectively. During the intervention, PH supplementation did not meet the recommendation. Percentage of simple CHO to total energy in T group 11.5±5.4% was significantly higher (p = 0.00) than in C group 6.0 (1.2524.2)%. PH supplementation decreased serum LDL cholesterol level (-2.1 ± 16.2 mg/dL) lower than placebo (-10.9 ± 15.3 mg/dL), but not significant different (p = 0.15). This study shows that PH supplementation 8.4 g/day in combination with LCBD 1200 kcal/day for 4 weeks in obese I aged 30−50 years old is not proven to decrease the serum LDL cholesterol level.