Hubungan antara Ukuran Lingkar Pinggang dengan Masa Lemak Tubuh, Profil Lipid, dan Gula Darah Puasa pada Remaja Obese

Latar belakang. Obesitas pada anak masih menjadi masalah dunia, termasuk Indonesia. Obesitas abdominal, yang ditandai dengan besarnya ukuran lingkar pinggang, dapat meningkatkan risiko penyakit kardiovaskular, metabolik, dan kematian. Tujuan. Penelitian ini bertujuan untuk mendapatkan gambaran ukuran lingkar pinggang pada anak obes, serta hubungannya dengan masa lemak tubuh, profil lipid, dan kadar gula darah puasa. Metode. Penelitian ini merupakan studi potong lintang. Subjek penelitian adalah anak usia 14-18 tahun dengan obesitas. Pemeriksaan tinggi badan, berat badan, lingkar lengan atas, lingkar pinggang, dan bioelectric impedance analyzer (BIA) dilakukan untuk memperoleh gambaran antropometri subjek. Pemeriksaan darah puasa dilakukan untuk memperoleh data profil lipid dan gula darah puasa. Hasil. Sebanyak 69 subjek terlibat dalam penelitian ini. Semua subjek mempunyai lingkar pinggang ≥P80, dengan lingkar pinggang terlebar adalah 138 cm. Ukuran lingkar pinggang mempunyai korelasi yang bermakna dengan kolesterol high density lipoprotein (HDL), sedangkan korelasi dengan masa lemak tubuh, profil lipid lainnya, dan kadar gula darah puasa tidak bermakna. Kesimpulan. Obesitas pada anak umumnya disertai dengan ukuran lingkar pinggang yang melebihi P80. Ukuran lingkar pinggang mempunyai korelasi yang bermakna dengan kadar kolesterol HDL. Ukuran lingkar pinggang tidak boleh digunakan secara tunggal untuk memperkirakan masa lemak tubuh, profil lipid di luar kolesterol HDL, dan gula darah puasa

Buku Ajar Nutrisi Pediatrik dan Penyakit Metabolik

xv, 293 hal. : il. ; 17,5 x 25 cm

Buku Ajar Nutrisi Pediatrik dan penyakit Metabolik

xv + 293 hal.; 25 c

Buku ajar nutrisi pediatrik dan penyakit metabolik (jilid 1 revisi)

xv, 293 pages : illustrations ; 26 c

Factors affecting exclusive breastfeeding in term infants

Background Exclusive breastfeeding by healthy mothers to their healthy, term babies who underwent vaginal birth, should be readily accomplished. However, exclusive breastfeeding by Indonesian mothers has declined. Objective To assess the monthly success rate prevalences for exclusive breastfeeding for the first 6 months of life, as well as factors that affect exclusive breastfeeding. Methods A prospective cohort study was conducted in 243 healthy mothers with healthy term babies who underwent normal births at Cipto Mangunkusumo Hospital (CMH), Jakarta, Indonesia. Guided interviews were conducted monthly for six months. Bivariate and multivariate analyses were performed on the factors potentially affecting breastfeeding with equal subject numbers. Results Exclusive breastfeeding prevalences were 64.8% (first month), 53.7% (second month), 43% (third month), 30.7% (fourth month), 23.5% (fifth month), and 22.3% (sixth month). Multivariate analysis revealed that the mother’s confidence in breast milk production, as well as husband or family support, affected the success of exclusive breastfeeding for each month. Maternal not working/studying outside the home affected the success of exclusive breastfeeding in the third (RR 3.38; 95%CI 1.21 to 9.43) and fourth months (RR 6.56; 95%CI 1.39 to 30.99). Conclusion Exclusive breastfeeding prevalences in Cipto Mangunkusumo Hospital decrease in a monthly fashion up to the sixth month. Several factors affecte the success rate for each month in the six month period, including maternal confidence in breast milk production and family support

Plasma lipid profile and leptin concentration in super-obese children

Background Leptin induced weight loss is completely specific for adipose tissue loss, whereas food restriction result in both loss of adipose tissue and lean body mass in mammals. Most obese person has high endogenous leptin levels, indicating leptin resistance. There has been lack of data regarding plasma leptin level in Indonesian obese children. Objective This study was aimed to investigate the plasma leptin level and lipid profile in super-obese children. Methods This was a cross sectional study performed in Pediatric Out Patient Clinic Mangunkusumo Hospital and Private Women & Children Hospital in Eastern part of Jakarta. Super-obese is defined as children with BMI above 97 centiles CDC 2000 chart. Blood sample was obtained from all subjects, consisted of peripheral blood picture, lipid profiles and leptin level. Results Seventy nine super-obese children were eligible with age ranged between 12 months and 180 months and mean of age was 84.9 months (SD 36.8). More than 60% subjects had high LDL cholesterol, while 19% had low HDL level. The lowest leptin blood level was 2.877 μ g/dL, while the highest was 70.430 μ g/dL (mean 23.990; SD 12.726). Forty five subjects, all boys, had increased plasma leptin level. Conclusions In super-obese children, most of the subject experienced hyperlipidemia (LDL cholesterol) followed by hypertriglyceridemia. There was small number of low HDL cholesterol found. Super-obese girls had normal serum leptin level, in contrast, more than 60% super-obese boys had elevated serum leptin level

Daily consumption of growing-up milk is associated with less stunting among Indonesian toddlers

BACKGROUND In Indonesia, animal protein intake in children is low and might contribute to a high prevalence of stunting. This study was aimed to evaluate the association between animal protein source consumption and stunting in toddlers. METHODS This cross-sectional study obtained secondary data from the Ironcheq questionnaire validation study to detect the risk of iron deficiency in toddlers. The Ironcheq study was carried out in five integrated health service posts (Posyandu) in Jakarta from 2013 to 2014. Data from 172 subjects, consisting of 41 stunted (height-for-age z-score less than -2) and 131 normal children, were analyzed to evaluate the association between animal protein source consumption and stunting using multivariate logistic regression test. RESULTS Stunted children tend to come from a family with low parental education and socioeconomic status. Consuming growing-up milk (GUM) ≥300 ml/day was protective against stunting (adjusted OR 0.28, 95% CI 0.13–0.63), whereas consuming red meat product ≥5 times/week was a risk factor (crude OR 3.70, 95% CI 1.17–11.74), however after adjusted to age, sex, and other variables in the questionnaire, the OR was not significant (adjusted OR 3.64 95% CI 1.00–13.26). CONCLUSIONS A daily consumption of 300 ml of GUM may be considered to prevent stunting in toddlers. Red meat products (sausage, nugget, and meatball), which are commonly consumed because of its practicality, could not be considered as significant animal protein sources because of a wide variation of their nutritional content

Clinical features of dengue hemorrhagic fever and risk factors of shock event

Background Dengue hemorrhagic fever (DHF) can lead to high morbidity and mortality. Its clinical features vary from time to time. Many studies were performed to determine the risk factors of se- vere dengue infection. Objective To find out clinical features and risk factors for predict- ing the likelihood of shock in DHF. Methods A retrospective cohort study was conducted in all con- firmed DHF children who were hospitalized at the Department of Child Health, Cipto Mangunkusumo Hospital within the period of January 1, 2003 until June 30, 2004. Risk factors for development of shock were analyzed using chi-square test and multiple logistic regressions with a level of significance of <0.05. Results A total of 101 patients, consisted of 47 males and 54 females were enrolled in this study. Mean age was 6.5 (SD 3.6) years, ranged from 5 months to 15 years. About 31.7% patients had grade III DHF, 30.7% grade II, and 26.7% grade IV (including 1 patient with encephalopathy). Shock was more frequent among patients aged between 6-10 years, female, under-nourished, body temperature <38°C, hematocrit level 46-50 vol%, and platelet count <20 000/ml. During year 2003-2004, there was increased number of patients who developed shock. Based on univariate analysis, hepatomegaly, high hematocrit value, and thrombocytopenia were considered significantly different. Among those variables analyzed with multiple logistic regression method, only hepatomegaly and thrombocytopenia were identified as predictors of shock. Conclusion There was an alteration on clinical features of DHF in our hospital in 2003-2004 period compared to the previous years. Hepatomegaly and platelet count <50 000/ml are independent risk factors of shock among DHF patient

The effect of Ringer’s acetate versus Ringer’s lactate on aminotransferase changes in dengue hemorrhagic fever

Background Dengue hemorrhagic fever (DHF) infection causes hepatocelullar impairment. In management of DHF, World Health Organization (WHO) recommends the crystalloids Ringer’s acetate (RA) or Ringer’s lactate (RL), which are similar in composition to plasma. Acetate in RA is not metabolized in the liver, hence not burdening the liver, whereas lactate in RL is metabolized mostly in the liver, thus placing a burden on the liver. Objective To compare aminotransferase changes as markers of hepatocellular impairment subsequent to the use of RA and RL in the management of DHF with and without shock. Methods This study was a double-blind randomized controlled trial on DHF patients aged 1-18 years in Cipto Mangunkusumo Hospital who had not received prior treatment with crystalloids or colloids. Subjects were randomly assigned to receive either RA or RL intravenously. Aminotransferase levels were examined on the first, second and third weeks from the onset of fever. Results Ninety-two patients who fulfilled inclusion criteria were enrolled in this study, consisting of those without and with shock. Mean transaminase levels of patients without shock in the RA and RL groups did not differ significantly. Mean transaminase levels of patients with shock in the RA group were lower than those in the RL group, but this difference was not significant statistically. Mean alteration of transaminase levels in patients with and without shock were not significantly different. Conclusion In DHF without shock, there is no significant differ- ence between aminotransferase level changes of patients receiv- ing RA and RL solutions. In DHF with shock, aminotransferase levels of patients receiving RA tend to be lower than those receiv- ing RL, but this difference is insignifican