Hubungan Berat Badan Lahir, Asi Eksklusif, dan Gizi Makanan dengan Stunting pada Anak

This study aims to determine the relationship between Birth Weight, Exclusive Breastfeeding, and Nutritional Intake with stunting in children. The method used in this research employs a quantitative approach. The sample in this study consists of 40 toddlers. The variables in this research include Birth Weight, Exclusive Breastfeeding, and Nutritional Intake as independent variables, and stunting in children as the dependent variable. The instrument used is a questionnaire consisting of questionnaires to be filled out, and the data analysis conducted in this research utilizes regression model testing. The results of the research indicate that Birth Weight has a significant relationship with stunting in children, with a coefficient of determination of 73.7%; Exclusive Breastfeeding has a significant relationship with stunting in children, with a coefficient of determination of 73.4%; and Nutritional Intake has a significant relationship with stunting in children, with a coefficient of determination of 72.3%. The conclusion of this study is that the occurrence of stunting in children can be associated with several factors such as low birth weight, exclusive breastfeeding, and nutritional intake provided to the child during the child's growth period, which are factors related to the occurrence of stunting in children. Keywords: Exclusive Breastfeeding, Food Nutrition, Low Birth Weight, Stunting

DETERMINANTS OF FOOD CHOICE IN OBESITY

ABSTRACT The prevalence of obesity is increasing at all ages in Indonesia. Obesity does not only cause health complications, such as dyslipidemia, cardiovascular disease, cancer, and osteoarthritis but also has a negative effect on a countr’s socioeconomic conditions. Previous studies have explained that food choices affect the incidence of obesity. This literature review aims to explain the factors that influence the food choice related to obesity. Genetic and environmental factors affect the food choice in individuals that can cause obesity. Environmental factors play a major influence on food choice, including peers, family, economic status education environmental conditions, stress, and sedentary behavior. Detection of environmental factors that influence food choice can be one of the strategies to prevent obesity.   Key words : Obesity, Diet, Food Preference, Food Choice, Adolescent

Cut-off value of Waist-to-Hip Ratio as a pedictor of metabolic syndrome in adolescents with obesity

Abstract.Background and aim: Metabolic syndrome is present in 7% of adolescents and 19 to 35% in obese adolescents, and the cause of this condition has not been fully understood. Early identification of the risk involved could be an initial step in preventing a metabolic syndrome. Increased waist circumference, which is a parameter of central obesity, is also risk factor for this condition. This study aims to determine the pos-sibility cut-off value of waist-to-hip (WHR) as a predictor of metabolic syndrome. Methods: We studied 208 obese adolescents between the ages of 13 to 18 years from junior and senior high schools who living in rural dan urban areas in East Java. These obese adolescents were divided into two groups, namely with and without a metabolic syndrome. Anthropometric measurements, including waist-to-hip ratio (WHR), were carried out to analyze the cut-off values between the two groups. Results: 208 obese adolescents (51.4% males and 48.6% females) without the metabolic syndrome and 104 obese adolescents with metabolic syndrome were evaluated. There was a significant relationship between WHR and metabolic syndrome in obese adolescents (r = 0.203, P = 0.003). Those adolescents with a high WHR value > 0.891 had twice risk to develop meta-bolic syndrome compared to those with lower (OR 2.033; 95% CI = 1.165-3.545). Conclusions: Increased waist-to-hip ratio > 0.89 in adolescents was associated with higher risk to develop metabolic syndrome and can be proposed as a predictor for metabolic syndrome in obese adolescents. (www.actabiomedica.it)Key words: Waist-to-hip ratio, Metabolic Syndrome, Adolescence, Risk FactorsIntroductionMetabolic syndrome (MetS), also known as “Insulin Resistance Syndrome” or “Syndrome X”, has an increas-ing prevalence in children and adolescents. The cause of this condition has not been fully understood (1). There-fore, early identification of MetS risk factors and adopt-ing suitable preventive measures is an essential step in preventing its occurrence (2,3). One of the components of MetS is central obesity, which can be measured using various anthropometric parameters, such as waist and hip circumferences, and waist-hip ratio (WHR). Further-more, the periodic measurement of these parameters can be used for early identification of MetS (4). The cut-off value of WHR can be used as a predicting indicator of metabolic syndrome in obese children (5). However, this value varies among different countries (6). This study aims to determine the cut-off value of WHR as a predictor of metabolic syndrome in obese adolescents in Indonesia.Materials and methodsStudy population and designThis is an observational case-control study per-formed between January to May 2020 on obese ado-lescents with and without the metabolic syndrome. The cut-off value that discriminates those with versus those wthout the metabolic syndrome was searched

Cut-off value of Waist-to-Hip Ratio as a predictor of metabolic syndrome in adolescents with obesity

Background and aim: Metabolic syndrome is present in 7% of adolescents and 19 to 35% in obese adolescents, and the cause of this condition has not been fully understood. Early identification of the risk involved could be an initial step in preventing a metabolic syndrome. Increased waist circumference, which is a parameter of central obesity, is also risk factor for this condition. This study aims to determine the possibility cut-off value of waist-to-hip (WHR) as a predictor of metabolic syndrome. Methods: We studied 208 obese adolescents between the ages of 13 to 18 years from junior and senior high schools who living in rural dan urban areas in East Java. These obese adolescents were divided into two groups, namely with and without a metabolic syndrome. Anthropometric measurements, including waist-to-hip ratio (WHR), were carried out to analyze the cut-off values between the two groups. Results: 208 obese adolescents (51.4% males and 48.6% females) without the metabolic syndrome and 104 obese adolescents with metabolic syndrome were evaluated. There was a significant relationship between WHR and metabolic syndrome in obese adolescents (r = 0.203, P = 0.003). Those adolescents with a high WHR value > 0.891 had twice risk to develop metabolic syndrome compared to those with lower (OR 2.033; 95% CI = 1.165-3.545). Conclusions: Increased waist-to-hip ratio > 0.89 in adolescents was associated with higher risk to develop metabolic syndrome and can be proposed as a predictor for metabolic syndrome in obese adolescents

Music Enhances Brain Development in Premature Infants: A literature Review

Preterm infants have a high risk of neurodevelopmental problem with a decrease of functional capacity of brain network. Without early intervention, it will develop as long-lasting brain network deficiency. We examine the studies of music effect on early life of preterm infants in neonatal intensive care units (NICU). It founds that music has a positive correlation with brain development in preterm infants. The preterm infants exposed with repetitive music as NICU environment enrichment have a chance to develop brain as good as the term infants and have long-lasting beneficial effects on brain development

Pengaruh Penyakit Infeksi terhadap Kadar Albumin Anak Gizi Buruk

Latar belakang. Penyakit infeksi dan gizi buruk merupakan hubungan yang sinergis. Serum albumin merupakan prognostik faktor yang penting untuk pasien gizi buruk terutama yang dirawat di rumah sakit. Pasien rawat inap dengan gizi buruk mempunyai risiko komplikasi klinis yang lebih berat, dan mortalitas lebih tinggi dibanding pasien tanpa gizi buruk. Tujuan. Mengetahui pengaruh penyakit infeksi terhadap kadar albumin anak dengan gizi buruk yang dirawat di rumah sakit. Metode. Penelitian analitik deskriptif retrospektif dari data sekunder status semua pasien gizi buruk dengan atau tanpa edema yang dirawat di bangsal anak RSUD Dr Soetomo, Surabaya sejak Mei tahun 2008-Juni 2009. Data yang diambil adalah data umur, jenis kelamin, dan status penyakit. Pasien dibagi dua kelompok, yaitu kelompok infeksi dan non infeksi, dan diukur kadar albuminnya. Analisis data menggunakan chi-square dan t-test. Hasil. Didapatkan 77 anak dengan gizi buruk tipe non edema, 44 anak dengan penyakit infeksi dan 33 anak dengan penyakit non infeksi. Nilai rerata albumin pada anak gizi buruk dengan infeksi lebih rendah dan bermakna secara statistik dibandingkan gizi buruk non infeksi (3,08±0,74 g/dL dibanding 3,56±0,99 g/dL, p=0,019). Anak gizi buruk dengan serum albumin rendah mempunyai risiko untuk mendapatkan penyakit infeksi lebih tinggi dibanding anak gizi buruk tanpa penyakit infeksi (RR:1,35, CI 95%:1,030-1,946). Kesimpulan. Kadar serum albumin yang rendah pada anak gizi buruk yang dirawat di rumah sakit lebih berisiko untuk mendapatkan infeksi. Sari Pediatri 2013;15(1):46-50

PLA2G6-Associated Neurodegeneration: A Rare Case Report of Neurodegeneration with Brain Iron Accumulation in Children

Abstract This report aimed to describe and review the clinical features, neuroimaging findings, and PLA2G6 mutations identified in a 34-month-old girl with regression of developmental milestones. A 34 months old girl came to Dr.Soetomo Hospital’s outpatient clinic, Surabaya, with a developmental regression for six months, and got worse until she could not do any activity and was followed by recurrent seizures. She had a sibling who had similar problems and symptoms and then died at five years of age. The head MRI revealed brain atrophy, the possibility of an early sign of metabolic disorder, and a white matter lesion at the globuspallidus bilateral that supports the encephalopathy metabolic view. The genetic test revealed a positive homozygous such as a pathogenic variant in the PLA2G6 gene, which confirmed the diagnosis. PLA2G6-Associated with Neurodegeneration (PLAN) should be considered as a diagnosis in children with developmental regression

METS-IR vs. HOMA-AD on Obese adolescents

Purpose : Obesity is associated with chronic low-grade inflammation in which is the key in the pathogenesis Insulin Resistance (IR) and Metabolic Syndrome (MetS). Homeostasis model assessment of insulin resistance (HOMA-IR) has been validated as a surrogate measure of IR. The combination of HOMA and adiponectin, known as HOMA-AD was proposed to measure IR in adults. However, study on these indicators in obese adolescents is still limited. This study aims to analyse METS-IR and HOMA-AD to determine MetS and IR in obese adolescents. Methods : A cross-sectional study was conducted on obese adolescents who looked healthy from secondary schools in Surabaya and Sidoarjo, East Java, aged 12-18 years. Subjects were selected randomly and grouped into 2, namely MetS and non-MetS based on IDF 2000. Anthropometric examination and blood measurements, such as fasting blood glucose levels, lipid profiles, insulin, and adiponectin level were carried out according to standards. HOMA-IR, HOMA-AD, AND METS-IR were calculated using formula. Spearman’s Rho correlation were conducted between assessment tools (METS-IR and HOMA-AD) to identify the correlation with MetS component (lipid profile, FBG, and blood pressures). A receiving operation curve (ROC) performed to find area under curve (AUC) and cut-off points based on the biggest Youden index. Result : A total of 250 subjects were enrolled the study, and found 103 subjects had MetS. METS-IR correlates with all lipid profile and blood pressures (p < 0.05). While HOMA-AD correlated with TG (r = 0.356, p = 0.000), systolic-BP (r = 0.188, p = 0.003), and HDL-c levels (r=-0.249, p = 0.000). Cut-off point for METS-IR to determines MetS in obese adolescents was ≥ 46.53 (sensitivity of 64.24% and specificity of 75.76%), while HOMA-AD was ≥ 0.43 (sensitivity of 71.52% and specificity of 59.60%). Cut-off point for METS-IR index to determines IR was ≥ 52.01 (sensitivity of 83.44% and specificity of 44.44%). Cut-off point for HOMA-AD to determine IR was ≥ 0.37 (sensitivity of 74.17% and specificity of 84.85%). Conclusion : METS-IR is better surrogate to determine MetS with cut-off point of ≥ 46.53, while HOMA-AD is better to determine IR with cut-off point ≥ 0.37 in obese adolescents

Association of Adipoq +45 T>G Gene Polymorphism with Insulin Resistance and Icam-1 Value in Obese Adolescents

Background: Obesity is defined as the accumulation of excess body fat tissue which harms health, such as cardiovascular disease, metabolic syndrome, diabetes mellitus type 2 and dyslipidemia. Lower adiponectin levels are strongly associated with overweight, obesity, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular risk factors in adulthood. ADIPOQ +45 T>G gene polymorphism is one of a genetic variations that affect plasma adiponectin levels. Methods: A cross-sectional study of 180 obese adolescents aged 13-18 years in Surabaya and Sidoarjo. Obesity is defined as body mass index (BMI)>p95 on the BMI for age curve according to Centers for Disease Control and Prevention (CDC) 2000. Blood samples were taken for ICAM-1 examination using the ELISA method, HOMA-IR with fasting insulin and glucose calculations, and ADIPOQ + 5 T>G gene polymorphisms by PCR-RFLP. Data were analyzed using the Chi-square, Mann-Whitney, and T-test using SPSS version 21, p-value<0.05 was considered significant. Results: There was a significant difference in the mean BMI by age group (p <0.001). There was no statistically significant difference between the median BMI in the three groups (wild, mutant homozygote, and mutant heterozygote) of genotype distributions. ADIPOQ +45 T>G gene polymorphisms occur with the same frequency in both males and females. There was no association between the genotype distribution of the ADIPOQ +45 T>G gene polymorphism with insulin resistance and ICAM-1 value, but the ICAM-1 value was found to be higher in the ≥ 15 years age group. There was no association between insulin resistance and ICAM-1 values. Conclusion: There was no association between ADIPOQ + 45 T>G gene polymorphisms with insulin resistance and ICAM-1 values in obese adolescents. There was no association between insulin resistance and ICAM-1 values

Predictive Value of Prognostic Nutritional Index in Children with COVID-19

Background and aim: Severe malnutrition might contribute the poor outcomes in COVID-19. This study aims to investigate the relationship between prognostic nutritional index (PNI) and mortality in children with COVID-19 infection and its predictive value for predicting poor prognosis. Methods: A case control study using medical records of paediatric patients with COVID-19 was conducted from June 2020-July 2022. Subjects were divided into two groups: non-survived and survived. PNI value were calculated as 10 x serum albumin (g/dL) + 0.005 x total lymphocyte count (/mm3). PNI was compared with nutritional status and several markers that have been used in COVID-19, including (1) neutrophil to lymphocyte ratio (NLR), (2) systemic immune inflammation index (SII), and (3) platelet to lymphocyte ratio (PLR). Results: Among 124 eligible subjects, 34 (27.41%) were in the non-survived group and 90 (72.58%) children in the survived group. Children with severe malnutrition had lower albumin and a greater risk of death than those with good nutrition. PNI, NLR, and SII were significantly correlated with the mortality children with COVID-19 except for PLR; P = 0.001, P = 0.001, P = 0.021, and P = 0.118, respectively. Receiver operating characteristic curves stated that PNI (AUC = 0.741, P < 0.0001). The cut-off values of PNI were 41.975 with sensitivities of 73.5% and specificities of 73.3%. PNI value <41.975 had a 7.64 times greater risk of mortality (P < 0.0001). Conclusion: PNI might be used as predictive value for predicting poor outcome in children with COVID-19 infection