Madarina Julia

Tracking for Underweight, Overweight and Obesity from Childhood to Adolescence: A 5-Year Follow-Up Study in Urban Indonesian Children

Aims: To assess tracking of body mass index (BMI) of urban Indonesian children from childhood to adolescence and to compare the prevalence of underweight, overweight and obesity in 6- to 8-year-old children from two surveys: years 1999 and 2004. Methods: A longitudinal study assessing BMI tracking of 308 urban children followed from age 6–8 to 11–13 years and two cross-sectional surveys comparing the prevalence of underweight, overweight and obesity in 6- to 8-year-old children: year 1999 (n = 1,524) and 2004 (n = 510). Results: Childhood BMI determined 52.3% variation of later BMI. After 5.1 (0.6) years the prevalence of overweight and obesity increased from 4.2 and 1.9% in childhood to 8.8 and 3.2% in adolescence. The prevalence of underweight decreased from 27.3 to 18.8%. All obese children remained obese, 84.6% overweight children stayed overweight, 56.0% underweight children remained underweight. In cross-sectional comparison the prevalence of overweight and obesity raised from 5.3 to 8.6% and from 2.7 to 3.7%, respectively. The prevalence of underweight remained constant. Conclusions: The prevalence of overweight and obesity increases as children grow into adolescence. Overweight or obese children are more likely to remain overweight or obese. Cross-sectional comparison shows, while the prevalence of underweight stays constant, the prevalence of overweight and obesity increases.

Influence of socioeconomic status on the prevalence of stunted growth and obesity in prepubertal Indonesian children.

This cross-sectional study assesses the prevalence of stunting, overweight, and obesity in prepubertal children from different socioeconomic groups in Indonesia. Children from rural, poor urban, and nonpoor urban communities were studied (n = 3,010). The prevalences of stunting, wasting, overweight, and obesity were 19.3%, 5.0%, 2.7%, and 0.8%, respectively. The odds ratios (OR) for stunting, as compared with nonpoor urban children, were higher among rural children (2.92; 95% confidence interval [CI], 2.37–3.59) than among poor urban children (1.58; 95% CI, 1.18–2.13). The prevalence of wasting was not influenced by socioeconomic status. Both rural and poor urban children were significantly less likely to be overweight than were nonpoor urban children: in comparison with nonpoor urban children, the OR values were 0.19 (95% CI, 0.10–0.36) for rural and 0.13 (95% CI, 0.04–0.43) for poor urban children. Boys were more likely to be stunted or obese than girls: OR for stunting, 1.75 (95% CI, 1.44–2.12); OR for obesity, 4.07 (95% CI, 1.40–11.8). Stunted children were less likely than non-stunted children to be overweight: OR, 0.10 (95% CI, 0.03–0.43). In Indonesia, undernutrition is still related to poverty, whereas obesity is more related to prosperity.

The influence of socioeconomic status on blood pressure of Indonesian prepubertal children.

This cross-sectional study assesses the association between socioeconomic status and blood pressure of school-aged prepubertal children living in Indonesia. It has been shown that elevated blood pressure (BP) contributes to the development of coronary artery disease and to the pathogenesis of cerebrovascular accidents. There is also evidence of some correlations between childhood BP and BP in adulthood.1 In contrast to consistently negative association between socioeconomic status (SES) and BP in industrialized countries, findings in developing countries are heterogeneous.2 The aim of the present study was to evaluate the association between nutritional status and SES, defined as rural, poor urban and non-poor urban, and BPs of school-aged prepubertal children living in Indonesia.

Gene-lifestyle interaction: The role of SNPs in UCP2 -866G/A and UCP3 -55C/T on dietary intake and physical activity in Indonesian obese female adolescents

BACKGROUND: Obesity is linked to high dietary intake and low physical activity. Studies showed that those factors were not only regulated by environment but also regulated by genetic variations. However, the relationship has less been understood in obese children and adolescents. OBJECTIVE: The objective of this study was to examine the role of SNPs (single nucleotide polymorphisms) in uncoupling protein (UCP) 2 -866G/A and UCP3 -55C/T on dietary intake and physical activity in obese female adolescents. METHODS: This is an observational study with cross sectional design. Respondents were obese female adolescents enrolled from obesity screening done in six junior high schools in Yogyakarta. RESULTS: Seventy eight obese female adolescents joined this study. From 2 SNPs that have been analysed, we found that SNPs in UCP2 was associated with dietary intake and physical activity (p = 0.02 and p = 0.02, respectively). Interestingly, subjects with combination of UCP2 -866GG and UCP3 -55CC had slightly higher percent fat to total energy intake compared to those with UCP2 -866AA and UCP3 -55TT (mean difference = –3.8 ± 1.9; p = 0.059). CONCLUSION: We concluded that SNPs on UCP2 was related to dietary intake and physical activity in Indonesian obese female adolescents.

Home Care Intervention to Improve Nutritional Status of Severe Acute Malnourished (SAM) Children in Yogyakarta, Indonesia

This study aims to evaluate effects of home care to improve nutritional status of acute malnourished children. Quasi-experimental with pretest-posttest control group design was carried out. The study was used 22 health centers in Yogyakarta. Samples were selected in intensive, strengthening and independent phases. Data collected included anthropometric measurement, and socio-demographic characteristics. Data were analyzed using chi square, t-test and linier mixed effect model. After three months, significant escalations were found in the anthropometric indicator among experimental groups. Then, the proportion of wasting in the experimental group was reduced to 56.7% (P=0.0001), whereas proportion of wasting in the control group showed no reduction (P=0.317). Three month of home care program was be able to improve the nutritional status of children.

Effect of FTO rs9939609 variant on insulin resistance in obese female adolescents

ObjectivesFTO rs9939609 variant has been shown to be associated with insulin resistance in Caucasian children. However, studies in Asia show inconsistent findings. We investigated the association between FTO rs9939609 polymorphisms and insulin resistance in obese female adolescents in Indonesia, a genetically distinct group within Asia.ResultsA total of 78 obese female adolescents participated in this study. The risk allele (A) frequency of FTO rs9939609 variant in Indonesian obese female adolescence was 44.2%. The frequency of insulin resistance was higher in the subjects with AA (54.6%) or AT (59.6%) than the subject with TT genotype (50%), but did not statistically different (p = 0.81 and p = 0.47, respectively). The insulin resistance rate was also higher in the risk allele (A) than the non-risk allele (T) subjects (0.58 vs. 0.55), but did not statistically different (p = 0.75). There was no association between FTO rs9939609 variant and body mass index, fasting glucose level, fasting insulin level, homeostatic model assessment of insulin resistance, and waist circumference (p > 0.05). In conclusion, FTO rs9939609 variant may not be associated with insulin resistance in Indonesian obese female adolescents. A multicenter study with a larger sample size is needed to clarify these findings.

What information and the extent of information research participants need in informed consent forms: a multi-country survey

BackgroundThe use of lengthy, detailed, and complex informed consent forms (ICFs) is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in biomedical research.MethodsThis multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 (not important) to 5 (very important).ResultsOf the 2484 questionnaires distributed, 2113 (85.1%) were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making (mean score, ranging from 3.58 to 4.47). Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF (mean score = 4.47, 4.47, and 4.45, respectively).ConclusionsResearch participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF.

KORELASI TINGGI BADAN IBU DENGAN PANJANG BADAN BAYI BARU LAHIR DI KOTA PALU

Background: Body length of newborn babies is related to health in adulthood. Some studies suggested that short people tend to have lower intellectual performance that can reduce working capacity, poor reproductive performance and increase risk of cardiovascular disease and type 2 diabetes. In addition, the less the body’s length of newborns the more adverse long-term health such as obesity, cardiometabolic disorders, and neuro psychiatric conditions were encountered. Objective: To determine the relation of mothers’ height with body length newborns in Palu. Samples are babies born in the first 24-72 hours of private hospitals, health centers, and maternity clinics in Palu. Method: An observational study with cross sectional design. The independent variable is the mothers’ height and the dependent variable is the length of the body of the newborns. Data collection used questionnaires. Data analysis used linear regression. Result and Discussion: There was a correlation between the height of mothers with the body length of newborns (r = 0.26) (p <0.001). There was a significant relationship between mothers’ upper arm circumference, the amount of iron preparations consumed, the height of the father (p <0.001) as well as maternal education (p <0.020) and the sex of the newborn (p <0.015) with the body length of newborns. There was no significant relationship between body length of newborns with socioeconomic status (p <0.861). Conclusion: Mothers’ height is not the main factor affecting the body length of newborns in the city of Palu. Education to newly wed couples and pregnant women about the importance of knowledge that body length of newborns is not only influenced by genetic factors but also by the maternal intake. Keywords: Mothers’ height, newborn body length

46 XX Ovotesticular Disorder of Sexual Development with Detected SRY(Sexdetermining Region Y) Gene: A Case Report

Ovotesticular disorder or true hermaphroditism is a condition in which an individual has both ovary and testis. The ovary is usually located on the left side, whereas the testis is on the opposite side. The SRY gene is detected in one third of cases of 46 XX ovotesticular DSD. The most common karyotype of ovotesticular DSD is 46 XX. Here, we report the case of a girl with SRY positive 46 XX karyotype diagnosed as ovotesticular DSD by gonadal biopsy. The patient presented with female phenotype and ambiguous genital since birth. The external genital showed an accessoria penile without OUE with rough right labia majora that looked like scrotum. Testicle was felt on the right side of scrotum. USG revealed no appearance of normal uterus, right testicle was visualized but no visualization of left testicle. Right and left ovaries were not clearly visualized. Karyotyping-46 XX and SRY gene was detected on 472 bp fragment on multiplex PCR of AZF/SRY gene analysis. Diagnostic laparoscopy showed left hemiuterus with fallopian tube and unilateral left side ovary. The shape and size of left fallopian tube was normal. Histopathologic examination report revealed left gonad was ovarium with primary follicle and right gonad was testicle with leydig cell and seminiferous tubules. This patient was decided as a girl. The operation was initiated and divided into 2 phases. The first phase was orchidectomy of the right side testicle and the second phase was genital reconstruction (clitoroplasty and labioplasty).

Sexual dimorphism in interleukin 17A and adipocytokines and their association with insulin resistance among obese adolescents in Yogyakarta, Indonesia

BACKGROUND AND OBJECTIVES Pro-inflammatory cytokines interleukin 17A (IL-17), leptin, and adiponectin have been associated with obesity and insulin resistance. Moreover, differences in sex and ethnicity as well as plasma concentration of adipocytokines and cytokines have been associated with the risk of insulin resistance. This study was conducted to elucidate whether sex differences exist in the risk of insulin resistance in Indonesian adolescents and to determine how plasma leptin, adiponectin, and IL-17 predict insulin resistance. METHODS AND STUDY DESIGN The study participants were 69 obese-overweight boys, 53 obese-overweight girls, 59 non-obese boys, and 50 non-obese girls aged 15-18 years. Insulin resistance was determined using the homeostatic model assessment of insulin resistance index. Plasma IL-17, leptin, and adiponectin were measured using ELISA. Data were analysed using one-way ANOVA and linear regression analysis. Odd ratios [ORs; 95% confidence intervals (CIs)] were analysed to estimate the risk of insulin resistance; the significance level was set at 95%. RESULT The OR (95% CI) for insulin resistance was higher in obese-overweight boys than in obese-overweight girls. The plasma IL-17 was higher in boys, whereas plasma adiponectin and leptin were significantly higher in girls. In all participants, obesity status and plasma leptin were the most efficient predictors of insulin resistance, whereas the IL-17 could not significantly predict insulin resistance. CONCLUSION Sexual dimorphism exists in IL17 as well as leptin and adiponectin in adolescents. Plasma IL-17 cannot be used to predict insulin resistance in adolescents of both sex.