Maria Mexitalia

The role of uncoupling protein 2 and 3 genes polymorphism and energy expenditure in obese Indonesian children.

Abstract Aim: Uncoupling protein (UCP) genes, which may contribute to energy metabolism in mitochondria, may be involved in the pathogenesis of obesity. We analyzed the differences in energy expenditure between single nucleotide polymorphisms (SNPs) UCP3-55C/T, UCP3 Y210Y, and UCP2 A55V among Indonesian children. Methods: The study included 76 schoolchildren (36 obese and 40 healthy; mean age, 12.8 years) in Semarang, Indonesia. Body composition was measured by bioelectrical impedance analysis; resting energy expenditure (REE) by indirect calorimetry; physical activity by uniaxial accelerometer; and total energy expenditure (TEE) by the equations extrapolated from REE and physical activity. UCP3-55C/T, UCP3 Y210Y, and UCP2 A55V were examined by restriction length fragment polymorphism analysis. Results: The TEE of the subjects with the T/T genotype at UCP3-55C/T after adjusting for fat-free mass (63.2±7.2 kcal/kg/day) and T/T at UCP2 A55V (62.8±5.6 kcal/kg/day) was lower than that of the subjects with the C/C and C/T genotypes (p<0.05). The REE of the subjects with these T/T genotypes tended to be lower than that of the subjects with C/C and C/T (p≥0.05). No significant differences in REE or TEE were found between the UCP3 Y210Y genotypes. Conclusions: The subjects with the T/T genotypes of UCP3-55C/T or UCP2 A55V had lower TEE than those with other genotypes.

Validating predictive factors for resting energy expenditure of adolescents in Indonesia.

Our objectives were to (1) compare the measured and predicted resting energy expenditure (REE) using 18 equations in normal-weight and obese adolescents, and (2) examine potential predictive factors for accurately estimating REE in obese adolescents. The subjects chosen were 41 obese and 35 normal-weight adolescents living in an urban area in Indonesia. REE was measured using indirect calorimetry and compared with predicted REE determined via 18 equations. New predictive equations were developed via stepwise multiple regression analysis. Mean differences between the predicted and measured REE were within ± 5% with 13 equations tested in normal-weight subjects, and only six equations in obese subjects. New predicted REE derived from our new equations was significantly correlated with measured REE (P < 0.0001, R2 = 0.5–0.7). Measured REE was overestimated by existing predictive equations, especially in obese subjects. New predictive equations need to be developed that take age, climate and ethnicity into account, in addition to physical characteristics.

UCP2 and UCP3 polymorphisms as risk factors of insulin resistance for Indonesian obese adolescents

Uncoupling Protein 2 (UCP2) dan Uncoupling Protein 3 (UCP3) is a mitochondrial transmembrane carriers which uncouple the transport of protons across the inner mitochondrial membrane from electron transport and the synthesis of ATP from ADP. The UCPs play a role in energy homeostasis and have considered to be candidate gene for controlling obesity and insulin resistance. The aim of our study is to analyze UCP2 and UCP3 polymorphisms as risk factors of insulin resistance in obese adoslescent. n nA case control study was conducted in Junior High School in Semarang, Central Java, Indonesia during 2007- 2008. Seventy five subjects included in this study. Height, weight and body mass index (BMI) were measured. Insulin resistance was estimated by using the homeostasis model assessment (HOMA-IR) score which calculated as fasting insulin (microU/mL) x fasting glucose (mmol/L)/22.5. Three polymorphic sites i.e. UCP3 -55c/t, UCP3 Y210Y, and UCP2 A55V were investigated by using the Restriction Length Fragment Polymorphism. The data were analyzed by 2x2 table and odd rasio with 95% confidence interval. n nThere were 38 obese (27 male, 11 female) and 37 normoweight ( 25 male, 12 female) subject with the mean age was 13.2 (SD 0.32) years. Of 38 obese, there were 3 (7.9%) subject had insulin resistance. None of normoweight subjects had insulin resistance. There was a significant correlation between BMI and insulin resistance (r = 0. 601, p< 0.001). Of 38 obese subject, C allele of UCP2 A55V and C allele of UCP3 Y210Y are a risk factors of insulin resistance (OR 2.45, 95% CI 1.97-3.04 , p< 0.0001 ; OR 2.6, 95% CI 2.10-3.24, p< 0.0001 respectively), whereas UCP3 -55c/t was not considered as risk factors of insulin resistance. n nOur study suggest that C allele of UCP2 A55V and C allele in UCP3 Y210Y are a risk factors of insulin resistance in Indonesian obese adolescent. Larger studies is needed to prove the role of UCPs in controlling insulin resistance.

Effect of tuberculosis treatment on leptin levels, weight gain, and percentage body fat in Indonesian children

Purpose Tuberculosis (TB) remains a problem in the community. TB patients usually experience malnutrition, which is characterized by both decreased body weight (BW) and body fat percentage (BFP). Leptin, an important regulator of BW, also plays an important role in cellular immunity, which is integral to defense against Mycobacterium tuberculosis infection. We analyzed the effect of an anti-TB treatment regimen on the leptin level, BW, and BFP of children with TB. Methods The design of this study was a group interrupted time series. The subjects were children with probable TB according to clinical criteria based on an Indonesian scoring system adopted from the Consensus of Expert Panel. BW; BFP; energy intake; fat and protein intake; and leptin levels before, 2 months after (intensive phase), and 6 months after (continuation phase) anti-TB treatment, were measured. About 40 children, aged 5–14 years, participated in this study. Results The BW, BFP and leptin level increased from before treatment to after completion of the intensive phase and still showed an increased during the continuation phase: BW 18.65 kg, 19.75 kg, and 20.85 kg; BFP 18.3%, 19.5%, and 20.2%; and leptin level 1.9 mg/dL, 3.07 mg/dL, and 3.4 mg/dL, respectively (P<0.01). Conclusion Leptin level, BW, and BFP increased throughout the course of anti-TB treatment, compared with pretreatment values. Further research is needed to compare the results with data for healthy children.

Beberapa Faktor Risiko Gizi Kurang dan Gizi Buruk pada Balita 12-59 Bulan

Abstract: Several Risk Factors Of Moderate And Severe Malnutrition In Children Under Five Years Old Aged 12-59 Months . The type of research was observational using case-control study and the qualitative study through the in-depth interview (mixed method). The research location was in Pontianak City. The number of samples was 80 people consisting of 40 people from a case and 40 people from control. Assessment of nutritional using anthropometry measurement based on weight for height. Height measurement using microtome and measure weighting scale. Result show that the multivariate analysis found two variables significantly associated with the prevalence of moderate and severe malnutrition in children under five years old aged 12-59 months, i.e.: poor of attitude toward food (OR = 6.980, p = 0.002, 95% CI = 1.998-24.385) and poor environmental health (OR = 5.033, p = 0.012, 95% CI = 1.432-17.683). Abstrak : Beberapa Faktor Risiko Gizi Kurang Dan Gizi Buruk Pada Balita 12-59 Bulan . Tujuan penelitian yaitu untuk membuktikan faktor risiko agent, host dan environment yang berpengaruh terhadap kejadian gizi kurang dan gizi buruk pada balita di kota Pontianak. Penelitian ini bersifat observasional dengan pendekatan case control. Lokasi penelitian dilaksanakan di Kota Pontianak. Jumlah sampel sebanyak 80 orang, yang terdiri dari kasus sebanyak 40 orang dan kontrol sebanyak 40 orang. Penilaian status gizi menggunakan pengukuran antropometri berdasarkan berat badan per tinggi badan (BB/TB). Pengukuran tinggi badan menggunakan microtoise dan mengukur berat badan menggunakan timbangan balita. Berdasarkan hasil analisa multivariat menunjukkan terdapat hubungan yang signifikan yaitu sikap ibu terhadap makanan buruk (OR : 6,98 p = 0,002 95 % CI 1,99-24,38) dan kesehatan lingkungan buruk (OR : 5,03 p = 0,012 95 % CI 1,43-17,68) dengan kejadian gizi kurang dan gizi buruk pada anak balita.

Aspartate aminotransferase-platelet ratio index, adiponectin and body mass index in children with fatty liver

Obesity in children is becoming a global epidemic. Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent and potentially serious complication of childhood obesity. Adiponectin level was decreased on obese children. Adiponectin is a protective factor against non-alcoholic fatty liver disease on obesity. The early identification of fibrosis is important in children with NAFLD in order to prevent the development of liver disease in adulthood. One of non-invasive procedure to predict liver fibrosis is the aspartate aminotransferase (AST)-platelet ratio index (APRI). The purpose of our study was to assess a correlation between APRI, adiponectin and body mass index (BMI) in obese children with fatty liver. n nA cross-sectional study was conducted from August to September 2007. Subjects were obese children from one junior high school in Semarang, Indonesia. Complete blood count, transaminase enzyme measurement, adiponectin level and abdominal ultrasound (USG) were performed on each subject. Only subjects with bright liver on USG underwent APRI analysis. Spearman’s correlation was used for statistical analysis. n nOf 37 obese children, 19 children had bright liver on USG. The mean APRI was 0.16 (0.119). The mean Adiponectin was 4.04. Only one obese subject (5.0%) with bright liver had an APRI > 0.5. APRI was significantly correlated to alanine amino transferase (ALT) levels (r = 0.62), but not significantly correlated to BMI (r = 0.35) and adiponectin (r = 0.45). There was no correlation between BMI, ALT (r = 0.16), AST (r = 0.16), and adiponectin (r = 0.30). n nThis study suggest that obese children with fatty liver might have high APRI levels indicating the presence of liver fibrosis. However, there is no correlation between APRI, adiponectin and BMI.