Universa Medicina

4-10

Authors: Galuh Chandra Irawan, Ani Margawati, Ali Rosidi

Background Tuberculosis (TB) is a leading cause of morbidity and mortality, especially in middle- and low-income countries. The risk of developing TB may be related to nutritional status. Socioeconomic and behavioral factors are also shown to increase the susceptibility to TB infection. The objective of this study was to determine nutritional factors as risk factors of pulmonary TB in adult. Methods This was an observational study of case control design. The study subjects were community members consisting of 19 adult cases of pulmonary tuberculosis and 38 controls. Data on nutritional intakes were obtained by semiquantitative food frequency questionnaire (FFQ), while smoking behavior, history of DM, body mass index, education, and income were obtained by structured interviews. The data were analyzed by independent t-test and logistic regression for calculation of the odds ratio (OR). Results The bivariate test showed that the adequacy levels for energy (OR=6.8; 95% CI: 1.51-30.54), protein (OR=5.1; 95% CI: 1.52-17.14), vitamin A (OR=4.2; 5% CI: 1.31-13.54), vitamin C (OR=3.8;95% CI: 1.21-12.36), selenium (OR=4.2; 95% CI: 1.34-13.58), body mass index (OR=4.4; 95% CI: 1.32-14.35) and smoking behavior (OR=3.7; 95% CI: 1.15-11.9), were significant risk factors for pulmonary tuberculosis. Multiple logistic regression test showed that low body mass index (<18.5 kg/m2) (OR=6.0; 95% CI: 1.32-27.18) was a the most influential risk factor of pulmonary tuberculosis. Conclusion Low body mass index is the most influential risk factor for pulmonary tuberculosis incidence in adult. Nutrition profile in adult is an important determinant of TB incidence.

19-24

Authors: Suhendro Suwarto, Surya Ulhaq, Bing Widjaja

Introduction Skin hydration decreases with aging. Aquaporin-3 (AQP3) is a major protein that plays a role in skin hydration, therefore it is a novel target for skin moisturizing treatment. Retinoic acid (RA) as a well-known active agent in antiaging treatment increases AQP3 expression, but frequently causes harmful side effects. Asiaticoside, a saponin compound isolated from Centella asiatica (CA) is also known as an antiaging cosmetic and plays a role in wound healing. The aim of this study was to evaluate and compare the effect of asiaticoside isolated from CA and the effect of RA on the AQP3 expression in normal human epidermal keratinocytes (NHEKs). Methods An experimental laboratory study was performed using primary NHEKs that were derived from the foreskin of a boy. AQP3 expression in NHEKs was examined in vitro after the cells were incubated for 24 hours with asiaticoside or with RA at several concentrations. The AQP3 expression was evaluated by immunocytochemistry and quantitatively analyzed by Image-J software. Independent t-test and one-way ANOVA were used to analyze the data, followed by post-hoc Tukey test. Results There was an increasing trend of AQP3 expression upon exposure to asiaticoside at all concentrations compared to the control group. However, RA exposure seemed to induce a higher level of AQP3 expression. Asiaticoside effected a lower increase in AQP3 expression in NHEKs than did RA (p=0.042). Optimal results were achieved at 1 mg/ml concentration of asiaticoside. Conclusions Asiaticoside isolated from CA can enhance the AQP3 expression in NHEKs. Therefore it can be used as an active ingredient in cosmetic moisturizer formulation for dry skin treatment.

34-41

Authors: Wulan Christijanti, Aditya Marianti, Wiwi Isnaeni

Background Diabetes mellitus is a chronic disease caused by lack of insulin production in the pancreas or by insulin resistance, the disease being characterized by elevated blood glucose levels. Hyperglycemia in diabetes could lead to oxidative stress due to the rise in 8-oxo-2'-deoxyguanosine (8-oxo-dG) levels and the decrease in levels of total antioxidant status (TAS). The purpose of this study was to assess the effect Aloe vera extract on 8-oxo-dG level and total antioxidant status in diabetic rat testis. Methods This was an experimental laboratory study with 20 rat samples which were divided into 4 groups (1 control group and 3 treatment groups). Diabetes was induced in the rats by streptozotocin (STZ) at 65 mg/kgBW. The diabetic rats were then treated for 28 days with Aloe vera extract at 0 mg (P0), 200 mg rind (P1), 200 mg pulp (P2), respectively. The level of 8 -oxo-dG was measured by ELISA and total antioxidant status with 2,2' -azino-bis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS). Data were analyzed with ANOVA and Least Significant Difference Advanced Test at P<0.05. Results 8-Oxo-dG levels were significantly different between the control group and both P0 and P2, but not between the control group and P1. Among the treatment groups the 8-oxo-dG levels were significantly different. Mean total antioxidant status was significantly different between control and treatment groups, and also between treatment groups (p<0.05). Conclusions Aloe vera extract reduced free radicals (level of 8-oxo-dG) and increased the total antioxidant status in diabetic rat testis.

49-58

Authors: Lilik Maslachah, Rahmi Sugihartuti

Background Leukocytes play an important role in the elimination of malaria infection. The leukocyte profile upon elimination of the malaria parasites that have been exposed to antimalarials and are subsequently capable of faster growth has not been researched. The aim of this research was to evaluate the role of mouse leukocytes in the elimination of parasites as shown by the leukocyte profile. Methods An experimental research with post test only control group design was conducted involving 24 male mice of the Swiss Albino strain weighing 20 g -30 g, and 2.5 months old. They were randomized into four groups: two control groups (K1, KP) and two treatment groups (P1, P4). Artemisinin at a dose of 0.04 mg/g body weight was given to the mice for 3 days, starting 2 days after infection. The leukocyte profile was observed on the 2nd, 5th, 8th, and 10th day after infection. The results were analyzed by two-way Anova. Results As shown in treatment control group KP and treatment group P4, P. berghei that had been passaged in the mice and were still viable after repeated exposure to artemisinin, may cause changes in leukocyte profile. On the 10th day of infection, the neutrophil percentage in group P1 showed a significantly different decrease when compared with the other groups (K1, KP and P4) (p<0.05). Conclusion Repeated exposure to artemisinin of mice infected with P. berghei can cause changes in neutrophil profile in mice.

68-76

Authors: Rizaldy Taslim Pinzon, Fransiska Theresia Meivy Babang, Esdras Ardi Pramudita

Background The mortality rate after ischemic stoke is influenced by various factors. Prognosis after ischemic stroke can be predicted using a scoring system to help the doctor to evaluate patient’s condition, neurologic deficits, and possible prognosis as well as make appropriate management decisions. The objective of this study was to identify the factors which determine mortality rates in patients after ischemic stroke and to determine the prognosis of ischemic stroke patients using the predictive mortality score. Methods This was a nested case control study using data from the stroke registry and medical records of patients at the Neurology Clinic of Bethesda Hospital Yogyakarta between 2011-2015. Data was analysed using simple and multiple logistic regression analysis. The scoring was analyzed using receiver-operating characteristic (ROC) curve and the cut-off point using area under the curve (AUC). Results Multiple logistic regression analysis showed a significant association between mortality of ischemic stroke patients and age (OR: 4.539, 95% CI: 1.974-10.439, p<0.001), random blood glucose (OR: 2.692, 95% CI: 1.580-4.588, p<0.001), non-dyslipidemia (OR: 2.313, 95% CI: 1.395-3.833, p=0.001), complications (OR: 1.609, 95% CI: 1.019-2.540, p=0.041), risk of metabolic encephalopathy (OR: 2.499, 95% CI: 1.244-5.021, p=0.010) and use of ventilators (OR: 17.278, 95% CI: 2.015-148.195, p=0.009). Conclusions Age, high random blood glucose level, complications, metabolic encephalopathy risk and the use of ventilators are associated with mortality after ischemic stroke. The predictive mortality score can be used to assess the prognosis of patients with ischemic stroke.

80-87

Authors: Donna Adriani Kusumadewi Muhammad, Minarma Siagian, Dewi Irawati SS

Background Hypertension and myocardial infarction account for the high rate of mortality globally. Hibiscus sabdariffa (HS) Linn. is rich in antioxidants and previous studies have demonstrated its anti-hypertensive effects. Several studies show that regular physical activity is an important component to reduce cardiovascular mortality. The objective of this study was to evaluate the effects of a combination of aerobic exercise and HS extract on nitric oxide (NO) and endothelin-1 (ET-1) in rats. Methods An experimental study was conducted on 36 male Wistar rats, aged 4 weeks and 60-70 g in weight. The interventions were aerobic exercises and HS at 400 mg/kg BW/day administered for 4, 8 and 12 weeks. The rats were randomized into 12 groups: 3 control groups (C4, C8, C12), 3 aerobic exercise groups (A4, A8, A12), 3 HS groups (H4, H8, H12), and 3 combination groups [aerobic exercise and HS] (HA4, HA8, HA12). After 4, 8, and 12 weeks, the rats were sacrificed and their abdominal aorta was collected for determination of nitric oxide and ET-1 concentrations. One way ANOVA was used to analyze the data. Results There was a significant difference in NO levels between all groups, with the 4-week aerobic exercise group (A4) showing the highest NO levels compared to the other eleven groups (p<0.05). In contrast, the ET-1 levels were not significantly different between all groups. Conclusions This study demonstrated that the combination of HS supplementation and aerobic exercise increases NO in rats, and provided further evidence to the traditional use of the plant as an antioxidants agent.

94-101

Authors: Siti Aminah, Suparmo Suparmo, Sri Naruki, Hastari Wuryastuty

Background The decline in estrogens could lead to an imbalance of bone formation and absorption as well as bone mineralization. Phytoestrogens are known to have the potential to maintain bone health. Calcium and phosphorus are essential components for bone mineralization. This study aimed to investigate the effect of soybean sprout flour consumption on serum calcium and phosphorus levels in ovariectomized rats. Methods A randomized post-test-only control group design involving 25 female Sprague-Dawley rats aged 2 months, which were divided into five groups: (i) normal controls on standard feed diet AIN-93 (C-N), (ii) ovariectomy controls on standard feed diet (OVX -N); (iii) ovariectomized rats on standard feed diet + ethinylestradiol (OVX -E), (iv) ovariectomized rats on standard feed diet + soybean flour (OVX -S); (v) ovariectomized rats on standard feed diet + soybean sprout flour (OVX -SS). The rats were treated for 6 weeks, then on the last day of treatment blood sampling was conducted. Analysis of calcium and phosphorus in serum was performed using the Arsenazo III photometric method. Data were analyzed using one-way Anova. Results Mean serum calcium level was highest in the OVX-SS group (12.59 mg/dL ± 1.32), while mean serum phosphorus level was highest in the C-N group (1.708 mg/dL ± 0.28). Soybean sprout flour consumption had a significant effect on serum calcium levels (p=0.019), yet it had no effect on body weight and serum phosphorus levels of the rats. Conclusion Consumption of soybean sprout flour could positively affect serum calcium levels in rats.

110-122

Authors: Retty Ratnawati, Annisa Nurul Arofah, Anastasia Novitasari, Sartika Dewi Utami, Made Ayu Hariningsih, Masruroh Rahayu, Sri Budhi Rianawati, Hari Purnomo, Mochammad Dalhar

BACKGROUND Catechins inhibits apoptosis through anti oxidant and anti inflamation pathway. Catechins also increases brain-derived neurotrophic factor (BDNF). There was a few research that explained the role of catechins in traumatic brain injury (TBI). The objective of the study was to evaluate the effect of catechins administration on neurologic severity score (NSS) through apoptosis and neurotropic pathway in traumatic brain injury rat model. METHODS A post test only controlled group design was performed using traumatic brain injury rat (Rattus novergicus) model through weight drop models. It was devided into negative control group, positive control group, TBI+catechins 513 mg/kgBW, TBI+catechins 926 mg/kgBW, TBI+catechins 1113 mg/kgBW. NSS was measured in the first hours, day three, and day seven. The expressions of NFkB, TNFa, Bcl-2, Bax, caspase 3, caspase 8, BDNF, and the numbers of apoptosis cells were evaluated by imunohistochemystry method. One way Anova and Kruskal Wwallis were used to analyse the data. Results TNFa, caspase 8, number of apoptosis cells were significantly decreased on the seventh day administration compared to the third day administration (p<0.05). Catechins increased the expression of Bcl-2/Bax and BDNF significantly (p<0.05). Yet, there were no significant differences between expression of caspase 3, NSS, Bcl-2/Bax ratio, and BDNF toward third days administration of catechins compared with seven days administration (p>0.050). Conclusions Administration of catechins decreased NSS through inhibiting inflammation and apoptosis, as well as induced the neurotrophic factors in rat brain injury. Catechins may serve as a potential intervention for TBI.

131-137

Authors: Soetrisno Soetrisno, Sri Sulistyowati, Anwar Sandi Wibowo

Background Preeclampsia is a major cause of maternal and fetal morbidity and mortality. The imbalance of anti-angiogenic and angiogenic factors plays a role in endothelial dysfunction in preeclampsia. L-arginine is expected to improve the process of spiral artery remodeling. This study aims to examine the use of L-arginine to repair endothelial damage by measuring the thickness of uterine spiral arteries in mouse (Mus musculus) models of preeclampsia. Methods The researchers carried out an experimental study using 30 sixteen-day old pregnant Swiss mice (in good health, weighing 20-25 grams), which were randomly divided into 3 groups (each consisting of 10 mice). The groups were as follows: 1) normal pregnancy K(-); 2) preeclampsia model K(+); and 3) preeclampsia model receiving L-arginine (P). The authors performed histopathological examination of the mouse placenta, which had been dissected, embedded in paraffin wax and subsequently stained with hematoxylin and eosin (HE). The results were analyzed in SPSS v. 21 for Windows using Anova with Tukey. Results The mean thickness of spiral arteries in group K(-) was 53.95 + 26.96 mm, in K(+) 96.50 + 16.66 mm, and in P 62.79 + 8.04 mm. Statistically, there were significant differences between groups K(-) and K(+) (p=0.001) and between K(+) and P (p=0.000), but non-significant differences between K(-) and P (p=1.000). Conclusions The treatment with L-arginine proved to be effective in repairing endothelial damage by reducing intimal hyperplasia and atherosis and, in turn, the thickness of uterine spiral arteries in mouse models of preeclampsia.

150-156

Authors: Natharina Yolanda, Irene

Background Pediatric nephrolithiasis is an important cause of morbidity worldwide. Even with low prevalence, nephrolithiasis can cause detrimental long-term effects on kidney function. Idiopathic hypercalciuria is the most common cause of renal stones in children. This case report presents a pediatric patient with bilateral nephrolithiasis and hydronephrosis associated with underlying idiopathic hypercalciuria. Case description We report on a 17-month-old boy presenting with two days of high fever, irritability, nausea, and poor feeding. The patient had been diagnosed with bilateral nephrolithiasis at the age of 6 months. On examination, the patient was febrile and hypertensive. Laboratory evaluation revealed anemia, leukocytosis, normokalemia, normocalcemia, and normal glomerular filtration rate. Blood gases were within normal limits. Urinalysis revealed pH 5.0, hematuria, pyuria, and bacteriuria. Urine culture was positive for Proteus mirabilis and Enterobacter gergoviae. Electrolyte analysis from urine samples revealed hypercalciuria. Ultrasonography found stones at the left ureteropelvic junction with corresponding grade I hydronephrosis and stones in the right lower calyx without hydronephrosis. The patient was treated with antibiotics, an antihypertensive agent, thiazide diuretics, and was referred to a pediatric urologist. Conclusion This case can be considered as idiopathic. Most children with renal stones have metabolic risk factors including enteric, endocrinologic, or renal sources. Metabolic evaluation is mandatory in pediatric renal stone patients and hypercalciuria is an important etiology to be evaluated. Ignorance of the underlying metabolic abnormality or failure in its identification in pediatric urolithiasis could lead to catastrophic long-term effects.

160-165

Authors: Gilbert WS Simanjuntak, Golda AM Simanjuntak, Reinne Natali Christine

Background Macular hole surgery can be done under general or local anesthesia, and general anesthesia is still the standard procedure. The objective of this study was to investigate the results of macular hole surgery under local anesthesia. Methods A retrospective study on medical records of patients who had undergone macular hole surgery under local anesthesia. Funduscopic examination of macular hole had been performed and all other diseases with deterioration of visual acuity eliminated. Surgery was performed under retrobulbar local anesthesia, using 2 ml of 2% lidocaine mixed with 3 ml bupivacaine in one syringe. Vitreous tamponade used 20% sulfur hexafluoride (SF6). Demographic and clinical characteristics, visual acuity before and after surgery, and improvements that occurred were assessed. Results No significant interruption occurred during surgery. Mean age of the patients was 53.89 ± 13.3 years (22-74 years), with mean duration of symptoms of 48.83 ± 100.51 weeks (1-560 weeks). The patients comprised 20 males (55.6%) and 16 females (44.4 5). There were improvements in visual acuity after surgery in 31 patients (86.1%), the rest (13.9%) had identical or lower visual acuity after surgery. A total of 20 patients (55.6%) had postoperative visual acuity of 6/18 or better. Initial mean preoperative visual acuity was 0.08 ± 0.08 (0.01 - 0.29) and improved after the surgery to 0.38 ± 0.26 (0.00 - 1.00), the improvement being statistically significant (p=0.000). Conclusion Retrobulbar anesthesia is an effective and safe method in macular hole surgery. Macular hole surgery can be done well under local anesthesia, and visual acuity improved significantly.

173-178

Authors: Mohammad Esmaeil Hejazi, Mohammadamin Rezazadehsaatlou, Leila Namvar, Armin Sadeghi, Veghar Hejazi, Yasin Hejazi, Katrin Buyuk Aghazadeh

BACKGROUND Tracheostomy is one of the most frequently performed procedures in intensive care units. The widespread attraction of percutaneous dilatational tracheostomy (PDT) is increasing in modern intensive care units (ICU). Bronchoscopic guidance seems to secure the safety of the technique. Multiple studies done to explain characterize differences in complications and cost-effectiveness of open and percutaneous tracheotomy. The objective of this study was to evaluate the benefits of percutaneous dilatational tracheostomy (PDT) using the Ciaglia technique with bronchoscopic guidance. METHODS A total of 100 elective percutaneous dilatational tracheostomies using the Ciaglia technique with a little modification were performed under flexible fiber optic bronchoscopic guide. The demographic variables were recorded, the underlying cause for patient’s referred to the center for PDT, and intraoperative as well as early postoperative complications. Patients followed for several days after tracheostomy for early complications. RESULTS No severe complications related to percutaneous dilatational tracheostomy were noticed during and after the procedure. Three patients had bleeding during incision and two led to subcutaneous hematoma. There were no other complications such as infection, emphysema and puncture of posterior wall. CONCLUSIONS We recommended the use of endoscopic guidance bedside percutaneous tracheostomy using the Ciaglia technique with a little modification because it is safe and simple to do without significant complications. PDT with bronchoscopic guidance is a safe and easy procedure that can be done at the bedside setting.

187-196

Authors: Surilena Hasan, Yovita Alviany, Cerellia Clarissa, Sonia Sudana

Background Family support and low discrimination perceptions are a factor in protecting against mental disorders and poor quality of life in male to female (MtF) gender dysphoric individuals. The aim of this study was to determine the role of family factors, peer support, self-esteem, perceived discrimination, depression, anxiety, and stress on the quality of life among MtF gender dysphoric individuals. Methods A cross-sectional study was conducted involving 106 MtF gender dysphoric individuals of Sanggar Swara Jakarta. Respondents filled out questionnaires on demographics, WHOQL-BREF, perceived discrimination, Rosenberg self-esteem, family support, social support (SSQ6), family relations (FACES III), and depression anxiety stress scale (DASS). Simple and multivariate logistic regression tests were used to analyze the data. Results Among the 106 MtF gender dysphoric individuals of Sanggar Swara Jakarta with an age range of 18-45 years, 78.3% had no family support, 64.1% no peer support, 62.3% high perception discrimination, 64.1% low self-esteem, 36% extreme family relations, 44.3% depression, 59.4% anxiety, 35.8% stress and 62.3% poor quality of life. Employment, perception of discrimination, self-esteem, family support, and anxiety were significantly associated with quality of life (p<0.05). Multiple logistic regression analysis showed that perceived discrimination (Odds Ratio=13.89; 95% CI: 5.89-11.99), and family support (Odds Ratio=29.11; 95% CI: 2.45-8.21) were significantly associated with quality of life. Conclusion High perceived discrimination and no family support increase the risk of poor quality of life in MtF gender dysphoric individuals. These findings suggest the need for prevention and intervention of stigmatization and discrimination that should have a special focus on families with MtF gender dysphoric individuals.

205-213

Authors: Pusparini, Lie Tanu Merijanti, Alvina Lesmana, Meiyanti

Background Vitamin D insufficiency is associated with obesity and central obesity, which is in turn associated with the accumulation of visceral fat. Visceral fat secretes adiponectin which has a role in the pathogenesis of the metabolic syndrome, diabetes mellitus and cerebrovascular disease. The aim of this study was to determine the relationship between serum 25-hydroxy vitamin D [25(OH)D] level and adiponectin level in adults with central obesity. Methods This study was a cross sectional study with 80 subjects with central obesity and 80 healthy subjects as controls. The age of the subjects ranged from 55 to 65 years. The data collection included anthropometry and blood biochemistry (lipid profile, fasting blood glucose, 25(OH)D, and adiponectin). The data were analyzed using independent t test with p <0.05. Results Mean waist circumference and 25(OH)D level in the central obesity group were 94.9 ± 7.8 cm and 14.3 ± 6.6 ng/mL, respectively, and in the control group 72.4 ± 5.0 cm and 19.2 ± 8.6 ng/mL respectively. There were significant differences in adiponectin level between the central obesity group and the control group at the 25(OH)D level of <20 ng/mL (p=0.001), but no significant differences between the two groups at the 25(OH)D level of ³20 ng/mL (p=0.538). Conclusion The central obesity subgroup with 25(OH)D level of <20 ng/mL have lower adiponectin levels compared with the control group. This study demonstrates the role of adiponectin as a link between insulin resistance and vitamin D status in adults.

221-227

Authors: Mirna Widiyanti, Reynold Ubra, Eva Fitriana

Background In acquired immunodeficiency syndrome (AIDS) cases, cytopenias of all major blood cell lines were increasingly recognized in patients with HIV infection. Anemia commonly occurs during HIV infection and has been associated with increased progression to AIDS and decreased survival. The aim of this study was to determine the prevalence of anemia and associated risk factors in adults with HIV-AIDS receiving antiretroviral therapy (ART). Methods A cross sectional study was conducted involving 90 adults with HIV-AIDS. Sociodemographic data were collected using a questionnaire. In all patients, CD4+ lymphocyte counts were performed by means of a PIMA analyzer, while hemoglobin was determined using a Sysmex hematology analyzer. The WHO cutoff value of hemoglobin was adjusted to altitude to define anemia. Mild to moderate anemia was defined as hemoglobin 8-13 g/dL for men and 8-12 g/dL for women. Severe anemia was defined as hemoglobin 8 g/dL. Data was analyzed by using logistic regression test. Results There were 90 subjects with HIV-AIDS in this study. Anemia was found in 50 subjects (55.6%), consisting of 12.2% with mild anemia and 43.4% with moderate to severe anemia. Multiple logistic regression showed that an important risk factor for anemia was low body mass index (BMI) between <17-18.5 (OR=4.20; 95% CI=1.23-14.36). However, the CD4 <350 cells/mm3 was not a significant risk factor for anemia (OR=1.03; 95% CI=0.21-5.04). Conclusions Low BMI increases the risk of anemia in subjects with HIV receiving ART. Better screening for anemia and infectious diseases, and modified harm reduction strategy for injection drug users are primary needs in HIV patients.

236-242

Authors: Verawati Sudarma, Lukman Halim

Background Low vitamin D has been associated with various health problems. Aging influences body composition, especially body fat and fat-free mass. Anthropometric measurements, such as body weight (BW), body mass index (BMI), body fat (BF), skeletal muscle mass (SMM), waist circumference (WC) and the waist-height ratio (WHtR) represent body composition which many studies proposed will influence serum vitamin D [25(OH)D]. The objective of the present study was to determine which anthropometric measurements were determinants of 25(OH)D levels in elderly. Methods A cross-sectional study was conducted involving 126 elderly (>60 years old) men and women at Pusat Santunan Dalam Keluarga (PUSAKA) Central Jakarta centers. Anthropometric measurements [body mass index (BMI), skeletal muscle mass (SMM), body fat (BF), and waist circumference (WC)] were determined by bioelectrical impedance analysis using the Omron body composition monitor with scales (HBF-375, Omron, Japan). Fasting blood samples were taken to measure 25(OH)D level by electrochemiluminescence immunoassay. Multivariate linear regression was used to analyze the data. Results The data showed that BMI, BF, and WC were higher than recommended, while SMM and serum 25(OH)D were lower. When the analysis was done based on sex, there were significant differences in BF, SMM, WHtR, and serum 25(OH)D. In the linear regression multivariate analysis of log 25(OH)D with age and body anthropometric measurements, only SMM reached significance level (β=0.019; p=0.025). Conclusions This study demonstrated a positive association between skeletal muscle mass and serum levels of vitamin D in elderly.