The Indonesian Biomedical Journal

4-25

Authors: Anna Meiliana, Andi Wijaya

BACKGROUND: As population demographic shift and the number of individuals with Alzheimer Disease (AD) continue to increase, the challenge is to develop targeted, effective treatments and our ability to recognize early symptoms. In view of this, the need for specific AD biomarker is crucial. CONTENT: In recent years it has become evident that CSF concentrations of some brain-specific proteins are related to underlying disease pathogenesis and may therefore aid clinical investigation. Among several, we have focused on three candidates that have been suggested to fulfil the requirements for biomarkers of AD: β-amyloid 42 (Aβ42), total Tau (T-tau) and tau phosphorylated at various epitopes (P-tau). An increasing number of studies suggest that supplementary use of these CSF markers, preferably in combination, adds to the accuracy of an AD diagnosis. More recently visinin – like protein (VLP-1), a marker for neuronal cell injury has been studied. CSF VLP-1 concentrations were 50% higher in AD patients than in the control population. SUMMARY: The number of studies aimed at the identification of new biomarkers for AD is expected to increase rapidly, not only because of the increasing insights into the pathological mechanisms underlying this disease, but also because new therapies have been developed or are under consideration now, which warrant an early and specific diagnosis for effective treatment of the patients.

45-53

Authors: Sri Andarini, Djanggan Sargowo

BACKGROUND: Obesity, especially obesity in adolescent, is a worldwide health problem needing much of our attention because it can continue to be obesity in adulthood. About 50% obese adolescents grew up to be obese adults. It was a concern since it is one of risk factor associated with cardiovascular events including hypertension, dyslipidemia, insulin resistance and stroke. Visceral obesity is correlated with diabetogenic, atherogenic, prothrombotic, pro-inflammation, and abnormal metabolism. The objective of this study was to assess the prevalence of obese adolescents in Malang and to identitfy the differences in food compositions between metabolic syndrome and non-metabolic adolescents. METHODS: Prevalence of obesity was determined by assessing BMI in 20 Senior and Junior High Schools. Metabolic syndrome was diagnosed using IDF criteria; waist circumference of >80cm and >90cm for female and male, respectively, and increased triglyceride and decreased HDL concentration levels. The food composition was assessed using food recalls, and then regression linier test was done to define the correlation between food intake and the components of metabolic syndrome. RESULTS: The prevalence of adolescent obesity in Malang had reached 3.32%, with the prevalence of obesity in male subjects higher than in female subjects, i.e. 54.1% compared to 45.9%. The boys had higher mean for height and weight than the girls did, however, the BMI was higher in girls rather than boys. The difference of fat in food composition was significantly higher for the metabolic groups (p=0.031), but the carbohydrate did not significantly differ between the two groups (p=0.407). CONCLUSIONS: The prevalence of adolescent obesity in Malang had reached 3.32%, with the prevalence of 54.1% in male and 45.9% in female. From the statistics test, fat intake showed a significant difference between metabolic syndrome and non-metabolic syndrome groups, but other food compositions didn’t.

61-5

Authors: Rini Budiyati, Widjaja Lukito, Andi Wijaya

BACKGROUND: Visfatin is a novel adipokine secreted from visceral adipose tissue and has insulinomimetic properties. Visceral obesity is a risk factor for metabolic syndrome. Insulin resistance and inflammation are linked to visceral obesity and metabolic syndrome. Dysregulation of visfatin as an adipokine could play an important role in metabolic syndrome through insulin resistance and inflammation, or lower HDL cholesterol concentration. However, this need more evidence. METHOD: This was a crossectional study in 40 Indonesian obese men and 40 Indonesian obese women. Age: 30-60 years in men and 50-60 years for women, from February to March 2008 in Jakarta. RESULTS: No correlation between visfatin and hs-CRP as a marker of inflammation (r=0.190, p=0,101), or HOMA-IR as a marker of insulin resistance (r=-0.020, p=0.246). Suprisingly visfatin concentration is correlated with HDL Cholesterol (r=0.416, p=0.000). CONCLUSIONS: Visfatin plays an important role in metabolic syndrome through lipid metabolism. Positive correlation between visfatin and HDL cholesterol, was assumed that visfatin had a protective effect. Visfatin also known as as nicotinamide phosphoribosyltransferase (NAMPT) links Nicotinamide Adenine Dinucleotide (NAD) metabolism and raising of HDL Cholesterol. But the exact mechanisms need to be further studied.

73-9

Authors: Candra Ninghayu, Andi Wijaya, Suryani As'ad

BACKGROUND: Obesity raises the risk for atherosclerotic cardiovascular disease (ASCVD) through many risk factors including atherogenic dyslipidemia. Atherogenic dyslipidemia is characterized by high levels of triglyceride, increased small dense low density lipoprotein particles, and reduced levels of high density lipoprotein cholesterol. The exact mechanisms of central obesity and this atherogenic lipoprotein phenotype (ALP) is not clearly understood. Central obesity is characterized by a state of systemic low grade inflammation and insulin resistance. Adipose tissue has recently been shown to secrete a variety of bioactive peptides, called adipocytokines, that can potentially affect glucose and lipid metabolism. The aim of this study was to observe the role of adiponectin, tumor necrosis factor-α (TNF- α) and insulin resistance in atherogenic dyslipidemia in nondiabetic central obese males. METHODS: This was a cross-sectional study on 75 non-diabetic central obese male subjects (waist circumferences > 90 cm). Adiponectin and TNF-α testing were performed by ELISA; insulin resistance was assessed by the Homeostasis Model Assessment (HOMA) index, triglyceride was assessed by GPO-PAP, HDL cholesterol and small dense LDL were measured by homogenous method. Statistical analysis was done by SPSS for Windows v. 11.5 with a significance level at p < 0.05. The Pearson and Spearman’s Rho correlation coefficient was used to assess the correlation between various anthropometric and biochemical parameters. RESULTS: There were 75 patients aged 38.0±6.3 years, Adiponectin concentration was 3.55±1.38 μg/ml, HOMA index was 2.28±1.63, TNF-α was 12.42±11.25 pg/ml, triglyceride was 185.17±109.00, HDL-cholesterol was 44.15±9.23 mg/dL, small dense LDL 23.22±12.26 mg/dL. This study revealed that there were correlations between adiponectin and triglyceride (r=-0.236, p=0.042), adiponectin and HDL cholesterol (r=0.300, p=0.009), adiponectin and atherogenic dyslipidemia (r=-0.256, p=0.027), whereas there was no correlation between insulin resistance and TNF-α with the atherogenic dyslipidemia. CONCLUSION: Adiponectin might contribute to atherogenic dyslipidemia in central obese non-diabetic males. Advancing our understanding of the function and measurement of adiponectin serum concentration will be useful in clinical diagnosis of obesity related atherogenic dyslipidemia.