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"ABSTRAKPada perempuan pascamenopause diperlukan marka biokimiawi dan klinis pada masa jendela terapeutik yang diharapkan dapat digunakan untuk menapis HKND yang berperan sangat penting dalam menghindari dampak demensia tipe alzheimer setelah terapi hormon. Penapisan HKND dapat dimanfaatkan juga untuk upaya terapeutik HKND pada perempuan pascamenopause dan mencegah perburukan ke dalam kondisi demensia tipe alzheimer. Dilakukan studi potong lintang pada 282 perempuan pascamenopause di Jakarta yang dibagi menjadi 2 kelompok, yaitu kelompok positif dengan HKND dan kelompok tanpa HKND. Pemeriksaan dilakukan pada sejumlah variabel seperti usia, lama menopause, keluhan vasomotor, IMT, kadar FSH, kadar LH, kadar leptin, kadar estradiol, dan status kognitif, kemudian dianalisis secara statistik. Diperoleh nilai FSH yang berhubungan bermakna dengan kejadian HKND p = 0,018 , serta variabel lain seperti nisbah FSH/estradiol p = 0,029 dan nisbah FSH/sOB-R p = 0,011 , sementara variabel lain tidak bermakna. Analisis multivariat menunjukkan nisbah FSH/estradiol adalah variabel yang paling berperan terhadap kejadian HKND, dengan nilai OR 1,15. Berdasarkan kurva ROC didapat nilai titik potong nisbah FSH/estradiol dalam memprediksi HKND adalah 1,94 dengan sensitivitas 66,5 dan spesifisitas 46,8 . Nisbah FSH/estradiol pada perempuan pascamenopause yang menderita HKND yang lebih tinggi secara bermakna dibandingkan dengan kelompok tanpa HKND dikaitkan dengan peran neuron KNDy terhadap peningkatan sekresi GnRH dan rendahnya neurosteroid estradiol di otak perempuan pascamenopause yang berisiko menderita HKND. Nilai nisbah FSH/estradiol > 1,94 dapat digunakan untuk penapis diagnostik HKND pada perempuan pascamenopause.

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ABSTRACTBiochemical and clinically important markers are needed in the window therapeutic period for postmenopausal women which are expected to be used as a screening methods for CIND as it is very important in avoiding the effect of dementia associated Alzheimer disease after hormone therapy. CIND screening was also useful for CIND treatment strategies in postmenopausal women and preventing postmenopausal women from impaired cognitive function due to dementia. A cross sectional study included 282 postmenopausal women in Jakarta was done, and subjects were further classified into two groups, with CIND and without CIND. Several related variables such as age, duration of menopause, vasomotor symptoms, BMI, FSH level, LH level, leptin level, estradiol level, and cognitive status, were assessed and analyzed statistically. The prevalence of CIND was significantly correlated with FSH level p 0.018 , along with ratio of FSH levels estradiol p 0.029 and ratio of FSH sOB R p 0.011 , while other variables were not. By multivariate analysis, FSH estradiol ratio of 1.15 was found as the most significant factor with probability of having CIND in postmenopausal women. Using the ROC curve, the ratio threshold of FSH estradiol to predict CIND was 1.94, with sensitivity 66.5 and specificity 46.8 . Level of FSH estradiol ratio in postmenopausal women with CIND was significantly higher than women without CIND, and is related to the role of KNDy neurons that induce the secretion of GnRH, and low level of neurosteroid estradiol in postmenopausal women rsquo s brain with risk of CIND. Ratio of FSH estradiol levels 1.94 could be used for screening methods of CIND in postmenopausal women."

"Salah satu mekanisme terjadinya resistemi leptin pada obesitas adalah kelainan reseptor leptin (Ob-R). Beberapa penelitian membuklikan bahwa aktifitas ikatan leptin di serum manusia berhubungan dengan reseptor leptin terlarut (soluble leptin receptor) dan restriksi asupan energi menyebabkan penurunan kadar leptin darah. Penelitian ini adalah untuk mengetahui beda kadar reseptor leptin terlarut serum dan densitas reseptor leptin dijaringan lemak adventitial aorta setelah dilakukan restriksi diet selama 4 minggu. Kadar reseptor leptin terlarut diukur dengan ELISA dan densitas reseptor leptin di jaringan lemak dengan irnunohistokimia. Kadar reseptor leptin terlarut pada kelompok perlakuan 40% diet normal lebih rendah dibanding kontrol (p=0,02). Tidak didapaikan perbedaan reseptor leptin terlarut yang bermakna antara kelompok perlakuan 40% diet normal, 1 hari puasa-1 hari makan normal dan 1 hari pitasa-2 hari makan normal. Di sisi lain, densitas reseplor leptin dijaringan lemak advenlitia aorta justru lebih tinggi pada kelompok restriksi 40% daripada kontrol. Restriksi diet 40% kalori normal harian menurunkan kadar reseptor leptin terlarut di serum, tetapi meningkatkan densitas reseptor leptin dijaringan lemak advential aorta tikus. Perubahan ini mungkin merupakan akibat mekanisme up regulation dalani mempertahankan homeostasis. (Med J Indones 2006; 15:145-50)

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One of the five possible mechanisms of leptin resistance in human obesity is the defect in the leptin receptor (Ob-R). Evidence has accumulated that leptin-binding activity in human serum is related to a soluble form of the leptin receptor, and restriction of energy intake resulted a decrease in circulating leptin levels. Aim of this study is to examine the difference of serum soluble leptin receptor level and ieplin receptor density in rat adipose tissue of adventitial aorta after four weeks treated with different restricted diets. Soluble leptin receptor level was measured by ELISA and leptin receptor density by using immuno-hisfochemistry. The soluble leptin receptor in group treated with 40% of normal daily calori diet was found significantly lower than control (p = 0.02). There were no any significant differences among group treated with 40 % of normal daily calori diet, "I day fast-] day eat", and "ldayfaxt-2 days eat" groups, and among I day fast-1 day eat", "day fast - 2 days eat" and control groups as well. On the other hand, leptin receptor density in adipose tissues was higher in restricted diet group than control. Diet of 40 % normal daily calorie for 4 weeks decreased soluble leptin receptor level, but increased adipocyte leptin receptor density of the adipose tissue of rat adventitial aorta. These changes may be resulted from an up regulation mechanism in relation with homeostatic maintenance. (Med J Indones 2006; 15:145-50)"

"Sindrom ovarium polikistik (SOPK) diketahui terkait dengan obesitas melalui: resistensi leptin. Salah satu penyebab resistensi leptin adalah defisiensi reseptor leptin (LEPR) dibubarkan. Tujuan dari penelitian ini adalah untuk menentukan ekspresi mRNA dari LEPR. gen dilarutkan pada subjek obesitas dan non-obesitas dengan PCOS dan non-SOPK sertamengetahui korelasi antara ekspresi gen tersebut dengan obesitas dan PCOS. Kecepatan Ekspresi mRNA gen LEPR dalam sampel darah diukur menggunakan metode waktu nyata PCR. Penelitian dilakukan pada 96 subjek dengan empat kelompok sampel, yaitu: PCOS non-obesitas, PCOS bebas obesitas, PCOS obesitas, dan PCOS obesitas. Hasil pengukuran menunjukkan ekspresi mRNA rata-rata dari gen LEPR terlarut di masing-masing kelompok 2,10 x 10-4 ng/μL ± 1,88 x 10-4; 1,27 x 10-4 ng/μL ± 1,31 x 10-4; 1,99x 10-4 ng/μL ± 2,35 x 10-4; dan 1,44 x 10-4 ± 2,21 x 10-4 ng/μL. LEPR. ekspresi gen mRNA terlarut dalam semua kelompok obesitas diketahui lebih rendah jika dibandingkan dengankelompok obesitas (P < 0,05) dan tidak ada perbedaan yang signifikan antara kelompok umum tanpa PCOS dan PCOS (1,69 x 10-4 ± 1,65 x 10-4; 1,71 x 10-4 ± 2,27 x 10- 4, P > 0,05). Studi ini menemukan bahwa penurunan ekspresi mRNA dari gen LEPR yang larut berhubungan dengan obesitas dan tidak berhubungan dengan PCOS.Polycystic ovary syndrome (SOPK) is known to be associated with obesity through: leptin resistance. One of the causes of leptin resistance is dissolved leptin receptor (LEPR) deficiency. The aim of this study was to determine the mRNA expression of LEPR. gene was dissolved in obese and non-obese subjects with PCOS and non-PCOS as well asdetermine the correlation between the expression of these genes with obesity and PCOS. Expression velocity of LEPR gene mRNA in blood samples was measured using real-time PCR method. The study was conducted on 96 subjects with four sample groups, namely: non-obese PCOS, obesity-free PCOS, obese PCOS, and obese PCOS. The measurement results showed the average mRNA expression of the soluble LEPR gene in each group was 2.10 x 10-4 ng/μL ± 1.88 x 10-4; 1.27 x 10-4 ng/μL ± 1.31 x 10-4; 1.99x 10-4 ng/μL ± 2.35 x 10-4; and 1.44 x 10-4 ± 2.21 x 10-4 ng/μL. LEPR. soluble mRNA gene expression in all obesity groups was found to be lower when compared to obese group (P < 0.05) and there was no significant difference between the general group without PCOS and PCOS (1.69 x 10-4 ± 1.65 x 10-4; 1.71 x 10-4 ± 2.27 x 10-4, P > 0.05). This study found that decreased mRNA expression of the soluble LEPR gene was associated with obesity and not associated with PCOS."

"ABSTRAK Latar Belakang: Gangguan kognitif merupakan salah satu masalah pada aging population berkaitan dengan perubahan neuroendokrin pascamenopause. Gangguan kognitif minimal (minimal cognitive impairment/MCI) merupakan kondisi peralihan fungsi kognitif antara penuaan normal dan demensia.Tujuan: Untuk mengetahui hubungan kadar kisspeptin dan kadar hCG hipofisis dengan gangguan kognitif minimal pada perempuan pascamenopause.Metodologi: MCI ditentukan dengan sistem skoring yang terdiri dari status diabetes melitus, toleransi glukosa terganggu, dislipidemia, Geriatric Depression Scale (GDS), uji Rey Osterrieth Complexion Figure (ROCF), uji digit span backward dan uji Trail Making Test B. Studi potong lintang terhadap 181 perempuan pascamenopause usia £ 65 tahun, terbagi 2 kelompok yaitu dengan MCI 90 orang dan tanpa MCI 91 orang.Hasil: Analisis terhadap usia, lama menopause, indeks massa tubuh, lama pendidikan, kadar kisspeptin dan kadar hCG hipofisis. Kadar kisspeptin menunjukkan perbedaan bermakna anatar kedua kelompok (p<0,001). Kadar kisspeptin dan lama menopause berkorelasi positif dengan skor MCI (r=0,607 dan r=0,542; berurutan). Namun, tidak ada perbedaan kadar hCG hipofisis antara kedua kelompok (p=0,664), dan skor MCI tidak berkorelasi dengan kadar hCG hipofisis (p=0,398; r=0,06).Kesimpulan: Kadar kisspeptin signifikan lebih tinggi pada perempuan pascamenopause dengan MCI, dan menunjukkan korelasi positif. Sementara kadar hCG hipofisis tidak berbeda di antara kedua kelompok dan tidak menunjukkan korelasi.

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ABSTRACT

Backgroud: Cognitive impairment is one of problems among elderly women due to neuroendocrine alteration after menopause. Minimal cognitive impairment (MCI) is a transition state of cognitive function between normal aging and dementia.

Aims: To investigate relationship between kisspeptin and pituitary hCG with MCI in postmenopausal women.

Methods: MCI was determined by scoring; with diabetic status, glucose intolerant, dyslipidemia, Geriatric Depression Scale (GDS), Rey Osterrieth Complexion Figure (ROCF), digit span backward, and Trail Making Test (TMT) B. Using cross-sectional study, 181 postmenopausal women £ 65 years old, were grouped into with and without MCI; 90 and 91 women, respectively.

Results: Data was analysed to their ages, span of menopause, body mass index (BMI), education grade, kisspeptin and hCG level. Kisspeptin level had significantly different among the groups (p<0.001). There was a positive relationship between kisspeptin level and span of menopause to MCI score (R=0.607 and R= 0.542, respectively). Pituitary hCG level, however, showed no difference among the groups. Moreover, MCI score showed no relationship to hCG level (p=0.398; R=0.063).

Conclusions: Kisspeptin level was significantly higher among postmenopausal women with MCI, and showed a positive relationship. While pituitary hCG had no difference among the groups, and showed no relationship."

"Salah satu mekanisme terjadinya resistensi leptin pada obesitas adalah kelainan reseptor leptin (Ob-R)."

"Wanita Indonesia yang memasuki masa menopause cenderung mengalami obesitas, Gejolak panas sebagai salah satu gejala menopause yang paling sering dikeluhkan oleh wanita yang memasuki masa menopause, berkaitan dengan obesitas. Obesitas diketahui berhubungan dengan leptin, suatu hormon polipeptida yang mempunyai peran dalam reproduksi dan pusat pengatur suhu. Penelitian ini bertujuan mengetahui apakah terdapat peningkatan kadar leptin pada wanita perimenopause-menopause dengan gejolak panas di RSCM. Penelitian deskriptif dengan desain kasus-kontrol. Subjek penelitian 50 wanita perimenopause-menopause, berusia 40-55 tahun. Kelompok kasus dan kontrol ditegakkan berdasarkan Kuesioner Menqol Menopause. Kelompok gejolak panas adalah wanita yang menjawab YA pada pertanyaan Kuesianer Menqol Menopause 1-3, dengan kelompok kontrol adalah wanita yang tidak ada keluhan gejolak panas, dan menjawab tidak atau satu saja jawaban ya pada poin 1-3. Hasil: Tidak terdapat perbedaan yang bermakna antara kadar leptin pada kelompok yang mengalami gejolak panas dan kelompok tanpa gejolak panas dengan median leptin kasus vs control 21.86 (7.41-46.66) vs 16.53 (4.32-37.81) ng/ml , p=0.154. Meski demikian, terdapat hubungan yang signifikan antara obesitas dengan gejolak panas (p=0.047). Karakteristik gejolak panas yang didapatkan dikategorikan masih ringan karena frekuensi terjadinya gejolak panas yang jarang, dengan durasinya sangat cepat dan tidak mengganggu aktifitas. Gejolak panas cenderung dirasakan pada wanita berpendidikan menengah dibandingkan pendidikan tinggi (p=0.01), pada kelompok menengah ke atas (p 0.037),dan pada kelompok yang terbiasa tidur dengan air conditioner (p=0.057) dan berolahraga secara teratur (p 0.248). Kebiasaan mengkonsumsi tahu, tempe dan tidur cukup 6 jam sehari tidak memiliki hubungan terhadap terjadinya gejolak panas. Skor MENQOL Menopause kelompok dengan gejolak panas lebih tinggi dibandingkan dengan kelompok tanpa gejolak panas (p<0.001), serta gangguan kualitas hidup cenderung dirasakan lebih berat pada kelompok wanita dengan obesitas (p=0.061). Obesitas berhubungan bermakna dengan gejolak panas, tetapi leptin tidak berperan terhadap terjadinya gejolak panas. Gangguan kualitas hidup akibat gejolak panas cenderung dirasakan oleh kelompok yang obesitas.

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Hot flashes as one of menopausal symptoms that manifested to quality of life. Obesity has been linked to increased risk of hot flashes in menopausal women. Leptin as anti obesity hormone, has play a role in thermoregulatory dysfunction in menopause women with hot flashes. This research want to explore effect of leptin serum level to hot flashes in perimenopausal and menopausal women in Ciptomangunkusumo General Hospital. A descriptive study with case control design. The subject is 50 perimenopause women aged 45-55 years. The case and control groups are based MENQOL Questionnaire. Hot flashes are a group of women who answered YES to the question number 1-3, and control group of women who are no complaints of hot flashes. We performed bivariate analysis, using statistic by SPSS 17.

There is no significant differences between Leptin serum level in hot flashes group and non hot flashes with median level of leptin serum 21.86 (7.41-46.66) ng/ml, vs16.53 (4.32-37.81) ng/ml with p = 0.154. Obesity is correlated with hotflashes (p=0.047). Characteristics of hot flashes categorized as mild. The frequency of occurrence is rare, with very fast duration, and not disturb activity. To strata education obtained a meaningful correlation, hot flashes tending perceived in women with middle educated compared higher education (p=0.01), on group upper middle class than middle class (p 0.037) and women sleep with the air conditioner (p0.057) and exercise regularly (p=0.248). The habit of eating soy product such as tofu and tempe and slept 6 hours a day, not correlated statistically with the the occurrence of hot flashes. There is a significant difference in score of MENQOL Menopause, whereas in the group with hot flashes compared to without hot flashes. (p<0.001), impaired quality of life tend to be felt more severely in the group of women with obesity (p0.061). Obesity is statistically correlated with hotflashes, and leptin. But elevated leptin serum didn?t statistically correlated with hotflashes. Quality of life disturbance is severe in obesity group. Obesity can causes hot flashes with other mechanism such as fat as heat insulator."

"Osteoporosis dapat disebabkan oleh faktor genetik, salah satunya yaitu gen LEPR. Penelitian ini bertujuan menganalisis polimorfisme gen leptin reseptor (LEPR) Q223R pada pasien dengan dan tanpa osteoporosis. Sampel dibagi dua kelompok yaitu pasien dengan osteoporosis dan tanpa osteoporosis. Polimorfisme genotip di analisis menggunakan Polymerase Chain Reaction (PCR) - Restriction Fragment Length Polymorphisms (RFLP). Distribusi pola genotip AA dan alel A LEPR Q223R menunjukkan peningkatan risiko osteoporosis. Analisis statistik dengan uji fisher exact antara pasien dengan osteoporosis dan tanpa osteoporosis menunjukkan perbedaan bermakna pada genotip (p=0.044) dan alel (p<0.05). Distribusi pola polimorfisme gen LEPR Q223R berisiko meningkat pada pasien dengan osteoporosis.

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Osteoporosis caused by genetic factor, one of which is LEPR gene. This study analyzed polymorphism leptin receptor (LEPR) Q223R in patient with and without osteoporosis. Samples were divided into two group, with osteoporosis and without osteoporosis. The polymorphism were genotyped using Polymerase Chain Reaction (PCR) ? Restriction Fragment Length Polymorphisms (RFLP) analysis. Mapping distribution of AA genotype and A Allele for LEPR Q223R presented an increased risk of osteoporosis. Statistic analysis of fisher exact test between patient with and without osteoporosis showed significant differences of genotype (p=0,044) and allele (p<0,05). Mapping distribution of polymorphism LEPR Q223R an increased risk of osteoporosis."

"Infeksi malaria saat kehamilan telah dilaporkan berasosiasi dengan peningkatan risiko lahirnya bayi berat badan lahir rendah (BBLR, berat badan lahir < 2500 g) di negara-negara endemis malaria, termasuk di Timika, Papua, Indonesia. Infeksi Plasmodium falciparum (P. falciparum) mengakibatkan penumpukkan eritrosit terinfeksi di plasenta, sehingga berkontribusi pada gangguan fungsi plasenta dan terhambatnya petumbuhan janin. Penelitian bertujuan untuk mengetahui pola ekspresi transkrip mRNA yang terlibat dalam aksis insulin-like growth factor (IGF) dan persinyalan leptin yang berperan dalam mengatur fungsi plasenta selama kehamilan. Plasenta ibu hamil terinfeksi malaria falciparum yang melahirkan bayi tunggal sebanyak 55 sampel digunakan untuk isolasi RNA total. RNA hasil isolasi kemudian ditranskripsi balik menjadi complementary DNA (cDNA) dengan reverse transcription polymerase chain reaction (RT PCR), kemudian diukur ekspresinya dengan quantitative real-time PCR (qPCR). Ekspresi IGF-I (r = 0,232, p = 0,089) dan reseptor leptin isoform pendek (OBRa) (r = 0,215, p = 0,115) pada plasenta cenderung berkorelasi positif terhadap skor-z berat badan lahir. Ekspresi OBRa juga berkorelasi negatif secara terhadap umur kehamilan ( = -0,294, p = 0,029). Sedangkan, ekspresi IGFBP-1 cenderung berkorelasi negatif terhadap berat plasenta (r = -0,237, p = 0,081). Ekspresi leptin dan reseptor leptin isoform panjang (OBRb) plasenta menunjukkan korelasi yang lemah terhadap berat badan lahir, skor-z berat badan lahir, berat plasenta, maupun umur kehamilan. Faktor berat plasenta dan ekspresi OBRa menunjukkan kontribusi yang nyata terhadap skor-z berat badan lahir dibandingkan variabel lainnya. Keterkaitan antara ekspresi komponen aksis IGF-I dan persinyalan leptin pada plasenta dari kehamilan terinfeksi malaria menunjukkan respon plasenta terhadap kondisi intrauterin yang merugikan akibat infeksi malaria.

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Malaria infection during pregnancy has been reported to be associated with an increased risk for delivering low birth weight (LBW, birth weight < 2500 g) infants in malaria-endemic area, including in Timika, Papua, Indonesia. Plasmodium falciparum (P. falciparum) infection leads to placental sequestration of infected erythrocytes, causing impaired placental function and altered fetal growth. This study was aimed to investigate the expression pattern of mRNA transcripts involved in insulin-like growth factor (IGF) axis and leptin signaling which play a role in modulating placental function during pregnancy. A total of 55 placenta samples collected from falciparum malaria-infected mothers who delivered singleton infant were employed for total RNA isolation. The isolated RNA was reverse transcribed into complementary DNA (cDNA) using reverse transcription polymerase chain reaction (RT PCR), followed by measurement of gene expression using quantitative real-time PCR (qPCR). Placental expressions of IGF-I (r = 0,232, p = 0,089) and long isoform of leptin receptor (OBRa) (r = 0,215, p = 0,115) were tend to be positively correlated with birth weight z-score. The expression of OBRa was also negatively correlated with gestational age ( = - 0,294, p = 0,029). Meanwhile, the expression of IGFBP-1 showed a tendency to be negatively correlated with placental weight (r = -0,237, p = 0,081). Placental leptin and long isoform of leptin receptor (OBRb) expressions showed weak correlations with birth weight, placental weight, and gestational age. Placental weight and OBRa expression represent a significant contribution to determination of birth weight z-score as compared to the others variables. Correlation between placental expression of IGF axis and leptin signaling in malaria-infected pregnancies might reflect placental response to adverse intrauterine condition due to malaria infection."

"Peningkatan jumlah lanjut usia di Indonesia sering diiringi dengan peningkatan gangguan kognitif. Leptin diketahui memiliki fungsi protektif terhadap fungsi kognitif pada lanjut usia, namun hingga saat ini hasil temuan peran leptin pada fungsi kognitif masih beragam, dan belum banyak dibahas di Indonesia. Selain itu peneliti melakukan analisis tambahan menggunakan Food Record dan penilaian antropometri pada subjek. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar plasma leptin dengan fungsi kognitif pada lanjut usia di Jakarta. Penelitian ini merupkan penelitian analitik deskriptif potong lintang yang menggunakan purposive sampling sebagai metode pengambilan sampel. Subjek merupakan lanjut usia yang bertempat tinggal di Panti Sosial yang kemudian dilakukan pemeriksaan fungsi kognitif menggunakan instrumen MoCA-INA, kuesioner IADL, GPAQ, Food Record, plasma leptin, komposisi tubuh serta antropometri, yang dianalisis secara univariat, bivariat dan multivariat. Hasil dari penelitian, karakteristik subjek berusia 60-74 tahun, dengan mayoritas jenis kelamin wanita (69,1%), dengan status gizi normal (45,5%), massa lemak berkisar antara 18,10-57,10 %, massa otot berkisar antara 20,20-57,50 kg. Mayoritas tidak merokok, tingkat pendidikan rendah (≤ 12 tahun wajib belajar), aktifitas fisik sedang dengan keseluruhan kapasitas fungsional subjek mandiri. Sebesar (96,4%) lanjut usia mengalami gangguan fungsi kognitif, kadar leptin plasma memiliki nilai terendah 1,4 ng/mL, tertinggi 119,48 ng/m dengan median 6,2 ng/mL. Pada analisis bivariat ditemukan kadar leptin, IMT (Indeks Massa Tubuh), massa lemak, pendidikan, dan IADL memiliki hubungan bermakna dengan fungsi kognitif pada lanjut usia di Jakarta. Korelasi kadar leptin plasma dengan fungsi kognitif pada lanjut usia di Jakarta memiliki korelasi positif sedang dengan nilai r 0,52 dan signifikansi 0,000.

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The increasing of elderly population often accompanied by a rise in cognitive disorders. Leptin is known to have a protective function against cognitive decline in elderly. However, current finding regarding the role of leptin in cognitive function is vary, and has not been extensively discussed in Indonesia. Food record and anthropometric assessment is conducted as an additional analyses on subject. Aim of this study is to determine the relationship between plasma leptin levels and cognitive function in the elderly in Jakarta. This is a cross sectional descriptive analytical research using purposive sampling as the sampling method. Subject are elderly residing in social welfare home, and being assessed using MOCA-INA instrument, IADL and GPAQ questionnaire, plasma leptin, body composition, anthropometric and Food Record are measured. The data is analysed through univariate, bivariate and multivariate analysis. Result of this study are subject characteristic of age ranging from 60-74 years, with female as the majority (67.5%), normal nutritional status (46.2%), body fat ranging from 18.10 to 57.10 %, muscle mass 20.20 to 57.50 kg. Majority of subject do not smoke, have a low education level (≤ 12 year of education), engage in moderate physical activity, and having independent functional capacity. A total of 96.2% of the subject experience cognitive impairment. Plasma leptin levels ranging from 1.4 to 8.5 ng/mL, with median of 5.9 ng/mL. There is a significant relationship between leptin levels, body mass index, body weight, total body fat, education and IADL with cognitive function in the elderly in Jakarta. The correlation between plasma leptin levels and cognitive function in the elderly in Jakarta, shows a moderately positive correlation with r value of 0.47 and a significance of 0.000."

"Tesis ini bertujuan untuk mengetahui korelasi antara ekspresi reseptor leptin endometrium dengan ekspresi reseptor αvβ3 integrin endometrium pada fase luteal madya pasien infertilitas, untuk mencari tahu salah satu penyebab kegagalanimplantasi. Nilai leptin lokal endometrium dinilai melalui ekspresi leptin endometriumdan daya terima endometrium dinilai melalui ekspresi reseptor αvβ3 integrinendometrium. Penelitian ini dengan desain potong lintang di RSUPN Dr. CiptoMangunkusumo. Ekspresi reseptor dinilai dari H-score pada pewarnaanimunohistokimia yang diambil dengan cara biopsi endometrium sebagai baku emas. Dari 30 sampel didapatkan ekspresi reseptor leptin endometrium baik pada 23 sampel (76,7%), ekspresi reseptor leptin endometrium buruk pada 7 sampel (23,3%), sedangkan hasil daya terima endometrium baik pada 24 sampel (80%), dan dayaterima endometrium buruk pada 6 sampel (20%). Uji analisis membuktikkan kadarleptin serum berkorelasi kuat dengan ekspresi leptin endometrium (r=0,67;p<0,01)dengan ekspresi leptin endometrium, dan ekspresi leptin endometrium berkorelasidengan daya terima endometrium (r=0,72;p<0,01). Analisis multivariat menyebutkanfaktor-faktor yang berpengaruh terhadap daya terima endometrium secara berurutanadalah progesteron, ekspresi leptin endometrium, dan kadar leptin serum. ;The aim of this study is to correlate between endometrial leptin receptor expressionwith endometrial integrin αvβ3 expression on mid luteal phase of infertility patients toknow one of the cause of implantation failure. Leptin played important role in femaleneuroendocrine and endometrial implantation. Local leptin value were assessedthrough the expression of leptin endometrial receptor and endometrial receptivityassessed through the expression of integrin αvβ3 endometrial. This study was crosssectionaldesigninRSUPNDr.CiptoMangunkusumo.TheexpressionofthereceptorratedofH-scoreon immunohistochemical staining were taken by endometrial biopsyas the gold standard. From 30 samples obtained, good endometrial leptin receptor expression were found in 23 samples (76.7%), poor endometrial leptin receptorexpression in were found 7 samples (23.3% ), good endometrial receptivity werefound in 24 samples (80%) and poor endometrial receptivity in 6 samples (20%).Result of this study show leptin serum was strongly correlated (r=0,67;p<0,01) withleptin endometrial receptor expression and endometrial leptin receptor expression wasstrongly correlated with endometrial integrin αvβ3 expression (r=0,72;p<0,01).Multivariate analysis show factors that correlate to endometrial receptivitysequentially are progesterone, endometrial leptin receptor, and leptin serum. "