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"ABSTRAKStunting merupakan kondisi malnutrisi pada anak yaitu tinggi badan menurut usia lebih dari minus 2 simpang baku. Indonesia menempati urutan kelima di dunia. Stunting berkorelasi dengan asupan makanan terutama protein, IGF-1 dan protein pengikat Insulin like Growth Factor Binding Protein IGFBP-3 , dan Zinc Zn . Kualitas protein dinilai dari profil asam amino bebas plasma Plasma Free Amino Acid = PFAA dan kuantitas dinilai dari jumlah asupan protein harian. Beberapa penelitian menemukan kadar IGF-1 dipengaruhi oleh polimorfisme SNP rs5742612, rs35767 dan rs35766. Penelitian ini bertujuan untuk menganalisis peran profil PFAA, IGF-1, IGFBP-3, polimorfisme IGF-1, Insulin, dan Zn pada anak.Penelitian ini merupakan studi comparative cross sectional dilakukan di RS Cipto Mangunkusumo, Lembaga Biomolekular Eijkman, dan Labkesda DKI Jakarta. Subjek penelitian adalah anak usia 1 ndash;3 tahun berasal dari UPTD Puskesmas Jatinegara dibagi menjadi 2 kelompok yaitu 101 anak stunted dan 101 anak nonstunted.Pada penelitian ini didapatkan kadar 8 dari 9 AA esensial, 2 AA esensial kondisional, dan 2 AA nonesensial lebih rendah bermakna kelompok stunted dibandingkan nonstunted. Profil PFAA yaitu jumlah anak di bawah nilai rujukan berbeda bermakna antara kelompok stunted dan nonstunted. Terdapat korelasi 8 AA esensial, 1 AA esensial kondisional, dan 2 AA nonesensial dengan tinggi badan anak. Pada kelompok anak stunted, IGF-1, IGFBP-3, insulin, Zn, energi total dan protein lebih rendah bermakna dari kelompok anak nonstunted. Terdapat korelasi bermakna AA esensial dengan IGF-1 dan IGFBP-3. Polimorfisme rs35766 genotipe AG kodominan memiliki pengaruh terhadap kadar IGF-1 pada kelompok nonstunted. Faktor yang memengaruhi kejadian stunting adalah energi atau protein, IGF-1 yang berinteraksi dengan genotipe kodominan AG, IGFBP-3, dan Zn.Simpulan: PFAA, IGF-1 yang berinteraksi dengan SNP rs35766 genotipe kodominan AG, memiliki pengaruh terhadap kejadian stunting. Perlu penelitian lebih lanjut mengenai pemberian pola makan yang tepat untuk mencegah dan mengatasi anak stunted. Kata kunci: AA esensial, AA nonesensial, IGFBP-3, insulin, PFAA, stunting, Zn

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ABSTRACTStunting is a malnourished condition in children defined by height for age is under minus 2 standard deviation. Indonesia ranked fifth in world for this condition. Stunting mainly corelates with low protein intakes, IGF-1 and its binding protein Insulin-like Growth Factor Binding Protein/IGFBP-3 , and zinc Zn . Plasma free amino acid profile PFAA measures quality of protein intake, whilst its quantity measured by daily protein intake records. Previous studies found IGF-1 level affected by single nucleotide polymorphism SNP on rs5742612, rs35767 and rs35766. This study aims to analyze the role of PFAA, IGF-1, IGFBP-3, and IGF-1 polymorphism, insulin, and Zn in children.This study is a comparative cross-sectional study held in Cipto Mangunkusumo National General Hospital, Eijkman Institute for Molecular Biology, and Jakarta Provincial Public Health Laboratory. Subjects were children age 1 ndash;3 years old from Jatinegara Region Public Health Centre divided into two groups of 101 stunted children and 101 non-stunted children.Eight essential AA levels, 2 conditional essential AAs, 2 nonessential AAs were significantly lower in stunted groups than non-stunted. There was significant difference of profile PFAA below normal range between stunted and non-stunted group. Eight essential amino acids, 1 conditional essential amino acid, and 2 non-essential amino acid correlate with children rsquo;s height. IGF-1, IGFBP-3, insulin, Zn, total energy, and protein were significantly lower in stunted children compare to non-stunted children. Significant correlations found for all essential amino acids with IGF-1 and IGFBP-3. The rs35766 AG codominant polymorphism affects IGF-1 level in non-stunted group. Factors affects stunting condition were total energy or protein intake, IGF-1 that interacts with AG codominant genotype, IGFBP-3, and Zn.Conclusion: PFAA and IGF-1 that interacts with SNP rs35766 AG codominant genotype affect stunting. Further study needed to determine appropriate dietary habit for stunting prevention and treatsment. Keywords: Essential amino acid, IGFBP-3, insulin, non-essential amino acid, plasma free amino acid profile, stunting, zinc"

"Latar belakang: Gagal jantung kronik merupakan penyakit progresif lambat dengan morbiditas serta mortalitas yang tinggi. Penggunaan obat-obatan seringkali tidak berhasil, sehingga Enhanced External Counterpulsation (EECP) yang bersifat non-invasif dapat menjadi alternatif terapi dalam penanganan gagal jantung. Metode: Penelitian ini menggunakan desain uji klinik terkontrol secara randomisasi terbuka terhadap kelompok yang menjalani terapi EECP dan yang tidak menjalani terapi (non-EECP). Masing-masing kelompok terdiri dari 33 pasien. Pada semua pasien dilakukan pemeriksaan mieloperoksidase (MPO) sebagai penanda inflamasi pada awal dan setelah 6 bulan pengamatan untuk dinilai kelompok mana yang lebih banyak mengalami kejadian kardiovaskular. Hasil: Pengukuran kadar MPO awal (743,4 ± 232,9 pM) dan setelah 6 bulan pengamatan (534,8 ± 191,3 pM) pada kelompok EECP mengalami penurunan bermakna secara statistik (p < 0,001) tetapi pada kelompok non-EECP (679,4 ± 332,3 pM menjadi 517,6 ± 189,7 pM) secara statistik tidak bermakna (p = 0,110). Penurunan kadar MPO sangat bermakna secara statistik pada semua pasien kelompok EECP dibandingkan kelompok non-EECP (13 pasien). Hasil perhitungan risiko relatif (RR) menyatakan bahwa risiko penurunan MPO pada kelompok EECP 2,08 kali lebih baik daripada kelompok non-EECP. Pengamatan kejadian kardiovaskular setelah 6 bulan penelitian menunjukkan perbedaan bermakna antara kedua kelompok (p = 0,037). Kejadian kardiovaskular kelompok non-EECP ditemukan 15 pasien (45,5 %) sedangkan pada kelompok EECP hanya ditemukan 7 pasien (21,2 %). Kesimpulan: Terapi EECP menurunkan kadar MPO pasien GJK dan dapat menurunkan kejadian kardiovaskular dalam 6 bulan pengamatan. Makin tinggi kadar MPO berkorelasi dengan makin tingginya insiden kejadian kardiovaskular.

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Background: Chronic heart failure (CHF) is a slowly progressive disease with high morbidity and mortality; the management using pharmacological treatments frequently fail. Therefore, Enhanced External Counterpulsation (EECP), a non-invasive treatment, may serve as alternative treatment for heart failure.

Methods: Our study was an open randomized controlled clinical trial. All subjects were categorized into two groups, i.e. the group who had EECP therapy and those who did not have EECP (non-EECP group). Each group consisted of 33 patients. Myeloperoxidase (MPO) as inflammatory marker was examined in all subjects at baseline and after 6 months of observation to assess which group had more cardiovascular events.

Results: Baseline MPO measurement (743.4 ± 232.9 pM) and after 6 months (534.8 ± 191.3 pM) in 32 patients in EECP group showed statistically significant reduction (p < 0.001); however in the non-EECP group, mean reduction value of MPO from 679.4 ± 332.3 pM to 517.6 ± 189.7 pM was not statistically significant (p = 0.110). MPO level reduction was statistically significant in all subjects of EECP group compared to non-EECP group (13 patients). Measured relative risk (RR) demonstrated that there was 2.08 fold risk of reduced MPO in EECP group compared to non-EECP group. Cardiovascular events observed after 6 months study showed that there was a significant difference between groups (p = 0.037).

Conclusion: EECP therapy can reduce MPO level in CHF patients. It may lower cardiovascular events in 6 months observation. Higher MPO level are associated with higher incidence of cardiovascular events."