Evaluation of Body Iron Stores as Indicator of Iron Status in School-Age Children.

Objectives: To explore the application of the Cook method to estimate baseline Body Iron Stores (BIS) in children as well as change in BIS and safety following a one-year fortified food intervention. Methods: Data from two trials in Australia, Indonesia and India assessing the effect of a multiple micronutrient intervention with iron in a total of 1309 children 6-10y were used. Australian and Indonesian children received either 10 mg/d Fe (as EDTA) in a beverage or non-fortified beverage; Indian children received either 2.7 (control) or 18 mg/d Fe (as fumarate) in a drink and biscuit. Serum ferritin, transferrin receptor concentrations were measured at baseline and after 1y and subjects with CRP >5 mg/L were excluded. BIS were calculated following the Cook formula1 Results: Baseline BIS ranged from 2.55±3.00 mg/kg (mean±SD) in Indonesia and 3.22±3.20 mg/kg in India to 3.63±2.03 mg/kg in Australia. After one year, BIS significantly increased in intervention groups compared to controls (treatment effects (95%-CI) were 2.93 (2.53;3.33), 3.25 (2.93;357) and 0.87 (0.35;1.39) mg/kg, for countries respectively). BIS increase was higher in children with a low baseline BIS. In all intervention groups BIS did not exceed 12 mg/kg bodyweight. Conclusions: BIS calculated following the Cook formula seems a useful indicator for iron status in school-age children, as illustrated by the increase in BIS following the multiple micronutrient interventions with iron levels of 100%RDA. Graphs illustrating the relation between BIS at baseline and after one year intervention will be presented at the conference.

Negative impact of imflammation and insulin resistance on the biogenesis of HDL-c in Indonesian men with metabolic syndrome.

Aim To find out the relationship between inflammation and insulin resistance with impaired HDL biogenesis that cause low HDL-c concentration Methods Using a cross-sectional design, this study involved 163 adult men, aged 25-60 years old with metabolic syndrome (IDF criteria, 2005), without liver and kidney dysfunction. This study was undertaken in Jakarta in the year 2007-2009. Measured indicators were serum apolipoprotein A-1 (apoA-1), prebeta-1 HDL, cholesteryl ester transfer protein (CETP), HDL cholesterol (HDL-c), body weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and triglyceride. The apoA-1/HDL-c ratios were taken as indicator of HDL maturation, whereas CETP/HDL-c and CETP/TG ratios were indicated HDL catabolism. high-sensitivity CRP (hsCRP) and HOMA-IR were taken as indicator of inflammation and insulin resistance, respectively. Data were analyzed by using univariate, bivariate, and multivariate analysis. Results Positive correlations were found between hsCRP and CETP (rs= 0.200, p= 0.042), and CETP/HDL-c ratios (rs= 0.188, p= 0.013). HOMA-IR positively correlated with apoA-1/HDL-c ratios (rs= 0.190, p= 0.016) and negatively correlated with the CETP/TG ratios (rs= -0.162, p= 0.04). Results of general linear model analysis showed that serum hsCRP concentration had the highest contribution to CETP/HDL-c ratios, apoA-1, dan CETP (p= 0.009; 0.016; 0.054, respectively). Conclusions Inflammation and insulin resistance related to dysfunction of HDL biogenesis in men with metabolic syndrome. The inflammation correlated with increased HDL catabolism, whereas the insulin resistance correlated with decreased HDL maturation and increased HDL catabolism. These may lead to low HDL-c concentration. Inflammation had higher contribution to HDL biogenesis factors than insulin resistance.

Adiponectin, total anti-oxidant status, and high sensitivity C-reactive protein in Indonesian men with metabolic syndrome.

Aim: To examine biochemical markers of adiponectin, total anti-oxidant status (TAOS) and high sensitvity C-reactive protein (hsCRP) in individuals with and without metabolic syndrome (MetS). Methods: A cross-sectional study on 36 non-MetS and 36 MetS subjects was undertaken in Jakarta. Measured indicators were adiponectin, TAOS and hsCRP, apart from weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG). Odds ratio (OR) of adiponectin, TAOS and hsCRP were calculated to assess risk for the development of MetS. Median values were determined as cutoffs to define high and low values of each parameter. Relationships between adiponectin, TAOS and hsCRP with WC were analyzed by using Spearman correlation analysis, and the contributions of all indicators to the development of MetS were analyzed by using logistic regression. Results: Adiponectin dan hsCRP differed signifi cantly between non MetS and MetS subjects (4.2 + 1.4 vs 3.1 + 1.0 ug/mL) dan (0.97 + 0.92 vs 3.35 + 3.43 mg/L) (p < 0.01), but no signifi cant difference was found in TAOS (1.24 + 0.1 vs 1.28 + 0.2 mmol/L). Adiponectin associated negatively with WC (rs= -0.436; p < 0.01), while TAOS and hsCRP associated positively with WC (rs= 0.286, p = 0.02 and rs= 0.597, p < 0.01). The odds ratios (ORs) of adiponectin and hsCRP for the development of MetS were 4 (p = 0.01) and ~6,8 (p < 0.01), respectively; while the risk of subjects with adiponectinhs CRP ratio of ≤ 2.31 to develop MetS was 25 times (p < 0.01) those with adiponectin-hsCRP ratio > 2.31. Conclusion: The use of adiponectin-hsCRP ratio increases the predictive power for the occurrence of MetS by 4-6 times the predictive power of adiponectin or hsCRP alone.

Fat free mass index as parameter for nutritional status in non-dialysis chronic kidney disease patients stage 3, 4 and 5.

The aim of this study is to obtain body composition parameters for early detection of PEM in non dialysis CKD (ND-CKD) patients. The study was carried out using the cross sectional design. The subjects of the study consist of 45 ND-CKD patients and 45 healthy subjects matched for age, gender, height and body mass index (BMI). The nutritional status of patients and healthy subjects were classified based on BMI (WHO, 1995) into low, normal and high nutritional status groups. Fat free mass (FFM), FFM-index (FFM-I) and percentage of fat mass (FM percentage) in patients measured by anthropometric technique showed no significant difference with healthy subjects. Using the BIA method, FFM and FFM-I were significantly lower in the ND-CKD patients compared to the healthy subjects (p < 0,05). Significant difference in FFM, FFM-I, FM and FM percentage was observed between the patients with different nutritional status. (p < 0,001). Trend analysis statistical test showed that there is linear correlation of FFM, FFM-I and FM with nutritional status classification. FFM, FFM-I, FM and FM percentage in ND-CKD patients were not significantly different between the three stages of CKD. There was an acceptable degree of agreement between BMI with FFM-I for nutritional assessment in ND-CKD patients. The Receiver Operating Curve test showed the cut off points of FFM-I 14.23 kg/m2 to differentiate undernutrition and normal nutritional status in ND-CKD patients. This study showed FFM-I has good correlation with BMI and can be used to differentiate degrees of nutritional status in stage 3, 4 and 5 ND-CKD patients. FFM-I considered predictor parameters for nutritional status screening in ND-CKD patients.

Fatty acids intake among diverse ethnic groups in Indonesia.

The use of dietary pattern specifically fatty acids intake should prove to be an informative and powerful means to augment our understanding of the role of diet in chronic disease particularly CHD. Cross sectional study was implemented to describe the nutrients intake specifically fatty acids intake of 4 (four) ethnic groups in Indonesia, such as Minangkabau, Sundanese, Javanese and Buginese. The percentage of saturated fatty acid (SAFA) to total energy intakes were around 20%. The percentage of polyunsaturated fatty acid (PUFA) to the total energy were about 4.4% to 4.6% among the Sundanese and the Javanese.While among the other two ethnic groups, the percentage of PUFA to total energy were less, 2.6 % among the Minangkabau and 2.8% among the Buginese ethnic. The percentage of mono unsaturated fatty acid (MUFA) to total energy intake were higher among the two ethnic groups, Sundanese and Javanese (6.1% vs. 5.5%). While the percentages of MUFA between the other two ethnic groups Minangkabau and Buginese ethnic were lower (2.6% vs. 2.8%). Based on the ratio of PUFA: MUFA: SAFA, we could consider that Minangkabau and Buginese ethnic groups both had poor quality of dietary fat pattern. Having the poor quality of dietary fat pattern and higher fat intake, we might take into consideration that the Minangkabau ethnic groups, had higher risk toward dyslipidemia compared to the other three ethnic groups.

Nutritional status of hyperlipidemics elderly in Indonesia according to body mass lndex (study in four Indonesian big cities).

The objective of this study was to assess the nutritional status of hyperlipidemics elderly. A cross sectional study was undertaken in 4 big cities in Indonesia using multistage random sampling. The respondents were 656 hyperlipidemics and non hyperlipidemics elderly who were the subsample of 1261 sample of a larger population study. Data were collected through anthropometric measurements and biochemical blood analysis. To determine the nutritional status by Body Mass Index (BMI) the criteria used for elderly men and women are as follows, underweight BMI ≤ 18.5 kg/m2, normoweight BMI 18.5 - 24.9 kg/m2, overweight BMI 25 - 29.9 kg/m2, and obese BMI ≥ 30 kg/m2. To determine lipid status, the criteria used are as follows, hyperlipidemics elderly, those who had plasma total cholesterol ≥ 240 mg/dl and or triglycerides ≥ 200 mg/dl. Prevalence of hyperlipidemics in elderly women is higher then elderly men, 56.2% vs 47.0%. The BMI of hyperlipidemics is mostly overweight (60.4%) and obese (57.1%) for elderly men; and mostly normoweight (59.1%) and overweight (59.5%) for elderly women. The prevalence of hyperlipidemics among undernourished elderly men and women were also quite high, 38.7% and 31.6% respectively.