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All Journal Journal of Biomedicine and Translational Research Jurnal Media Gizi Indonesia (MGI) Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education The Indonesian Journal of Public Health Sari Pediatri Health Notions Amerta Nutrition Journal of Telenursing (JOTING) JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH Media Gizi Kesmas Indian Journal of Forensic Medicine & Toxicology JOURNAL LA MEDIHEALTICO Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Berita Kedokteran Masyarakat Asian Journal of Social and Humanities Jurnal Kesehatan Masyarakat Folia Medica Indonesiana
Nur Aisiyah Widjaja, Nur Aisiyah
Child Health Department, Faculty Of Medicine, Dr Soetomo General Hospital, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Education Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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The Use of STRONGkids, Total Lymphocyte Count, and Serum Albumin to Identify the Risk of Hospital Malnutrition in Children Rusti, Hafiza Amadhin; Widjaja, Nur Aisiyah; Irawan, Roedi; Setiawan, Ariandi
Folia Medica Indonesiana Vol. 59, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: • Medium- and high-risk STRONGkids scores are related with low total lymphocyte count and serum albumin, which are related to hospital malnutrition, albeit indirectly. • The use of STRONGkids with total lymphocyte count and serum albumin can detect the risk of hospital malnutrition in children. Abstract: Hospital malnutrition occurs in hospitalized patients who do not consume enough food while their nutritional requirements increase. It occurs particularly in children who have undergone gastrointestinal surgery. Despite the lack of a universal instrument for detecting hospital malnutrition, various parameters can be considered to assist in its identification. STRONGkids has demonstrated its efficiency in detecting malnutrition risk in children. Total lymphocyte count (TLC) and serum albumin are biochemical markers that are related to infection and protein leakage, which can worsen hospital malnutrition. The research objective was to analyze the correlation between STRONGkids and biochemical markers (TLC, serum albumin) to identify hospital malnutrition in children who underwent gastrointestinal surgery. This was a retrospective cross-sectional observational study utilizing medical records. The statistical analysis was conducted using SPSS 21. This study included 37 subjects, with a 24.32% hospital malnutrition incidence rate. The subjects were divided into two groups: hospital malnutrition (n=9) and non-hospital malnutrition (n=28). The STRONGkids of both groups at admission demonstrated a significant difference, while the albumin and TLC did not. The significantly different STRONGkids scores of both groups at admission correlated negatively with the length of hospital stay (LOS), body weight reduction, TLC, and albumin. Those parameters also did not correlate with hospital malnutrition. However, hospital malnutrition increased the risk of low albumin and TLC at discharge by 2.951 and 5.549 times, respectively. In conlusion, TLC and serum albumin cannot be used as independent markers for hospital malnutrition, but STRONGkids can be used in conjunction with TLC and serum albumin to identify hospital malnutrition risk.
Effect of Different Complementary Feeding on Iron Deficiency Anemia and Growth in Breastfed Infants: Home-Made VS Commercial Irawan, Roedi; Widjaja, Nur Aisiyah; Hanindita, Meta Herdiana
Folia Medica Indonesiana Vol. 55, No. 2
Publisher : Folia Medica Indonesiana

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After approximately 6 months of age, term breastfed infants are increasingly depend on other sources of iron to avoid iron deficiency anemia, due to the depletion of the low concentration of iron in human milk. The appropriate complementary feeding must include a balance composition of foods containing an adequate amount of macro- and micronutrients to avoid iron deficiency anemia. This study aimed to compare the risk of iron deficiency and growth in breastfeed infants receiving commercial fortified complementary foods or home-made. A cross-sectional study was held on April-June 2016 to evaluate infants aged 6-24 months with breast feeding intake for 6 month of life. Complementary feeding practices were determined by questionnaire; an unquantified food frequency and feeding practices questionnaire was used to determine usual food intake. Biochemical assessment of haemoglobin (Hb), serum ferritin (SF) and serum iron (SI) level were measured. Anthropometric were assessed using WHO Child Growth Standard 2005. Statistical analysis used were Chi-square Test. Thirty eight infants were enrolled, mean age of 16.2 (SD 10.5) months. 17 infants consumed commercial complementary foods and 21 infants use home-made. Infants with home-made had lower Hb level, SF and SI than those receiving commercial complementary food, and had higher risk of underweight, stunted and wasted. Infants with home-made complementary food had lower haemoglobin, serum feritin and serum iron levels than those in fortified complementary food CF; and a higher risk of stunted and wasted than children with commercial fortified CF.
Association Between Body Mass Index, Visceral Fat, and the Risk of Metabolic Syndrome Among Obese Adolescents in Indonesia Indriati, Ataillah Azizah; Widjaja, Nur Aisiyah; Ardiana, Meity; Hanindita, Meta Herdiana
Journal La Medihealtico Vol. 6 No. 6 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i6.2831

Abstract

This study examined the association between Body Mass Index (BMI) and visceral fat with the risk of Metabolic Syndrome (MetS) among obese adolescents in Surabaya and Sidoarjo, Indonesia. The research addressed the increasing burden of cardiometabolic disorders in adolescents, focusing on the importance of early screening for central adiposity. A cross- sectional design was employed involving 72 obese adolescents from junior and senior high schools. BMI was measured using standard anthropometry, while visceral fat was assessed through Waist Circumference (WC)and Bioelectrical Impedance Analysis (BIA). MetS was identified based on established clinical criteria. The findings revealed that both BMI and visceral fat were significantly associated with MetS, with BIA-derived visceral fat demonstrating the strongest predictive value. Adolescents with high visceral fat exhibited substantially higher risks of dyslipidemia, hypertension, and overall metabolic abnormalities. These results highlight the limitations of BMI as a standalone indicator and reinforce the need for integrating visceral fat assessment in school-based screening programs. Early identification and targeted interventions are essential to mitigate the progression of MetS during adolescence.
Correlation of Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio with Stunting in Children Stanpo, Gwyneth Trixie; Notopuro, Paulus Budiono; Widjaja, Nur Aisiyah
Journal of Biomedicine and Translational Research Vol 11, No 3 (2025): December 2025
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v11i3.28088

Abstract

Background: Globally, stunting affected approximately 148 million children under five in 2022. Chronic infection contributes to stunting through immune hyperactivation and excessive cytokine release. Since anthropometric assessments are prone to errors and may not accurately reflect the underlying inflammatory status, common systemic inflammatory markers, such as the Neutrophil-Lymphocyte Ratio (NLR), Monocyte-Lymphocyte Ratio (MLR), and Platelet-Lymphocyte Ratio (PLR), can serve as alternatives. These markers are simple, affordable, and accessible in every health center.Objective: To analyze the correlation of NLR, MLR, and PLR with stunting.Methods: A cross-sectional study involving pediatric patients aged 1-5 years from the Nutrition and Metabolic Outpatient Clinic of Dr. Soetomo Regional Hospital in Surabaya from 2022 to 2023. Forty-one samples met the inclusion and exclusion criteria. Data on NLR, PLR, MLR, and other hematological variables were obtained from the patients' hematology profiles. Group differences, correlations, and diagnostic performance were analyzed using Kruskal–Wallis, Spearman, and ROC methods, respectively.Results: Forty-one subjects were obtained and divided into three groups: 21 (51.2%) normal, 10 (24.4%) stunted, and 10 (24.4%) severely stunted. RBC and lymphocytes significantly increased in normal patients, whereas neutrophils, platelets, NLR, MLR, and PLR significantly increased in severely stunted patients. NLR, MLR, and PLR differed significantly between normal and stunted children (p =<0.001; p =0.002; and p =<0.001, respectively) and showed positive correlations between the NLR (p =<0.001; r =0.687), MLR (p =<0.001; r =0.558), and PLR (p =<0.001; r =0.784) with stunting. At cutoff values of 0.844 (NLR), 88.527 (PLR), and 0.174 (MLR), their AUCs were 0.90, 0.95, and 0.82, with sensitivities of 75%, 80%, and 60%, respectively.Conclusion: NLR, MLR, and PLR significantly differ among normal, stunted, and severely stunted children, showing positive associations with stunting. These markers, particularly PLR, may serve as a practical screening tool, warranting further validation through larger studies.
InsuTAG and Early Salutogenic Screening of Cardiometabolic Risk in Obese Adolescents Inner Beauty Bilqis, Tiber Raniar; Widjaja, Nur Aisiyah; Devy, Shrimarti Rukmini; Indriani, Diah; Irawan, Nur Roedi; Hanindita, Meta Herdiana; Ardianah, Eva
Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Vol. 14 No. SI1 (2026): Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Educat
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpk.V14.ISI1.2026.86-93

Abstract

Background: Insulin resistance (IR) is considered the common underlying cause of metabolic syndrome (MetS). Predicting the incidence of MetS and IR at the individual level is essential, especially in obese adolescents who are at high risk of cardiovascular disease (CVD). InsuTAG has shown reliable results in predicting IR and MetS in healthy elderly populations. This study aimed to investigate the use of InsuTAG as an assessment tool to predict IR and MetS in obese adolescents, using the homeostasis model assessment (HOMA) to quantify insulin resistance. Methods:  A cross-sectional analytic study was conducted from January to May 2020 in healthy obese adolescents aged 13-18 years-old. Blood analyses included lipid profile (LDL-c, HDL-c, total cholesterol, and triglycerides), fasting blood glucose, and fasting insulin. IR was defined as HOMA-IR > 5.22 for boys and > 3.82 for girls during the pubertal period. Results: The receiver operating characteristic (ROC) curve for InsuTAG demonstrated a greater area under the curve (AUC) for identifying IR than MetS (0.877 vs. 0.743, p = 0.000; 95% CI). The optimal InsuTAG cut-off to determine IR was > 23.48, with 78.43% sensitivity and 87.38% specificity. The cut-off to identify MetS was > 23.36, yielding 67.97% sensitivity and 72.82% specificity. Conclusion: InsuTAG is a useful tool for identifying IR and MetS. The optimal cut-off values are > 23.48 for IR and > 23.36 for MetS in obese adolescents. These findings support early prevention and health promotion efforts, ultimately strengthening self-care practices among obese adolescents.
Co-Authors Adha, Aziza Zahrotul Alexander Leonard Caesar Josediputra Alexander, Yoppi Yeremia Alpha Fardah Athiyyah Amer Siddiq Amer Nordin Anggie Lorenza Ardianah, Eva Ardina Maharani, Putri Ariandi Setiawan Arief Wibowo Arifani, Rizka Azzahra', Lama'ah Bahmid, Moh Bahmid, Moh. Boerhan Hidayat Boerhan Hidayat, Boerhan Cahyanti, Ika Yuniar Christine Florens Christine Florens Claudia Felisia Magdalena Kurube Dewi Retno Suminar Diah Indriani Dina Angelika Dwi Lestari Avianti Eddy Bagus Wasito Febrina Mustika Santoso Fitriari, Tutfah Razzak Hafiza Amadhin Rusti Hanindita, Meta Herdiana Hanindita, Meta Herdiana Hardiani, Kartika Hari Basuki Notobroto Harits, Muhammad Hendrayani, Ayu Ekanita HERMANTO, EDI Iitdrie Iitdrie, Iitdrie Indriati, Ataillah Azizah Inner Beauty Bilqis, Tiber Raniar Irawan, Nur Roedi Keya , Rino Tryanto Keya, Rino Tryanto Khadijah Rizky Sumitro Khadijah Rizky Sumitro KUNTORO Meity Ardiana Mochammad Bagus Qomaruddin Muthmainnah Muthmainnah Naoval Diza Ananda Notopuro, Paulus Budiono Noviyanti, Tausiyah Rohmah Noviyanti, Tausyiah Rohmah Nurfidaus, Yasmine Nurfirdaus, Yasmine Pebriaini, Prisma Andita Putri Ardina Maharani Rachmah Indawati Rafi Alfian Razan Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Ria Puspitasari Roedi Irawan Rusti, Hafiza Amadhin Santoso, Febrina Mustika Setiawan, Ariandi Shrimarti Rukmini Devy Sigit Ari Saputro SITI NURUL HIDAYATI Soenarnatalina Melaniani Soenarnatalina, Melaniani Sri Widati Stanpo, Gwyneth Trixie Sulistiawati Vianca Samara Andhary Windhu Purnomo