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Egg White Extract Supplementation Improves Albumin and IGF-1 Levels in Malnourished Elderly Patients: A Randomized Controlled Trial Mukmin, Sugianto; Nur Riviati; Mgs Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i2.1188

Background: Malnutrition is a prevalent issue among the elderly, often leading to hypoalbuminemia (low albumin levels) and decreased serum Insulin-like growth factor 1 (IGF-1) levels. These conditions are associated with increased morbidity and mortality. Egg white extract (EWE) supplementation has shown promise in improving hypoalbuminemia. This study investigated the effects of EWE supplementation on serum albumin and IGF-1 levels in malnourished elderly patients. Methods: A double-blind randomized controlled trial was conducted, involving 46 malnourished elderly inpatients with hypoalbuminemia. Participants were randomly assigned to receive either EWE (30 grams daily) or a placebo for two weeks. Serum albumin and IGF-1 levels were measured before and after the intervention. Results: After two weeks, the EWE group showed a significant increase in both serum albumin and IGF-1 levels compared to the placebo group. The mean serum albumin level in the EWE group increased from 2.80 g/dL to 3.7 g/dL, while the placebo group remained unchanged. The mean serum IGF-1 level in the EWE group increased from 1.74 ng/mL to 24.74 ng/mL, while the placebo group experienced a smaller increase. There was a moderate positive correlation between changes in albumin and IGF-1 levels. Conclusion: EWE supplementation effectively improves serum albumin and IGF-1 levels in malnourished elderly patients with hypoalbuminemia. This intervention may help reduce malnutrition-related complications and improve overall health outcomes in this vulnerable population.

Accuracy of Fat Mass and Muscle Mass Measured by Bioelectrical Impedance Analysis in Predicting Osteoporosis in Older Adults Riviati, Nur; Ari Dwi Prasetyo; Rizki Bastari; Surya Darma; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i2.1191

Background: Osteoporosis is a prevalent bone disease characterized by reduced bone mineral density (BMD) and increased fracture risk. This study aimed to evaluate the accuracy of fat mass (FM) and muscle mass measured by bioelectrical impedance analysis (BIA) in predicting osteoporosis in older adults. Methods: A cross-sectional study was conducted on 109 outpatients aged 60 years and older. FM parameters (total fat mass, visceral fat level, and fat mass index [FMI]) and muscle mass parameters (total muscle mass, appendicular skeletal muscle mass [ASM], and appendicular skeletal muscle mass index [ASMI]) were measured using BIA. Osteoporosis was diagnosed based on BMD measurements using dual-energy X-ray absorptiometry (DXA). Receiver operating characteristic (ROC) curves were used to determine cut-off points and assess the accuracy of BIA parameters in predicting osteoporosis. Results: The prevalence of osteoporosis was 52.3% (n=57). The optimal cut-off points for predicting osteoporosis were: total fat mass >36.25%, visceral fat level >12.05, FMI >7.82 kg/m2, total muscle mass <37.82 kg, ASM <16.795 kg, and ASMI <6.895 kg/m2. Among the FM parameters, visceral fat level had the highest accuracy (AUC = 60.9%, sensitivity = 64.9%, specificity = 78.8%) while FMI had the lowest (AUC = 53.5%, sensitivity = 56.1%, specificity = 57.7%). For muscle mass parameters, ASM showed the highest accuracy (AUC = 74.0%, sensitivity = 70.2%, specificity = 76.9%). Conclusion: BIA-derived FM and muscle mass parameters, particularly visceral fat level and ASM can be used to predict osteoporosis in older adults with good accuracy. This non-invasive and accessible method may be useful as a screening tool for osteoporosis, especially in settings where DXA is unavailable.

eNOS, Cardiac Senescence, and Cardiovascular Aging: A Meta-Analysis of Molecular Mechanisms and Clinical Outcomes Tri Nisdian Wardiah; Ali Zainal Abidin; Taufik Indrajaya; Nur Riviati
Open Access Indonesian Journal of Medical Reviews Vol. 4 No. 6 (2024): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v4i6.685

Endothelial nitric oxide synthase (eNOS) plays a critical role in maintaining cardiovascular homeostasis. Its dysfunction is implicated in cardiac senescence, a hallmark of aging characterized by cellular decline and increased risk of cardiovascular disease. This meta-analysis investigated the association between eNOS, cardiac senescence, and cardiovascular aging, exploring underlying molecular mechanisms and clinical outcomes. A systematic search of PubMed, Scopus, and Web of Science databases was conducted for relevant studies published between 2013 and 2024. Studies investigating the relationship between eNOS, cardiac senescence markers (e.g., telomere length, p53, p16), and cardiovascular outcomes (e.g., heart failure, myocardial infarction, stroke) were included. Data were extracted and pooled using random-effects models. Nine studies (n=4,875 participants) met the inclusion criteria. Meta-analysis revealed a significant association between reduced eNOS activity and increased cardiac senescence markers (standardized mean difference [SMD] = -0.85; 95% confidence interval [CI], -1.20 to -0.50; p<0.001). Furthermore, eNOS dysfunction was associated with an increased risk of cardiovascular events (relative risk [RR] = 1.62; 95% CI, 1.25 to 2.10; p=0.001). Molecular analysis indicated that eNOS dysfunction contributes to cardiac senescence through increased oxidative stress, inflammation, and impaired autophagy. In conclusion, this meta-analysis provides compelling evidence for the detrimental role of eNOS dysfunction in cardiac senescence and cardiovascular aging. Targeting eNOS may offer promising therapeutic strategies to mitigate age-related cardiovascular decline.

Targeting Interleukin-6 Signaling with Tocilizumab in Atherosclerosis: A Meta-Analysis of Anti-Inflammatory Effects and Plaque Stabilization Ali Zainal Abidin; Tri Nisdian Wardiah; Taufik Indrajaya; Nur Riviati
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i1.686

Atherosclerosis, a chronic inflammatory disease, is the leading cause of cardiovascular disease. Interleukin-6 (IL-6) plays a crucial role in atherogenesis, making it a potential therapeutic target. Tocilizumab, an IL-6 receptor antagonist, has shown promise in reducing inflammation and stabilizing atherosclerotic plaques. This meta-analysis aimed to evaluate the efficacy and safety of tocilizumab in atherosclerosis by analyzing its impact on inflammatory markers and plaque characteristics. A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted from January 2013 to January 2024. Studies evaluating the effects of tocilizumab on inflammatory markers and plaque characteristics in patients with atherosclerosis were included. Randomized controlled trials (RCTs) and observational studies with a comparative arm were eligible. Data were extracted and pooled using a random-effects model. Nine studies (n=1248 participants) met the inclusion criteria. Tocilizumab significantly reduced CRP levels (standardized mean difference [SMD] -1.23; 95% confidence interval [CI] -1.56 to -0.90; p<0.001) and IL-6 levels (SMD -0.87; 95% CI -1.12 to -0.62; p<0.001) compared to control groups. A significant reduction in plaque volume (SMD -0.45; 95% CI -0.71 to -0.19; p=0.001) and an increase in fibrous cap thickness (SMD 0.38; 95% CI 0.12 to 0.64; p=0.004) were also observed. No significant increase in adverse events was reported in the tocilizumab group. This meta-analysis demonstrates that tocilizumab effectively reduces inflammation and promotes plaque stabilization in atherosclerosis. These findings suggest that tocilizumab may be a promising therapeutic strategy for preventing cardiovascular events in patients with atherosclerosis. Further large-scale RCTs are needed to confirm these findings and establish the long-term safety and efficacy of tocilizumab in this population.

Egg White Extract Supplementation Improves Albumin and IGF-1 Levels in Malnourished Elderly Patients: A Randomized Controlled Trial Sugianto Mukmin; Nur Riviati; Mgs Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i2.1188

Background: Malnutrition is a prevalent issue among the elderly, often leading to hypoalbuminemia (low albumin levels) and decreased serum Insulin-like growth factor 1 (IGF-1) levels. These conditions are associated with increased morbidity and mortality. Egg white extract (EWE) supplementation has shown promise in improving hypoalbuminemia. This study investigated the effects of EWE supplementation on serum albumin and IGF-1 levels in malnourished elderly patients. Methods: A double-blind randomized controlled trial was conducted, involving 46 malnourished elderly inpatients with hypoalbuminemia. Participants were randomly assigned to receive either EWE (30 grams daily) or a placebo for two weeks. Serum albumin and IGF-1 levels were measured before and after the intervention. Results: After two weeks, the EWE group showed a significant increase in both serum albumin and IGF-1 levels compared to the placebo group. The mean serum albumin level in the EWE group increased from 2.80 g/dL to 3.7 g/dL, while the placebo group remained unchanged. The mean serum IGF-1 level in the EWE group increased from 1.74 ng/mL to 24.74 ng/mL, while the placebo group experienced a smaller increase. There was a moderate positive correlation between changes in albumin and IGF-1 levels. Conclusion: EWE supplementation effectively improves serum albumin and IGF-1 levels in malnourished elderly patients with hypoalbuminemia. This intervention may help reduce malnutrition-related complications and improve overall health outcomes in this vulnerable population.

Accuracy of Fat Mass and Muscle Mass Measured by Bioelectrical Impedance Analysis in Predicting Osteoporosis in Older Adults Nur Riviati; Ari Dwi Prasetyo; Rizki Bastari; Surya Darma; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i2.1191

Background: Osteoporosis is a prevalent bone disease characterized by reduced bone mineral density (BMD) and increased fracture risk. This study aimed to evaluate the accuracy of fat mass (FM) and muscle mass measured by bioelectrical impedance analysis (BIA) in predicting osteoporosis in older adults. Methods: A cross-sectional study was conducted on 109 outpatients aged 60 years and older. FM parameters (total fat mass, visceral fat level, and fat mass index [FMI]) and muscle mass parameters (total muscle mass, appendicular skeletal muscle mass [ASM], and appendicular skeletal muscle mass index [ASMI]) were measured using BIA. Osteoporosis was diagnosed based on BMD measurements using dual-energy X-ray absorptiometry (DXA). Receiver operating characteristic (ROC) curves were used to determine cut-off points and assess the accuracy of BIA parameters in predicting osteoporosis. Results: The prevalence of osteoporosis was 52.3% (n=57). The optimal cut-off points for predicting osteoporosis were: total fat mass >36.25%, visceral fat level >12.05, FMI >7.82 kg/m2, total muscle mass <37.82 kg, ASM <16.795 kg, and ASMI <6.895 kg/m2. Among the FM parameters, visceral fat level had the highest accuracy (AUC = 60.9%, sensitivity = 64.9%, specificity = 78.8%) while FMI had the lowest (AUC = 53.5%, sensitivity = 56.1%, specificity = 57.7%). For muscle mass parameters, ASM showed the highest accuracy (AUC = 74.0%, sensitivity = 70.2%, specificity = 76.9%). Conclusion: BIA-derived FM and muscle mass parameters, particularly visceral fat level and ASM can be used to predict osteoporosis in older adults with good accuracy. This non-invasive and accessible method may be useful as a screening tool for osteoporosis, especially in settings where DXA is unavailable.

Faktor-Faktor yang Berhubungan dengan Massa Otot, Kekuatan Otot, dan Performa Fisik pada Lansia Riviati, Nur; Indrajaya, Taufik; Chodilawati, Rukiah; Dibyantari, Ridzqie; Indra, Bima
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction. Despite its high prevalence and significant impact on health, comprehensive studies are still needed to explore the factors affecting sarcopenia parameters, such as muscle mass, muscle strength, and physical performance. This study aimed to identify the factors influencing sarcopenia parameters in the elderly, including muscle mass, muscle strength, and physical performance. Methods. A cross-sectional study was conducted from July to December 2022 on elderly individuals (>60 years old) at the Geriatric Polyclinic, Moh. Hoesin General Hospital, Palembang, selected through consecutive sampling. Muscle mass was measured using bioimpedance analysis, expressed in ASMI values; muscle strength was measured using a handheld dynamometer; and physical performance was assessed using the five-time sit-to-stand test. The SARC-F score was classified as normal (<4) and abnormal (≥4). Data on age, gender, serum albumin levels, comorbidities, and Mini Nutritional Assessment Short Form (MNA-SF) scores were collected for correlation analysis and comparison with muscle mass, muscle strength, and physical performance. Results. Of the 41 subjects, the average age was 70.75 (SD 7) years, with 56.1% being female. All subjects had low muscle mass, with an average ASMI of 3.31 (SD 0.59) kg/m² in females and 4.89 (SD 1.06) kg/m² in males. The average muscle strength for females was 16.9 (SD 6.1) kg and for males 27.5 (SD 8.3) kg. The five-time sit-to-stand test result for females was 24.2 (SD 14.2) seconds and for males, 21.8 (SD 11.1) seconds. Based on SARC-F, 8 subjects (19.5%) were categorized as at risk for sarcopenia. Serum albumin levels for all subjects were within the normal range [4.3 (SD 0.3) g/dl]. Malnutrition was found in 14 subjects (34.1%) according to the MNA-SF results. Comorbidities were present in 35 patients. Statistical analysis showed a significant correlation between serum albumin levels and muscle strength (r=0.35; p=0.005) and physical performance (r=-0.5; p<0.001). Nutritional status had no significant effect on the three parameters, but it did significantly affect muscle mass in elderly males (p=0.002). Comorbidities, including cardiovascular disease, non-insulin-dependent diabetes mellitus, and musculoskeletal disorders, were not significantly related to any of the sarcopenia parameters. Conclusions. Serum albumin is significantly associated with muscle strength and physical performance, while nutritional status is significantly associated with muscle mass in elderly males. Comorbidities were not significantly related to muscle mass, muscle strength, or physical performance in the elderly.

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