Indra Ihsan
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Andalas/RSUP Dr. M. Djamil Padang

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Journal : Paediatrica Indonesiana

Visfatin levels in non-obese, obese, and insulin resistant adolescents Indra Ihsan; Eka Agustia Rini; Rismawati Yaswir
Paediatrica Indonesiana Vol 56 No 5 (2016): September 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (227.268 KB) | DOI: 10.14238/pi56.5.2016.291-6

Abstract

Background Adipose tissue is not merely a site for energy storage, but is also the largest endocrine organ, secreting various adipocytokines. Plasma visfatin, an adipocytokine predominantly secreted from visceral adipose tissue, has insulin-mimetic effects, and has been closely linked to insulin resistance.Objective To compare plasma visfatin levels between obese and non-obese adolescents, as well as between obese adolecents with and without insulin resistance.Methods This cross-sectional study was conducted in students who attended three senior high schools in Padang. Subjects comprised 28 obese and 28 non-obese adolescents. The age of the subjects ranged from 14-18 years. Obesity criteria were based on body mass index (BMI) measurements. Fasting serum glucose level was measured by glucose hexokinase photometry and serum insulin was measured by chemiluminesence immunoassay. Plasma visfatin was measured by enzyme-linked immunosorbent assay (ELISA). The insulin resistance index was estimated from fasting serum insulin and glucose levels using the homeostatic model assessment for insulin resistance (HOMA-IR). Differences in the variables were tested using independent T-test and Mann-Whitney test, depending on the distribution of the variables.Results The mean plasma visfatin level was significantly higher in the obese than in the control group [2.55 (SD 1.54) vs. 1.61 (SD 0.64) ng/mL, respectively; (P=0.005)]. The insulin resistant group had significantly higher mean plasma visfatin level than the non-resistant group [3.61 (SD 1.59) vs. 1.96 (SD 1.18) ng/mL, respectively; (P=0.004)].Conclusion Obese adolescents with insulin resistance have signifcantly higher plasma visfatin levels compared to those without insulin resistance.
Delayed diagnosis of congenital hypothyroidism in an adolescent results in avoidable complications: a case report Indra Ihsan; Eka Agustia Rini
Paediatrica Indonesiana Vol 57 No 2 (2017): March 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (951.083 KB) | DOI: 10.14238/pi57.2.2017.108-16

Abstract

Delayed diagnosis of congenital hyporhyroidism (CH) remains a serious problem. A retrospective analysis of 1,000 CH cases in Turkey found a mean age of 49 months at the time of clinical diagnosis. Only 3.1% of cases were diagnosed during the neonatal period and 55.4% were diagnosed after 2 years of age.1 In Cipto Mangunkusumo Hospital, Jakarta, 53% cases were diagnosed at 1-5 years, 3.3% at 6-12 years, and 6.7% after 12 years of age, while the remainder were diagnosed at < 1 year of age.2 The majority of affected children exhibit signs and symptoms that are highly non-specific, as most infants with CH are asymptomatic at birth, and only 5% of cases can be diagnosed based on clinical examination during the first day of life.3 The other factors that contribute to delayed diagnosis are uneducated parents, who do not notice or dismiss the importance of mild/moderate deviations in physical and mental growth, as well as constipation, feeding difficulties, or other vague, non-specific symptoms in infancy. Parents are often unaware of the importance of early diagnosis and commencement of therapy for CH.4