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Vitamin D levels and depression in type 2 diabetes mellitus patients: a cross-sectional study Putranto, Rudi; Adhiatma, Kresna; Tarigan, Tri Juli Edi; Rumende, Cleopas Martin; Shatri, Hamzah; Rengganis, Iris; Nugroho, Pringgodigdo; Rinaldi, Ikhwan
Medical Journal of Indonesia Vol. 32 No. 3 (2023): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.237005

Abstract

BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) is increasing and commonly accompanied by comorbidities, such as depression. Vitamin D levels have been associated with T2DM and depression although the mechanism is uncertain. This study aimed to compare vitamin D levels between patients with T2DM with and without depression in the Indonesian community, where such research is rare. METHODS This cross-sectional study was conducted at Cipto Mangunkusumo Hospital. The participants who met the inclusion criteria on an outpatient basis were screened for depression using the Beck Depression Inventory-II (BDI-II) questionnaire and then divided into 2 groups: patients with T2DM with (BDI-II ≥14) and without (BDI-II <14) depression. Both groups were examined for vitamin D levels using the ELISA method, and an analysis of the mean difference between both groups was performed. RESULTS Of 60 patients, 23 (38%) experienced depression. The median vitamin D levels were 21.8 ng/ml (IQR 14.9–26.6) in the depression group and 26.5 ng/ml (IQR 23.96–34.08) in the non-depression group (p = 0.001). After performing multivariate analysis with confounding variables, the adjusted OR of variables (sex, sun exposure score, and body mass index) was 1.123 (95% CI: 1.003–1.259; p = 0.045). CONCLUSIONS Vitamin D levels were significantly lower in patients with T2DM with depression. Future studies should be carried out to determine the benefits of vitamin D supplementation in patients with T2DM with depression and their pathophysiology.
Efficacy of fetal hemoglobin inducers in adult transfusion-dependent beta-thalassemia patients: a systematic review and meta-analysis Naufal, Muhammad Afif; Fauzi, Ahmad; Rengganis, Iris
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257796

Abstract

BACKGROUND Patients with transfusion-dependent beta-thalassemia (TDBT) face risks of iron overload, which also burdens national expenditures in Indonesia. Elevated fetal hemoglobin (HbF) expression is associated with reduced blood transfusion dependency. This study aimed to assess the efficacy and safety profile of HbF inducers as adjuvant therapy for adult patients with TDBT and appraise its feasibility for Indonesian patients. METHODS This study analyzed 7 trials of HbF inducers, such as hydroxyurea, thalidomide, butyrate, and decitabine, in 382 adult participants (mean age >16), including 28 patients with non-TDBT. Outcomes assessed included hemoglobin (Hb) levels, transfusion needs, and adverse events (AEs). Studies were sourced from PubMed, Cochrane, Embase, and individual searches. The standardized mean difference (SMD) was used as the primary effect size. The protocol was registered in PROSPERO (CRD4202454646368). RESULTS High heterogeneity was observed, with HbF inducers associated with a significant decrease in transfusion needs (SMD = −0.88; 95% confidence interval [CI] = −1.37 to −0.26); I2 = 79%, P✗2<0.01). No significant change in Hb levels was found (SMD = 0.11; 95% CI = −0.69 to 0.91; I2 = 90%, P✗2<0.01). The most common AEs were transaminitis and cytopenias, which were tolerable and alleviated upon dose cessation. CONCLUSIONS HbF induction agents can be used as adjuvant therapy for TDBT, considering their cost-effectiveness, efficacy, and safety profiles.