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All Journal BALI MEDICAL JOURNAL (BMJ) journal of internal medicine INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Jurnal Teknik ITS IPTEK Journal of Proceedings Series R.E.M (Rekyasa Energi Manufaktur) Jurnal The Indonesian Biomedical Journal Jurnal Administrasi Pendidikan Indonesia Jurnal Penyakit Dalam Udayana Jurnal Kelautan Nasional Wave: Jurnal Ilmiah Teknologi Maritim ISM (Intisari Sains Medis) : Jurnal Kedokteran International Journal of Marine Engineering Innovation and Research GANESHA MEDICINA Public Health and Preventive Medicine Archive Makara Journal of Technology Jurnal Penyakit Dalam Indonesia
I Ketut Suastika
Institut Teknologi Sepuluh Nopember Surabaya
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HUBUNGAN KENDALI GLIKEMIK DENGAN ASYMMETRIC DIMETHYLARGININE PENDERITA DIABETES MELITUS TIPE 2 LANJUT USIA Ngurah Hariawa, Kadek; Suastika, Ketut
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Abstract

Increasing life expectacy is usually in line with increasing prevalence of matabolic diseases, especially diabetes mellitus(DM). Old age and DM are risk factors for cardiovascular disease. Endothelial dysfunction is the early process of atherosclerosis.Asymmetric dimethylarginine (ADMA) is a marker for endothelial dysfunction. Until recently however, there is a lack of studyon the correlation of diabetes control and ADMA in elderly with DM.The objective of this study was to assess the correlation of diabetes control with ADMA in diabetes elderly. The designof the study was cross sectional analytic study. The study subects were diabetic patients aged 60 years or above without smokingand existance of end stage renal disease.The 80 study subjects consisted of 57 males and 43 females, ages ranging from 60 to 80 years. The majority of thesubjects were with other diseases i.e. hipertension 62 (77.5%), dyslipidemia 51 (63.8%), overweight 59 (73.9%), decreased renalfunction with creatinin clearence below 60 ml/mnt 58 (72.5%), hyperhomocysteinemia 35 (43.8%). The subjects with goodglicemic control were 25 (32%), moderate 31 (38.8%), and bad glicemic control 24 (30%). Pearson correlation showed there wasno correlation between glicemic control (fasting blood glucose, 2 hour after meal blood glucose, HbA1c) and ADMA. Analysis onother factors showed a correlation of ADMA with sistolic blood pressure (r=-0.222; p=0.024) and homocystein (r=0.333; p=0.001).Multiple liniar regression analysis constanly showed a correlation between homocystein and ADMA (B=0.473; p=0.003). Thenew construction model of this study was the formula ADMA (µmol/L)= 0.213+0.473 log homocystein µmol/L. Based on thecriteria used diabetes control, we found mean difference of ADMA at systolic blood pressure (p=0.031). There was no meandiffrence of ADMA found based on the treatment regimens given i.e. those given insulin or not (p=0.547) and those givenmetformin or not (p=0.219).In conclusion, blood glucose control has no correlation with ADMA in the elderly with DM, however homocystein haspositve correlation with ADMA in elderly with DM. The elderly with DM have several accompanying of diseases.
PREDIKTOR DISFUNGSI EREKSI PADA PENDERITA DIABETES TIPE 2 DI POLIKLINIK PENYAKIT DALAM RS SANGLAH DENPASAR Ratna Saraswat, Made; Sanjaya, Dwija; Suastika, Ketut
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Abstract

Erectile dysfunction (ED) is a commonly reported condition among men with diabetes, however little is known aboutthe predictive factors associated with diabetic ED. To examine the predictors related to ED among type 2 diabetes outpatient, aconsecutive cross sectional study at Internal Medicine Outpatient Clinic, Sanglah Hospital was conducted, enrolled 137 type 2diabetes men aged between 35 ? 77 years old. We found 79.5% of type 2 diabetics with ED. Erectile function score was significantlycorrelated with other component of International Index of Erectile Function 15 (IIEF 15) including orgasmic function(r=0.622, p<0.001), sexual desire (r=0.782, p<0.001), intercourse satisfaction (r=0.911, p<0.001), and overall satisfaction (r=0.842,p<0.001). Erectile function was also correlated with age (r=0.315, p<0.001). Chi square analysis among diabetic complication,ED were significantly higher among patient with albuminuria/proteinuria (p=0.025, prevalence ratio 7.43 (95% IC 0.95 ? 58.15).Other factors such as duration of diabetes, central obesity, cigarette smoking, alcoholism, diabetic control (HbA1C and lipidprofile), diabetic complications, and hypertension were not significantly correlated with ED. ED were high among type 2 diabeticsand erectile function were correlated with orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.ED also correlated with age and albuminuri/proteinuria but not with other predictors.
HUBUNGAN ANTARA KONSENTRASI ASAM URAT SERUM DENGAN RESISTENSI INSULIN PADA PENDUDUK SUKU BALI ASLI DI DUSUN TENGANAN PEGRINGSINGAN KARANGASEM Ngurah Wises, Ida Bagus; Suastika, Ketut
journal of internal medicine Vol. 10, No. 2 Mei 2009
Publisher : journal of internal medicine

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Abstract

Elevated serum uric acid concentrations are commonly seen in association with individual cardiovascular risk factorsuch as hypertriglyseridemia, hypertension, obesity, and hyperglycemia, a cluster that, when found together in the same person,characterizes the so-called metabolic syndrome. The original conceptualization of this syndrome was on the basis of resistance tothe actions of insulin. The reduction of endothelial nitric oxide bioavailability and the production of reactive oxygen species byuric acid may be the mechanism for insulin resistance. Otherwise insulin has a physiological action on renal tubules by stimulatingreabsorption of sodium and urate, resulting an increase in serum uric acid levels. In this condition, HOMA-IR was the modelwhich is a convenient means of evaluating insulin resistance.To know the association between serum uric acid concentration and insulin resistance, a cross sectional analytic studywas conducted on Balinese in Tenganan region between Desember 2007 and January 2008. The study involved 80 participantsage of 18-65 years old, agree to participate by informed consent. Serum concentration of insulin was measured by immunoassaymethod, plasma glucosa, serum uric acid, HDL-cholesterol, trigycerides, serum creatinin, were determined by enzymatic procedureafter overnight fast. Descriptive statistic analysis on numeric data presented as mean ± SD, nominal and ordinal data inproportion. Inferential statistic analysis with bivariate KendallÕs tau correlation and simple logistic regression was performed andmultiple logistic regression was used to know the independency of its association.Of 80 eligible samples, 39 (49%) men, and 41 (51%) women, mean age was 41.73 ± 12.41 yo, mean of waist circumferencewas 77.99 ± 10.91 cm, mean of serum uric acid concentration was 5.49 ± 1.38 mg/dL, mean of plasma glucosa was 92.04± 8.79 mg/dL, median of insulin was 2.70 (2.00 Ð 17.90) mIU/mL, median of HOMA-IR was 0.685 (0.38-4.10), mean of HDLcholesterol was 59.19 ± 14.01 mg/dL, and median of triglycerides was 122.50 (48 Ð 369) mg/dL. In univariate analysis, theinsulin resistance were positively correlated with serum uric acid, waist circumference, and triglycerides (r= 0.234; P = 0.003),(r = 0.269; P = 0.001), and (r = 0.153; P = 0.046) respectively and negatively with HDL cholesterol (r = -0.297; P = 0.009). Inmultivariate analysis with multiple logistic regression both the 2nd tertile of uric acid (4,7 Ð 6,6 mg/dL) and waist circumferencewere independently associated with the insulin resistance (PR 3.97; IK 95% : 1.273 Ð 12.386; P = 0.018), and (PR 5.79; IK 95%: 1.417 Ð 23.650; P = 0.014) respectively. Conclusion: There is association between serum uric acid concentration and insulinresistance, and both the 2nd tertile of uric acid and waist circumference are independently and significantly associated with insulinresistance.
PREVALENSI SINDROMA METABOLIK PADA POPULASI PENDUDUK BALI, INDONESIA Dwipayana, M Pande; Suastika, K; Saraswati, IMR; Gotera, W; Budhiarta, AAG; -, Sutanegara; Gunadi, IGN; Badjra Nadha, K; Wita, W; Rina, K; Santoso, A; Kajiwara, N; Taniguchi, H
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

An epidemiological study on metabolic syndrome (MS) in seven villages population of Bali (6 villages and 1 suburban),Indonesia have been conducted. One thousand eight hundred fourty (age, 13 " 100 year; M/F, 972/868) subjects were recruitedin the study. Criteria for obesity was based on WHO for Asia PaciÞ c population (2000) and for MS based on a joint statement ofIDF, NHLBI, AHA, WHF, and IAS (2009). The prevalence of central obesity based on waist circumference (WC) was 35% (M,27.5%; F, 43.4%) and MS was 18.2% (M, 16.6%; F, 20.0%).Waist circumference, as a central role in metabolic syndrome, hassigniÞ cant correlation with other components of metabolic syndrome, i.e. diastolic blood pressure (R = 0.129; p &lt; 0.001), fastingblood glucose (R = 0.088; p &lt; 0.001), HDL cholesterol (R = -0.066; p = 0.006), triglyceride (R = 0.349; p &lt; 0.001), and totalcholesterol (R = 0.179; p &lt; 0.001).Of the study could be concluded as follow: the prevalence of obesityand MS were relativelyhigh; Waist circumference was correlated with other components of metabolic syndrome and the best parameter for predictingmetabolic syndrome.
KORELASI ANTARA OBESITAS SENTRAL DENGAN ADIPONEKTIN PADA LANSIA DENGAN PENYAKIT JANTUNG KORONER Aryana, IGPS; Kuswardhani, RA Tuty; Suastika, K; Santoso, A
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Obesity is rapidly becoming a global problem not only in developed countries but also in developing countries such asIndonesia. Visceral obesity (central obesity) is an importance risk for cardiovascular disease and recognition that adipose tissuecan be regarded as a large endocrine organ that secreted inflammatory and anti inflammatory molecules (adiponectin). This studyaims to know the correlation between central obesity and adiponectin in geriatric Coronary Heart Disease (CHD) patients.Thisstudy was cross sectional analytic study of geriatric CHD at out and in patients in Sanglah Hospital. Data are presented as groupmean ± SD and analyzed by t-test, chi-square, and Pearson correlation with SPSS 12 software.Forty five patients (35 males and 10 females), 23 patient unstable angina pectoris, 14 patient acute myocardial infarction,and 8 patient stable angina pectoris were recruited and examined. There was high prevalence of central obesity 51.1% (23patients). Mean of log adiponectin were significantly difference between central obese and non central obese (1.80 ± 0.61 vs 1.09± 0.41 with p). Central obesity increased risk of hypoadiponectinemia 5 times than non central obesity (p = 0.011, CI 95% 1.4- 17.8). Waist circumference has negative correlation with log plasma adiponectin (R = -0.663, p < 0.001).There was high prevalence of central obesity in geriatric coronary heart disease patients. Central obesity increased risk ofhypoadiponectinemia 5 times than non central obesity. Waist circumference has negative correlation with plasma adiponectin.Increased of waist circumference will decrease of adiponectin (cardioprotective protein) and will increase risk of Acute CoronarySyndrome in geriatric patients.
INTERLEUKIN-1?, INTERLEUKIN-6, AND ANTAGONIST INTERLEUKIN-1RECEPTOR AS MEMORY IMPAIRMENT RISK FACTOR IN COMPLEX PARTIAL EPILEPSY Purwa-Samatra, D. P. G.; Sudewa-Djelantik, A. A. G.; Suastika, and K.
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol 7 No 1 (2013): IJBS Vol.7 No.1 January-June 2013
Publisher : Udayana University

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Abstract

Memory impairment is one of the most common adverse following epilepsy, particularly complex partial epilepsy. Cytokines physiologically play an important role in memory impairment by preventing long term potentiation process in hypocampus. Several literatures have mentioned that IL-1b, IL-6 and antagonist receptor IL-1Ra are crucial cytokines in complex partial epilepsy. This study aims to find out whether high level of IL-1b and IL-6 as well as low level of IL-1Ra might be risk factors of memory impairment in complex partial epilepsy patient. This was a case control study, enrolling 30 complex partial epilepsy patients with memory impairment as case group and 30 complex partial epilepsy patients without memory impairment as control group. In this study, it was obtained that the mean of IL-1? level in case group was significantly higher compared to the control (2.74 ± 4.36 vs. 0.42 ± 0.18 pg/ml, p = 0.007). The mean of IL-6 in case group was significantly higher compare to control (5.89 ± 6.32 vs. 2.34 ± 1.80 pg/ml, p = 0.006). The mean of IL-1Ra level of the case group was not significantly higher compared to the control (519.81 ± 262.64 vs. 413.28 ± 106.85, p = 0.767). By applying bivariate analysis, McNemar’s test, we observed that IL-1? with cut off point 0.63 pg/ml and OR = 70 is a risk factor of memory impairment in complex partial epilepsy indicated by p = 0.001. Similar result was also gained for IL-6 with cut off point 2.87 pg/ml and OR = 4.57 as a risk factor of memory impairment in complex partial epilepsy indicated by p = 0.007. Meanwhile, IL- 1Ra with cut off point 471 pg/ml and OR = 0.727 was not as a risk factor of memory impairment in complex partial epilepsy indicated by p = 0.573. It can be concluded that the high level of IL-1B and IL-6 were the risk factors of memory impairment in complex partial epilepsy patients. High level 1L-1B patient was 70 times higher risk of becoming memory impaired. High IL-6 patients will have the risk nearly 5 times higher. The low level of IL-1Ra does not as a risk factor in epilepsy patients for having the following memory impairment.
LOW PLASMA CORTISOL LEVEL IS A RISK FACTOR FOR ADULT ATOPIC DERMATITIS AND NEGATIVELY CORRELATED TO PLASMA LEVELS OF NOREPINEPHRINE AND INTERLEUKIN-4 Wardhana, Made; Suata, Ketut; Suastika, Ketut
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Abstract

Atopic dermatitis is a skin inflammatory disease characterized by hyperactivity of the humoral immune system with a typical onset in infancy or early childhood. Many studies have focused on the patho-physiological role of the immune system in atopic dermatitis, but since the stress hormone receptor was recognized on the surface of immune cells, it appeared that cortisol was prominent stress hormones in regulating the immune system. Some studies have shown that individuals with atopic diseases such as atopic dermatitis, allergic rhinitis and bronchial asthma had lower concentration of saliva cortisol than those with non-atopic conditions. With this evidence, it can be assumed that lower concentration of cortisol as the result of hypo-response of hypothalamus-pituitary-adrenal to stressor can increase and interleukin (IL-4) concentrations. Both substances stimulate lymphocyte T helper 2 (Th2) cells to synthesize IL-4, which has an important role in atopic dermatitis pathogenesis to increase hypersensitivity to various environmental allergens. Until recently, few studies are available concerning the low concentration of plasma cortisol as a risk factor for atopic dermatitis, as well as its correlation with plasma levels of and IL-4. The purpose of this study was to show that low concentration of plasma cortisol is a risk factor for atopic dermatitis and it is negatively correlated with and plasma IL-4. Matched pair case control design, involving 36 cases and 36 controls, was used to show that low concentration of cortisol is a risk factor for atopic dermatitis, and cross sectional design was applied to find out the negative correlation between cortisol and IL-4 in 88 samples consisting of 52 patients with atopic dermatitis and 36 healthy person or persons without atopy. The result of the case-control study showed that plasma cortisol concentration of the case group was significantly lower (4.89 + 2.1 ug/dl; CI 95 %; p < 0.001) than in those of the control group (9.12 + 2.33 ug/dl) at confidence level of 95%; p < 0.001. Multiple logistic regression analysis showed odd ratio of cortisol 3.45, which was higher than the ratio of other parameters such as IL-4, history of atopy and skin moisture. Plasma and IL-4 concentrations of the patients with atopic dermatitis were significantly higher than in the subjects without atopy. The correlation test indicated that plasma cortisol was negatively correlated to norepinephrine (r = - 0.68; p < 0.05), and IL-4 (r = - 0.55; p = 0.05) levels in patients with atopic dermatitis. Based on the above findings, it can be deduced that low concentration of plasma cortisol, being correlated to increased plasma levels of norepinephrne and interleukin-4, is a risk factor for atopic dermatitis in adult
HUBUNGAN POSITIF ANTARA ULKUS KAKI DIABETIK DENGAN PERSENTASE SEL BERMARKAH CD4+ PEMBAWA MALONDIALDEHID Putu SutirtaYasa, I Wayan; Suastika, Ketut; Sudewa Djelantik, Anak AgungGede; Mantik Astawa, I Nyoman
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 1 Januari 2009
Publisher : Udayana University

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Abstract

Tingginya angka kejadian ulkus kaki diabetik (UKD) dan luka di kaki yangsulit sembuh memberi petunjuk kemungkinan ada proses kematian sel imun yangsangat banyak dan belum jelas mekanismenya secara molekuler pada jaringan UKD.Telah diteliti hubungan antara derajat UKD dengan persentase sel bermarkahCD4+ pembawa malondialdehid (MDA). Penelitian ini adalah penelitianobservasional dengan rancangan cross sectional analytic study yang dilakukan diRumah Sakit pemerintah dan swasta di Denpasar, Badung, Tabanan, dan Gianyar.Parameter yang diukur dari bahan darah adalah kadar gula darah memakai metodeenzimatik (heksokinase), dan dari bahan jaringan kaki, dihitung sel bermarkah CD4+pembawa MDA memakai metode imunohistokimia (reagen dari Biodesign danAbcam ). Dari 80 sampel UKD didapatkan 49 (61,2%) penderita laki-laki dan 31(38.8%) penderita wanita, berdasarkan tingkat keparahan UKD, sampel dipilah lagimenjadi: 29 (31,9%) derajat 2; 20 (21,9%) derajat 3; 13 (14,3%) derjat 4; dan18(19,8%) derajat 5, rata-rata persentase sel bermarkah CD4+MDA adalah 75,0 ±20,5 %, Didapatkan korelasi positif kuat antara persentase sel bermarkah CD4+pembawa malondialdehid dengan derajat UKD (r = 0,71; p < 0,01). Pada penelitianini membuktikan ada mekanisme kematian sel imun dan sekaligus menjawabpermasalahan bahwa pada penderita UKD mudah terkena infeksi dan sulit untukdisembuhkan, dengan dibuktikan bahwa ada korelasi positif kuat antara derajat UKDdengan persentase pembentukan MDA dari sel bermarkah CD4+, ini menyatakanbahwa semakin berat derajat UKD semakin banyak mengalami kematian sel imun..
ALDEHYDE DEHIDROGENASE LEVEL AND FATTY ACID ETHYL ESTER AS BIOCHEMICAL MARKERS PERSIST LONGER THAN ETHANOL IN WISTAR RATS AFTER CHRONIC ALCOHOL CONSUMPTION Suaniti, Ni Made; Sudewa Djelantik, A. A. Gde; Suastika, Ketut; Mantik Astawa, Nyoman
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 2 Juli 2010
Publisher : Udayana University

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Abstract

Alcohol consumption in human has increased from year to year in Indonesia and more recently, anincreasing number of cases of alcohol intoxication, alcoholic liver disease, and death were observed.The purpose of this experimental study was to examine the significance of two known biochemicalmarkers of alcohol given by mouth in the Wistar rats. The study design used was the “Truerandomized experimental post test only control group design". The rats were randomly distributedaccording to the experimental design and were treated daily for six weeks (chronic intake) with 5%and 20% alcohol. This study used 15 rats with 5 rats for treatment group treated with 5% alcohol, 5rats for treatment group treated with 20% alcohol, and 5 rats as control group treated with distilledwater. The biochemical markers were aldehyde dehydrogenase (ALDH) and Fatty Acid Ethyl Esters(FAEE). ALDH and FAEE were two biochemical markers of ethanol which are sensitive and specificfor alcohol consumption. The study was conducted in two phases. Initially, rats were treated orallyeveryday for six weeks with 5% and 20% alcohol, and then the blood level of ethanol, ALDH andFAEE were measured. Blood samples were collected at 6 and 24 hours after the last oral intake ofchronic alcohol administration. Qualitative analysis was carried out to detect the presence of ethanol,ALDH, and FAEE in the treatment groups and quantitative analysis to determine their levels in theblood of Wistar rats. Statistical analysis of ALDH was done by using parametric test and the presenceof FAEE persisting longer than ethanol by non-parametric test. The results showed that ALDHpersisted and increased significantly following chronic consumption of alcohol in the rats. Similarly,FAEEs persisted longer than ethanol after alcohol intake. After six hours, the ALDH level increasedby 108.14% in the rat treated chronically with 5% alcohol and by 85.07% in rat treated with 20%alcohol. After 24 hours, FAEE also persisted longer in the blood than ethanol following treatmentwith alcohol 5%. ALDH levels increased by 83.11% after chronic treatment with 5% alcohol and by112.05% in the rats treated with 20% alcohol. In the blood collected 24 hours after the last treatmentwith 5% alcohol, ALDH increased by 95.11% and by 86.79% in the rats treated with 20% alcohol.FAEE persisted longer than ethanol in the blood following administration of 5 % and 20% alcoholboth at 24 hours following chronic treatment. The longer persisting ALDH and FAEE were new andgood biochemical blood markers for chronic alcohol consumption in the Wistar rats.
THE HIGH PLASMA RETINOL BINDING PROTEIN 4 LEVEL AS A RISK FACTOR CONSEQUENTLY OF TYPE 2 DIABETES MELLITUS OF ABDOMINAL OBESITY Budhitresna, AAG; Suastika, Ketut; Mantik Astawa, Nyoman; Santoso, Anwar
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 5, No. 1 Januari 2011
Publisher : Udayana University

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Abstract

Abdominal obesity (Ab-Ob) related to cardiometabolic risk, that is riskfactor constellation for succeeded cardiovasculer disease and type 2 DiabetesMellitus (DM). That factors such as atherogenic dislipidemia, hypertension,hyperglycemia, protrombotic state, and proinflammation state. Type 2 DMcharacterised by insulin resistance (IR). Plasma levels of retinol binding protein 4(RBP4) that is secreted by adipocytes are increased in insulin resistance (IR) state.Experiment in mice suggest that elevated RBP4 level cause IR. Although theunderlying mechanism is not clearly understood, RBP4 considered playimportance role consequently of type 2 DM in Ab-Ob.This research was carried out to determine the role of high plasma RBP4level as a risk factor consequently of type 2 DM in Ab-Ob. The research wasconducted by cross sectional analytic in 81 patients with Ab-Ob and case controlstudy with matching on 33 patients with Ab-Ob type 2 DM as cases and 33patients with Ab-Ob non type 2 DM as control. The plasma of TNF-?, sTNFR1,and RBP4 levels was measured by ELISA. IR status of the patients wasdetermined by HOMA-IR, whereas the ?-cell function was determined byHOMA-B. Ab-Ob was defined by using criteria for Asian peoples (male WC ? 90cm; female WC ? 80 cm). The result of 81 patients with Ab-Ob showed that bothplasma of TNF-? and sTNFR1 levels were significant positive correlated withplasma RBP4 level (coeficient correlation r = 0,294; p = 0,008 dan r = 0,458; p =<0,001 respectively). In addition, the plasma of RBP4 level significantly positivecorrelation with HOMA-IR (r = 0,450; p = 0,000) and significantly negativecorrelation with HOMA-B (r = -0,564; p = <0,001). In the matched case-controlstudy, it was shown that mean plasma of RBP4 level of type 2 DM group (76,08 ±16,84 ?g/ml) statistically higher than that without type 2 DM group (41,13 ±14,75 ?g/ml) (p = <0,001). The odds ratio higher plasma of RBP4 level was 5,426(CI 95%; 1,343 – 21, 928) statistically significant for increases risk type 2 DM (p= < 0,05). It has been proven that RBP4 was a dominant and consisten risk factor(66.9%, p = < 0.001) which influenced the incidence of type 2 DM in Ab-Ob. It can be concluded that high plasma of RBP4 level have a greater risk tosuffered from type 2 DM compared to low plasma of RBP4 in Ab-Ob. The highplasma of RBP4 level is most dominant and consistent risk factor consequently oftype 2 DM. These mechanism could behind the association between high plasmaof RBP4 level and type 2 DM.
Co-Authors A Santoso A. A. Mas-Putrawati AAG Budhiarta AAG Budhitresna Ade Reza Hariyadi Agung Pranoto Agus Joko Purwanto An Apriyani Tebiary Anak Agung Ayu Mirah Adi Anak Agung Gde Budhiarta Anak Agung Gde Budhiarta Anak Agung Gede Sudewa Djelantik Angga Yustiawan Anwar Santoso Ardi Nugroho Yulianto Aries Sulisetyono Aryana, I Gust Putu Suka Aryawan, Wasis Dwi Askandar Tjokroprawiro Astika, I Nyoman Buana Ma'ruf Buana Ma'ruf Budhiarta, Anak Agung Gde Dedi B. Purwanto Dewa Putu Gede Purwa Samatra Dian Purnamasari Dian Purnamasari Dikantoro, Regi Y. Djoenaidi Widjaja Djoko W. Soeatmadji Dwija Sanjaya Ericson Estrada Sipayung Gede Kambayana Gede Putu Arsana Gede Sukrawan Giles Anthony Thomas Gunanta, Julhari H Taniguchi H. S. Habiba Muhiddin, H. S. Habiba Hari Bagianto I Gde Raka Widiana I Gusti Agung Dewi Sarihati I Gusti Ayu Mardewi I Gusti Putu Suka Aryana I Ketut Aria Pria Utama I Made Bakta I Made Jawi I Made Jawi I Made Pande Dwipayana I Made Siswadi Semadi I Made Siswadi Semadi I Made Siswadi Semadi I Nengah Sujaya I Nyoman Astika I NYOMAN MANTIK ASTAWA I Nyoman Wande I Nyoman Wande I Putu Gede Adiatmika I Putu Gede Adiatmika I Wayan Mustika I Wayan Mustika I Wayan Putu Sutirta Yasa I Wayan Weta I Wayan Wita Ida Bagus Aditya Nugraha Ida Bagus Ekaputra Ida Bagus Ekaputra, Ida Bagus Ida Bagus Ngurah Wises Ida Bagus Putu Putrawan IGN Gunadi Ignatius Ferdi Yuatmadja IMR Saraswati Iswara, Ni Putu Ayu Astri Prana K Badjra Nadha K Rina K Tangking Widarsa Kadek Ngurah Hariawa Ketut Adi Jaya Sutana Ketut Suata Komang Ayu Kartika Sari Kusuma, Anak Agung Ngurah Jaya Luh Gede Sri Yenny Luh Seri Ani Made Ratna Saraswat MADE RATNA SARASWATI . Made Wardhana Made Wiryana Malik, Safarina G. Marisye Christantia N Kajiwara N. K. Niti Susila, N. K. Ni Ketut Rai Purnami Ni Made Suaniti Ni Nengah Dwi Fatmawati Ni Nyoman Trisna Yuliharti Tersinanda Ni Putu Ayu Astri Prana Iswara Noor Virliantarto Nurhadi Nurhadi Nym Astika Oktavianthi, Suksma Pradana Soewondo Purnami, Ni Ketut Rai Purwanto, Dedi B. Putra, Wing H. A. Putri Virliani Putri Virliani Putri Virliani R. A.T. Kuswardhani R. Prawira Bayu Putra Dewa Raka-Sudewi A. A. Regi Y. Dikantoro Regi Yudha Dikantoro S. Soetjiningsih, S. S., Hantono Setyawan, Dony Sidartawan Soegondo Siorcani, Putu Tasha Sri Trisnawati Sri Trisnawati Sri Yuniari Sri Yuniari, Sri Suastika, Arresta Vitasatria Sutanegara - Sutjahjo Suherman, Sutjahjo Teguh Putranto Thomas Eko Purwata Tuty Kuswardani W Wita Wasis Akriananta Wibowo Harso Nugroho Wibowo Nugroho, Wibowo Wing H. A. Putra Wira Gotera Wisnu Firstdhitama