Setiati, S
Indonesian Rheumatology Association

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Prevalence and factors associated with vitamin D deficiency in systemic lupus erythematosus patients Pangestu, Y; Setiati, S; Setiyohadi, Bambang; Sukmana, N
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Background: In addition to the calcium-phosphorus metabolism, vitamin D might also play a role in the immune system. Studies have showed lower levels of vitamin D among SLE patients compared with controls. Researches regarding vitamin D in SLE patients have only been conducted in four seasons’ countries (Caucasians subjects in a large part) , but no data has been available in tropical countries, particularly Indonesia. The presence of VDR gene polymorphism in different populations will affect the role of vitamin D in the immune system. Objectives: To determine the prevalence of vitamin D deficiency and identify its risk factors such as lack of sunlight exposure, sunscreen usage, long-term corticosteroid therapy, disease activity, insufficient vitamin D supplementation, and obesity in SLE patientswith vitamin D deficiency.Methods: A cross-sectional study was conducted on SLE patients who were under treatment at Cipto Mangunkusumo General Hospital or members of Indonesian Lupus Foundation. Then those patients completed questionnaires and their 25(OH)D serum levels were measured. The cut-off value of 25(OH) D levels for vitamin D inadequacy is 75 nmol/L, which then grouped into vitamin D insufficiency (25(OH)D 25 - <75 nmol/L) and vitamin D deficiency (25(OH)D <25 nmol/L). SLE activity was assessed with MEX-SLEDAI.Results: During May-June 2008, 80 SLE patients were enrolled with 96.3% female subjects, median age of 26 years (range 17-56 years), 66.3% non-obese, 93.8% using steroid, 62.5% with active disease, and 63.8%have adequate sun exposure. In addition, 81.5% didnot use sunscreen and 83.8% did not take vitamin D supplementation. All patients had vitamin D inadequacy with 41.2% in insufficiency level and the other 58.8% in deficiency level. The median of 25 (OH)D levels were 21.85 nmol/L (range 11.5-57.7 nmol/L). It also has been found that vitamin D deficiency occurred more in subjects who were obese, used sunscreens, had lower exposure to sunlight, in a long-term high-dose steroid therapy, had active SLE disease, and had no vitamin D supplements.Conclusions: All SLE patients had vitamin D inadequacy. Vitamin D deficiency occurred more in subjects who were obese, used sunscreens, had lower exposure to sunlight, in a long-term high-dose steroid therapy, had active SLE disease, and had no vitamin Dsupplements.
Atherosclerosis prevalence and the correlation between atherosclerosis risk factors and carotid intima-media thickness in below 40-year-old women with systemic lupus erythematosus Sari, R M; Kasjmir, Yoga I; Antono, D; Setiati, S
Indonesian Journal of Rheumatology Vol 2, No 2 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Objectives: To determine the prevalence of atherosclerosis in female systemic lupus erythematosus (SLE) patients aged below 40 years old and the factors correlated with carotid intima-media (CIM) thickening.Methods: A cross-sectional study was conducted on 80 female SLE respondents aged below 40 years old who were either in- or outpatient of Cipto Mangunkusumo General Hospital, Jakarta. History of disease and treatment was taken, and laboratory test and  ultrasonography of the carotid artery to evaluate CIM thickness were performed.Results: The prevalence of atherosclerosis was 40%, comprising of CIM thickening and/or presence of atherosclerotic plaque in the carotid artery. The median values of CIM thickness in the right common carotid artery, right carotid bulb, left common carotid artery, and left carotid bulb were 0.040 cm, 0.04535 cm, 0.0430 cm, and 0.047 cm, respectively. There was also a positive correlation reported of CIM thickness with increased age, the duration of SLE disease, and the duration of steroid treatment.Conclusions: We found a positive correlation of CIM thickness with age, the duration of SLE disease, and the duration of steroid treatment in female SLE patients aged below 40 years.
The characteristics of hemophilic patients with decreased bone density in Cipto Mangunkusumo Hospital Jakarta Anggoro, S; Setyohadi, B; Sukrisman, L; Setiati, S
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Hemophilia can cause musculoskeletal complications and decreased bone density is one of those complications. The profile of hemophilic patients with decreased bone density in Indonesia is still unknown.Objective: To estimate the proportion of decreased bone density hemophilia and to learn the characteristics of hemophilic patients with decreased bone density.Methods: This is a cross-sectional study done in June - November 2012. Subjects were adult hemophilic patients from 19-50 years old in Hematology- Oncology outpatient clinic Cipto Mangunkusumo Hospital. Estimated variables were bone density mass, age, bodymass index, physical activity, arthropathy, substitution therapy, HIV, and HCV infection.Result: 63 subjects were included in the study with median age of 26 years old. The proportion of decreased bone density in hemophilia was 6.3%. Subjects with decreased bone density were younger (19 years old vs 26 years old), have lower BMI (18,6 + 2,8 kg/m2 vs 21,5 + 3,8 kg/m2), used more substitution therapy (4047 IU/month vs 2000 IU/month), and have better clinical arthropathy score. HCV infection happened on 25% subjects with decreased bone density while HIV was on 1.6% of subjects.Conclusion: Decreased bone density was found in 6.3% of subjects with hemophilia. They were younger, have lower BMI, better joint score, lower infection caused by transfusion, and more bleeding compared with subjects with normal bone density.