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Serum β-amyloid 1–42 Levels as Alternative Non-invasive Screening Biomarker for Alzheimer’s Disease and Vascular Dementia in Indonesian Elderly Population Indah Aprianti Putri; Huda Shalahuddin Darusman; Muhammad Hamdan; Pukovisa Prawiroharjo; Budi Utomo; Jusak Nugraha; Yohanna Kusuma; Nurrani Mustika Dewi; Ferry Sandra
The Indonesian Biomedical Journal Vol 17, No 6 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i6.3869

BACKGROUND: Alzheimer’s disease (AD) and vascular dementia (VaD) impose a substantial public health burden in Indonesia; however, accessible blood-based biomarkers for early screening remain limited. Although cerebrospinal fluid β-amyloid 1–42 is an established biomarker, its invasive nature restricts its use for population-level screening. Therefore, it is necessary to have locally-produced serum β-amyloid 1–42 ELISA kit that is specifically designed for Indonesian elderly population. In this study, a locally-produced β-amyloid 1–42 ELISA kit was validated and used for the screening of AD, VaD and mild cognitive impairment (MCI) Indonesian population.METHODS: A cross-sectional study including 166 subjects: 31 AD, 34 VaD, 34 MCI patients, and 67 cognitively normal controls was conducted. All participants underwent cognitive assessments including Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment-Indonesian version (MoCA-Ina), as well as brain magnetic resonance imaging (MRI) 3-Tesla for the assessment of medial temporal atrophy/white matter changes. Fasting venous blood sampling was taken from each subjects for the measurement of serum β-amyloid 1-42 measurement using locally-produced ELISA kit.RESULTS: Median serum β-amyloid 1–42 levels were 11.03, 10.99, and 10.99 pg/mL for the AD, VaD, and MCI subjects, respectively. The β-amyloid 1–42 levels were correlated with MMSE scores in all group (AD: r=−0.455, p=0.010; VaD: r=−0.419, p=0.014; MCI: r=−0.412, p=0.015). The validity analysis of the locally-produced serum β-amyloid 1–42 ELISA kit, showed sensitivity of 94.12% (95% CI: 87.3–97.9), specificity of 80.36% (95% CI: 72.4–86.8), and diagnostic accuracy of 83.56% (95% CI: 77.2–88.5).CONCLUSION: Serum β-amyloid 1–42 levels are lower in AD and VaD subjects compared to MCI and control subjects. Serum β-amyloid 1-42 is inversely correlated with cognitive function across all groups based on MMSE score. Additionally, the locally-produced β-amyloid 1-42 ELISA kit demonstrated sensitivity of 94.12% and specificity of 80.36%, meeting Global CEO Initiative Consensus for pre-screening tools, supporting its potential as a scalable, non-invasive screening biomarker in Indonesian primary care settings.KEYWORDS: G-banding karyotyping, next generation sequencing, non-invasive prenatal testing

Sarcopenia as a Risk of Modern Obesity Treatments: A Review of Molecular Mechanisms and Prevention Strategies Anna Meiliana; Nurrani Mustika Dewi; Andi Wijaya
The Indonesian Biomedical Journal Vol 17, No 6 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i6.3583

While lifestyle interventions and metabolic surgery for obesity have limitations, incretin-based therapies have emerged as highly effective treatments. However, their success is shadowed by a significant risk, which is the loss of lean skeletal muscle, which can induce sarcopenia or sarcopenic obesity. Given the vital role of skeletal muscle in overall health, it is crucial to accurately assess this condition using standard clinical measures. Exercise stands as the most potent countermeasure, acting as medicine to preserve muscle and improve metabolic health. Its benefits are driven by a complex interplay of mechanisms. Different exercise types trigger the release of myokines and exerkines, while a regulated inflammatory response is essential for muscle adaptation and regeneration. This regenerative process, involving muscle stem cells, is further governed by epigenetic factors and critical molecular pathways like Akt and insulin that maintain muscle mass. To optimize these effects, adequate protein intake and targeted nutritional strategies are essential, supporting muscle protein synthesis and recovery. Supplementation, particularly with leucine-rich amino acids or vitamin D, may further enhance anabolic responses, especially in older adults. Clinical monitoring of muscle mass, strength, and nutritional biomarkers should be integrated into obesity care to detect early signs of sarcopenia and guide individualized interventions. Therefore, it is imperative that obesity therapy evolves to prevent muscle loss. This review highlights the risk of therapy-induced sarcopenia from modern obesity treatments, emphasizing the need for integrated prevention strategies, centered on exercise, and reinforced by nutrition, supplementation, and clinical monitoring to ensure healthy, sustainable weight loss.KEYWORDS: sarcopenia, skeletal muscle, inflammation, obesity, incretin

Elevated D-dimer is Associated with Anemia, Immune Dysregulation, and Hepatic–Renal Dysfunction in Acute Burn Patients Anindya Paramita; Lynda Hariani; Lobredia Zarasade; Noer Halimatus Syakdiyah; Nurrani Mustika Dewi; Ferry Sandra
The Indonesian Biomedical Journal Vol 18, No 1 (2026)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v18i1.3925

BACKGROUND: Burn injury induced increased risk of venous thromboembolism (VTE) due to hypercoagulability, immobilization, and endothelial injury. Despite this risk, VTE in burn patients often remains clinically undetected. Although D-dimer is widely used as a VTE marker, its utility in burn patients is inconsistent, particularly in the early post-burn period. Therefore, this study was conducted to evaluate the correlation between D-dimer levels and factors related to VTE, including hematologic, coagulation, immunologic, organ function parameters, and burn characteristics.METHODS: An analytical observational study was conducted involving adult patients with acute burn injuries enrolled in Dr. Soetomo General Hospital from March to June 2025. Demographic, anthropometric, burn characteristic, and existing comorbid were documented from subjects’ medical records. Blood samples from subjects were collected immediately via venipuncture. D-dimer was analyzed with Enzyme-Linked Fluorescent Assay (ELFA) method, hematology and coagulation profiles were also assessed using hematology analyzer and automated coagulation system, respectively. Meanwhile, hepatic and renal function were analyzed with chemistry analyzers.RESULTS: Most burn subjects (18 of 20) demonstrated elevated D-dimer levels. Higher D-dimer levels were associated with increased leukocyte counts and upward trend of RDW-CV and RDW-SD. Further analysis among the subjects with elevated D-dimer level showed significant negative correlations were observed between D-dimer levels and anemia-related parameters, including hemoglobin, erythrocyte count, and hematocrit (all p<0.05). Elevated D-dimer was also associated with immune dysregulation, reflected by increased basophil percentages and decreased immunoglobulin (Ig) levels. Additionally, D-dimer levels showed significant positive correlations with aspartate aminotransferase (AST), alanine aminotransferase (ALT), and blood urea nitrogen (BUN), suggesting a link between hypercoagulability and kidney as well as renal dysfunction following burn injury.CONCLUSION: Leukocyte count, RDW-CV, and RDW-SD are higher in burn patient with elevated D-dimer levels, suggesting that high D-dimer might be correlated with VTE. Elevated D-dimer in burn patients correlates with several VTE risks including anemia, immune dysregulation, and hepatic–renal dysfunction, indicating early coagulation activation and systemic injury following burn injury. KEYWORDS: burn injury, D-dimer, hypercoagulability, VTE, anemia, immune dysregulation, organ dysregulation

Lifestyle Modifications and Nutraceutical Interventions in the Prevention and Management of Metabolic Syndrome Anna Meiliana; Nurrani Mustika Dewi; Andi Wijaya
The Indonesian Biomedical Journal Vol 17, No 3 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i3.3412

Abdominal obesity, dyslipidemia, hypertension, and hyperglycemia are metabolic risk factors that are grouped together to define metabolic syndrome (MetS). It is now widely recognized that MetS is linked to a higher risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD). Overall, the pathophysiology of MetS initiated by the imbalance of nutrition intake and physical activity. It involves a complex interplay of insulin resistance (IR), inflammation, dysregulated adipocyte function, and genetic susceptibility, all of which contribute to the metabolic dysfunction. Lifestyle modifications play a crucial role in managing and preventing MetS. Key strategies include adopting a balanced diet like Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), or caloric restriction (CR), engaging in regular physical activity, and maintaining a healthy weight. Nutraceuticals, including polyphenols and CR-mimetic agents, improve insulin sensitivity, reduce inflammation, lower blood pressure and cholesterol levels, reducing oxidative stress, and promoting autophagy. In addition to lifestyle changes, drug therapy may be necessary for some individuals to manage specific risk factors, such as diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), calcium channel blockers, and beta blockers for hypertension; biguanides, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide 1(GLP-1) receptor agonists, sodium-glucose co-transporter 2 (SGLT2) inhibitors, and thiazolidinediones for hyperglycemia; and statins for dyslipidemia. Early diagnosis, including waist circumference and blood pressure measurement, serum cholesterol and glucose testing, and intervention, is essential to effectively manage MetS and prevent the progression of associated diseases. In conclusion, understanding the risk factors and associated risks of MetS, along with the implementation of lifestyle modifications such as dietary and nutraceutical interventions including polyphenols and CR-mimetic agents, is vital for reducing the burden of this syndrome. Early diagnosis and proactive management are key to improving long-term health outcomes.KEYWORDS: metabolic syndrome, abdominal obesity, insulin resistance, diet, nutraceuticals

Therapeutic Potential of Gut Microbiota in Hypertension: Mechanisms of Immune Modulation and Inflammation Anna Meiliana; Nurrani Mustika Dewi; Andi Wijaya
The Indonesian Biomedical Journal Vol 17, No 4 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i4.3565

Emerging evidence links gut dysbiosis to numerous ailments, including hypertension and metabolic diseases. Multi-omics techniques have revealed that hypertensive individuals exhibit distinct alterations in their gut bacterial composition and metabolite profiles. The gut microbiome influences blood pressure through several mechanisms. For instance, microbiota-derived metabolites can have beneficial effects, such as those from short-chain fatty acids (SCFAs), or detrimental ones, like trimethylamine N-oxide (TMAO). These molecules modulate downstream signaling pathways via G protein-coupled receptors or direct immune cell activation. Furthermore, dysbiosis can compromise the gut epithelial barrier, leading to systemic inflammation that activates key regulatory pathways like the renin-angiotensin-aldosterone system (RAAS), the autonomic nervous system, and the immune system. Given these connections, the gut microbiome is a promising therapeutic target for hypertension. This review explores the potential of modulating the gut microbiota to manage blood pressure, focusing on the underlying mechanisms of immune modulation, inflammation, and microbial metabolites. By focusing on the 'how' rather than the 'what' of hypertension, it is identified that immune-mediated inflammation is orchestrated by the gut microbiota, as the core mechanism driving the disease. Gut dysbiosis is triggered by environmental factors like high-salt diets, perpetuates a pro-inflammatory state that undermines the efficacy of conventional antihypertensive drugs and contributes to treatment-resistant hypertension. Consequently, modulating the gut microbiota through targeted interventions, including dietary fiber, probiotics, and fecal transplantation, might represents a critical evolution in treatment. This approach moves beyond managing symptoms to directly correcting the inflammatory dysfunction at the heart of the disease, offering a powerful strategy to complement existing therapies.KEYWORDS: hypertension, inflammation, gut microbiota, metabolite

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