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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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Published by Universitas Sriwijaya

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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

BioScientia Medicina is an open access international scholarly journal in the field of biomedicine and translational research aimed to publish a high-quality scientific paper including original research papers, reviews, short communication, and technical notes. This journal welcomes the submission of articles that offering a sensible transfer of basic research to applied clinical medicine. BioScientia Medicina covers the latest developments in various fields of biomedicine with special attention to medical sciences, Traditional Herb, genetics, immunology, environmental health, toxicology, bioinformatics and biotechnology as well as multidisciplinary studies. The views of experts on current advances in nanotechnology and molecular/cell biology will be also considered for publication as long as they have a direct clinical impact on human health.

Arjuna Subject : Kedokteran - Anatomi

Articles 1,209 Documents

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Post-Pandemic Prevalence and Distribution of Refractive Errors in Balinese Schoolchildren: A Cross-Sectional Analysis Dharmi Lestari, Ni Putu; Ariesanti Tri Handayani; Anak Agung Mas Putrawati Triningrat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1377

Background: Uncorrected refractive errors are a leading cause of preventable visual impairment in children worldwide, impacting academic and social development. The COVID-19 pandemic disrupted routine pediatric eye health services and altered children's lifestyles, creating an urgent need to re-evaluate the burden of these conditions. This study aimed to determine the prevalence and geographical distribution of refractive errors among elementary school children across six districts in Bali, Indonesia, during the post-pandemic period (2022–2023). Methods: A descriptive cross-sectional study was conducted using secondary data from the John Fawcett Foundation (JFF) school eye health screening program. The final analysis included 2,145 elementary school children (47.5% male, 52.5% female) from 13 schools across six districts in Bali, screened between January 2022 and December 2023. Visual acuity was measured using a Snellen chart, followed by non-cycloplegic autorefraction for all children failing the initial screening. Ametropia was defined based on established spherical equivalent and cylindrical thresholds. Prevalence was calculated for each district, and a Chi-square test was used to analyze the association with gender. Results: The overall prevalence of ametropia was 4.1% (88/2,145). Myopia was the most common refractive error, accounting for 58 cases (2.7% of all children), followed by astigmatism with 22 cases (1.0%) and hypermetropia with 8 cases (0.4%). Significant geographical disparities were observed, with prevalence rates ranging from a low of 1.8% in Tabanan district to a high of 6.9% in Denpasar district. The highest prevalence rates were found in the urban and semi-urban districts of Denpasar (6.9%) and Buleleng (6.3%). There was no statistically significant association between gender and the presence of refractive error (p=0.115). Conclusion: The post-pandemic prevalence of refractive errors in this large cohort of Balinese schoolchildren reveals a significant public health challenge defined by a sharp urban-rural divide. The concentration of refractive errors, primarily myopia, in urban centers like Denpasar points to the profound impact of environmental and lifestyle factors on visual development. This evidence provides a clear mandate for the strategic deployment of targeted pediatric eye care resources to the island's most affected communities, ensuring the early detection and management necessary to prevent lifelong visual impairment and secure the future well-being of Bali's next generation.

The Dual Role of Hypoxia-Inducible Factor-1α in Sepsis-Induced Immunomodulation and Organ Dysfunction: A Systematic Review and Meta-Analysis Hudari, Harun; Mega Permata; Ratna Maila Dewi Anggraini; Raden Ayu Linda Andriani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1378

Background: Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, remains a leading cause of global mortality. Hypoxia-inducible factor-1α (HIF-1α) is a master transcriptional regulator of the cellular adaptive response to hypoxia but plays a complex, paradoxical role in sepsis. While essential for innate immune function, its sustained activation may amplify inflammation and drive organ damage. This meta-analysis was conducted to synthesize the evidence on the association of HIF-1α with key markers of immunomodulation and organ dysfunction in sepsis. Methods: We performed a systematic review and meta-analysis following PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies published between January 2014 and December 2024. We included observational studies that measured HIF-1α levels in adult sepsis patients and reported outcomes related to organ dysfunction (Sequential Organ Failure Assessment [SOFA] score) or mortality, and immunomodulation (Interleukin-6 [IL-6] levels). Seven studies meeting the inclusion criteria were included in the final analysis. Data were pooled using a random-effects model. Standardized Mean Difference (SMD) and Odds Ratios (OR) with 95% confidence intervals (CI) were calculated. Results: The seven included studies comprised 1,288 patients. The overall quality of the included studies was moderate to high as per the Newcastle-Ottawa Scale. The pooled analysis revealed that HIF-1α levels were significantly elevated in sepsis patients who died compared to those who survived (OR = 2.68, 95% CI: 1.55–4.64, p < 0.001), with moderate heterogeneity (I² = 45%). Furthermore, HIF-1α levels were strongly associated with greater organ dysfunction, as measured by the SOFA score (5 studies; SMD = 0.92, 95% CI: 0.51–1.33, p < 0.0001), with substantial heterogeneity (I² = 78%). HIF-1α levels also showed a significant positive correlation with the pro-inflammatory cytokine IL-6 (4 studies; SMD = 1.15, 95% CI: 0.65–1.65, p < 0.00001), with high heterogeneity (I² = 82%). Conclusion: This meta-analysis provides robust evidence that elevated HIF-1α levels are significantly associated with increased sepsis severity, characterized by greater organ dysfunction, a heightened pro-inflammatory state, and a higher risk of mortality. These findings underscore the maladaptive consequences of sustained HIF-1α activation in sepsis, positioning it as a critical prognostic biomarker and a complex, high-value target for future therapeutic modulation.

The Temporal Windows of Glycemic Injury: Association of Early and Late First-Week Hyperglycemia with Retinopathy of Prematurity in Low-Birth-Weight Infants Dharmi Lestari, Ni Putu; I Wayan Eka Sutyawan; Putu Junara Putra; I Gde Raka Widiana; Siska; Putu Yuliawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1379

Background: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness, driven by aberrant retinal vascular development in preterm infants. While hyperglycemia is a recognized risk factor, its impact may vary depending on its timing relative to the biphasic pathogenesis of ROP. This study aimed to generate a hypothesis regarding the differential association of hyperglycemia on postnatal day 1 versus day 7 with the incidence of ROP in a high-risk neonatal population. Methods: We conducted a retrospective, cross-sectional, hypothesis-generating study at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Medical records of 68 preterm (<37 weeks gestation) and low-birth-weight (<2500 grams) infants who underwent ROP screening were reviewed. The exposures of interest were hyperglycemia (blood glucose >125 mg/dL) on postnatal day 1 (D1) and day 7 (D7). The primary outcome was the diagnosis of any stage of ROP. Statistical analysis involved Chi-square tests and exploratory multivariate logistic regression to adjust for select confounders. Results: Of the 68 infants included (mean gestational age 30.5 ± 2.2 weeks, mean birth weight 1447.5 ± 373.0 grams), 11 (16.2%) were diagnosed with ROP. Hyperglycemia was present in 29.4% of infants on D1 and 13.2% on D7. In logistic regression analysis, a strong statistical association was observed between hyperglycemia and ROP for both D1 (Adjusted Odds Ratio [AOR] = 55.7; 95% Confidence Interval [CI]: 5.1–611.0; p=0.001) and D7 (AOR = 74.5; 95% CI: 9.0–613.4; p<0.001). However, the profoundly wide confidence intervals indicate significant statistical instability and imprecision. Conclusion: This study found a strong, albeit statistically imprecise, association between hyperglycemia on both the first and seventh day of life and the incidence of ROP. These findings support the hypothesis that the timing of glycemic dysregulation may be critical, potentially impacting different phases of ROP pathogenesis. The results, while preliminary, underscore the need for larger, prospective studies to confirm these associations and elucidate the role of glycemic control in ROP prevention.

Enhancing the Early Inflammatory Response: The Role of Ozonated Aloe Vera Oil on IL-6 and TNF-α in Cutaneous Wound Repair Gunawan, Evan Sebastian; Bernardus Parish Budiono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1380

Background: Dysregulation of the initial inflammatory phase is a primary driver of impaired healing and the formation of chronic wounds, creating a critical need for therapies that can optimize this early response. This study tested the hypothesis that a novel formulation of ozonated aloe vera oil functions as a sophisticated bioregulator, promoting a beneficial, pro-regenerative inflammatory phenotype by transiently enhancing the host's innate repair signals. Methods: This was a preclinical, randomized, controlled study using fifty male Sprague-Dawley rats with 1 cm full-thickness excisional wounds. The therapeutic agent, ozonated aloe vera oil, was chemically characterized by its peroxide value (PV). Animals were randomized to receive topical treatment with either a positive control (aloe vera oil), a negative control (gentamicin ointment), or one of three graded doses of ozonated oil (Low PV, Medium PV, High PV). The primary outcomes, systemic (serum) and local (wound tissue homogenate) concentrations of Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), were quantified by ELISA on days 3 and 7. Results: On day 3, all ozonated oil formulations induced a profound and significant upregulation of both local and systemic TNF-α and IL-6 compared to controls (p < 0.001). The topical treatment increased systemic TNF-α levels by over 40% and local tissue concentrations by over 60%. Critically, this pro-inflammatory surge was transient; by day 7, both local and systemic cytokine levels in all groups had returned to statistically indistinguishable baseline levels. Conclusion: Ozonated aloe vera oil acts as a potent, transient modulator of the wound microenvironment, enhancing the expression of key initiatory cytokines. This mechanism, likely mediated by the activation of redox-sensitive transcription factors, optimizes the crucial first phase of healing without inducing pathological chronic inflammation. This study supports a novel therapeutic paradigm aimed at enhancing, rather than suppressing, the body's innate capacity for repair.

Redefining the Therapeutic Ladder in Refractory Chronic Constipation: A Systematic Review and Meta-Analysis of the Role of Ileal Bile Acid Transporter (IBAT) Inhibitors Imam Suprianto; Fania Rizkyani Sariza
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1381

Background: Chronic constipation (CC) refractory to conventional laxatives is a prevalent clinical challenge that significantly impairs quality of life. Ileal bile acid transporter (IBAT) inhibitors, a novel class of drugs, modulate colonic function by increasing the delivery of bile acids to the colon. This study aimed to quantitatively synthesize the evidence for the efficacy and safety of IBAT inhibitors in this difficult-to-treat population to clarify their position in the therapeutic algorithm. Methods: Following PRISMA guidelines, we systematically searched PubMed, Scopus, Embase, and Cochrane CENTRAL, along with clinical trial registries, from inception to June 1st, 2025. We included parallel-group, randomized controlled trials (RCTs) comparing the IBAT inhibitor elobixibat with placebo in adults with CC refractory to at least two prior laxative classes. The primary efficacy outcome was the overall responder rate. Key secondary outcomes included change in spontaneous bowel movements (SBMs) per week, quality of life (QoL) scores, and incidence of adverse events. Data were pooled using a random-effects model. Number needed to treat (NNT) and to harm (NNH) were calculated. Results: Our search identified six eligible RCTs enrolling 2,155 patients. Patients treated with elobixibat were significantly more likely to be responders compared to placebo (Risk Ratio [RR] = 2.58; 95% CI: 1.87–3.56; p < 0.00001), with moderate heterogeneity (I² = 59%). The NNT to achieve one additional responder was 5 (95% CI: 4–7). Elobixibat significantly increased the mean number of SBMs per week (Mean Difference [MD] = 1.65; 95% CI: 1.19–2.11; p < 0.00001; I² = 64%). The most common adverse events were gastrointestinal; elobixibat significantly increased the risk of diarrhea (RR = 4.21; 95% CI: 3.01–5.89; NNH = 6) and abdominal pain (RR = 2.35; 95% CI: 1.63–3.38; NNH = 11). Most events were mild to moderate. Conclusion: This meta-analysis provides robust evidence that the IBAT inhibitor elobixibat is a highly effective therapy for refractory CC, offering a significant improvement in symptoms for a substantial portion of patients. This benefit must be carefully balanced against the high incidence of mechanism-based gastrointestinal side effects. These findings establish elobixibat as a potent, mechanistically distinct option, thereby informing its strategic placement on the therapeutic ladder for patients failed by conventional laxatives.

Re-evaluating WHO Warning Signs in Pediatric Dengue: Abdominal Pain, Not Vomiting, is Associated with Plasma Leakage Cynthia Cynthia; Andreas Eric; I Kadek Suarca; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1382

Background: Dengue virus infection represents a significant cause of morbidity and mortality in pediatric populations across endemic regions. The progression to severe disease is characterized by a critical phase of plasma leakage. The World Health Organization (WHO) has established warning signs to aid in clinical triage, yet the independent clinical significance of these signs, particularly abdominal pain and vomiting, requires more precise clarification to optimize patient management. Methods: This study was a retrospective, cross-sectional analysis conducted at Wangaya General Hospital in Denpasar, Indonesia. Electronic medical records of 172 pediatric patients hospitalized with a diagnosis of dengue between January and May 2024 were reviewed. The primary outcome was significant plasma leakage, defined as a hematocrit increase of 20% or more from the admission baseline. Bivariate and multivariate logistic regression analyses were performed to determine the association of abdominal pain and vomiting with plasma leakage, controlling for the confounding effects of age, gender, and the day of fever at assessment. Results: In the multivariate logistic regression model, the presence of abdominal pain was independently and significantly associated with an increased likelihood of plasma leakage (Adjusted Odds Ratio [aOR]: 2.15, 95% Confidence Interval [CI]: 1.05–4.41; p=0.036). Conversely, the association for vomiting was not statistically significant after adjustment for confounders (aOR: 1.25, 95% CI: 0.65–2.42; p=0.508). The co-occurrence of both symptoms was also identified as a significant indicator of plasma leakage in the adjusted model (aOR: 2.09, 95% CI: 1.01–4.34; p=0.047). Conclusion: In this retrospective analysis of a hospitalized pediatric study, abdominal pain emerged as a robust independent correlate of significant plasma leakage, whereas vomiting did not. This differential association suggests that abdominal pain should be weighted more heavily in the clinical assessment of children with dengue as a key indicator of ongoing or impending hemoconcentration. These findings, while limited by their retrospective nature, can help refine clinical risk assessment in resource-constrained settings.

Pharmacological and Non-Pharmacological Strategies for Sedation and Analgesia in Critically Ill Children: A Systematic Review and Narrative Synthesis Andreas Eric; Cynthia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1383

Background: The management of pain and agitation in the Pediatric Intensive Care Unit (PICU) is critical for patient comfort and preventing adverse outcomes. A wide array of sedation and analgesia strategies exists, but a synthesized appraisal of contemporary evidence is needed to guide clinical practice. This systematic review evaluates the efficacy and safety of various pharmacological and non-pharmacological interventions for sedation and analgesia in critically ill children. Methods: A systematic search was conducted in PubMed, Embase, Cochrane CENTRAL, and CINAHL for studies published between January 2020 and December 2024. Following the PRISMA 2020 guidelines, two independent reviewers screened studies, extracted data, and assessed the risk of bias using the Cochrane RoB 2 tool for Randomized Controlled Trials (RCTs) and the Newcastle-Ottawa Scale (NOS) for observational studies. Results: From 4,366 identified records, five studies (two RCTs, three observational) involving 875 patients met the inclusion criteria. Study 1, an RCT (n=120), found that adjunctive ketamine significantly reduced mechanical ventilation duration by a mean of 2.1 days (95% CI: 1.2-3.0, p=0.001) compared to standard care. Study 3, a prospective cohort study (n=350), linked continuous sedation to longer PICU stays (median 9 vs. 6 days, p<0.001) and a higher incidence of iatrogenic withdrawal syndrome (45% vs. 18%, p<0.001) compared to intermittent sedation. Study 4, an RCT on music therapy (n=85), demonstrated a significant reduction in postoperative pain scores. Observational studies supported the opioid-sparing effects of multimodal analgesia (Study 5) and noted differences in recovery profiles between midazolam and propofol (Study 2). Conclusion: This review highlights the benefits of a multimodal, goal-directed approach to pediatric sedation and analgesia. Adjunctive ketamine and non-pharmacological interventions show promise in reducing opioid reliance and improving clinical outcomes. Protocols favoring intermittent sedation may reduce length of stay and withdrawal incidence. These findings support a paradigm shift away from deep, continuous sedation towards more nuanced, patient-centered strategies.

The Gut-Muscle Axis in Sarcopenia: A Meta-Analysis of Gut Microbiome Compositional Features and Their Correlation with Muscle Mass, Strength, and Physical Performance in Older Adults Vyora Ulvyana; Roza Mulyana; Rose Dinda Martini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1384

Background: Sarcopenia, the age-related decline in muscle mass and function, is a major geriatric syndrome. The gut-muscle axis has emerged as a key area of investigation, yet the association between gut microbiome composition and sarcopenic parameters in humans remains quantified by a collection of studies with varied methodologies. This meta-analysis aimed to synthesize the existing correlational evidence linking gut microbiome features to the core components of sarcopenia in older adults. Methods: We performed a systematic search of PubMed, Scopus, Web of Science, and Embase for observational studies published between January 2015 and July 2025 that assessed gut microbiome composition and sarcopenia metrics in adults aged ≥60. Correlation coefficients (r) were pooled using a random-effects model. We assessed heterogeneity using the I² statistic, conducted pre-specified subgroup and sensitivity analyses, and evaluated study quality with the Newcastle-Ottawa Scale (NOS). Results: Six cross-sectional studies (N=1,189) met the inclusion criteria. The methodological quality was high (median NOS score = 8). The pooled analysis revealed a significant, small positive correlation between gut microbial alpha diversity and muscle strength (handgrip strength) (pooled r = 0.19, 95% CI: 0.11-0.27; I² = 41%). The relative abundance of the genus Faecalibacterium, known for its potential to produce butyrate, was significantly correlated with physical performance (pooled r = 0.24, 95% CI: 0.16-0.32; I² = 28%). A non-significant negative correlation was found between the family Enterobacteriaceae and muscle mass (pooled r = -0.14, 95% CI: -0.29-0.01; I² = 62%). Subgroup analysis suggested this heterogeneity was partly explained by the diagnostic criteria used for sarcopenia. Conclusion: This meta-analysis provides quantitative evidence of a modest but significant association between gut microbiome composition and muscle health in older adults. A microbial profile with higher diversity and greater abundance of putative beneficial taxa is correlated with better muscle function. These associative findings, while limited by the cross-sectional nature of the data and the potential for reverse causality, reinforce the clinical relevance of the gut-muscle axis and underscore the need for longitudinal, multi-omic studies to elucidate mechanisms and test microbiome-targeted therapies.

Orthoplastic Limb Salvage of a Gustilo-Anderson Grade IIIB Open Trans-Articular Knee Fracture: A Case Report on Staged Reconstruction with a Rotational Fasciocutaneous Flap Satriya Teguh Imam; Amru Sungkar; Rhyan Dharma
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1385

Background: High-energy, open trans-articular knee fractures with extensive soft-tissue loss represent a formidable challenge, carrying a high risk of deep infection, nonunion, and amputation. Successful limb salvage necessitates a collaborative orthoplastic approach, combining aggressive surgical debridement and skeletal stabilization with timely, vascularized soft-tissue coverage. Case presentation: A 16-year-old male was admitted after a severe traffic accident, sustaining a Gustilo-Anderson Grade IIIB open fracture of the right knee. The injury comprised a comminuted distal femur fracture, a comminuted tibial plateau fracture (Schatzker VI), a comminuted patellar fracture, and a proximal fibula fracture. A 12x15 cm soft-tissue defect with a depth of 6 cm exposed the joint capsule and all fracture sites. The patient underwent a staged management protocol. The initial surgery involved extensive debridement of non-viable tissue and stabilization with a spanning multi-planar external fixator, followed by a second-look debridement. Definitive coverage was achieved on day five with a large, medially-based rotational fasciocutaneous flap and a split-thickness skin graft over the donor site. At the 1-year follow-up, all fractures had united, and the soft-tissue envelope was stable and sensate. The patient achieved a functional knee range of motion of 0-100 degrees and could ambulate without aids. The Lysholm knee score was 85, and the Knee Society Score (KSS) was 88. Conclusion: This case report demonstrates that a meticulously planned, staged orthoplastic strategy can achieve successful limb salvage even in devastating open knee injuries. A large, local rotational fasciocutaneous flap can serve as a reliable and less complex alternative to free tissue transfer for covering massive defects in this region, particularly in young patients with favorable tissue characteristics.

Beyond Cholesterol: The Independent Roles of Inflammation and Renal Dysfunction in Carotid Atherosclerosis Among Indonesian Elders Rukiah Chodilawati; Taufik Indrajaya; Ferry Usnizar; Sudarto; Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1386

Background: Atherosclerosis remains a leading cause of mortality in aging populations, driven by a complex interplay of metabolic and inflammatory factors. While dyslipidemia is a cornerstone of risk, the contributions of systemic inflammation, marked by high-sensitivity C-reactive protein (hsCRP), and declining renal function are increasingly recognized. This study aimed to elucidate the independent associations of hsCRP, dyslipidemia, and renal function with the presence of carotid atherosclerosis in an understudied elderly Indonesian population. Methods: We conducted a single-center, case-control study at a tertiary hospital in Palembang, Indonesia, from January to June 2024. One hundred participants aged ≥60 years were enrolled from the geriatric outpatient clinic. Cases were defined by the presence of carotid plaque, identified via B-mode Doppler ultrasound, and defined according to international consensus criteria. Controls had no evidence of plaque. We performed multivariate logistic regression to identify independent predictors of atherosclerosis, including hsCRP, lipid parameters, and estimated glomerular filtration rate (eGFR). Results: After multivariable adjustment, three factors emerged as significant, independent predictors of carotid atherosclerosis. High total cholesterol (≥200 mg/dL) was the most powerful predictor, associated with a more than seven-fold increased odds of plaque (Adjusted Odds Ratio [aOR]: 7.38; 95% Confidence Interval [CI]: 2.87–18.94; p<0.001). Elevated hsCRP (≥2 mg/L) (aOR: 3.38; 95% CI: 1.33–8.59; p=0.005) and abnormal eGFR (≤90 mL/min/1.73m²) (aOR: 3.36; 95% CI: 1.10–10.22; p<0.001) were also robustly associated with atherosclerosis, each conferring over a three-fold increase in odds. Conclusion: In this elderly Indonesian study, dyslipidemia remains a dominant risk factor for carotid atherosclerosis. However, systemic inflammation (high hsCRP) and mild renal dysfunction (abnormal eGFR) are also powerful, independent contributors. These findings highlight the multifactorial nature of atherosclerosis and underscore the importance of a comprehensive risk assessment that extends beyond traditional lipid profiling to include markers of inflammation and renal health.

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