Althea Medical Journal is an online journal published since February 2014 (e-ISSN 2337-4330) by the Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia. Althea Medical Journal is indexed in major databases, including Science and Technology Index (SINTA) Rank 2, Directory of Open Access Journals (DOAJ), and SCOPUS. The journal is published quarterly (February, May, August, and November). Althea Medical Journal, which previously publishes articles related to research in the fields of biomedical science, clinical medicine, family-community medicine, and public health, since March 2024 has only accepted articles related to aging-related diseases, wellness, and healthy lifestyle which includes neurodegenerative diseases, cardiovascular diseases, cancer, immune system disorders, and musculoskeletal disorders.
Faculty of Medicine Universitas Padjadjaran
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Internet Gaming Disorder Among Junior High School Adolescents in Jakarta: A Comparative Analysis Between Public and Private Schools
Background: The increasing availability of mobile games and expandinng access to devices have contributed to the growing prevalence of Internet Gaming Disorder (IGD), particularly among adolescents. The IGD is associated with impaired well-being and functioning, including sleep, psychological, academic, and social problems. However, evidence regarding effective school-based interventions remains limited. This study aimed to explore the prevalence of IGD among junior high school students in public and private schools in Jakarta, Indonesia. Methods: An analytic observational study with a cross-sectional design was conducted among 2,320 junior high school students from January to August 2025. Demographic data were collected using a basic questionnaire, and IGD was assessed using the Internet Gaming Disorder Test-10 (IGDT-10). Data were analyzed using the Chi-square test and Mann–Whitney test with SPSS version 23.0 Results: The prevalence of Internet Gaming Disorder (IGD) among junior high school adolescents in Jakarta was 2.2%. In private school, IGD was significantly associated with duration of gaming ≥4 hours/day and male gender, whereas in public school, IGD was significantly associated with the use of multiple gaming devices. Conclusions: The prevalence of IGD among junior high school students in Jakarta was 2.2%. Factors associated with IGD varied between public and private schools, suggesting that prevention strategies should be tailored to the school context. Early identification of excessive gaming behaviors may support adolescent well-being and healthy development.
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Body Image in Relation with Stress Level and Self-Esteem Among Adolescents with Thalassemia Major
Background: Body image influences how adolescents perceive and accept physical changes. Adolescents with thalassemia major require regular blood transfusions, which may lead to iron overload and complications such as bone and skull deformities, growth delay, and low body mass index. These physical changes may contribute to body dissatisfaction, stress, and reduced self-esteem. This study aimed to examine the relationship between body image, stress, and self-esteem among adolescents with thalassemia major. Methods: This analytical observational study used a cross-sectional design and was conducted from July to October 2023. A total of 54 adolescents aged 12–19 years from Jakarta, Bekasi, and Bogor participated in the study. After obtaining informed consent from their mothers, participants completed the Multidimensional Body-Self Relations Questionnaire–Appearance Scales (MBSRQ-AS), the Depression Anxiety Stress Scales (DASS-42), and the Rosenberg Self-Esteem Scale (RSES). Body image, stress level, and self-esteem were assessed using these instruments. Data were analyzed using the chi-square test. Results: Most participants were female (61.1%), with a mean age of 14.4 ± 2.42 years. The majority had a positive body image (61.1%), were not experiencing stress (70.4%), and had high self-esteem (83.3%). No significant associations were found between body image and stress (p=0.630), body image and self-esteem (p=0.261), or stress and self-esteem (p=0.274). Conclusion: No significant associations were observed between body image and stress, body image and self-esteem, or stress and self-esteem among adolescents with thalassemia major. Despite disease-related physical changes, most participants reported a positive body image, low stress levels, and high self-esteem.
Combined Permethrin and Salt Water Immersion Effects on Eosinophils, Immunoglobulin E, Histamine, and C3 Complement in Scabies Patients
Background: Scabies reduces quality of life due to intense nocturnal pruritus. Pruritus is associated with hypereosinophilia, increased immunoglobulin E (IgE), histamine release, and complement C3 activation. This study aimed to determine the effectiveness of combined permethrin and salt-water immersion therapy in reducing eosinophil counts, IgE, histamine, and complement C3 levels in patients with scabies. Methods: A quasi-experimental pre-test–post-test control group study was conducted among 92 students with scabies at an Islamic boarding school in Banten Province, Indonesia, from December 2024 to December 2025. Participants were selected using purposive sampling and divided into intervention and control groups. The intervention group received combined permethrin and warm salt-water immersion therapy, while the control group received permethrin alone. Eosinophil count, IgE, histamine, and complement C3 levels were measured before and after treatment. Data were analyzed using paired and independent t-tests. Results: Significant reductions were observed in the intervention group after therapy in eosinophils (t=65.0; p<0.001), IgE (t=152.9; p<0.001), histamine (t=152.1; p<0.001), and complement C3 (t=152.4; p<0.001). Post-treatment comparisons showed significant differences between groups for eosinophils (t=2.07; p<0.05), IgE (t=2.66; p<0.05), histamine (t=2.09; p<0.05), and complement C3 (t=4.25; p<0.001). Conclusions: Combined permethrin and warm salt-water immersion therapy significantly reduced inflammatory and immunological markers in patients with scabies and may help alleviate nocturnal pruritus.
Effect of Jogging Duration on Concentration Levels among University Students
Background: Concentration is an important component of cognitive function. However, many college students experience reduced attention spans, often lasting only 10 to 15 minutes. Previous studies have shown that poor concentration levels remain common among university students. Physical exercise, such as jogging, may improve brain function and enhance concentration. This study aimed to evaluate the influence of jogging duration on concentration levels among university student. Methods: This experimental study was conducted in 2024, involving medical students from a university in Jakarta, Indonesia. Participants were screened using the Physical Activity Readiness Questionnaire (PAR-Q) and selected through random sampling. Respondents were divided into three groups: a 10-minute jogging group, a 30-minute jogging group, and a control group without jogging intervention. The intervention was conducted for 8 weeks at each participant’s location. Concentration levels were assessed before and after the intervention using the Concentration Grid Test, administered at the university. Data were analyzed using ANOVA to compare changes in concentration scores and the Kruskal-Wallis to compare post-intervention scores among groups. Results: A total of 28 students participated, with females comprising the majority of participants (64.3%; n=18). The 10-minute jogging group demonstrated a significant improvement in concentration levels compared with the control group (p=0.004). Concentration Grid Test scores increased by 4.6 points in the 10-minute jogging group (p<0.001), and by 3.8 points in the 30-minute jogging group (p=0.003). Conclusions: A 10-minute jogging session improves concentration levels among university students, suggesting that short-duration physical activity provide cognitive benefits and may support academic performance and well-being.
One Minute Stair Step Test in Predicting VO2 max among Healthy Young Adults
Background: Cardiovascular risk factors such as hypercholesterolemia and hypertension, are increasing among Indonesian young adults despite their apparently healthy status. Valid field methods for assessing VO₂max, a key indicator of cardiorespiratory fitness, are needed for large-scale screening. This study validated the one-minute stair step test (OMSST) against the Bruce treadmill protocol as the reference standard. Methods: This cross-sectional study included 51 healthy males (20.41±0.57 years, BMI 22.52±3.28 kg/m²) in Bandung, Indonesia. VO₂max was measured using the Bruce protocol and estimated using the OMSST (40-cm step, 30 steps/min). Anthropometrics variables, heart rate recovery at 60 seconds (HRR60), and multiple regression variables (age, height, weight, and HRR60) were analyzed using paired t-tests, correlations, and Bland-Altman plots. Results: The mean VO₂max estimated using the OMSST (50.91±3.29 mL/kg/min) closely matched that measured Bruce protocol (49.75±3.61 mL/kg/min; p=0.091), with a small positive bias (1.16 mL/kg/min) and 95% limits of agreement within acceptable bounds. A strong correlation (r=0.85, p<0.001) confirmed validity. HRR60 (91.12±15.10 bpm) significantly predicted VO₂max. Conclusion: OMSST is a valid, simple, low-cost field surrogate for laboratory VO₂max testing in young males, ideal for middle-income settings. Future studies should assess diverse populations and longitudinal reliability.
Effect of Red Dragon Fruit Extract Ingestion on Mitochondrial Cytochrome c Levels in Rat Soleus Muscle Following Moderate Exercise
Background: Exercise-induced free radicals harm cellular mitochondria and trigger apoptosis via cytochrome-c release. Red dragon fruit (RDF) extract is known for its potent antioxidant properties. This study aimed to investigate whether RDF extract could counteract oxidative stress and apoptosis in rat soleus muscle post-exercise. Methods: This experimental study employed a randomized posttest-only control group design, conducted at the Animal House Unit of the Biology Laboratory, Universitas Sumatera Utara. Using 25 male rats, approximately 3 months old and weighing 200 g, selected by simple random sampling. Subjects were divided into five groups: sedentary control (K1), exercise-only (K2), and three test groups receiving RDF extract (75, 150, and 300 mg/kg) alongside moderate-intensity swimming for 31 days. Measured variables included malondialdehyde (MDA), cytochrome-c, and muscle histology. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests (p<0.05). Results: RDF-treated rats showed significantly lower levels of MDA and cytochrome-c compared to the exercise-only group. The Kruskal-Wallis test revealed significant differences among groups for both MDA (p=0.002) and cytochrome-c (p=0.003). Post-hoc analysis showed that the exercise-only group (K2) exhibited the highest cytochrome-c levels (mean rank 16.50), whereas the highest RDF dose (300 mg/kg) significantly reduced it (mean rank 6.75, p=0.008 vs. K2). Histopathological analysis confirmed less muscle tissue damage and reduced inflammatory cell infiltration in extract-treated groups. Conclusions: RDF extract suppresses exercise-induced oxidative stress, inhibits apoptotic signaling, and protects muscle tissue, demonstrating its potential as a post-exercise recovery supplement.
Association Between High-Sodium Food Consumption and Sleep Quality among Young Adults
Background: Excessive sodium intake is associated with various health issues, including hypertension and cardiovascular disorders, which may contribute to circadian rhythm disturbances and nocturnal urination that can impair sleep quality. This study aimed to explore the association between high-sodium food consumption and sleep quality among young adults. Methods: This cross-sectional study involved 107 preclinical medical students aged 18-22 years at Atma Jaya Catholic University of Indonesia, North Jakarta, Indonesia, conducted between August and October 2024. Sodium consumption data were collected using a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ), whereas sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants were selected using proportional-to-size sampling. Data were analyzed using the Fisher’s Exact test. Results: Of the 107 respondents, 36.4% consumed high-sodium foods exceeding the recommended intake limits. Male respondents showed a higher mean sodium intake (2.262 mg +/- s.d) compared with female respondents (1.897 mg +/- s.d), although the difference was not statistically significant (p=0.260). Most participants (77.6%) had good sleep quality based on PSQI assessment. Interestingly, a significant association was observed between high-sodium food consumption habits and sleep quality (p=0.000) Conclusion: High sodium dietary habits are associated with poor sleep quality among young adults. These findings highlight the importance of monitoring the daily sodium intake and reducing the consumption of sodium-rich foods to support better sleep quality and overall health.
Correlation Between Exercise Frequency and Menstrual Cycle Characteristics in Perimenopausal Women Aged 45–50 Years
Background: During perimenopause, declining estrogen levels often lead to altered menstrual patterns and other age-related health concerns. Consequently, the role of physical activity warrants closer examination. This study investigated the correlation between exercise frequency and menstrual cycle characteristics in premenopausal women Methods: A cross-sectional observational study was conducted in Singaraja City, Indonesia, from July to October 2024. A total of 150 premenopausal women aged 45–50 years were recruited through random sampling. Exercise frequency was measured using the World Health Organization’s Global Physical Activity Questionnaire (GPAQ) and categorized as never, low (1–2 times/week), moderate (3–4 times/week), and high (>5 times/week). Menstrual cycle characteristics were assessed according to the International Federation of Gynecology and Obstetrics (FIGO) criteria, including cycle frequency, regularity, duration, and sanitary product use. Correlations between exercise frequency and menstrual parameters were analyzed using Spearman’s Rho test. Results: Almost half of the women (45.3%) exercised 1–2 times/week. Interestingly, 22.0% never exercised. Moderate negative correlations were observed between exercise frequency and menstrual cycle period (r=-0.35, p<0.001) as well as regularity (r=-0.42, p<0.001). However, no significant correlation was found between exercise frequency and menstrual duration, and only a weak negative correlation with sanitary product use (r=-0.17, p=0.038). Conclusions: Physical activity appears to modulate menstrual cycle patterns during perimenopause. Consequently, regular exercise may facilitate hormonal homeostasis and support reproductive health throughout the menopausal transition, ultimately enhancing overall quality of life
Cervical Cancer Chemoprevention Using Hippobroma longiflora Extract through Modulation of Ki-67 and p53 in Benzo[a]pyrene-Induced Wistar Rats
Background: Cervical cancer remains one of the most common malignancies affecting women worldwide and is closely linked to dysregulated cell proliferation and impaired tumor suppressor responses. Herbs contain effective anticancer compounds that may be used alone or as adjuvants to existing chemotherapy regimens to improve efficacy and/or reduce drug-induced toxicity. Hippobroma longiflora (L.) G.Don a or kitolod is a medicinal plant known to contain antioxidant and anticancer compounds. This study evaluated the effect of ethanol extract of kitolod leaves on Ki-67 and p53 expression in a Benzo[a]pyrene (B[a]P)-induced cervical carcinogenesis model in female Wistar rats. Methods: This experimental study used a post-test-only control group design. Female Wistar rats (n=25) were grouped into five groups: a healthy control group without B[a]P exposure, a negative control group receiving only B[a]P (0.3 mg/kg BW/day); and three treatment groups receiving B[a]P combined with kitolod leaf extract at doses of 100, 200, or 300 mg/kg BW/day for 30 days. Phytochemical screening and gas chromatography–mass spectrometry (GC-MS) were used to characterize the extract. Cervical histopathologal and immunohistochemical examinations were performed to assess Ki-67 and p53 expression. Data were analyzed using one-way ANOVA followed by Bonferroni post hoc tests, with p<0.05 considered statistically significant. Results: Compared with the negative control, kitolod leaf extract significantly reduced Ki-67 expression and increased p53 expression (p<0.001). The greatest effect was observed at the 300 mg/kg BW/day dose. Conclusions: Kitolod leaf ethanol extract modulates Ki-67 and p53 expression in B[a]P-exposed rats, suggesting anti-proliferative activity and enhancement of tumor suppressor responses during early cervical carcinogenesis.
Macrovascular and Microvascular Complications of Diabetic Patients: Study form in Gatak Primary Health Care, Sukoharjo, Indonesia
Background: Diabetes is a major global health problem, and Indonesia being one of the countries with high prevalence. Fasting plasma glucose (FPG) and HbA1c are the main biomarkers used to assess glycaemic control. Screening for macrovascular and microvascular complications is necessary for early intervention to prevent permanent disability. This study aimed to determine the incidence of macrovascular and microvascular complications in diabetic patients in primary health care. Methods: A descriptive cross-sectional study was conducted from July to September 2022 among patients with diabetes who routinely attended Gatak Primary Health Care. Screening for macrovascular complications included PAD with Ankle-Brachial Index assessment; whereas the microvascular complications using monofilament testing for neuropathy, eye examination for retinopathy, and microalbuminuria for nephropathy. Result: Among 65 patients with diabetes, most were female (83.1%), with a mean age of 62.43±9.47 years. The mean fasting plasma glucose (FPG) was 192.62±86.92 mg/dl, and the mean HbA1c was 12.55±3.59%. Both macrovascular complication (PAD 32.3%) and microvascular complications (retinopathy 57.1%, neuropathy 44.9%, nephropathy 49.2%) were identified, demonstrating the burden of diabetes-related outcomes in primary care. Conclusion: Macrovascular and microvascular complications were highly prevalent among patients with diabetes in primary care, with microvascular complications occurring more frequently. These findings indicate that inadequate glycaemic control contributes substantially to complication rates.
Effect of Vitamin D Supplementation on Irisin, Telomerase, Klotho, and Tumor Necrosis Factor-alpha (TNF-α) in Elderly: A Quasi-Experimental Study
Background: Vitamin D plays a crucial role in aging by regulating mitochondrial function, inflammation, oxidative stress, and telomere stability. Vitamin D deficiency is common among the elderly and is linked to accelerated aging. Biomarkers such as irisin, telomerase, klotho, and tumor necrosis factor-alpha (TNF-α) are associated with aging processes. This study aimed to evaluate the effect of vitamin D supplementation on these biomarkers in elderly individuals. Methods: This quasi-experimental pretest-posttest study was conducted in Kadugadung Village, Banten, Indonesia from Maret to September 2024. A total of 47 healthy elderly individuals (≥60 years) were recruited using purposive sampling. The treatment group (n=25) received 800 IU/day of vitamin D for 20 days, whereas the control group (n=22) received none. Blood samples were collected before and after the intervention to measure serum irisin, telomerase activity, klotho, and TNF-α. Baseline variables included body mass index (BMI), blood pressure, hemoglobin, hematocrit, blood glucose, cholesterol, and uric acid. Data were analyzed using paired and independent statistical tests. Results: Vitamin D supplementation significantly increased serum irisin levels (p=0.016), meanwhile no significant changes were observed in telomerase activity (p=0.128), klotho (p=0.819), or TNF-α (p=0.098). In the treatment group, blood glucose was correlated positively with TNF-α (r=0.423, p<0.05), whereas cholesterol was correlated negatively with TNF-α (r=-0.51, p<0.01). Furthermore, telomerase activity was correlated positively with irisin (r=0.348, p<0.05) Conclusion: Vitamin D supplementation at 800 IU/day significantly enhances serum irisin, but does not affect telomerase, klotho, or TNF-α. These findings suggest a potential role of vitamin D in modulating aging-related biomarkers. Correction Notice: This article has been corrected. See the Erratum published in Althea Medical Journal, Volume 12, Number 4 (2025).
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Effects of Aloe Vera Extract on Basal Cell Thickness and Lymphocyte Infiltration at the Gastroesophageal Junction in a Rat Model of Gastroesophageal Reflux Disease
Background: Gastroesophageal reflux disease (GERD) is a chronic gastrointestinal disorder with increasing global prevalence. Aloe vera contains bioactive compounds with potential anti-inflammatory properties. This study aimed to evaluate the anti-inflammatory effects of Aloe vera extract in a Sprague-Dawley rat model of GERD. Methods: This experimental study included 32 male Sprague-Dawley rats randomly divided into eight groups: normal (N), negative control (NC), two positive controls receiving pantoprazole for 7 or 14 days (PCI and PCII), and four treatment groups receiving Aloe vera extract at doses of 250 or 500 mg/kg body weight for 7 or 14 days (DI–DIV). After treatment, the rats were euthanized and gastroesophageal junction (GEJ) tissues were collected for histopathological analysis. Basal cell thickness and lymphocyte infiltration were assessed. Data were analyzed using one-way ANOVA followed by post hoc testing. Results: Administration of Aloe vera extract at doses of 250 and 500 mg/kg body weight significantly reduced basal cell thickness compared with the untreated GERD group (p<0.05). However, no significant reduction in lymphocyte infiltration was observed (p>0.05). Conclusions: Aloe vera extract exhibits anti-inflammatory effects in GERD-induced rats by reducing basal cell thickness at the GEJ. These findings suggest its potential as a complementary therapeutic approach for GERD, although further studies are needed to evaluate long-term efficacy and safety.
Effect of Cucumber (Cucumis sativus) Extract Cream on Aquaporin-3 and Hyaluronic Acid Levels in Wistar Rats with Xerosis Cutis
Background: Xerosis cutis is characterized by impaired barrier function and reduced hydration markers, including Aquaporin-3 (AQP3) and hyaluronic acid (HA). Cucumber extract (Cucumis sativus) contains antioxidants and humectants compounds that may improve skin hydration. This study investigated the effects of cucumber extract cream on AQP3 and HA levels in female Wistar rats (Rattus norvegicus) with grade II xerosis cutis. Methods: This in vivo experimental study used a post-test-only control group design. Twenty-five female Wistar rats were randomly assigned into five groups: healthy control, xerosis control, positive control (10% ceramide), and treatment groups receiving 3% and 5% cucumber extract cream. Xerosis was induced by topical application of 70% acetone followed by 100% ethanol for 5–7 days until grade II xerosis developed. The creams were then applied topically for 14 days. AQP3 and HA levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: HA levels differed significantly among groups (p=0.016). The 5% cucumber extract cream maintained HA levels comparable to healthy controls (611.25±248.61 vs. 685.26±194.95 ng/L; p=0.394). In contrast, ceramide and 3% cucumber treatments showed lower HA levels relative to healthy controls. AQP3 levels showed no statistically significant differences among groups (p=0.131), although descriptively higher expression was observed in the 5% cucumber-treated group. Conclusion: Cucumber extract cream at 5% concentration helps maintain HA levels and shows a tendency to increase AQP3 expression, suggesting potential benefits for improving skin hydration in xerosis cutis and supporting skin health associated with aging.
Evaluation of Urinary hsa-miR-21-5p Expression as a Non-Invasive Biomarker for Prostate Cancer
Background: Prostate cancer is one of the most common malignancies among men worldwide. Prostate-specific antigen (PSA) testing and prostate biopsy are commonly used for diagnosis. However, these methods may be invasive and can lead to delayed detection in some cases. This study aimed to evaluate the expression of hsa-miR-21-5p in urine samples from prostate cancer patients compared with healthy individuals to assess its potential as a non-invasive biomarker. Methods: This observational study used a cross-sectional design and was conducted in Yogyakarta, Indonesia, between October and December 2018. Expression profiling of hsa-miR-21-5p was performed using quantitative real-time polymerase chain reaction (qRT-PCR) in urine samples obtained from 12 prostate cancer patients and 8 healthy controls. Relative expression levels were analyzed using GenEx software and calculated using the Livak (2^−ΔΔCt) method. Results: The age of prostate cancer patients ranged from 60 to 83 years, whereas the healthy control group had a mean age of 53.88 ±2.59 years (range 50–58 years). A slight decrease in hsa-miR-21-5p expression was observed in urine samples from prostate cancer patients compared with healthy controls (fold change=0.7; p>0.05). Conclusion: Expression of hsa-miR-21-5p shows a tendency toward downregulation in urine samples of prostate cancer patients, however, no statistically significant difference is identified. Further studies with larger sample sizes are required to clarify its potential role as a non-invasive biomarker for prostate cancer detection.
Effects of Moderate-Intensity Treadmill Training on Cardiac Mitochondrial Mitophagy and Dynamics in Young and Aged Wistar Rats
Background: Cardiac aging is closely associated with mitochondrial dysfunction and impaired quality control mechanism. Exercise has been shown to modulate mitochondrial homeostasis, however, its effects on cardiac mitophagy and mitochondrial dynamics during aging remain unclear. This study investigated the effects of moderate-intensity treadmill training on mitochondrial maintenance-related gene expression in the hearts of young and aged Wistar rats. Methods: Young and aged rats were divided into four groups: young control, young exercise, aged control, and aged exercise (n=6 per group). Exercise groups performed treadmill running at 20 m/min for 30 minutes/day, 5 days/week for 8 weeks. Cardiac gene expression levels of Pink1, Parkin, Mfn1, Mfn2, Opa1, Drp1, and Fis1 were analyzed using semi-quantitative polymerase chain reaction (PCR). Data were analyzed using one-way ANOVA or Kruskal–Wallis test followed by appropriate post hoc analyses. Results: Exercise significantly increased Mfn2 expression in aged exercise rats compared with aged controls (p=0.029), suggesting partial restoration of age-related decline. Expression of Mfn1 and Drp1 varied among groups but showed no significant pairwise differences. Expression levels of Opa1, Fis1, Pink1, and Parkin remained unchanged. These results indicate that moderate exercise selectively enhances mitochondrial fusion capacity while maintaining balanced fission and basal mitophagy activity. Conclusion: Moderate-intensity treadmill training promotes mitochondrial fusion-related adaptation in aging cardiac tissue. Regular moderate exercise may represent a potential non-pharmacological strategy to support mitochondrial function and mitigate cardiovascular aging.
Reduced Left Ventricular Global Longitudinal Strain in Obese Adolescents
Background: Obesity in adolescents is associated with early cardiac structural and functional alterations that may progress to ventricular dysfunction later in life. Two-dimensional speckle-tracking echocardiography (2D STE) enables early identification of subclinical ventricular dysfunction. Nevertheless, its application in the adolescents remains limited. This study aimed to assess differences in left ventricular (LV) function among well-nourished, overweight, and obese adolescents using 2D STE. Methods: A cross-sectional study was conducted among adolescents aged 15–18 years from five senior high schools in Bandung, Indonesia between June and August 2023. Participants were randomly categorized into well-nourished, overweight, and obese groups. Transthoracic echocardiographic using M-mode and 2DSTE was performed to evaluate LV function, particularly global longitudinal strain (GLS). Statistical analyses were performed using SPSS with significance defined as p<0.05. Results: Sixty adolescents were included, 65% were male with a mean age of 16.4±0.6 years. Conventional echocardiography showed no significant differences in systolic or diastolic function among groups. However, obese adolescents demonstrated significantly greater LV posterior wall thickness and larger LV and right ventricular basal volumes compared with other groups. GLS analysis revealed significantly reduced LV deformation in obese group compared with overweight and well-nourished groups (–20.0±1.9 vs. –22.3±1.4 vs. –22.7±1.9, respectively; p<0.001). Conclusion: Reduced LV GLS detected by 2D STE indicates early subclinical myocardial dysfunction in obese adolescents despite normal conventional echocardiographic findings. Early cardiovascular screening and lifestyle interventions, including balanced nutrition and regular physical activity, may help reduce future cardiometabolic risk.
Insomnia as a Risk Factor for Cardiovascular Disease Among Adults in Eastern Indonesia
Background: Insomnia is a common sleep disorder with increasing prevalence among adults and has been linked to a higher risk of cardiovascular disease (CVD). This study aimed to investigate the association between insomnia severity and CVD risk among adults. Methods: This correlational study with a cross-sectional design involved adults aged 30–59 years with insomnia. Participants were recruited using convenience sampling, at Kota Hospital and Bahteramas Hospital, Kendari, Indonesia, between November 2023 and April 2024. Insomnia severity was measured using the Insomnia Severity Index (ISI), and CVD risk was assessed using the Framingham Risk Score. Data were analyzed using the Pearson chi-square and multinomial logistic regression analysis. Results: Of the 144 respondents, the majority were female (59.0%), aged >50 years (62.5%) with a mean age of 49.63±10.08 years. Gastroesophageal reflux disease (GERD) was the most common comorbidity (39.6%), and 57.6% were smokers. Most respondents had moderate insomnia (87%) and low CVD risk (66%). Severe insomnia was more frequently observed among participants with moderate and high CVD risk. A significant positive relationship was found between insomnia severity and CVD risk (p=0.000, r=0.669), with insomnia explaining 50.2% of the variance in CVD risk. Conclusion: Insomnia is significantly associated with cardiovascular risk and may represent a modifiable lifestyle-related risk factor. Improving sleep quality may contribute to healthier lifestyles and reduced CVD risk.
Correlation between Nicotine Dependence and Cardiorespiratory Fitness within the Wellness Matrix Framework among University Students
Background: The increasing use of tobacco and electronic nicotine delivery systems (ENDS) among youth represents a significant public health concern. In Indonesia, nicotine use among university students may contribute to long-term health risks. This study evaluated the correlation between nicotine dependence, measured using the Hooked-on Nicotine Checklist (HONC), and cardiorespiratory fitness assessed through maximal oxygen uptake (VO₂max) within the Wellness Matrix Framework. Methods: A cross-sectional study was conducted among 40 male undergraduate students aged 18–24 years at Universitas Padjadjaran who actively used cigarettes, e-cigarettes, or vape products. Participants were selected using purposive sampling. Nicotine dependence was assessed using a modified HONC questionnaire, whereas VO₂max was estimated using the YMCA 3-Minute Step Test. Descriptive statistics, the Shapiro-Wilk tests, and Pearson correlations analysis were applied (α=0.10). Results: Participants showed moderate nicotine dependence (mean HONC score: 5.6 ± 2.37) and moderate fitness (mean VO₂max: 44.31±3.86 mL/kg/min). A weak inverse correlation was found between HONC scores and VO₂Max (r=-0.275, p=0.085). Body mass index showed a strong negative correlation with VO₂max (r=-0.824, p<0.001). Subgroup analysis showed consistent negative trends between nicotine dependence and VO₂max across single, dual, and triple product users. Duration of nicotine use showed negligible correlation with VO₂max (r=0.041, p=0.802). Conclusion: Higher nicotine dependence is associated with lower cardiorespiratory fitness and affects multiple wellness dimensions. These findings underscore the importance of holistic interventions targeting physical and psychosocial wellness among young adults.
Relationship between Serum 25-Hydroxyvitamin D Levels and Cardiovascular Disease Risk among Road Sanitations Workers
Background: Road sanitation workers are frequently exposed to sunlight during outdoor work, which may influence vitamin D status. Although several studies suggest that outdoor workers have a lower risk of vitamin D deficiency than indoor workers, evidence regarding the association between 25-hydroxy vitamin D [25-(OH)D] levels and cardiovascular disease (CVD) risk among sanitation workers remains limited. This study aimed to examine the relationship between serum 25(OH)D levels and CVD risk among road sanitation workers. Methods: This analytical cross-sectional study included 105 road sanitation workers in West Cengkareng District, Jakarta, Indonesia selected using consecutive random. The 10-year cardiovascular risk was calculated using the World Health Organization/International Society of Hypertension (WHO/ISH) risk charts. Serum 25-(OH)D levels were measured from peripheral venous blood samples. Data were analyzed using the chi-Square test and Fisher's exact test, with statistical significance defined as p<0.05. Results: Vitamin D deficiency was observed in 59.05% of participants, whereas 85.7% had low-to-moderate CVD risk. No significant association was found between 25(OH)D levels and CVD risk (p=0.582). However, significant associations were identified between age (p=0.001), body mass index (p=0.003), blood pressure (p=0.037), smoking status (p=0.037) and cardiovascular disease risk. Conclusions: Vitamin D deficiency is not associated with increased CVD risk among road sanitation workers. However, regular monitoring of vitamin D status may support occupational health and overall well-being.
Early Metabolic Alterations and Predictors of Obesity Among Young Adults in Indonesia: Focus on Lipid Abnormalities and Cardiometabolic Risk
Background: The prevalence of obesity and metabolic syndrome (MetS) is rising among young adults, contributing to early cardiometabolic risk amid lifestyle transitions in Indonesia. This study examined the associations between obesity, MetS components, and body composition among Indonesian young adults. Methods: A total of 99 participants were classified based on body mass index (BMI) into normoweight (n=51) and obese (n=48) groups. Anthropometric measurements, body composition, blood pressure, and lipid profiles were assessed. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Bivariate and multivariable logistic regression analyses were performed to identify factors independently associated with obesity. Results: Obesity was significantly associated with several MetS components. Abdominal obesity was observed only in the obese group (33.3%). Hypertriglyceridemia and low HDL cholesterol were more prevalent among obese participants compared with normoweight individuals (27.1% vs. 5.9% and 51.0% vs. 31.4%, respectively). MetS (≥3 NCEP ATP III criteria) was identified in 12.5% of obese participants and was absent in the normoweight group. Multivariable analysis identified family history of hypertension (adjusted OR 2.82; 95% CI 1.06–7.48) and elevated triglyceride levels (adjusted OR 4.78; 95% CI 1.13–20.22) as independent predictors of obesity. Conclusions: Obese young adults exhibit early metabolic abnormality, particularly abdominal obesity, low HDL cholesterol, and hypertriglyceridemia. Early metabolic screening and targeted preventive strategies are important to reduce future cardiometabolic risk.
Physical Activity Levels Based on Indonesian Population Characteristics: Evidence from the Indonesian Family Life Survey-5
Background: According to the World Health Organization, approximately 80% of the global population is physically inactive. Sedentary behavior is a major contributor to the increasing risk of chronic diseases. This study aimed to describe physical activity levels among the Indonesian population and examine their associations with sociodemographic and lifestyle factors. Methods: This cross-sectional study was conducted from March to November 2024 using secondary data from the Indonesian Family Life Survey-5 (IFLS-5). Variables analyzed included age, gender, ethnicity, marital status, body mass index (BMI), perceived health status, occupation, education level, residence, sleep quality, smoking status, and physical activity level. A total of 4,156 respondents were included. Associations between population characteristics and physical activity levels were examined using the chi-square test. Results: Nearly half of the respondents engaged in light physical activity (47.8%), followed by moderate (28.0%) and vigorous physical activity (24.2%). Significant associations were found between physical activity levels and age (p=0.015), gender (p<0.001), ethnicity (p=0.006), occupation (p<0.001), education level (p<0.001), residence (p<0.001), sleep quality (p<0.001), and smoking status (p<0.001). Agricultural workers (46.7%) and individuals with severe sleep disturbances (40.0%) were more likely to engage in vigorous physical activity. Conclusion: Most Indonesians engage predominantly in light physical activity. Several sociodemographic and lifestyle factors are significantly associated with physical activity levels, underscoring the importance of promoting healthier and more active lifestyles.
Protective Effect of Black Rice Extract Cream on Ultraviolet B-Induced Skin Hyperpigmentation in Mice
Background: Hyperpigmentation is a common sign of skin aging caused by prolonged ultraviolet B (UVB) exposure. Black rice (Oryza sativa L. var glutinosa), known for its high antioxidant content, has moisturizing and regenerative properties that may support skin health. This study aimed to evaluate the effect of black rice extract cream on transforming growth factor beta (TGF-β) and tumor necrosis factor alpha (TNF-α) expression in a UVB-induced hyperpigmentation mouse model. Method: An in vivo experimental study with post test only control group design was conducted in 2024 at the Stem Cell and Cancer Research Laboratory, Semarang, Indonesia. Twenty-eight male C57BL/6 mice were randomly divided into four groups: healthy control (K1), UVB-exposed negative control group (K2), UVB-exposed group treated with 7.5% (K3) and 15 % (K4) black rice extract cream for14 days. On day 15, TGF-β and TNF-α expression levels were analyzed using the RTq-PCR, normalized to GAPDH. Data were analyzed using One-way ANOVA followed by post-hoc testing. Results: TGF-β gene expression was the highest in K4 (1.87±0.23), followed by K3 (1.52±0.42l) which was statistically significant different between groups (p=000); whereas TNF-α gene expression was the lowest in K4 (1.92±1.02) compared with K3 (5.40±2.28), and the difference between groups was also statistically significant (p=000). Conclusion: Black rice extract cream increase TGF-β expression and reduces TNF-α expression in UVB-induced hyperpigmentation. These findings suggests its potential as a natural topical agent to mitigate UVB-induced skin damage and premature aging.
Correlation between Hemoglobin Concentration and Oxygen Saturation Post-Exercise with Cardiorespiratory Fitness: Early Indicators for Cardiovascular Health in Young Adults
Background: Cardiorespiratory fitness (CRF) is an important indicator of cardiorespiratory health and a strong predictor of mortality. Several factors affect CRF, including arterial oxygen content (CaO2), which is influenced by hemoglobin (Hb) concentration and oxygen saturation. However, the correlation between CRF and Hb remains inconclusive. This study aimed to explore the correlation between Hb concentration and oxygen saturation post-exercise with CRF, especially in young adults. Methods: A cross-sectional study was conducted in October 2024, involving 68 medical students from a university in Jakarta, Indonesia. Consecutive stratified sampling was applied based on gender. The Global Physical Activity Questionnaire (GPAQ) and the Physical Activity Readiness Questionnaire (PAR-Q+) were used as screening tools. Hb concentration and oxygens saturation were measured using a digital hemoglobinometer and pulse oximetry, while CRF was evaluated using a 20-meter multistage test. Additional measurements included body mass index (BMI), blood pressure, and heart rate. Data were analyzed with correlation and multiple linear regression tests. Results: The most participants were female (57.4%). Normal Hb concentration was found in 80.9% with mean Hb levels of 14.15±1.54 g/dL in males and 12.9±1.37 g/dL in females. CRF correlated positively with Hb concentration (p=0.005; r=1.13), and negatively with oxygen saturation post-exercise (p=0.005; r=-0.4). These correlations were significant in males and not in females. Conclusion: Hb concentration and oxygen saturation post-exercise significantly correlate with CRF in males, whereas BMI and physical activity play stronger roles in females. Maintaining optimal Hb levels, preventing anemia, and promoting active lifestyles are essential strategies to support CRF, cardiovascular health, and long-term wellness.
Overnutrition Status Is Associated with Elevated Blood Pressure among Adolescents in Central Jakarta, Indonesia
Background: Overweight and obesity are rising among Indonesian adolescents and are known risk factors for hypertension. This study aimed to examine the relationship between overnutrition status and blood pressure among adolescents. Method: A cross-sectional study was conducted from May to September 2024, among overweight and obese adolescents aged 12–16 years in Central Jakarta, Indonesia. Nutritional status was determined by body mass index (BMI) Z-scores based on CDC growth charts, adjusted for sex and age. Blood pressure was measured using a digital sphygmomanometer and classified according to the 2017 AAP guidelines. Data were analyzed using chi-square tests. Results: A total of 98 adolescents participated (67.3% male; mean age 13 years). Overweight (49%) and obesity (51%) were almost equally distributed, with the highest BMI recorded at 46.7 kg/m². More than half (58.2%) had elevated blood pressure, with one case reaching grade 2 hypertension (143/84 mmHg). Overnutrition status was significantly associated with elevated blood pressure (p=0.044). Stratified analysis showed a strong association among males (p=0.005), where 42.4% of obese males exhibited elevated blood pressure, but no significant association was observed among females (p=0.58). Conclusion: Overnutrition is significantly associated with elevated blood pressure among adolescents, particularly in males. Early interventions promoting balanced nutrition, physical activity, and healthy lifestyle habits are critical to reducing the long-term cardiovascular risk in this age group.
Consumption of Sugar-Sweetened Beverages Is Related to Fasting Blood Glucose and the Nutritional Status among Young Adults in Indonesia
Background: Habitual consumption of sugar-sweetened beverages (SSBs) is linked to elevated blood glucose and increased body weight. Medical students often experience high stress, which may increase SSBs consumption. This study aimed to examine the associations between SSB consumption, fasting blood glucose, body mass index (BMI), and waist circumference among medical students. Methods: A cross-sectional study was conducted in October 2022 using a total sampling method involving 184 first-year students at the Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia. SSBs consumption was assessed using a semi-quantitative food frequency questionnaire (SQ-FFQ). Fasting blood glucose was measured by glucometer after an overnight fast. Body height, weight, and waist circumference were measured using a stadiometer, digital scale, and tape measure, respectively. Physical activity was assessed with the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Associations were tested using Kruskall Wallis, independent t-test, and chi square as appropriate. Results: Most students consumed SSBs 3–4 times per week and in amount >495 mL. The volume of SSBs consumption was associated with BMI (p=0.02), fasting blood glucose (p<0.001), and waist circumference (p<0.01). Similarly, the frequency of SSBs consumption was associated with fasting blood glucose (p=0.04) and waist circumference (p<0.01), but not with BMI (p=0.16). Conclusion: Consumption of SSBs among students is high. Frequent and high-volume consumption of SSBs is associated with elevated fasting blood glucose levels and the nutritional status, whereas higher volume is associated with increased BMI. Reducing SSB intake and promoting healthier beverage choices may support a sustainable healthy lifestyle in young adults.
Association Between Smoking and Central Obesity in Individuals Aged ≥40 Years Based on the Indonesian Family Life Survey-5
Background: Obesity and smoking are major public health concerns and leading causes of preventable morbidity and mortality. Smoking may contribute to central obesity through multiple mechanisms, and individuals aged ≥40 years are at higher risk. This study aimed to examine the association between smoking and central obesity, considering sociodemographic factors, using data from the Indonesian Family Life Survey-5 (IFLS-5). Methods: A cross-sectional study was conducted using secondary data from IFLS-5. Participants included Indonesians aged ≥40 years with complete data on smoking and waist circumference. Smoking status was assessed using the Brinkman Index (BI) and classified as light (0–199), moderate (200–599), or heavy (>600). Central obesity was defined as waist circumference ≥90 cm for male and ≥80 cm for female. Associations were analyzed using Chi-square tests at 95% confidence interval. Results: Of 3,391 participants, the majority were male (95.4%) with a mean age of 52.76±9.78 years (range 40–101). The prevalence of central obesity was 22.3% (n=790), and the largest group of participants were moderate smokers (54.9%). Central obesity was significantly associated with smoking status (p=0.003), age (p<0.001), gender (p<0.001), and education level (p<0.001). No significant associations were found with marital status (p=0.826), occupation (p=0.374), or residence (p=0.750). Conclusions: Smoking, age, gender, and education level are significantly associated with central obesity among Indonesians aged ≥40 years. Preventive measures, including smoking cessation and lifestyle interventions, are essential to reduce central obesity and the risk of cardiovascular disease.
Correlation of Various Levels of Body Mass Index to Vascular Endothelial Growth Factor-A
Background: Obesity, reflected by high body mass index (BMI) value, has become a global health concern. Both obesity and vascular endothelial growth factor-A (VEGF-A) are major risk factors for cardiometabolic diseases. Although many studies have shown that obesity induces angiogenesis through increased VEGF-A, there remains a gap regarding the correlation between BMI categories and VEGF-A levels. This study aimed to analyze the correlation between various level of BMI and VEGF-A concentrations. Methods: This cross-sectional in vivo study analyzed blood samples from 90 adults enrolled in the Universitas Padjadjaran Wellness Program ( December 2022–June 2023) selected using simple random sampling.VEGF-A concentrations were measured using multiplex ELISA assays. Data normality was assessed using the Kolmogorov-Smirnov test. Differences between BMI groups were analyze with ANOVA, and correlations were evaluated using Pearson’s test. Results: Of the 90 samples, 62 were included, and were grouped as normal weight (29%), overweight (32.2%), obesity class I (30.6%), obesity class II (6.4%), and obesity class III (1.6%). Mean VEGF-A concentrations showed an increasing trend with higher BMI, though differences between groups were not statistically significant (p=0.482). A weak positive correlation was observed between BMI and VEGF-A levels (r=0.267; p=0.036). Conclusion: Higher BMI is associated with higher VEGF-A, indicating obesity-induced inflammation and angiogenic activity. These findings highlight the importance of weight control through balanced diet and physical activity to mitigate long-term risks of cardiometabolic and chronic diseases.
Systemic Immune-Inflammation Index as a Potential Indicator of COVID-19 Severity in a Tertiary Hospital in Indonesia
Background: The progression of coronavirus disease 2019 (COVID-19) to severe stages is strongly influenced by host immunity and inflammatory. The Systemic Immune-Inflammation Index (SII) is a novel biomarker reflecting both immunity and inflammation. This study aimed to analyze differences in SII according to COVID-19 severity. Methods: A cross-sectional study was conducted using medical records of COVID-19 patients hospitalized at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between March 2020 and August 2021. SII was calculated as the absolute neutrophil count and platelet count divided by the absolute lymphocyte count obtained from peripheral blood samples. COVID-19 severity was classified based on oxygen saturation (SpO₂). Receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the discriminatory ability of SII. Results: Of the 1,192 patients included, 410 (34.3%) had severe symptoms and 782 (65.7%) had mild to moderate symptoms. The median SII at admission was significantly higher in severe symptoms [1779 x 109 /L (IQR 46-40416)] compared with mild to moderate symptoms [880 x 109 /L (IQR 14.5-23280)]; p<0.001. ROC analysis showed an SII cut-off of 1244 with an AUC of 0.695 (95% CI 0.668–0.721), sensitivity 65.9%, and specificity 66.2%. Conclusions: SII may serve as a potential biomarker for predicting COVID 19 severity. Its simplicity and availability from routine blood counts make it particularly valuable for early risk stratification, especially in resource-limited settings. Moreover, early recognition of elevated SII could support timely interventions, prevent disease progression, and improve clinical outcomes.
Determinants of Cardiovascular Disease Risk in the Chronic Disease Management Program at Pasirkaliki Public Health Center, Bandung, Indonesia
Background: Cardiovascular diseases (CVDs) are the leading causes of death worldwide and are influenced by multiple risk factors. Stratifying CVD risk using the World Health Organization (WHO) CVD risk charts for Southeast Asia can support routine management, especially for patients with chronic diseases. This study aimed to assess determinants of CVD risk among patients enrolled in the Chronic Disease Management Program at a Public Health Center. Methods: This cross-sectional study was conducted in June 2024 at Pasirkaliki Public Health Center, Bandung, Indonesia. Purposive sampling was applied to select medical records and data was extracted, including age, gender, smoking status, history of diabetes mellitus (DM), systolic blood pressure (SBP), and total cholesterol (TC). CVD risk was stratified using WHO CVD risk classification charts for Southeast Asia. Descriptive and correlation analyses were performed. Results: A total of 124 data patients were collected, with the majority were female adults, non-smokers, had a history of DM with grade 1 hypertension and TC levels between 5.0–5.99 mmol/L. CVD risk stratification showed 43.5% high risk, 25% moderate risk and 16.9% low risk. Interestingly, very high risk was detected in 13.7% and 0.8% was an extremely high risk. Age was strongly correlated with CVD risk (r=0.708, p<0.01), and SBP showed a moderate correlation (r=0.646, p<0.01), whereas TC levels were not significantly correlated (p=0.064). Conclusion: Patient-related factors increase the CVD risk, particularly age and SBP. Routine risk stratification and strengthened chronic disease management program are essential to reduce CVD-related morbidity and mortality.