Edward Kurnia Setiawan Limijadi

Adiponectin is an adipokine involved in glucose and lipid metabolism and plays an important role in enhancing insulin sensitivity and suppressing inflammation. Higher circulating adiponectin levels are generally associated with improved metabolic regulation in individuals with type 2 diabetes mellitus (T2DM). The objective of this study is to evaluate the effect of Intermittent fasting (IF), Exercise (Ex), and combination (CO) on insulin resistance marker; to assess the effect of IF, Ex, and the combination on adiponectin level; To determine the most effective intervention. In conclusion, all interventions significantly improved insulin sensitivity and glucose homeostasis in diabetic rats, as indicated by improvements in glucose, insulin, and HOMA-IR levels. In addition, all interventions significantly increased adiponectin levels under diabetic conditions. Among the intervention groups, the combination of exercise and intermittent fasting demonstrated the greatest effectiveness

Coronavirus disease-19 (COVID-19) is an infection that causes physical and psychological stress. Cortisol and prolactin are hormones that have been studied in association with infectious states. Viral infections trigger the production of acute-phase proteins and antibodies essential for viral elimination. This study aimed to prove the correlation between stress hormone levels and inflammatory markers and antibodies in COVID-19 patients. A cross-sectional approach was employed in this study, with a target population of patients with moderate-to-severe COVID-19. Cortisol, prolactin, and specific antibodies were quantified via ELISA, while CRP and procalcitonin levels were measured using immunoturbidimetric and immunofluorescence assays. Additionally, anti-SARS-CoV-2 antibodies were evaluated using the ECLIA principle. Statistical analysis was performed using the Spearman rank correlation test. Fifty-six subjects were included in this study. The study found correlations between cortisol and prolactin levels and CRP (p=0.007, r=0.357; p=0.132, r=0.204) and procalcitonin (p=0.006, r=0.365; p=0.315, r=0.137). The correlations between cortisol and prolactin levels and IgM were p=0.163, r=-0.189; and p=0.299, r=-0.141. The correlations between cortisol and prolactin levels and IgG were p=0.017, r=-0.317, and p=0.207, r=-0.171. There is a weak positive correlation between cortisol levels and CRP and procalcitonin levels. There is a weak negative correlation between cortisol levels and anti-SARS-CoV-2 IgG.

Background: Breast cancer metastasis remains a major contributor to morbidity and mortality, partly due to the disease’s marked biological heterogeneity. Identification of reliable biomarkers associated with metastatic progression is essential for improving risk stratification and clinical management. Matrix metalloproteinase-2 (MMP-2) and routine hematological and metabolic parameters have been implicated in cancer progression, but their roles in breast cancer metastasis remain inconsistent across populations. Methods: This cross-sectional study evaluated general, hematological and metabolic parameters in breast cancer patients from Dr. Kariadi General Hospital, the main referral hospital for Central Java, Indonesia. Associations with metastasis were assessed using univariate analyses, followed by least absolute shrinkage and selection operator (LASSO) logistic regression for variable selection. Multicollinearity was assessed using variance inflation factor (VIF), and selected variables were entered simultaneously into a multivariable binary logistic regression model. Associations between selected hematological parameters and estrogen receptor (ER) and progesterone receptor (PR) status were also examined. Associations between clinicopathological variables and histologic grade were analyzed using the Kruskal–Wallis test. Results: Histologic grade was the only general characteristic significantly associated with metastasis ( P < 0.001). In univariate analysis, metastatic patients showed significantly higher MMP-2, WBC count, and SGOT levels, whereas lower MCV and uric acid levels were detected. Multivariable logistic regression identified MMP-2 ( P = 0.015; OR = 1.124, 95% CI: 1.023–1.236) and platelet count ( P = 0.047; OR = 0.973, 95% CI: 0.947–1.000) as independently associated with breast cancer metastasis. Platelet count was also significantly associated with ER status ( P = 0.039), but not with PR status ( P = 0.054). Kruskal–Wallis analysis demonstrated significant differences in MMP-2 and uric acid levels across histologic grades I–III. Conclusion: Elevated MMP-2 levels and reduced platelets were independently associated with breast cancer metastasis, while platelets were additionally associated with ER status. These findings suggest that MMP-2 and platelet count may serve as potential biomarkers associated with metastatic behavior and hormone receptor status in breast cancer.

Introduction: Chimeric antigen receptor T cell (CAR-T cell) therapy is an immunotherapy for acute leukemias utilizing recombinant receptors specific to antigens involved in T-cell function to direct tumor cell recognition and elimination. However, major limitations include relapse due to antigen escape and tumor heterogeneity, as well as on-target off-tumor effects. Bispecific CAR-T cells are developed to overcome these issues. Method: A literature search was conducted to identify relevant articles using three databases (PubMed, Scopus, ProQuest) between 2016 and 2025. Studies written in English and in vivo , in vitro , and clinical trial research designs were included. Articles without complete data and case reports were excluded. The systematic review followed PRISMA guidelines. Results: Nine studies were included in the final synthesis. Bispecific CAR-T cell therapy was superior in tumor eradication and limiting adverse effects in both AML and ALL. CARs used in AML often targeted CD123 and CD33; development of more diverse targets, including cell signaling of tumor growth (FLT3, NKG2D, TIM3, FRβ), addressed heterogeneity. CD19 was the most common CAR in ALL, additionally targeting CD22, CD20, and BAFF-R; addressing CD19-negative relapse was quite common. Phase I clinical trials were done for CD19/CD22 bispecific CAR-T cells, proving effective with low incidence of cytokine release syndrome, neurotoxicity, or other adverse effects. Preclinical trials showed that bispecific CAR-T cells had longer in vivo persistence. Conclusion: Bispecific CAR-T cell therapy is more effective in managing acute leukemias than conventional CAR-T cells. Future research should focus on developing diverse targets and advancing into clinical trials. Systematic Review Registration: Open Science Framework (OSF) Registries https://osf.io/ , registration DOI: https://doi.org/10.17605 .

Background/Objectives: Contralateral breast cancer (CBC) is a significant concern among breast cancer survivors, particularly in those with moderator-high penetrance germline mutations such as BRCA1, BRCA2, CHEK2, and ATM. While radiotherapy (RT) is a crucial component of breast cancer (BC) treatment, its potential role in increasing CBC risk remains unclear. This systematic review and meta-analysis aim to evaluate the incidence of radiation-induced CBC in germline mutation carriers. Methods: Following PRISMA guidelines, we conducted a comprehensive search in six electronic databases (PubMed, Scopus, Cochrane Library, ProQuest, EBSCO, and Epistemonikos) for studies published fifteen years prior, up to August 2025. We included cohort and case–control studies assessing the association between RT and CBC incidence in germline mutation carriers. A meta-analysis was performed using a random-effects model to estimate cumulative risk (CR) and rate ratios (RR). Results: Seven studies were included. The 5-year cumulative risk (CR) of contralateral breast cancer (CBC) was 0.55 for BRCA1/2, 0.89 for ATM, and 0.80 for CHEK2 carriers. At 10 years, overall CR increased to 0.65, with ATM and CHEK2 remaining high. Rate ratio (RR) analysis showed a significant risk for ATM (2.98), while overall RR indicated more than a two-fold increased CBC risk with radiotherapy (RR = 2.70 common-effect; 2.53 random-effects). Conclusions: Radiotherapy significantly increases contralateral breast cancer risk, particularly in ATM and CHEK2 carriers, emphasizing the importance of personalized genetic risk stratification in treatment decisions.

Background: Type 2 diabetes mellitus (T2DM) is one of the degenerative diseases that continues to increase. Diabetes is one of the three biggest causes of death in Indonesia in 2017. This burden is exacerbated by the presence of uncontrolled diabetes cases, which have a negative impact on almost every system of the human body. Coagulopathy, which is defined as a disorder of the blood clotting process, is one of the clinical manifestations of uncontrolled T2DM. Chronic hyperglycemia in T2DM can affect the hypercoagulation process which includes changes in platelet activation time, endothelial cell function, and fibrinolysis. Objective: To determine and analyze the differences in coagulation and fibrinolysis profiles of controlled and uncontrolled T2DM patients. Method: The design of this study was cross-sectional with a target population of adult T2DM patients at the Diponegoro National Hospital in Semarang City. Data collection on respondents includes filling out questionnaires and taking blood samples to examine the coagulation and fibrinolysis profiles and Hba1C levels of respondents Results: There were no abnormalities in prothrombin time (PT) and activated partial prothrombin time (APTT) values in the two groups of this study and there was also no difference in the mean values of PT and APTT between the two groups in this study. Increased D-dimer concentrations occurred in both groups but there was no significant difference between the two groups (p > 0.05). Conclusion: There was no significant difference in PT, APTT, and D-dimer values in the two groups of the study.

Diabetes mellitus is associated with an increased risk of several malignancies, driven by shared pathophysiological mechanisms including chronic inflammation, oxidative stress, insulin resistance, and dysregulated growth factor signaling. This study adopts a narrative and mechanistic review design, synthesizing evidence from preclinical and selected clinical studies to examine how marine-derived nutraceutical compounds potentially modulate molecular pathways implicated in diabetes-induced carcinogenesis. The review focuses on key bioactive classes, including marine polysaccharides (e.g., fucoidan and alginate), omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid), polyphenols (fucoxanthin and phlorotannins), and marine peptides. Across experimental models, these compounds have been consistently associated with reduced markers of oxidative stress, suppression of pro-inflammatory mediators (e.g., NF-κB and IL-6), and modulation of insulin-related pathways such as IGF-1/PI3K/Akt and MAPK signaling. Reported effects include reductions in reactive oxygen species levels, downregulation of inflammatory cytokine expression, and improved metabolic biomarkers in in vitro and animal models. However, the evidence remains largely preclinical, with substantial heterogeneity in compound composition, dosing, and bioavailability across studies. Consequently, direct clinical efficacy cannot be inferred. Key limitations include reliance on experimental models, limited quantitative comparability across studies, and translational barriers related to standardization, pharmacokinetics, and long-term safety. Overall, this review provides a mechanistic framework that may inform future translational and clinical investigations, while underscoring the need for rigorously designed human studies.

Objective: To evaluate the diagnostic performance and determine the optimal cutoff values of the triglyceride-to-high-density lipoprotein cholesterol ratio and lipid accumulation product index as predictors of metabolic syndrome among adults with obesity in Indonesia. Materials and methods: This cross-sectional study analyzed secondary data from the 2023 Indonesia Health Survey, which included 3,988 samples (2,958 women). Descriptive statistics were used to characterize the sample. Receiver Operating Characteristic curve analysis and the Youden index were employed to assess diagnostic performance and [...] ABSTRACT Objective: To evaluate the diagnostic performance and determine the optimal cutoff values of the triglyceride-to-high-density lipoprotein cholesterol ratio and lipid accumulation product index as predictors of metabolic syndrome among adults with obesity in Indonesia. Materials and methods: This cross-sectional study analyzed secondary data from the 2023 Indonesia Health Survey, which included 3,988 samples (2,958 women). Descriptive statistics were used to characterize the sample. Receiver Operating Characteristic curve analysis and the Youden index were employed to assess diagnostic performance and

Iron deficiency, commonly indicated by low ferritin concentrations, remains a major nutritional problem among adolescent girls and poses risks to growth, cognitive development, and long-term health. While previous studies have largely focused on single nutrients or iron intake, evidence on the relationship between overall dietary patterns and ferritin status among Indonesian adolescents is limited. This study aimed to examine the association between dietary patterns and ferritin status among adolescent girls in Pekalongan, Indonesia. A cross-sectional study was conducted among 80 adolescent girls aged 15–19 years. Serum ferritin levels were measured using ELISA, and dietary patterns were derived using pattern-based dietary assessment. Age, nutrition knowledge, body mass index, physical activity, and hemoglobin concentration were also examined as potential correlates. Dietary pattern was significantly associated with ferritin status, with poorer dietary patterns linked to lower ferritin concentrations. In contrast, no significant associations were observed for body mass index, physical activity, hemoglobin levels, or other individual characteristics, suggesting that overall dietary quality may play a more prominent role in iron stores than single anthropometric or behavioral factors. Given the cross-sectional design and modest sample size, causal inference and generalizability are limited. Nevertheless, the findings highlight the potential value of improving dietary quality through adolescent-focused nutrition education and school-based nutrition strategies to support iron status and reduce the risk of iron deficiency in this population.

Background: Obesity is increasingly recognized as a metabolic disorder driven by gut microbiota dysbiosis and chronic low-grade inflammation within adipose tissue. Emerging evidence highlights the gut–adipose tissue axis as a critical mediator of energy balance and metabolic regulation. Marine algae—rich in polysaccharides, polyphenols, and carotenoids—offer bioactive compounds that modulate gut microbial composition and generate beneficial metabolites termed “postbiotics.” Objective: This review aims to comprehensively summarize current advances in understanding how marine-algal-derived postbiotics influence the gut microbiota–adipose tissue axis and contribute to obesity prevention and management. Methods: A structured literature search was conducted across PubMed, Scopus, Web of Science, ScienceDirect, and SpringerLink for studies published between 2015 and October 2025. Eligible studies included in vitro, in vivo, and human trials examining the effects of marine-algal compounds on gut microbiota composition, short-chain fatty acid (SCFA) production, adipose inflammation, and metabolic outcomes. Results: Marine-algal polysaccharides (fucoidan, alginate, laminarin, carrageenan, and ulvan) act as fermentable fibers that enhance SCFA production and enrich beneficial taxa such as Akkermansia, Lactobacillus, and Bacteroides, while reducing endotoxin-producing bacteria. Polyphenols and carotenoids (fucoxanthin, phlorotannins, astaxanthin) directly target adipogenesis, oxidative stress, and adipose browning. Animal studies consistently demonstrate reduced body weight, improved insulin sensitivity, and decreased inflammation following algae supplementation. Human trials—though limited—confirm safety and show microbiota modulation with modest weight loss. Conclusions: Marine-algal-derived postbiotics represent a promising, natural, and sustainable strategy to target the gut microbiota–adipose tissue axis in obesity. They offer multi-targeted mechanisms through microbial and host pathways, supporting their integration into functional food and nutraceutical development. Further clinical research and regulatory standardization are warranted to translate these findings into evidence-based interventions.