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BackgroundUncoupling protein 2 (UCP2) gene polymorphisms have been reported as genetic risk factors for obesity and type 2 diabetes mellitus (T2DM). We examined the association of commonly observed UCP2 G(−866)A (rs659366) and Ala55Val (C > T) (rs660339) single nucleotide polymorphisms (SNPs) with obesity, high fasting plasma glucose, and serum lipids in a Balinese population.MethodsA total of 603 participants (278 urban and 325 rural subjects) were recruited from Bali Island, Indonesia. Fasting plasma glucose (FPG), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were measured. Obesity was determined based on WHO classifications for adult Asians. Participants were genotyped for G(−866)A and Ala55Val polymorphisms of the UCP2 gene.ResultsObesity prevalence was higher in urban subjects (51%) as compared to rural subjects (23%). The genotype, minor allele (MAF), and heterozygosity frequencies were similar between urban and rural subjects for both SNPs. All genotype frequencies were in Hardy-Weinberg equilibrium. A combined analysis of genotypes and environment revealed that the urban subjects carrying the A/A genotype of the G(−866)A SNP have higher BMI than the rural subjects with the same genotype. Since the two SNPs showed strong linkage disequilibrium (D’ = 0.946, r2 = 0.657), a haplotype analysis was performed. We found that the AT haplotype was associated with high BMI only when the urban environment was taken into account.ConclusionsWe have demonstrated the importance of environmental settings in studying the influence of the common UCP2 gene polymorphisms in the development of obesity in a Balinese population.

a b s t r a c tBackground/Purpose: The purpose of this study is to examine the association between age and metabolic disorders in the population of Bali. Method: A cross-sectional study was conducted on metabolic syndrome (MS) as defined on the basis of recommended parameters for diagnosis of the syndrome in the population of seven villages of Bali comprising six villages and one suburban area. At least three of the five parameters must be present for the diagnosis. Three hundred ten elderly people aged 60 years or more, with a male:female ratio of 168:142, of 1840 subjects were recruited in the study. The criteria for obesity were based on the 2000 World Health Organization recommendations for Asia Pacific population, for prediabetes [impaired fasting glycemia (IFG) and impaired glucose tolerance] and diabetes mellitus (Results: The prevalence of IFG and DM were twofold in the elderly as compared with those in the younger-aged groups (21.4 vs. 11.7; 11.7 vs. 4.8, respectively). Blood pressure and fasting blood sugar levels were higher in the elderly than in the younger-aged group (133/81 mmHg vs. 117/76 mmHg; 102.7 mg/dL vs. 93.0 mg/dL, respectively; p < 0.001). There was no statistically significant difference in triglyceride and high-density lipoprotein cholesterol levels between both groups. Waist circumferences were lower among the elderly than among younger-aged groups (75.8 cm vs. 80.9 cm; p < 0.001). The elderly, with lower waist circumference, revealed significantly higher prevalence of MS as compared with the younger-aged group {22.9% vs. 17.3%; p ¼ 0.026; prevalence risk 1.423 [confidence interval (CI) ¼ 1.043-1.944]}. The subjects who had 1, 2, 3, 4, and 5 components of MS were 34.6%, 23.8%, 13.0%, 4.3%, and 0.9%, respectively. The prevalence risk of each component of MS for the occurrence of MS were: elevated triglyceride [30.2 (CI ¼ 14.5-63.1)], elevated fasting blood sugar )], increased waist circumference [8.1 (CI ¼ 4.3-15.0)], reduced high-density lipoprotein cholesterol [4.4 (CI ¼ 2.4-7.9)], and elevated blood pressure [3.7 (CI ¼ 1.9-7.2)].Conclusions: It could be inferred that in comparison with the younger-age group, the elderly had higher (twice) prevalence of IFG and DM, lower prevalence of central obesity, but higher prevalence of MS. Old age (60 years and more) had 1.4-fold risk for MS as compared with that in the younger-aged group, and elevated triglyceride levels appeared to be the most important risk factor for MS.

A study on the prevalence of coronary heart disease (CHD) and its risk factors in Ceningan Island was conducted. The prevalence of CHD was 11.5%. Older age (odds ratio, OR, 27.0), underweight (OR, 3.6), systolic hypertension (OR, 4.6), high total cholesterol (OR, 5.9), and high low-density lipoprotein cholesterol (OR, 3.1) were risk factors for a history of myocardial infarction (MI). By logistic regression analysis, only age (B=3.937) and underweight (B=1.275) consistently appeared to be risk factors for MI. The prevalence of CHD in the population was comparatively high.

Aims/Introduction. To know the prevalence of obesity, metabolic syndrome, impaired fasting glycemia and diabetes in the population of Bali.Materials and Methods. A cross-sectional study enrolling 1840 subjects, aged 13-100 years with male-to-female ratio of 972/868, were studied at seven villages across the island of Bali.Results: The prevalence of central obesity was 35% (male, 27.5%; female, 43.4%); metabolic syndrome (MS), 18.2% (male, 16.6%; female, 20.0%); impaired fasting glycemia (IFG), 13.1% (male, 14.3%; female, 12.4%); and diabetes mellitus (DM), 5.9% (male, 6.1%; female, 5.7%). The subjects who had 1, 2, 3, 4, and 5 components of MS were 34.6%, 23.8%, 13.0%, 4.3%, and 0.9% respectively. The population in two tourist areas (Legian and Ubud) had the highest prevalence of central obesity (61.2% and 70.1%), but they did not necessarily have a higher prevalence of DM. The two tourist areas (Legian, 24.1%; and Ubud, 21%) as well as Sangsit village (23.3%) have the highest prevalence of MS.Conclusions. The prevalence of obesity, MS, IFG and DM were comparatively low. Analysis across the villages revealed that higher prevalence of central obesity was not necessarily associated with higher prevalence of DM. There is a need to further study the risk of obesity on MS and DM in tourist areas of Bali.

Transcription factor 7-like 2 (TCF7L2) protein plays an important role in glucose and lipid metabolisms. Single nucleotide polymorphisms (SNPs) in the TCF7L2 gene contribute to increased fasting plasma glucose (FPG) and body mass index (BMI), and altered lipid concentrations in various population. We investigated whether the TCF7L2 SNPs were associated with obesity, high FPG and altered lipid profile in the Balinese. A total of 608 Balinese from rural and urban Bali, Indonesia, were recruited. Triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and FPG were measured, and BMI was calculated. Ratios of TG/HDL-C, LDL-C/HDL-C, and TC/HDL-C were determined. Genotyping of SNPs rs7903146, rs10885406, and rs12255372 were done in all samples. Genetic association analyses under a dominant model showed that the rs7903146 (OR 5.50, 95% CI 2.34-12.91, p = 8.5 × 10), rs12255372 (OR 4.15, 95% CI 1.66-10.33, p = 0.003) and rs10885406 (OR 2.43, 95% CI 1.39-4.25, p = 0.003) were significantly associated with high TC/HDL-C ratio. The rs10885406 also presented a significant association with high TG (OR 2.21, 95% CI 1.29-3.81, p = 0.004) and low HDL-C (OR 3.02, 95% CI 1.58-5.80, p = 0.001) concentrations, as well as high TG/HDL-C ratio (OR 1.95, 95% CI 1.16-3.27, p = 0.013). None of the SNPs exhibited significant association with obesity or high FPG. SNPs in the TCF7L2 gene are associated with altered lipid profile in the Balinese.

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Latar belakang: Proses inflamasu pada pasien diabetes merupakan salah satu pathogenesis kejadian kardiovaskular. C-reactive protein (CRP) merupakan penanda inflamasi yang dapat digunakan untuk memprediksi penyakit-penyakit kardiovaskular. Data mengenai perbandingan efek insulin dan obat hipoglikemik oral (OHO) dalam menurunkan kaadr CRP masih kurang. Tujuan: Penelitian ini bertujuan untuk menentukan apakah kadar CRP pada pasien diabetes tipe melitus 2 dengan terapi insulin lebih rendah dibandingkan dengan pasien dengan OHO. Metode: Penelitian ini merupakan studi potong-lintang analitik yang melibatkan 75 pasien diabetes tipe 2 dengan insulin dan OHO dengan metode consecutive sampling. Kriteria eksklusi meliputi pasien dengan infeksi akut/sepsis, penyakit koroner, keganasan, penyakit ginjal kronik, penyakit hati, pasien yang menjalani terapi radiasi, perokok, dan pasien dengan terapi statin atau fibrat. Data dianalisis dengan t-test tidak berpasangan dan ANCOVA untuk meng-adjust variabel perancu. Hasil: Sebanyak 35 pasien (52%) dari total 75 pasien menggunakan insulin dan 36 (48%) menggunakan OHO. Rerata kadar CRP pada pasien diabetes tipe 2 yaitu 1,9 ± 2,08 mg/L. Rerata kadar CRP pada kelompok yang menggunakan insulin dan OHO sebesar 1.5 ± 1.78 mg/L dan 2,4 ± 2,30 mg/L (p = 0.04). Setelah penyesuaian terhadap variabel perancu, perbedaan kadar CRP antara kelompok yang menggunakan insulin dan OHO tetap signifikan (p = 0.02). Simpulan: Kadar CRP pada pasien diabetes tipe 2 dengan terapi insulin lebih rendah secara signifikan dibandingkan dengan menggunakan OHO.