ORIGINAL ARTICLE

The Effect of Overnutrition Toward the Risk of Dengue Shock Syndrome in Pediatric Patient: In-Depth Investigation of sVCAM-1 and Adiponectin Level

Ni Kadek Elmy Saniathi , Bambang Udji Djoko Rianto, Mohammad Juffrie, Soetjiningsih .

Ni Kadek Elmy Saniathi
Postgraduate Student of Faculty of Medicine Gadjah Mada University Faculty of Medicine and Health Warmadewa University. Email: elmye84@gmail.com

Bambang Udji Djoko Rianto
Ear, Nose, and Throat-Head and Neck Department Faculty of Medicine Gadjah Mada University/Sardjito General Hospital

Mohammad Juffrie
Pediatric Department Faculty of Medicine Gadjah Mada University/Sardjito General Hospital

Soetjiningsih .
Pediatric Department Faculty of Medicine Gadjah Mada University/Sardjito General Hospital
Online First: April 15, 2018 | Cite this Article
Saniathi, N., Rianto, B., Juffrie, M., ., S. 2018. The Effect of Overnutrition Toward the Risk of Dengue Shock Syndrome in Pediatric Patient: In-Depth Investigation of sVCAM-1 and Adiponectin Level. Bali Medical Journal 7(1): 244-248. DOI:10.15562/bmj.v7i1.912


Introduction: Overnutrition has become an emergent health problem worldwide and could signifcantly alter the normal human physiology. It still unknown how overnutrition could affect the
outcome of pediatric patient with dengue infection. This study aimed to unveil how overnutrition affects the risk of dengue shock syndrome (DSS) in dengue pediatric patient by evaluating the adiponectin which has immune-modulatory property and the inflammation
marker sVCAM-1.


Methods: An analytic observational nested case-control study was conducted in Paediatric Division Sanglah General Hospital, Bali, Indonesia from January 2015 to October 2016. Initially, patient’s anthropometric parameters were measured and the diagnosis of the
dengue infection was established according to the medical record and blood plasma was isolated to determine the level of adiponectin and sVCAM-1.


Result: The study showed that overnutrition increased the risk of DSS as much as 2.67 times greater than normal but it was not statistically signifcant (95%CI: 0.72 - 9.95). The mean level of sVCAM-1 was observed to be higher in overnutrition patients in almost all categories
of dengue infection, but none is statistically signifcant. However, its level appears to be lower in over nutritious DSS patients compared to their non-DSS counterparts (4638.64 (±934.99) vs. 5680.80 (±601.77); P = 0.013). The adiponectin level was found to be consistently lower
in patients with overnutrition regardless the category of dengue infection, but signifcant differences only observed in over nutritious DHF and overnutritious non-DSS comparisons.


Conclusion: It can be concluded that overnutrition increase the risk of DSS in pediatric patient with dengue infection whether it was not statistically signifcant. The lower level of adiponectin and elevated expression of sVCAM-1 could be the explanation of this phenomenon.

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