Background. The lifestyle modification (LSM) programs program addresses diet, exercise, stress management, and nutritional depletion using cognitive-behavioral approaches to improve the causes of chronic disease. The purpose of the study is to evaluate the effect before and after three months of LSM on lipid profile and body weight parameters of obese subjects Method. The participants of age 25-50 years recruited through personal contact consisted of 20 obese subjects who appeared to engage in diet and regular exercise (get at least 150 minutes of exercise a week). The types of physical exercise aerobic (walking, swimming, jogging) were included in the study. The anthropometric measurements and blood sample was taken before and after three months of LSM. Height (m) is measured using a wall-mounted height bar and body weight (kg) is measured using a scale and its value is used in BMI calculations. The serum of profile lipid was determined by enzymatic colorimetric method and sd-LDL examination was performed indirectly in which the ratio of LDL /Apolipoprotein B.                                                     Result. After 3 months of LSM, there was a significant decrease in serum LDL, ApoB, BMI, WC, and FPG (p < 0.05) in the obese subject. However, no significant difference was observed in TG, HDL, sd-LDL, PPG, and HbA1C (p>0.05).                        Conclusion. Lifestyle modification of obese subjects for three months can decrease parameters of body weight and profiles lipids, which means it can prevent cardiovascular diseases.

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Introduction: The prognosis of HIV had changed dramatically from a deadly infectious disease into a manageable infection. Initiation of ARV, especially protease inhibitor, was thought to be associated with metabolic abnormalities. Weight gain in HIV could be a positive indicator for better prognosis. However, excessive weight gain was associated with deleterious effects. Studies regarding protease inhibitor in weight gain had different results. In this study, we intend to identify association of PI therapy duration with BMI. Methods: We conducted a cross-sectional study in Adam Malik Hospital, Medan from August to December 2019. We recruited HIV patients above 18 years old during the outpatient with at least 6-month duration of PI therapy. During visits, patients were screened for inclusion criteria and assessed for BMI. Fasting blood glucose and insulin plasma sample were taken in the morning. Data was analysed by SPSS 22.0. Results: Thirty-five subjects fulfilled inclusion criteria, 25 of subjects were males (71.4%). Mean age of subjects was 38.85 ± 9.7 years. Data analysis presented that there were no significant differences between two groups of treatment (24.33 ± 3.3 kg/m2 vs 24.39 ± 5.0 kg/m2; p = 0.966). There were significant differences between two groups regarding fasting blood glucose level (84.4 ± 6.8 mg/dL vs 114.9 ± 53.6 mg/dL; p = 0.015) and fasting insulin level (7.28 ± 3.4 µU/mL vs 26.01 ± 23.5 µU/mL; p = 0.000). Conclusion: BMI was not associated with duration of PI therapy in our study. Fasting blood glucose and fasting insulin were significantly higher between groups. Keywords: HIV, protease inhibitor, BMI, insulin, obesity, weight gain.

Abstract. Introduction. Diabetes Melitus (DM) can cause complications, such as pulmonary tuberculosis (TB). Metabolic disorders are thought to be related to Tumor Necrosis Factor-α (TNF-α) metabolism, adipocytokines secreted by macrophages, which inhibit insulin transduction, has anti-mycobacterial activity, however, also negatively affect pathological TB process. This study aims to determine differences in TNF-α levels and Body Mass Index (BMI) in DM with pulmonary TB after intensive phase of antituberculosis treatment. Method. This prospective comparative analytical study with one-group pretest-posttest design, conducted during August 2019-September 2019 in outpatient of Type 2 DM with pulmonary TB at USU Hospital, Madani Medan Hospital, Teladan Health Center and Laboratory of Haji Adam Malik Medan after approval from the Health Research Ethics Commission. Data were analyzed after normality test, then mean difference and correlation test by using the SPPS program where p <0.05 was considered significant. Results. This study showed an increase BMI, and decrease of fasting blood glucose, 2-hour post-prandial blood glucose, HbA1C and TNFα levels before and after intensive phase of antituberculosis treatment (p = 0,000; p = 0,000; p = 0,000; p = 0,000).  Conclusion. There was a significant increase of BMI and decrease of TNFα level after intensive phase of antituberculosis treatment.

Metabolic diseases related to Human Immunodeficiency Virus (HIV) caused an increase in the workload of health services. Prevalence of HIV infection in Indonesian provinces varied considerably, ranging from less than 0.1% to 4%. Several studies have analyzed the correlation between insulin resistance and the usage of antiretroviral drugs, especially protease inhibitors. The main mechanism that responsible for insulin resistance is related to glucose transporter inhibition (GLUT4). This study objective is to assess the correlation between prolonged administration of protease inhibitors and insulin resistance in patients with that have diagnosed with HIV. Method. This research is an observational research using a cross-sectional design. The study was carried at the POSYANSUS Polyclinic at H. Adam Malik General Hospital in August - December 2019. The study sample were 34 HIV-treated patients receiving protease inhibitor ARV therapy. The study was analysed using chi square. Results. The characteristics of the study subjects had the most frequent age range at the age of 34 - 49 years (54.3%), men (71.4%) and women (28.6%). The longest use of antiretroviral drugs is most in the 6-12 months group (60%). Insulin resistance number in this study was 13 people (37.1%). The average HOMA-IR value of the study subjects was 2 (0.8-16.5), fasting blood sugar levels were 86 (70-283) mg / dl, fasting insulin levels were 9.1 (4.1-79.4) (µU / ml)., urea levels of 20.88 ± 9.7 mg / dl and creatinine levels of 0.81 ± 0.15 mg / dl. There was a significant correlation between the duration of ARV treatment with insulin resistance (p = 0.018; OR 7.65) Conclusion. There is a significant correlation between the duration of ARV treatment with insulin resistance. The longer Protease Inhibitor was used, the bigger insulin resistance.