A  decrease in high-density lipoprotein (HDL) happens in type 2 diabetes mellitus. The cytokines TNFa and IL-6 are proinflammatory cytokines that are elevated in the blood in many patients with DM. Turmeric is one of the natural ingredients with antioxidant, anti-cholesterol, and anti-inflammatory properties through its active substance, curcumin. Objective: To prove the effectiveness of the combination of metformin and turmeric extract on HDL levels, TNFa levels, and IL-6 levels in Streptozotocin-Nicotinamide-induced Wistar rats. Methods: The study used a post-test-only controlled group design. The subjects were 24 male Wistar rats which were randomly divided into four groups, namely K1, K2, P1, and P2. The whole group was a type 2 DM model induced by streptozotocin-nicotinamide. Group K2 was given metformin 45mg/KgBW/day, group P1 was given turmeric extract at a dose of 200 mg/KgBW/day, and group P2 was given a combination of metformin and turmeric extract. On day 15, blood was drawn for HDL, IL-6, and TNFa examination. The data were analyzed using the one-way Anova test. Results: The mean HDL level in the P2 group (72,4±33,31) was the highest compared to the other three groups. The lowest mean TNFa level among the four groups was the P2 group (7,56±0,44). The lowest mean levels of IL-6 were obtained in the P2 group (58,82±2,15). One-way Anova test on HDL, IL-6, and TNFa levels showed a significant difference between groups with p-value = 0.000. Conclusion: The combination of metformin and turmeric extract can increase HDL levels and reduce IL-6 levels and TNFa levels better than giving metformin or turmeric extract alone.Keywords:  turmeric extract, HDL, IL-6, TNFa

Background Secretory IgA (sIgA) content of breastmilk in the first postpartum month is a reflection of the pregnant woman's immune response to environmental antigen exposure. The role of secretory IgA in breastmilk is to protect and support the development of the neonatal immune response in early life. Objective To examine possible factors associated with sIgA levels in breastmilk and colostrum, including environmental exposure, food consumed, maternal history of atopy, and the appearance of allergic symptoms in infants. As a secondary objective, we determined the association between infant factors (IgE, exposure to cigarette smoke) and maternal factors (sIgA, maternal allergies) with infant allergies. Methods This prospective cohort study of 80 postpartum mothers and their infants was conducted at Sultan Agung Islamic Hospital, Semarang. We collected maternal colostrum on the second or third postpartum day and mature milk between the 22nd to 25th postpartum day. Exposure factors to mothers and infants in the final trimester of pregnancy up to one month postpartum was recorded through a questionnaire and home visits. The infant’s IgE level was measured at 4 months of age. Results Mean colostrum sIgA was 108.9 (SD 16.5) mg/dL (95%CI 97.9 to 121.1 mg/dL) and mean mature milk sIgA was 94.1 (SD 23.9) mg/dL (95%CI 89.1 to 99.2 mg/dL). Mean colostrum sIgA levels were higher in mothers exposed to cigarette smoke [119.1 (SD 1.7) vs. 92.9 (SD 1.5) mg/dL; P=0.026] and frequent infections [128.2 (SD 1.7) vs. 95.9 (SD 1.6) mg/dL; P=0.007] compared to that in unexposed mothers. Mean colostrum sIgA was also higher in mothers with atopic allergy than in those without (136.8 mg/dL vs. 99.3 mg/dL; p=0.017) and in mothers of infants with IgE levels >29 IU/ml than in mothers of infants with IgE levels <29 IU/mL (136.8 vs. 101.2 mg/mg/dL; P=0.045). Elevated colostrum sIgA (>136.8 mg/dL) was not associated with allergies in the infants (P=0.269). Conclusions Maternal atopic allergy and frequent infections are associated with increased colostrum sIgA levels. Breastmilk sIgA levels are not associated with allergies in the infant. Maternal exposure to antigens may stimulate the production of specific breastmilk sIgA.

In type 2 diabetes mellitus, lipid profile is often found in the form of high-density lipoprotein (HDL) decrease. TNFa and IL-6 are proinflammatory cytokines that are elevated in the blood in many patients with diabetes mellitus. Turmeric is one of the natural ingredients that has anti-cholesterol and anti-inflammatory effects through the work of its active substance, curcumin. This study aimed to evaluate the effect of turmeric extract combined with metformin on HDL, TNFa, and IL-6 levels in diabetic rats. Twenty-four Wistar rats were injected intraperitoneally with streptozotocin and niacinamide. The diabetic rats then were divided into four groups; control group, metformin group, turmeric group, and combination group. The dose of metformin and turmeric which were given, respectively, 45mg/KgBW/day and 200 mg/KgBW/day. While the combo group was given half dose of each. Blood serum was taken to examine the HDL, IL-6, and TNFa levels. The levels of HDL, IL-6, TNFa on diabetic rats that received the combination of metformin and turmeric extract (p0.05) were the best among of all the groups. This means that the combination of metformin and turmeric is better in increasing HDL, reducing IL-6, and TNFa levels better than metformin or turmeric extract alone.