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Doctor of Medicine Study Proves the Effect of Vitamin D and Aerobic Exercise on Inflammatory Markers in Obesity Sufferers
Doctor of Medicine Study Proves the Effect of Vitamin D and Aerobic Exercise on Inflammatory Markers in Obesity Sufferers
Located in the Hall, Fl. 4, Udayana University Postgraduate Building, Denpasar, the Doctoral Promotion exam took place with the promovendus candidate, dr. Putu Adi Suputra, S.Ked, M.Kes, with the dissertation title "The Effect of Giving Vitamin D and Moderate Intensity Continuous Training on Levels of Tumor Necrosis Factor Alpha, Interleukin-6 and Leptin in Obesity Sufferers." (27/6/2024)
Obesity is often associated with low serum 25(OH)D (vitamin D), which is associated with insulin resistance and metabolic abnormalities. Obesity causes an increase in TNF-α, IL-6 and leptin. Exercise is one of the therapies for treating obesity by reducing adipose tissue. Several in vitro studies consistently state that the active form of vitamin D is (1,25 (OH)2D), inhibiting the expression of pro-inflammatory cytokines. However, human intervention studies are still controversial and inconsistent. The aim of this study is to prove the effect of giving vitamin D in moderate intensity continuous training on TNF-α, IL-6 and leptin which causes a reduction in chronic low-grade inflammation in the pathomechanism of obesity.
This research is a true experimental study using a randomized pre and post-test control group design. The sample consisted of 36 subjects, 18 subjects as treatment (MICT and vitamin D) and 18 subjects as control (MICT). The research lasted for 12 weeks. Aerobic exercise is carried out for 60 minutes with a frequency of 3 times a week, with an intensity of 64-75% of the maximum pulse. The vitamin D given is cholecalciferol at a dose of 5000 IU. Data analysis used the independent t-test and non-parametric Mann-Whitney statistics for the difference test between 2 unpaired samples. To test the difference between two paired samples, the paired t-test, the non-parametric Wilcoxon Signed Rank Test, were used. The effect size test is used to find out how much influence the independent variable has on the dependent variable.
The results of this study were that there was a decrease in TNF-α in the treatment group (Δ-17.5%) compared to the control group (Δ-5.5%) but this was not statistically significant (p>0.05). A decrease in IL-6 also occurred in the treatment group (Δ-8.8%), compared to the control (Δ-5.9%) but was not statistically significantly different (p>0.05). Meanwhile, in leptin, there was a statistically significant decrease in the treatment group (Δ-20.24%) compared to the control (Δ2.2%) with a p value < 0.05. After carrying out Cohen's effect size test, the value was 0.85, which means that there is a strong influence of the intervention on leptin.
The conclusion of this study is that there is no effect of giving vitamin D and MICT on TNF-α and IL-6. There is an effect of giving vitamin D and MICT on reducing leptin. The possible mechanism for decreasing leptin that occurs when administering vitamin D 5000 IU and MICT is by inhibiting the NF-kB pathway, suppressing leptin secretion and decreasing adipose tissue. Future research requires larger doses of vitamin D and longer exercise.
This exam was led by the Coordinator of the Medical Science Doctoral Study Program, Faculty of Medicine, Udayana University, Dr. Dr. I Made Sudarmaja, M.Kes., with the examining team:
1. Prof. Dr. dr. I Made Jawi, M.Kes (Promoter)
2.Dr. Dr. Susy Purnawati, M.KK (Copromotor I)
3.Dr. Dr. I Made Muliarta, S.Ked., M.Kes (Copromotor II)
4. Prof. Dr. Dr. I Made Bakta, Sp.PD-KHOM
5. Prof. Dr. Dr. I Putu Gede Adiatmika, M.Kes
6. Prof. Dr. Dr. I Wayan Putu Sutirta Yasa, M.Si
7.Dr. Dr. Luh Putu Ratna Sundari, M. Biomed
8.Dr. Dr. I Gusti Putu Suka Aryana, Sp.PD, K-Ger, FINASIM
9.Dr. Dr. Ni Luh Kadek Alit Arsani, S.Ked., M.Biomed
10. dr. I Wayan Sumardika, S.Ked., M.Med.Ed., Ph.D
Meanwhile, academic invitations are:
1.Dr. Dr. I Made Krisna Dinata, M.Erg
2. Dr. dr. Nila Wahyuni, M.Fis
3.Dr. Dr. Made Kurnia Widiastuti Giri, M.Kes, PGDipl.MTHM
4.Dr. Dr. Made Budiawan, S.Ked., M.Kes
5.Dr. Dr. Ketut Indra Purnomo, M.Kes
In this exam, Dr. Dr. Putu Adi Suputra, S.Ked, M.Kes, was declared to have graduated as the 420th Doctoral Graduate of the Medical Science Doctoral Study Program, Faculty of Medicine, Udayana University with Cumlaude predicate
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