PENGARUH PEMBERIAN DIET FLEKSITARIAN TERHADAP RASIO TRIGLISERIDA/HIGH DENSITY LIPOPROTEIN-CHOLESTEROL (TG/HDL-C) PADA MAHASISWI OBESITAS
DOI:
https://doi.org/10.21776/majalahkesehatan.2022.010.01.3Keywords:
diet fleksitarian, HDL-C, obesitas, rasio TG/HDL-C, trigliseridaAbstract
Mahasiswi memiliki kecenderungan mengonsumsi makanan tinggi energi dan tinggi lemak. Secara jangka panjang dapat menyebabkan obesitas dan perubahan profil metabolik yang meningkatkan resiko terjadinya penyakit kardiovaskular. Beberapa penelitian menunjukkan diet berbasis plant based diet efektif dalam menurunkan trigliserida (TG) dan meningkatkan HDL-C. Diet fleksitarian merupakan plant based diet yang sesekali masih diperbolehkan mengonsumsi daging dalam jumlah sedang. Penggunaan rasio TG/HDL-C terbukti lebih baik dibanding pemeriksaan lipid sederhana untuk mengetahui abnormalitas lipid aterogenik. Penelitian ini bertujuan untuk menganalisis pengaruh diet fleksitarian terhadap perubahan rasio TG/HDL-C. Desain penelitian ini adalah quasi experimental berupa pre-post group. Subjek merupakan mahasiswi obesitas berusia 19-25 tahun sebanyak 16 orang yang diambil dengan metode purposive sampling dan dibagi dalam dua kelompok yaitu kelompok perlakuan dan kelompok kontrol. Kelompok perlakuan diberikan edukasi gizi dan diet fleksitarian sebesar 1500 kkal setiap hari senin-jumat selama 4 minggu sedangkan kelompok kontrol hanya diberikan edukasi gizi. Asupan makan subjek selama intervensi diperoleh menggunakan food recall 24 jam sebanyak 3 kali/minggu dan aktivitas fisik menggunakan Physical Activity Questionnaire (IPAQ). Analisis statistik menggunakan independent t-test, mann whitney dan paired t-test. Hasil menunjukkan terdapat penurunan trigliserida sebesar 8,1 mg/dL dan HDL-C sebesar 2,4 mg/dL serta peningkatan rasio TG/HDL-C sebesar 0,01 pada kelompok perlakuan setelah diberikan diet fleksitarian tetapi tidak berbeda signifikan dengan sebelum intervensi (p>0,05). Antara kelompok kontrol dan kelompok perlakuan tidak terdapat perbedaan yang signifikan pada rerata perubahan TG, HDL-C dan rasio TG/HDL-C (p>0,05). Kesimpulannya, diet fleksitarian cenderung dapat menurunan trigliserida dan HDL-C serta meningkatan rasio TG/HDL-C pada mahasiswi obesitas.
References
Pakar Gizi Indonesia. Ilmu Gizi Teori dan Aplikasi. Hardinsyah dan Supriasa IDN (Editors). Jakarta: Penerbit Buku Kedokteran EGC; 2016.
World Health Organization. Obesity and Overweight. 2020. (Online). Available online. http://www.who.int/mediacentre/factsheets/fs311/zh/. Accessed December 6, 2020.
Kemenkes RI. Laporan Nasional RISKESDAS 2018. Jakarta: Lembaga Penerbit Balitbangkes. 2019.
Badan Penelitian dan Pengembangan Kesehatan. Laporan Provinsi JawaTengah Riskesdas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. 2019.
Nugroho PS. Jenis Kelamin dan Umur Berisiko terhadap Obesitas pada Remaja di Indonesia. An-Nadaa: Jurnal Kesehatan Masyarakat. 2020; 7(2):110-114. doi:http://dx.doi.org/10.31602/ann.v7i2.3581
Puspitasari N. Faktor Kejadian Obesitas Sentral pada Usia Dewasa. Journal of Public Health Research and Development. 2018; 2(2):249-259. doi:https://doi.org/10.15294/higeia.v2i2.21112
Hutasoit ES. Faktor yang Mempengaruhi Obesitas pada WUS di Wilayah Kerja Puskesmas Payung Sekaki Kota Pekanbaru. Journal of Midwifery Science. 2020; 4(1):25-33. doi:https://doi.org/10.36341/jomis.v4i1.1117
Nurramadhani SR, Dieny FF, Murbawani EA, Tsani AFA, Fitranti DY, Widyastuti N. Status Besi dan Kualitas Diet Berdasarkan Status Obesitas pada Wanita Usia Subur di Semarang. Amerta Nutrition. 2019: 3(4):247-256. doi:http://dx.doi.org/10.20473/amnt.v3i4.2019.247-256
Dieny FF, Widyastuti N, Fitranti DY, Niss C, Tsani AFA, Jauharany FF. Defisiensi Besi pada Wanita Usia Subur Pranikah Obesitas. Media Gizi Mikro Indonesia. 2019; 10(2):101-110. doi:https://doi.org/10.22435/mgmi.v10i2.599
Alia JK, Jim EL, Panda AL. Hubungan Rasio Trigliserida/High Density Lipoprotein-Cholesterol (TG/HDL-C) dengan Kejadian Infark Miokard Akut di RSUP Prof. Dr. RD. Kandou Manado. Medical Scope Journal. 2020; 1(2):14-18. doi:https://doi.org/10.35790/msj.1.2.2020.27460
Jafar N, Hasan N, Hadju V, Thaha R. Gender Aspect of Triglyceride, HDL, and Their Ratio in High School Teachers in Makassar City, Indonesia. l-Sihah: The Public Health Science Journal. 2020; 12(2):167-180. doi:https://doi.org/10.24252/al-sihah.v12i2.15911.
Giannini C, Santoro N, Caprio S, Kim G, Lartaud D, Shaw M, Pierpont B, Weiss R. The Triglyceride-to-HDL Cholesterol Ratio: Association with Insulin Resistance in Obese Youths of Different Ethnic Backgrounds. Diabetes Care. 2011; 34(8):1869-1874. doi:https://doi.org/10.2337/dc10-2234
Sultani R, Tong DC, Peverelle M, Lee YS, Baradi A, M.Wilson A. Elevated Triglycerides to High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio Predicts Long-Term Mortality in High-Risk Patient. Heart, Lung and Circulation. 2020; 29(3):414-421. doi:https://doi.org/10.1016/j.hlc.2019.03.019
Aguirre M, Briceño Y, Gómez-Pérez R, Zerpa Y, Camacho N, Paoli M. Triglycerides/High Density Lipoprotein Cholesterol Ratio as a Cardiometabolic Risk Marker in Children and Adolescents from Mérida city, Venezuela. Endocrinología. Diabetes y Nutrición. 2018; 65(2):74-83. doi:https://doi.org/10.1016/j.endien.2017.10.014
Chu S-Y, Jung J-H, Park M-J, Kim S-H. Risk Assessment of Metabolic Syndrome in Adolescents using the Triglyceride/High-Density Lipoprotein Cholesterol Ratio and the Total Cholesterol/High-Density Lipoprotein Cholesterol Ratio. Annals of Pediatric Endocrinology & Metabolism. 2019; 24(1):41-48. doi:10.6065/apem.2019.24.1.41.
Lelis D de F, Calzavara JVS, Santos RD, Sposito AC, Griep RH, Barreto SM, et al. Reference Values for the Triglyceride to High-Density Lipoprotein Ratio and Its Association with cardiometabolic Diseases in a Mixed Adult Population: The ELSA-Brasil study. Journal of Clinical Lipidology. 2021; 19(23):1-13. doi:https://doi.org/10.1016/j.jacl.2021.07.005
Wakabayashi I, Daimon T. Comparison of Discrimination for Cardio-Metabolic Risk by Different Cut-Off Values of the Ratio of Triglycerides to HDL Cholesterol. Lipids in Health and Disease. 2019;18(156):1-10. doi: https://doi.org/10.1186/s12944-019-1098-0.
Liu D, Guan L, Zhao Y, Liu Y, Sun X, Li H, et al. Association of Triglycerides to High-Density lipoprotein-Cholesterol Ratio with Risk of Incident Hypertension. Hypertension Research. 2020; 43(9):948–955. doi:https://doi.org/10.1038/s41440-020-0439-8
Nainggolan OH, Wulanjani HA. Hubungan Ratio Trigliserida/HDL-C dengan HbA1c pada Penderita Diabetes Melitus Tipe 2. Medica Hospitalia. 2018; 5(1):36-40. doi:https://doi.org/10.36408/mhjcm.v5i1.348
Jayanthi R, Srinivasan AR, Hanifah M, Maran AL. Associations among Insulin Resistance, Triacylglycerol/High Density Lipoprotein (TAG/HDL ratio) and Thyroid Hormone Levels—a Study on Type 2 Diabetes Mellitus in Obese and Overweight Subjects. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017; 11:121-126. doi:https://doi.org/10.1016/j.dsx.2016.12.020
Jauharany FF, Kartasurya MI, Kartini A, Dieny FF, Ratna D, Sawitri, et al. Dietary Acid Load Berhubungan dengan Sindrom Metabolik dan Kesehatan Mental pada Mahasiswi Obesitas. Jurnal Gizi Klinik Indonesia. 2021; 17(3):113-124. doi:https://doi.org/10.22146/ijcn.59033
Afifah Y, Sulchan M, Nissa C. Rasio Trigliserida/High Density Lipoprotein-Cholesterol pada Remaja Stunted Obesity Usia 15-18 Tahun di Kota Semarang. Journal of Nutrition College. 2017; 6(2):172-179.
Wijayanti A, Margawati A, Wijayanti HS. Hubungan Stres, Perilaku Makan, dan Asupan Zat Gizi dengan Status Gizi pada Mahasiswa Tingkat Akhir. Journal of Nutrition College. 2019; 8(1):1-8. doi:https://doi.org/10.14710/jnc.v8i1.23807.
Syarofi ZN, Muniroh L. Apakah Perilaku dan Asupan Makan Berlebih Berkaitan dengan Stres pada Mahasiswa Gizi yang Menyusun Skripsi?. Media Gizi Indonesia. 2020; 15(1):38-44. doi:oh. Media Gizi Indonesia. 202.15(1): 38–44 https://doi.org/10.204736/mgi.v15i1.
Anto EO, Owiredu, Adua E, Obirikorang C, Fondjo LA, Annani-Akollor ME, et al. Prevalence and Lifestyle-Related Risk Factors of Obesity and Unrecognized Hypertension among Bus Drivers in Ghana. Heliyon. 2020; 6(1):1-9. doi:https://doi.org/10.1016/j.heliyon.2019.e03147
Livingstone KM, And, McNaughton SA. Dietary Patterns by Reduced Rank Regression are Associated with Obesity and Hypertension in Australian Adults. British Journal of Nutrition. 2017; 117:248–259. doi:https://doi.org/10.1017/S0007114516004505.
Laufs U, Parhofer KG, Ginsberg HN, Hegele RA. Clinical Review on Triglyceride. European Heart Journal. 2020; 41(1):99-109. doi:https://doi.org/10.1093/eurheartj/ehz785.
Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, et al. Obesity, Adiposity, and Dyslipidemia: A Consensus Statement from the National Lipid Association. Journal of Clinical Lipidology. 2013; 7(4):304-384. doi:http://dx.doi.org/10.1016/j.jacl.2013.04.001
Blatner DJ. The Flexitarian Diet: The Mostly Vegetarian Way to Lose Weight, Be Healthier, Prevent Disease and Add Years to Your Life. McGraw-Hill; 2009. doi:10.1036/0071549579
Joshi S, Ettinger L, Liebman SE. Plant-Based Diets and Hypertension. American Journal of Lifestyle Medicine. 2020; 14(4):397-405. doi:https://doi.org/10.1177/1559827619875411.
Derbyshire EJ. Flexitarian Diets and Health: A review of the Evidance-Based Literature. Frontiers in Nutrition. 2017; 3(55):1-8. doi:https://doi.org/10.3389/fnut.2016.00055
Voinea L, Popescu DV, Negrea TM, Dina R. Nutrient Profiling of Romanian Traditional Dishes—Prerequisite for Supporting the Flexitarian Eating Style. Information Journal. 2020; 11(514):1-14. doi:https://doi.org/10.3390/info11110514
Picasso MC, Lo-Tayraco JA, Ramos-Villanueva JM, Pasupuleti V, Hernandez A V. Effect of Vegetarian Diets on the Presentation of Metabolic Syndrome or Its Components: A Systematic Review and Meta-Analysis. Clinical Nutrition Journal. 2019; 38(3):1117-1132. doi:https://doi.org/10.1016/j.clnu.2018.05.021
Wozniak H, Larpin1 C, de Mestral C, Guessous I, Reny J-L, Stringhini S. Vegetarian, Pescatarian and Flexitarian Diets: Sociodemographic Determinants and Association with Cardiovascular Risk Factors in a Swiss Urban Population. British Journal of Nutrition. 2020; 124:844-852. doi:https://doi.org/10.1017/S0007114520001762
Kemala AAIS, Wihandani DM, Wiryanthini IAD. Hubungan Asupan Zat Gizi dengan Profil Lipid pada Diet Vegetarian di Kota Denpasar. Jurnal Medika Udayana. 2021; 10(4):57-62. doi:10.24843.MU.2021.V10.i7.P11
Dunaief DM, Fuhrman J, Dunaief JL, Ying G. Glycemic and Cardiovascular Parameters Improved in Type 2 Diabetes with the High Nutrient Density (HND) Diet. Open Journal of Preventive Medicine. 2012; 2(3):1-8. doi:10.4236/ojpm.2012.23053
Thaochalee C, Sarikaputi A, Bumrungpech A, Chalermchai T, Nararatwanchai T. Anti-Inflammatory Effects of Plant-Based Thai Diets in Overweight and Obese Individuals. Songklanakarin Journal of Science and Technology. 2020; 43(3):840-846. https://web.p.ebscohost.com/ehost/detail/detail?vid=0&sid=fbeb51a6-000c-419c-97c6-a3603cfcbcef%40redis&bdata=JkF1dGhUeXBlPWlwLHNoaWImc2l0ZT1laG9zdC1saXZlJnNjb3BlPXNpdGU%3D#AN=151716490&db=asn
Najjar RS, Moore CE, Montgomery BD. A Defined, Plant-Based Diet Utilized in an Outpatient Cardiovascular Clinic Effectively Treats Hypercholesterolemia and Hypertension and Reduces Medications. Clinical Cardiology. 2018; 41(3):307-313. doi:https://doi.org/10.1002/clc.22863.
Chiang J-K, Lin Y-L, Chen C-L, Ouyang C-M, Wu Y-T, Chi Y-C, et al. Reduced Risk for Metabolic Syndrome and Insulin Resistance Associated with Ovo-Lacto-Vegetarian Behavior in Female Buddhists: a Case-Control Study. PLOS one. 2013; 8(8):e71799. doi:https://doi.org/10.1371/journal.pone.0071799.
Trautwein EA, McKay S. The Role of Specific Components of a Plant-Based Diet in Management of Dyslipidemia and the Impact on Cardiovascular Risk. Nutrients. 2020; 12(9):2671. doi:https://doi.org/10.3390/nu12092671.
Mayra S, Ugarte N, Johnston CS. Health Biomarkers in Adults are More Closely Linked to Diet Quality Attributes than to Plant-Based Diet Categorization. Nutrients. 2019; 11(6):1427. doi:https://doi.org/10.3390/nu11061427.
World Health Organization. Regional Office for the Western Pacific. The Asia-Pacific perspective : redefining obesity and its treatment. (Online). 2000. Sydney : Health Communications Australia. https://apps.who.int/iris/handle/10665/206936.
Pratiwi IGAIH, Bagiari KE, Putra IGBGP. Hubungan antara Terapi Statin dengan Kadar Gula Darah Puasa dan Profil Lipid pada Pasien Coronary Artery Disease di RSUD Sanjiwani. Intisari Sains Media. 2021; 12(1):55-59. doi:10.15562/ism.v12i1.953
Puspaseruni K. Tatalaksana Dislipidemia terkait Penyakit Kardiovaskular Aterosklerosis (ASCVD): Fokus pada Penurunan LDL-C. Cermin Dunia Kedokteran (CDK) Journal. 2021; 48(10):395-401.
Dahlan MS. Besar Sampel dan Cara Pengambilan Sampel dalam Penelitian Kedokteran dan Kesehatan. Suslia A (Editor). Edisi Ke-3. Jakarta: Salemba Medika. 2010.
Mishra S, Xu J, Agarwal U, Gonzales J, Levin S, Barnard N. A Multicenter Randomized Controlled Trial of A Plant-Based Nutrition Program to Reduce Body Weight and Cardiovascular Risk in the Corporate Setting: the GEICO Study. European Journal of Clinical Nutrition. 2013; 67(7):718-724. doi:https://doi.org/10.1038/ejcn.2013.92.
Campbell EK, Fidahusain M, II TMC. Evaluation of an Eight-Week Whole-Food Plant-Based Lifestyle Modification Program. Nutrients. 2019; 11(2068):1-12. doi:https://doi.org/10.3390/nu11092068.
Fogelholm M, Malmberg JJ SJ. International Physical Activity Questionnaire. Critical Reviews in Physical and Rehabilitation Medicine. 2006; 38(4):753-760. doi:10.1615/CritRevPhysRehabilMed.2018026180.
Supariasa I dewa nyoman, Bakri B, Fajar I. Penilaian Status Gizi. Rezkina E, Agustin cahya ayu (Editor). Edisi Ke-2. Jakarta: Penerbit Buku kedokteran EGC. 2016.
Direktorat Gizi Masyarakat. Tabel Komposisi Pangan Indonesia. (Online). 2018. https://www.panganku.org/.
Björnson E, Adiels M, Taskinen M-R, Borén J. Kinetics of Plasma Triglycerides in Abdominal Obesity. Current Opinion in Lipidology. 2017; 28(1):11-18. doi:https://doi.org/10.1097/MOL.0000000000000375.
Alberti K. G. M. M, Zimmet P, Shaw J. Metabolic Syndrome - a New World-Wide Definition. A Consensus Statement from the International Diabetes Federation. Diabetic Medicine. 2006; 23(5):469-480. doi:10.1111/j.1464-5491.2006.01858.x.
Zhang T, Chen J, Tang X, Luo Q, Xu D, Yu B. Interaction between Adipocytes and High-Density Lipoprotein:New Insights into the Mechanism of Obesity-Induced Dyslipidemia and Atherosclerosis. Lipids in Health and Disease volume. 2011; 18(1):1-11. doi:https://doi.org/10.1186/s12944-019-1170-9.
Liana P. Peran Small Dense Low Density Lipoprotein terhadap Penyakit Kardiovaskular. Jurnal Kedokteran dan Kesehatan 2014; 1(1):67-72. https://ejournal.unsri.ac.id/index.php/jkk/article/view/2570/0.
Zhang Z, Ma G, Chen S, Li Z, Xia E, Sun YS, Yang F, Zheng L, Feng X.. Comparison of Plasma Triacylglycerol Levels in Vegetarians and Omnivores: A Meta-Analysis. Nutrition. 2013; 29(2):426-430. doi:https://doi.org/10.1016/j.nut.2012.07.016.
Wang F, Zheng J, Yang B, Jiang J, Fu Y, Li D. Effects of Vegetarian Diets on Blood Lipids: a Systematic Review and Meta‐Analysis of Randomized Controlled Trials. Journal of the American Heart Association. 2015; 4(10):e002408. doi:https://doi.org/10.1161/JAHA.115.002408
Zhang Z, Wang J, Chen S, Wei Z, Li Z, Zhao S, Lu W. Comparison of Vegetarian Diets and Omnivorous Diets on Plasma Level of HDL-C: a Meta-Analysis. PLOS one. 2014; 9(3):e92609. doi:https://doi.org/10.1371/journal.pone.0092609.
Yokoyama Y, Levin SM, Barnard ND. Navigation Association between Plant-Based Diets and Plasma Lipids: a Systematic Review and Meta-Analysis. Nutrition Reviews. 2017; 75(9):683-698. https://doi.org/10.1093/nutrit/nux030.
Dinu M, Abbate R, Gensini GF, Casini A, Sofi F. Vegetarian, Vegan Diets and Multiple Health Outcomes: a Systematic Review with Meta-Analysis of Observational Studies. Critical Reviews in Food Science and Nutrition. 2017; 57(17):3640-3649. doi:https://doi.org/10.1080/10408398.2016.1138447.
Oussalah A, Levy J, Berthezène C, Alpers DH, Guéant J-L. Health Outcomes Associated with Vegetarian Diets: an Umbrella Review of Systematic Reviews and Meta-Analyses. Clinical Nutrition. 2020; 39(11):3283-3307. doi:https://doi.org/10.1016/j.clnu.2020.02.037.
Huang Y-W, Jian Z-H, Chang H-C, Nfor ON, Ko P-C, Lung C-C, et al. Vegan Diet and Blood Lipid Profiles: a Cross-Sectional Study of Pre and Postmenopausal Women. BMC Women’s Health. 2014; 14(15):1-6. doi:https://doi.org/10.1186/1472-6874-14-55.
Ferdowsian HR, Barnard ND. Effects of Plant-Based Diets on Plasma Lipids. The American Journal of Cardiology. 2009; 104(7):947-956. doi:https://doi.org/10.1016/j.amjcard.2009.05.032.
Kent L, Morton D, Rankin P, Ward E, Grant R, Gobble J, et al. The Effect of a Low-Fat, Plant-Based Lifestyle Intervention (CHIP) on Serum HDL Levels and the Implications for Metabolic Syndrome Status-a Cohort Study. Nutrition and Metabolism. 2013; 10(1):1-6. doi:10.1186/1743-7075-10-58.
Chooi YC, Ding C, Chan Z, Lo J, Choo J, Ding BTK, Leow MKS, Magkos F. Lipoprotein Subclass Profile after Progressive Energy Deficits Induced by Calorie Restriction or Exercise. Nutrients. 2018; 10(1814):1-14. doi:https://doi.org/10.3390/nu10111814.
Santos HO, Macedo RCO. Impact of Intermittent Fasting on the Lipid Profile: Assessment Associated with Diet and Weight Loss. Clinical nutrition ESPEN. 2018; 24:14-21. doi:ttps://doi.org/10.1016/j.clnesp.2018.01.002.
Utami RW, Sofia SN, Murbawani EA. Hubungan antara Asupan Karbohidrat dengan Profil Lipid pada Pasien Penyakit Jantung Koroner. Jurnal Kedokteran Diponegoro. 2017; 6(2):1143-1155. doi:https://doi.org/10.14710/dmj.v6i2.18627.
Kelly RB. Diet and Exercise in the Management of Hyperlipidemiase. American family physician. 2010; 81(9):1097-1102. https://www.aafp.org/afp/2010/0501/p1097.html.
Moradi M, Daneshzad E, Azadbakht L. The Effects of Isolated Soy Protein, Isolated Soy Isoflavones and Soy Protein Containing Isoflavones on Serum Lipids in Postmenopausal Women: a Systematic Review and Meta-Analysis. Critical Reviews in Food Science and Nutrition. 2019; 60(20):3414-3428. doi:https://doi.org/10.1080/10408398.2019.1689097.
Shahavandi M, Djafari F, Shahinfar H, Davarzani S, Babaei N, Ebaditabar M, Djafarian K, Clark CCT, Bidar RR. The Association of Plant-Based Dietary Patterns with Visceral Adiposity, Lipid Accumulation Product, and Triglyceride-Glucose Index in Iranian Adults. Complementary Therapies in Medicine. 2020; 53:102532. doi:https://doi.org/10.1016/j.ctim.2020.102531.
Wulandari S, Lestari H, Fachlevy AF. Faktor yang Berhubungan dengan Kejadian Obesitas pada Remaja di SMA Negeri 4 Kendari Tahun 2016. Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat. 2017; 1(3):1-13. doi:http://dx.doi.org/10.37887/jimkesmas.v1i3.1239.
Marques LR, Diniz TA, Antunes BM, Rossi FE, Caperuto EC, Lira FS, Gonçales DC. Reverse Cholesterol Transport: Molecular Mechanisms and the Non-Medical Approach to Enhance HDL Cholesterol. Frontiers in Physiology. 2018; 9(526):1-11. doi:https://doi.org/10.3389/fphys.2018.00526.
Wang Y, Xu D. Effects of Aerobic Exercise on Lipids and Lipoproteins. Lipids in Health and Disease. 2017; 16(132):1-8. doi:https://doi.org/10.1186/s12944-017-0515-5.
Ruiz-Ramie JJ, Barber JL, Sarzynski MA. Effects of Exercise on HDL Functionality. Current Opinion in Lipidology. 2019; 30(1):16-23. doi:doi: 10.1097/MOL.0000000000000568.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Majalah Kesehatan FKUB
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
