Akurasi Indeks Antropometri Obesitas dalam Mempediksi Kontrol Glicemic Pasien Diabetes Mellitus Tipe 2 di Puskesmas Kota Pekanbaru

Arfianti Arfianti, Frilly Deyana, Dani Rosdiana, Nadiah Yamanza Ardini, Wahyuli Armi, Dewi Iramayana Sandra Kesumah

Abstract


Diabetes melitus (DM) tipe 2 adalah penyakit metabolik yang ditandai dengan peningkatan kadar gula darah. Kontrol gula darah merupakan salah satu tujuan utama tata laksana pasien DM. Obesitas merupakan faktor risiko utama dari DM tipe 2. Tujuan penelitian ini adalah mengetahui hubungan indeks antropometri dengan kontrol gula darah pada pasien DM tipe 2 yang dirawat jalan di puskesmas Kota Pekanbaru. Desain penelitian yang digunakan adalah observasional analitik dengan pendekatan cross-sectional. Sampel pada penelitian ini meliputi 103 pasien DM tipe 2 yang diperoleh dari Puskesmas Sidomulyo dan Simpang Tiga Kota Pekanbaru pada bulan Mei–Juni 2018.Subjek penelitian paling banyak perempuan (58,3%) dan berusia ≥45 tahun (96,1%). Tingkat pendidikanterbanyak adalah SMA (42,7%) dan 54,4% tidak bekerja. Riwayat diabetes ditemukan pada 68,9% subjek dan 85,4% subjek tidak memiliki riwayat merokok. Sebanyak 98,1% pasien diabetes mendapat obat hipoglikemik oral dan 84,5% pasien diabetes memiliki kadar gula darah tidak terkontrol. Penelitian ini menunjukkan bahwa obesitas berdasar atas IMT dan WC tidak berhubungan dengan kontrol gula darah. Sebaliknya, obesitas berdasarkan WHR (p=0,014) dan WHtR (p=0,015) memiliki hubungan dengan kontrol gula darah pada pasien DM. Namun WHR dan WHtR secara tunggal memiliki akurasi yang sangat lemah dalam memprediksi kontrol gula darah pada penderita DM tipe 2.

Accuracy of anthropometric Indexes of Obesity to Predict Glycemic Control among Type 2 Diabetic Patients in Primary Health Care in Pekanbaru

Type 2 diabetes mellitus (DM) is a metabolic disease characterized by elevated blood sugar levels. Glycemic control is the main goal of DM patient management. Obesity is a major risk factor for DM. This study aimed to investigate the association between anthropometric indexes and glycemic control in DM patients visiting primary health care facilities in Pekanbaru. This was a cross-sectional analytical observational study on 103 type 2 DM patients from Sidomulyo and Simpang Tiga public health centers in Pekanbaru during the period of May-June 2018. More female subjects participated in this study (58.3%) with overall average age of ≥45 years (96.1%). The highest level of education of the subjects was senior high school (42.7%) and most subjects were unemployed (54.4%). The family history of DM was found in 68.9% subjects and majority had no smoking history (86.4%). As many as 98.1% DM patients were taking oral hypoglicemic drugs. Most of the DM patients had uncontrolled glycemic status (84.5%). This study showed that BMI-based and WC-based obesity was not associated with glycemic control in DM patients. On the other hand, the association between obesity based on WHR (P = 0.02; OR = 5.26) and WHtR (P = 0.008; OR = 6.82) and glycemic control in DM patients was statistically significant. However, WHR dan WHtR alone has no discrimination power to predict glycemic control among type 2 diabetic patients.



Keywords


Diabetes Melitus tipe 2; indeks massa tubuh, waist circumference; waist-hip Ratio; waist to height ratio

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References


International Diabetes Federation. IDF Diabetes Atlas. Edisi ke-8; Belgia: International Diabetes Federation; 2017.

Idris H, Hasyim H, Utama F. Analysis of diabetes mellitus determinants in indonesia: a study from the Indonesian basic health research 2013. Acta Med Indones. 2017;49(4):291–8.

Marcadenti A, Fuchs SC, Moreira LB, Wiehe M, Gus M, Fuchs FD. Accuracy of anthropometric indexes of obesity to predict diabetes mellitus type 2 among men and women with hypertension. Am J Hypertens. 2011;24(2):175–80.

Rhee EJ. Diabetes in Asians. Endocrinol Metab. 2015;30(3):263–9.

Misra A, Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes. 2011;35(2): 167–87.

Motamed N, Sohrabi M, Poustchi H, Maadi M, Malek M, Keyvani H, dkk. The six obesity indices, which one is more compatible with metabolic syndrome? a population based study. Diabetes Metab Syndr. 2017;11(3): 173–7.

Lear SA, Kohli S, Bondy GP, Tchernof A, Sniderman AD. Ethnic variation in fat and lean body mass and the association with insulin resistance. J Clin Endocrinol Metab. 2009;94:4696–702.

Casanueva FF, Moreno B, Rodriguez-Azeredo R, Massien C, Conthe P, Formiguera X, dkk. Relationship of abdominal obesity with cardiovascular disease, diabetes and hyperlipidaemia in Spain. Clin Endocrinol. 2010;73(1):35–40.

Rock CL, Flatt SW, Pakiz B, Taylor KS, Leone AF, Brelje K, dkk. Weight loss, glycemic control, and cardiovascular disease risk factors in response to differential diet composition in a weight loss program in type 2 diabetes: a randomized controlled trial. Diabetes Care. 2014;37(6):1573–80.

Mulla I, Schmidt K, Cashy J, Wallia A, Andrei AC, Oakes DJ, dkk. Comparison of glycemic and surgical outcomes after change in glycemic targets in cardiac surgery patients. Diabetes Care. 2014;37(11):2960–5.

Hart PD. Receiver operating characteristic (ROC) curve analysis: a tutorial using body mass index (BMI) as a measure of obesity. J Phys Act Res. 2016;1:5–8.

Staiano AE, Katzmarzyk PT. Ethnic and sex differences in body fat and viseral and subcutaneous adiposity in children and adolescents. Int J Obes. 2012;36(10):1261–9.

Wang Z, Ding L, Huang X, Chen Y, Sun W, Lin L, dkk. Abdominal adiposity contributes to adverse glycemic control and albuminuria in Chinese type 2 diabetic patients: A cross-sectional study. J Diabetes. 2017;9(3):285–95.

Kim SR, Yoo JH, Song HC, Lee SS, Yoo SJ, Kim YD, dkk. Relationship of viseral and subcutaneous adiposity with renal function in people with type 2 diabetes mellitus. Nephrol Dial Transpl. 2011;26:(11)3550–5.

Jamar G, Almeida FR, Gagliardi A, Sobral MR, Ping CT, Sperandio E, dkk. Evaluation of waist-to-height ratio as a predictor of insulin resistance in non-diabetic obese individuals. A cross-sectional study. Sao Paulo Med J. 2017;135(5):462–8.

Al-Zurfi BMN, Aziz AA, Abdullah MR, Noor NM. Waist height ratio compared to body mass index and waist circumference in relation to glycemic control in malay type 2 diabetes mellitus patients, Hospital Universiti Sains Malaysia. Int J Collab Res Int Med Pub Heal. 2012;4(4):406–15.

WHO. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation. World Heal Organ. 2008.




DOI: http://dx.doi.org/10.15395/mkb.v50n3.1361

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