Tesis

Hubungan leptin dengan Cartilage Oligometric Matrix Protein (COMP) dan lebar celah sendi tibiofemoral medial pada pasien osteoartritis lutut dengan obesitas.

Latar Belakang: Obesitas merupakan faktor risiko utama osteoartritis (OA).
Penelitian terdahulu mendapatkan bahwa faktor mekanik saja tidak cukup untuk
menjelaskan hubungan kejadian OA dengan obesitas. Leptin diduga berperan
dalam proses destruksi kartilago pada OA. Tujuan penelitian ini adalah untuk
melihat adakah korelasi antara leptin serum dengan COMP dan dengan lebar
celah sendi tibiofemoral medial.
Metode: Penelitian ini merupakan studi potong lintang pada penderita OA yang
berobat di poliklinik Reumatologi RSCM dalam periode Juni-Juli 2014.
Pengambilan sampel dilakukan dengan metode consecutive sampling. Diagnosis
OA lutut berdasarkan kriteria American College of Rheumatology (ACR) 1896.
Dilakukan pemeriksaan leptin dan COMP serum dengan metode ELISA.
Pemeriksaan radiologi kedua lutut dilakukan dengan posisi antero-posterior pada
pasien yang berdiri tegak. Kemudian dilakukan pengukuran lebar celah sendi
tibiofemoral medial oleh ahli radiologi, Analisa statistik bivariat digunakan
mendapatkan korelasi antara leptin dengan COMP dan dengan lebar celah sendi
tibiofemoral medial.
Hasil: Sebanyak 51 subjek memenuhi kriteria inklusi penelitian, 45 orang
(88,2%) adalah wanita. Rerata kadar leptin didapatkan 38119,45 ± 21076,09
pg/ml. Nilai median COMP adalah 805,3(144,1-2241)ng/ml dan rerata lebar celah
sendi tibiofemoral medial 3,73 ± 1,58 mm. Pada analisa bivariat tidak ditemukan
korelasi antara leptin dan COMP ( r = 0,043, p= 0,764) dan juga antara leptin
dengan lebar celah sendi tibiofemoral medial( r = -0,135, p = 0,345). Pada subjek
dengan lama sakit > 24 bulan didapatkan korelasi negatif kuat antara leptin
dengan lebar celah sendi tibio femoral medial ( r = 0,614, p = 0,015).
Simpulan: Tidak didapatkan korelasi antara leptin dan COMP pada penelitian
ini. Penelitian ini juga tidak mendapatkan korelasi antara leptin dengan lebar celah
sendi tibiofemoral medial pada pasien OA lutut dengan obesitas.


Background: Obesity is a well-recognized risk factor for osteoarthritis. However,
the relationship between obesity and OA may not simply due to mechanical
factor. Increasing evidence support the role of leptin in OA cartilage destruction.
The objective of this study was to examine the possible correlation between leptin
serum with COMP and medial joint space width in knee OA with obesity.
Methods: This study was a cross sectional study in OA patients visiting
Rheumatology outpatient clinic in Cipto Mangunkusumo Hospital between JuneJuly
2014.
Samples
were
collected
using
consecutive
sampling
method.
Knee
OA

was
diagnosed
from
clinical
and
radiologic
evaluation
based
on American
College

of Rheumatology 1986 criteria. Serum was collected from 51 knee OA patients,
serum leptin and COMP were measured by ELISA. Antero-posterior radiographs
of the knee have been taken in weight bearing position, and then the radiologist
measured the minimum medial joint space width. The correlation between leptin
and same variables, such as COMP and tibiofemoral medial minimum joint space
width were analized by bivariate analysis.
Results: Fifty one subjects met the inclusion criteria, with 45 (88,2%) are women.
Mean of Leptin was 38119,45 (SD 21076,09). Median of COMP was
805,3(144,1-2241) and mean of minimum joint space width was 3,73 (SD1,58)
mm. In bivariate analysis we found no correlation between leptin and COMP ( r
= 0,043, p= 0,764) and also between leptin and medial joint space width ( r = 0,135,

p = 0,345).Cluster analysis for the subject with disease onset >24 month
showed strong negative correlation between leptin and tibiofemoral medial
minimum joint space width (r = 0,614, p = 0,015).
Conclusion: There was no correlation between leptin and COMP in this study.
This study also showed that there was no correlation between leptin and medial
tibiofemoral joint space width in knee OA with obesity.