Tesis

Hubungan Small Intestinal Bacterial Overgrowth (SIBO) dengan Perlemakan Hati Non-Alkoholik (Non-Alcoholic Fatty Liver Disease/NAFLD). = Association between Small Intestinal Bacterial Overgrowth (SIBO) with Non-Alcoholic Fatty Liver Disease/NAFLD).

Latar belakang. Berdasarkan teori Multiple Hit maka NAFLD dapat disebabkan oleh berbagai faktor selain sindrom metabolik dan komponennya (Diabetes, Obesitas dan Dislipidemia). SIBO diketahui berperan dalam terjadinya NAFLD maupun progresinya, namun beberapa studi terkait melaporkan hasil yang inkonsisten terkait peranannya terutama karena heterogenitas kebiasaan diet dan profil antropometerik, sehingga studi ini dibutuhkan untuk mengklarifikasi isu tersebut. Tujuan. Mengetahui hubungan SIBO dengan NAFLD maupun progresinya. Metode. Studi potong lintang pada senter tunggal merekrut subjek dewasa nonkonsumen alkohol yang memiliki ≥1 faktor risiko NAFLD (diabetes dan atau obesitas dan atau dislipidemia). Sampel dengan Irritable Bowel Syndrome (IBS), hepatitis B, hepatitis C, penyakit hati autoimun, penyakit hati imbas obat, karsinoma hepatoseluler, riwayat pembedahan saluran cerna, konsumsi Vitamin E, Pioglitazone, Amiodarone, Tamoxifen dan Asam Ursodeoksikolat dieksklusi. Subjek menjalani tes nafas glukosa, ultrasonografi hati, elastografi transien-parameter atenuasi terkontrol dan pemeriksaan laboratorium darah. Analisis statistik dikerjakan secara univariat. Hasil. Didapatkan 160 sampel yang dapat dianalisis pada penelitian ini. Sebanyak 115 sampel (71,9 %) menderita NAFLD dan 36 (31,3 %) diantaranya positif SIBO. Diketahui SIBO tidak memiliki hubungan yang bermakna dalam mempengaruhi kejadian NAFLD (p=0,191). Keberadaan SIBO juga tidak berhubungan dengan fibrosis (p=0,371) dan steatosis signifikan hati (p=0,951) subjek NAFLD. Kesimpulan. SIBO tidak berhubungan dengan kejadian NAFLD dan progresinya.
Kata kunci : small intestinal bacterial overgrowth; non-alcoholic fatty liver disease


Introduction. Based on multiple hit theory, NAFLD may be caused by various factors besides metabolic syndrome and its components (Diabetes, Obesity and Dyslipidemia). SIBO recently known to involved in NAFLD development and its progressivity, but inconsistency in various studies regarding its role still exists, especially due to heterogenicity of dietary habit and anthropometric profile, warranting this study to clarify this unknown issues. Aim. To find the role of SIBO in NAFLD development, progression and its related factors. Methods. Single centre cross-sectional study recruiting adult subjects with ≥1 NAFLD risk factors (diabetes melitus (DM), obesity, dyslipidemia) and does not have history of significant alcohol consumption. Exclusion criteria were Irritable Bowel Syndrome, hepatitis B/C/autoimmune/drug induced, hepatocellular carcinoma, gastrointestinal surgery history, vitamin E, Pioglitazone, Amiodarone, Tamoxifen and Ursodeoxycholic Acid consumption. Subjects underwent glucose breath test, ultrasonography, transient elastography-controlled attenuation parameter and blood tests. Statistical analysis was done using univariate analysis. Results. This study analyzed 160 subjects of which 115 (71.9%) had NAFLD and 36 (31.3%) was SIBO positive. SIBO known to have no significant association with NAFLD (p=0.191). SIBO also did not associate with significant liver fibrosis (p=0.371) and steatosis (p=0.951) in NAFLD subjects. Conclusion. SIBO is not associated with NAFLD development and progression.
Keywords: small intestinal bacterial overgrowth; non-alcoholic fatty liver disease