Tesis

Visceral Adiposity Index Sebagai Prediktor Diabetes Mellitus Tipe 2: Analisis Data Kohort Penyakit Tidak Menular Bogor Tahun 2011-2016 = Visceral Adiposity Index as a Predictor of Type 2 Diabetes Incidence: Cohort Study on Non-Communicable Diseases in Bogor City 2011-2016.

Latar Belakang. Penelitian yang ada telah memperlihatkan bahwa lemak visceral memiliki peran yang lebih penting dibandingkan lemak subkutan dalam patogenesis resistensi insulin dan Diabetes Melitus Tipe 2 (DMT2). Visceral Adiposity Index (VAI) merupakan rumus yang dikembangkan untuk mengestimasi akumulasi lemak visceral pada populasi Kaukasia dan memiliki nilai prediksi yang baik terhadap kejadian DMT2. Tujuan. Penelitian ini dibuat untuk mengetahui apakah VAI dapat digunakan sebagai prediktor DMT2 pada populasi Indonesia. Metode. Penelitian ini merupakan studi Kohort retrospektif, menggunakan data sekunder dari Studi Kohort PTM Litbangkes di Bogor dalam kurun waktu 2011-2016. Subyek dengan usia 25-65 tahun yang tidak menderita DMT2 di awal penelitian diobservasi. Insiden DMT2 selama masa observasi dicatat, responden dikatakan menderita DMT2 bila kadar gula darah puasa ≥126 mg/dL dan atau kadar gula darah setelah 2 jam setelah makan ≥ 200 mg/dL dan atau telah didiagnosis DMT2 oleh tenaga kesehatan selama masa observasi. Uji Hipotesis yang dilakukan adalah uji cox regression multivariat. Analisis statistik dipisah berdasarkan gender. Hasil. Subyek yang terinklusi penelitian sebesar 2852 orang (834 pria dan 2018 wanita). Sebanyak 149 kejadian DMT2 baru tercatat selama masa observasi. Analisis multivariat menunjukkan Nilai VAI pada kuartil 4 merupakan prediktor independen terhadap kejadian DMT2 (HRadj Pria : 3,592 (1,34-9,6; p 0,001); Wanita: 2,95 (1,24-5,69; p 0,008)) dengan Attributable risk laki-laki AR: 74/1000; AR%: 75% dan perempuan AR: 65/1000; AR%: 72%. Kesimpulan. Visceral Adiposity Index (VAI) merupakan prediktor independen terhadap kejadian DMT2 pada populasi di Indonesia.
Kata kunci: diabetes melitus tipe 2; Indonesia; prediktor; visceral adiposity index; visceral adipose tissue


Background. It has been reported that visceral fat plays a relatively more significant part in the progression to type 2 diabetes (T2DM) than subcutaneous fat. Visceral Adiposity Index (VAI) is an equation model developed in Caucasian to estimate visceral fat accumulation, and has been reported to better predict the development of T2DM. Objective. The objective of this research is to assessed whether VAI can be used as a predictor of T2DM in Indonesian population with different body composition compared to the Caucasian population. Method. We analysed a secondary data from the Bogor Non-communicable Diseases Cohort Study 2011-2016 which involved all participants aged 25-65 years old without the diagnosis of T2DM at baseline. Newly occurred diabetes were observed during the interval. DMT2 is define as having fasting plasma glucose ≥126 mg/dL, and or 2 hours post prandial blood glucose ≥ 200 mg/dL, or was diagnosed as DMT2 by a healthcare professionals. The role of VAI as the predictor for T2DM was analysed using Multivariate Cox regression analysis. Result. We observed 2852 subjects (834 male and 2018 female). A total number of new DMT2 case were 149. Multivariate analysis shown that 4 th quartile of VAI were independent predictor to DMT2 incidence (HRadj Male: 3,592 (1,34-9,6; p 0,001); Female: 2,95 (1,24-5,69; p 0,008)) with Attributable risk within male population AR: 74/1000; AR%: 75% and female AR: 65/1000; AR%: 72% respectively. Conclusion. VAI is a practical formula used to estimate the accumulation of visceral fat which can be used as a predictor for T2DM in Indonesian population.
Keywords: diabetes melitus tipe 2; Indonesia; predictor; visceral adiposity index; visceral adipose tissue