Tesis

Hubungan antara Kualitas Diet dengan Kadar Adiponektin Anak Usia Pra Sekolah di Jakarta Timur = Association between Diet Quality and Serum Adiponectin Level among Preschool Children in East Jakarta.

Latar belakang: Pola makan yang tidak sehat selama masa kanak-kanak akan berdampak pada risiko penyakit tidak menular (PTM) di kemudian hari. Salah satu indikator awal PTM yang dapat dimodifikasi oleh diet adalah adiponektin. Adiponektin dinilai berhubungan dengan PTM karena perannya dalam proses perjalanan penyakit obesitas, diabetes, inflamasi, aterosklerosis, maupun penyakit kardiovaskular. Data yang terdokumentasi dengan baik mengenai kualitas diet dan hubungannya dengan kadar adiponektin pada populasi anak belum banyak dieksplorasi. Tujuan: Kami mengidentifikasi kualitas makanan umum anak-anak Indonesia dan menilai hubungannya dengan kadar adiponektin serum sebagai penanda awal PTM. Metode: Delapan puluh enam (44 perempuan dan 42 laki-laki) anak usia prasekolah yang merupakan bagian dari subjek penelitian dari studi Kohort Ibu dan Anak di 10 kecamatan di Jakarta Timur dilibatkan dalam penelitian ini. Data diet didapat dengan mengumpulkan data 24hr food recall berulang selama sehari di hari kerja dan satu hari di akhir pekan, yang kemudian dianalisis lebih lanjut ke dalam perhitungan Healthy Eating Index (HEI) 2015. Kadar adiponektin serum ditentukan dengan uji Enzyme-Linked Immunosorbent Assay (ELISA). Analisis regresi linear berganda dilakukan untuk menilai hubungan antara HEI 2015 dan konsentrasi adiponektin serum, dengan penyesuaian terhadap faktor perancu. Hasil: Nilai rata-rata skor HEI 2015 subjek penelitian adalah 33,1 ± 8,2, jauh di bawah skor yang direkomendasikan yaitu ≥ 80. Rata-rata serum adiponektin adalah 10,3 ± 4,1 ug / mL, di mana 11,6% subjek memiliki kadar serum adiponektin di bawah normal. Uji regresi linear berganda menunjukkan bahwa HEI secara signifikan berkaitan dengan serum adiponektin baik sebelum maupun sesudah disesuaikan dengan faktor perancu (β = 0,232; 95% CI = 0,01-0,25; p = 0,03; β = 0,214; 95% CI = 0,03-0,21; p = 0,04). Kesimpulan: Terdapat hubungan antara HEI dan adiponektin. Hal ini menunjukkan bahwa kepatuhan terhadap diet berkualitas tinggi sejak usia dini berperan dalam meningkatkan kadar adiponektin yang sangat penting untuk mengurangi risiko PTM di masa dewasa.
Kata kunci: Adiponektin, kualitas diet, Healthy Eating Index, penyakit tidak menular, anak pra sekolah


Background: Unhealthy diet during childhood will have a direct effect on risk of developing non-communicable diseases (NCDs) in later life. One early indicator of NCDs that can be modified by diet is adiponectin. Adiponectin is considered to have association with NCDs because of its role in the course of obesity, diabetes, inflammation, atherosclerosis, and cardiovascular disease. Well-documented data regarding the quality of the diet and its relationship to adiponectin levels in the pediatric population have not been explored extensively. Objective: We identified the diet quality of Indonesian children and assessed its relationship to serum adiponectin level as the early markers of NCDs. Methods: Eighty-six (44 girls and 42 boys) preschool-aged children from a nested cohort study in 10 sub-districts in East Jakarta were included in this study. Dietary data was gathered by collecting repeated 24-hour recalls for a-day in the weekday and a-day in the weekend, which then further analyzed into HEI 2015 calculation. The EnzymeLinked Immunosorbent Assay (ELISA) test was used to determine serum adiponectin levels. Multiple regression analysis was performed to assess the association between HEI 2015 and serum adiponectin concentration, with adjustment for potential confounder. Results: The mean of subjects’ HEI 2015 score was 33.1±8.2, below the recommendation score of ≥ 80. The mean serum adiponectin was 10.3±4.1 ug/mL, in which 11.6% has serum adiponectin level below normal. Multiple linear regression test showed that HEI was significantly correlated with adiponectin serum either before or after adjusted with confounders (β=0.232; 95% CI=0.01-0.25; p=0.03; β=0.214; 95% CI=0.03-0.21; p=0.04), respectively. Conclusion: There is an association between HEI and adiponectin. This result suggests that adherence to a high-quality diet from an early age is crucial to reduce the risk of Indonesian children experiencing NCD as adults.
Keywords: Adiponectin, diet quality, Healthy Eating Index, non-communicable disease, preschool children