Tesis

Resistensi Insulin pada Pasien Neoplasma Ovarium Jinak dan Ganas di RS Cipto Mangunkusumo = Insulin Resistance on Ovarian Neoplasm and Ovarian Cancer in Cipto Mangunkusumo National General Hospital, Indonesia.

Latar belakang: Kanker ovarium merupakan salah satu keganasan ginekologi dengan tingkat mortalitas tertinggi. Seiring dengan perubahan gaya hidup dan pola makan, khususnya konsumsi karbohidrat, terjadi peningkatan kejadian resistensi insulin yang berhubungan dengan kejadian berbagai kanker. Akan tetapi, belum terdapat perbandingan kejadian resistensi insulin antara pasien neoplasma ovarium jinak dan kanker ovarium di Indonesia. Tujuan: Mengetahui perbandingan kejadian resistensi insulin antara pasien neoplasma ovarium jinak dan kanker ovarium di Indonesia. Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang (cross sectional). Subjek dari penelitian ini semua pasien neoplasma ovarium jinak dan ganas yang berkunjung ke Rumah Sakit Cipto Mangunkusumo selama periode Oktober 2019-Oktober 2020. Pasien dengan kesadaran dan hemodinamik tidak stabil, penyakit ginjal, penyakit hepar kronik, dan pasien dengan diabetes melitus sebelumnya dieksklusi dari penelitian. Data karakteristik klinis dan profil gula darah dibandingkan antar kelompok neoplasma jinak dan ganas. Tingkat resistensi insulin dihitung menggunakan perhitungan homeostatic model assessment-insulin resistance HOMA-IR. Hasil: Didapatkan sebanyak 58 subjek yang terdiri dari 28 subjek neoplasma ovarium jinak dan 30 subjek kanker ovarium selama periode penelitian. Didapatkan perbedaan usia, indeks massa tubuh, kejadian malnutrisi, kejadian menopause, riwayat kontrasepsi, dan riwayat keganasan ovarium keluarga yang berbeda antar kelompok (p < 0,05). Tidak didapatkan perbedaan gula darah puasa maupun kadar insulin antar kelompok. Tidak didapatkan perbedaan kadar HOMA-IR dan kejadian resistensi insulin antar kelompok (p > 0,05). Kesimpulan: Tidak didapatkan perbedaan kadar HOMA-IR dan kejadian resistensi insulin antara pasien dengan neoplasma ovarium jinak maupun kanker ovarium.
Kata kunci: HOMA-IR, kadar insulin, resistensi insulin, neoplasma ovarium jinak, kanker ovarium


Background: Ovarian cancer is one of the gynecology malignancies with the highest mortality rate. Along with changes in lifestyle and diet, especially carbohydrate consumption, there is an increase in the incidence of insulin resistance, known to be associated with incidence of various cancers. However, there is no comparison of insulin resistance incidence between patients with benign ovarian neoplasm and ovarian cancer in Indonesia. Objective: To compare of the incidence of insulin resistance between benign ovarian neoplasm and ovarian cancer patients in Indonesia. Methods: This study was an observational analytic study with cross sectional method. The subjects of this study were all patients with benign and malignant ovarian neoplasmas who visited Cipto Mangunkusumo Hospital during the period October 2019- October 2020. Patients with unstable hemodynamics, chronic kidney or liver disease, and diabetes mellitus previously were excluded from the study. Data on clinical characteristics and blood sugar profiles were compared between groups. Insulin resistance levels were calculated using the homeostatic model insulin resistance assessment calculation (HOMA-IR). Results: There were 58 subjects consisting of 28 benign ovarian neoplasma subjects and 30 ovarian cancer subjects during the study period. There were differences in age, body mass index, incidence of malnutrition, incidence of menopause, history of contraception, and family history of ovarian malignancy between groups (p < 0.05). There were no differences in fasting blood sugar and insulin level between groups. There was no difference in HOMA-IR level and incidence of insulin resistance between groups (p > 0.05). Conclusion: There was no difference in HOMA-IR level and incidence of insulin resistance between patients with benign ovarian neoplasm and ovarian cancer.
Keywords: HOMA-IR, insulin level, insulin resistance, benign ovarian neoplasm, ovarian cancer