Tesis

Peran Resistensi Insulin dan Skala Jaringan Lemak Viseral pada Dermatitis Seboroik Primer: Studi Kasus-Kontrol Berpasangan = The Role of Insulin Resistance and Visceral Fat Scale in Primary Seborrheic Dermatitis: A Matched Case-Control Study.

Latar Belakang: Dermatitis seboroik (DS) merupakan kelainan inflamasi kronik pada area kulit yang kaya kelenjar sebasea. Hingga saat ini patogenesis DS terus berkembang, termasuk dikaitkan dengan kejadian sindrom metabolik. Oleh karena sindrom metabolik terjadi akibat resistensi insulin yang diperankan oleh jaringan lemak viseral, maka diduga kedua hal tersebut juga memiliki peran terhadap kejadian DS. Tujuan: mengetahui rerata HOMA-IR dan skala jaringan lemak viseral pada pasien DS, serta menilai perbedaannya dibandingkan dengan kontrol. Metode: Penelitian kasus-kontrol berpasangan ini dilakukan di Poliklinik Dermatovenereologi RSCM selama Juli-Agustus 2022. Kelompok kasus ialah pasien berusia ≥ 18 tahun, tidak hamil, IMT ≥18,5 kg/m2 yang terdiagnosis DS secara klinis, serta tidak memiliki penyakit imunokompromais, infeksi kronis, kanker, autoimun, atau degeneratif lainnya. Kelompok kontrol ialah pasien non-DS yang match berdasarkan usia, jenis kelamin, dan kategori IMT. Seluruh subjek menjalani pemeriksaan klinis, laboratorium, dan pengukuran skala lemak viseral menggunakan alat BIA TANITA® SC330. Hasil: Masing-masing kelompok DS dan kontrol berjumlah 36 subjek pada studi ini. Median(min-maks) usia kelompok DS ialah 26,5(20-45) tahun, jenis kelamin laki-laki 52,8%, dan median(min-maks) IMT sebesar 24,2(18,5-38,8) kg/m2. Median HOMA-IR ditemukan lebih tinggi pada kelompok DS dibandingkan kontrol (1,54[0,72-4,09] VS. 1,22[0,53-2,73]; p=0,031). Namun, tidak terdapat perbedaan yang bermakna secara statistik untuk skala lemak viseral antara kelompok DS dengan kontrol (6,5[1 -14] VS. 6,0[1-12]; p=0,149). Kesimpulan: Nilai median HOMA-IR dan skala jaringan lemak viseral pada pasien DS adalah masing-masing 1,54 (IK95% 0,72-4,09) dan 6,5 (IK95% 1-14). Nilai HOMA-IR pada pasien DS lebih tinggi dibandingkan dengan kontrol dan bermakna secara statistik, tetapi tidak terdapat perbedaan bermakna secara statistik untuk skala lemak viseral.
Kata kunci: dermatitis seboroik, resistensi insulin, homeostatic model assessment for insulin resistance (HOMA-IR), jaringan lemak viseral, bioimpedance analysis (BIA).



Background: Seborrheic dermatitis (SD) is a chronic inflammatory disorder in sebaceous gland-rich skin. Until today the pathogenesis of SD continues to develop, including investigation about the link association between SD and metabolic syndrome. Metabolic syndrome is a disease caused by insulin resistance in which visceral fat tissue may play important role, therefore insulin resistance and visceral fat tissue are hypothesized to influence the development of SD. Objective: To measure the HOMA-IR and visceral fat rating scale in SD patients, and to investigate the differences compared to the control group. Methods: A matched case-control study was conducted in Dermatovenereology Clinic Cipto Mangunkusumo General Hospital in July-August 2022. Case group was nonpregnant patients aged ≥18 years old and BMI ≥ 18,5 kg/m2 which were clinically diagnosed with SD, and did not have any of immunocompromise, chronic infection, cancer, autoimmune, or degenerative disease. Control group was non-SD patients that were matched according to the age, gender, and BMI categories. All the subjects assigned for clinical and laboratory examination, and visceral fat measurement using BIA TANITA® SC330. This study involved 36 subjects in each SD and control group. Median(min-max) of age in SD group was 26.5(20-45) yo, male 52.8%, and median(min-max) of BMI was 24.2(18.5-38.8) kg/m2. Median HOMA-IR was significantly higher in SD group compared to the control group (1.54[0.72-4.09] VS. 1.22[0.53-2.73]; p=0.031). However, there was no significant difference for visceral fat rating scale between SD and control group (6.5[1-14] VS. 6.0[1-12]; p=0.149). Conclusion: The median HOMA-IR and visceral fat rating scale in SD were 1.54 (95%CI 0.72-4.09) and 6.5 (95%CI 1 -14). HOMA-IR in SD group is higher to the control group and statistically significant, but there is no significant difference for visceral fat rating scale.
Keywords: seborrheic dermatitis, insulin resistance, homeostatic model assessment for insulin resistance (HOMA-IR), visceral fat tissue, bioimpedance analysis (BIA).