Tesis

Korelasi antara Lemak Viseral dengan Parameter Fungsi Diastolik pada Pasien Diabetes Melitus Tipe 2 = Visceral Fat Correlation with Diastolic Function Paraemeters in Type 2 Diabetes Mellitus.

Latar belakang. Gangguan fungsi diastolik tidak terdiagnosis pada 33% diabetes melitus (DM) tipe 2. Pencegahan dengan mengontrol faktor risiko seperti penumpukan jaringan lemak menjadi penting. Lemak viseral berhubungan dengan peningkatan resistensi insulin, deposisi lemak epikardium, dan lipotoksisitas. Pada populasi umum, lemak viseral berkorelasi dengan parameter fungsi diastolik. Namun, belum diketahui korelasi antara lemak viseral dengan parameter fungsi diastolik pada populasi DM tipe 2. Tujuan. Mengetahui korelasi antara lemak viseral dengan parameter fungsi diastolik berupa E/E’, E’ lateral, E’ septal, tricuspid regurgitation velocity (TRV), dan left atrial volume index (LAVI) pada populasi DM tipe 2 Metode. Studi potong lintang dengan melakukan analisis korelasi pada data sekunder berupa data lemak viseral yang diukur dengan Bioimpedance Analysis (BIA) dan parameter fungsi diastolik yang diukur dengan ekhokardiografi pada pasien DM tipe 2 di sepuluh Puskesmas di Jakarta. Hasil. Analisis dilakukan terhadap 56 pasien DM tipe 2. Rerata usia 49.3 (8.7) tahun. Lemak viseral berkorelasi positif dengan parameter E/E’ (r = 0.304; p= 0.023), berkorelasi negatif dengan E’ septal (r = -0.363; p=0.006) dan E’ lateral (r=- 0.271; p= 0.043). Pada analisis multivariat, lemak viseral merupakan determinan paling kuat untuk peningkatan E/E’ (beta = 0.303; p < 0.018), penurunan E’ lateral (beta = -0.367; p < 0.003) dan E’ septal. (beta = -0.311; p < 0.043). Tidak terdapat korelasi antara lemak viseral dengan LAVI dan TRV Kesimpulan. Terdapat korelasi signifikan antara lemak viseral dengan parameter E/E’, E’ lateral, E’ septal pada populasi DM tipe 2


Background. Diastolic dysfunction was not diagnosed in 33% of patients with Type 2 Diabetes Mellitus (DM). Controlling risk factors such as adipose tissue deposition is crucial in preventing diastolic dysfunction. Visceral fat is significantly correlated with increasing insulin resistance, epicardial fat deposition, and lipotoxicity. In general population, visceral fat is correlated with diastolic function parameters. However, correlation between visceral fat and diastolic function parameters in type 2 diabetes mellitus population has not been investigated. Objective. We aimed to determine correlations between visceral fat and diastolic function parameters including E/E’, lateral E’, septal E’, tricuspid regurgitation velocity (TRV), and left atrial volume index (LAVI) in type 2 diabetes mellitus population. Methods. We performed cross-sectional study on type 2 diabetes mellitus patients admitted to ten primary health care in Jakarta between November 2020 – 2021. Visceral fat was measured by bioimpendance analysis (BIA). Diastolic function parameters were assessed by echocardiography. Other clinical and laboratory data were also recorded. Results. A total of 56 type 2 DM patients with normal ejection fraction, mean age 49.3 (8.7) years were analyzed. We found significant correlations between visceral fat and E/e’ (r = 0.304; p= 0.023), E’ septal (r = -0.363; p=0.006) and E’ lateral (r=- 0.271; p= 0.043). Multivariate analysis demonstrated that visceral fat is the most significant determinant for increased E/E’ ratio (beta = 0.303; p < 0.018) and decreased E’ lateral (beta = -0.367; p < 0.003) and E’ septal (beta = -0.311; p < 0.043). There was no correlation between visceral fat and TRV or LAVI. Conclusion. There were significant correlations between visceral fat and E/e’, E’ lateral, and E’ septal in type 2 diabetes mellitus population.