Tesis

Korelasi Kadar Short Chain Fatty Acid (SCFA) dengan Nilai Elastografi Transien dan Controlled Attenuation Parameter pada Pasien Non-Alcoholic Fatty Liver Disease (NAFLD) = Correlation of Short Chain Fatty Acid (SCFA) Levels with Transient Elastography Values and Controlled Attenuation Parameters in Non-Alcoholic Fatty Liver Disease (NAFLD) Patients.

Latar belakang: Hipotesis yang berkembang saat ini terkait mekanisme terjadinya Non-alcoholic Fatty Liver Disease (NAFLD) yaitu teori multiple hit, dimana salah satu faktor yang berperan yaitu mikrobiota usus. Short chain fatty acid (SCFA) merupakan metabolit utama mikrobiota usus dan diduga berperan pada perkembangan NAFLD. Tujuan: Mengetahui korelasi kadar short chain fatty acid (SCFA) dengan derajat fibrosis dan steatosis pada pasien NAFLD yang dinilai dengan elastografi transien dan controlled attenuation parameter. Metode: Studi potong lintang terhadap 33 subjek yang memenuhi kriteria inklusi di Rumah Sakit Cipto Mangunkusumo pada Januari hingga Agustus 2023. Selanjutnya dilakukan anamnesis, pemeriksaan fisik, pemeriksaan laboratorium, pemeriksaan fibroscan, dan pengambilan sampel feses untuk pemeriksaan SCFA dengan menggunakan metode GC-MS (Gas Chromatography-Mass Spectrometry). Hasil: Subjek penelitian sebagian besar wanita (51,5%) dan rerata usia 49 tahun dengan rerata nilai CAP 296 dB/m dan median nilai elastografi transien 6,1 kPa. Rasio nilai asetat, propionat, dan butirat subjek yaitu 59:24:17. Terdapat adanya korelasi negatif sedang antara nilai butirat absolut dengan nilai CAP (r= -0,522; p=0,002). Tidak didapatkan adanya korelasi antara kadar SCFA dengan nilai elastografi transien. Simpulan: Terdapat korelasi negatif sedang antara nilai butirat absolut dengan nilai CAP. Tidak didapatkan korelasi antara kadar SCFA dengan nilai elastografi transien.
Kata kunci: short chain fatty acid, SCFA, NAFLD, elastografi transien, controlled attenuation parameter


Background: The current hypothesis regarding the mechanism of Non-alcoholic Fatty Liver Disease (NAFLD) is the multiple hit theory that one of the factors involved is gut microbiota. Short chain fatty acid (SCFA) is the main metabolite of gut microbiota and is suspected to play a role in the development of NAFLD. Objective: To determine the correlation between short chain fatty acid (SCFA) levels and the degree of fibrosis and steatosis in NAFLD patients assessed by transient elastography and controlled attenuation parameter. Method: Cross-sectional study was conducted on 33 subjects who met the inclusion criteria at Cipto Mangunkusumo Hospital from January to August 2023. Subsequently, anamnesis, physical examination, laboratory examination, fibroscan examination, and fecal sample collection were performed for SCFA examination using GC-MS (Gas Chromatography-Mass Spectrometry) method. Results: Subjects were predominantly women (51.5%), with an average age of 49 years, an average CAP value of 296 dB/m, and a median transient elastography value of 6.1 kPa. The ratio of acetate, propionate, and butyrate values in the subjects was 59:24:17. A moderate negative correlation was observed between the absolute butyrate values and CAP scores (r= -0.522; p=0.002). No correlation was identified between short-chain fatty acid (SCFA) levels and transient elastography values. Conclusion: There is a moderately negative correlation between the absolute butyrate values and CAP scores. No correlation was found between short-chain fatty acid (SCFA) levels and transient elastography values.
Keywords: short chain fatty acid, SCFA, NAFLD, transient elastography, controlled attenuation parameter