Tesis

Pengaruh Status Urban-Rural Terhadap Petanda Inflamasi dan Resistensi Insulin pada Laki-Laki Dewasa Muda Pasca Pemberian Diet Tinggi Lemak Tinggi Kalori Jangka Pendek = The Influence of Urban-Rural Status on Inflammation and Resistance Markers Insulin in Young Adult Men After High Fat High Calorie Diet Short Term.

Latar belakang: Peningkatan prevalensi DM tipe 2 pada populasi dewasa terutama di negara berkembang dipengaruhi oleh perubahan pola makan westernized diet dan gaya hidup sedentari. Berdasarkan publikasi penelitian sebelumnya, melalui status populasi urban dan rural kedua hal tersebut dinilai berhubungan dengan peningkatan risiko resistensi insulin yang dipicu oleh proses inflamasi. Tujuan: Menilai pengaruh status urban dan rural terhadap resistensi insulin, sitokin proinflamasi dan antiinflamasi pasca pemberian high fat diet jangka pendek. Metode: Disain penelitian pra eksperimental atau the one group pre-test post-test design yang dilakukan pada subjek laki-laki dewasa suku Flores yang tinggal di wilayah urban dan rural pada tahun 2015. Analisis uji komparatif berpasangan non parametrik terhadap HOMA-IR, sitokin pro dan antiimflamasi pasca intervensi HFD jangka pendek dilakukan dengan uji Wilcoxon. Uji komparatif independen non parametrik antara delta HOMAIR, sitokin pro dan antiinflamasi dilakukan dengan uji Mann Whitney. Korelasi antara HOMA-IR, sitokin pro, dan antiinflamasi dilakukan dengan uji korelasi Spearman. Perbandingan antara proporsi TNF-α/IL-10 dilakukan dengan perbandingan ratio pre dan pasca pemberian HFD jangka pendek. Hasil: Kami mendapatkan 34 subjek penelitian, dengan 17 subjek populasi urban dan 17 subjek populasi rural. Di dapatkan peningkatan dari HOMA-IR dan IL-10 serta penurunan dari TNF-α, IL-6, dan IL-4 pasca pemberian HFD pada populasi rural. Sedangkan pada populasi urban di dapatkan peningkatan HOMA-IR, IL-6, IL-4, dan IL- 10 serta penurunan TNF-α pasca pemberian HFD. Uji Mann Whitney menunjukkan hubungan bermakna status urban dan rural terhadap TNF-α (p < 0,01), IL-6 (p 0,02), dan IL-4 (p < 0,01) pasca pemberian HFD. Terdapat korelasi negatif antara HOMA-IR dan TNF-α dengan uji Spearman r -0,24 (p 0,04). Perbandingan proporsi TNF- α/IL-10 pre dan pasca pemberian HFD menunjukkan penurunan proporsi yang bermakna dengan menggunakan uji Wilcoxon (p < 0,01) Kesimpulan: Pemberian HFD berpengaruh terhadap peningkatan HOMA-IR dan IL-10 pada kelompok populasi urban dan rural. Terdapat hubungan bermakna status urban dan rural terhadap sitokin proinflamasi TNF-α dan sitokin antiinflamasi IL-4 dan IL-10 pasca pemberian HFD. Penelitian ini menunjukkan tidak di dapatkan perbedaan yang bermakna terhadap nilai HOMA-IR antara populasi rural dan urban pasca pemberian HFD. Di dapatkan hubungan bermakna status urban dan rural terhadap sitokin proinflamasi TNF- α, IL-6 dan IL-4 pasca pemberian HFD. Serta didapatkan penurunan dari TNF-α dan peningkatan IL-10 pada kedua kelompok dengan perubahan ratio pasca pemberian HFD yang bermakna.
Kata kunci: Laki-laki dewasa muda, diet tinggi lemak tinggi kalori jangka pendek, resistensi insulin, proinflamasi, antiinflamasi.


Background: The increasing prevalence of type 2 diabetes in the adult population, particularly in developing countries, is influenced by changes in the pattern of a westernized diet and a sedentary lifestyle. Based on previous research publications, both urban and rural population statuses have been considered associated with an increased risk of insulin resistance triggered by inflammatory processes. Objective: To assess the influence of urban-rural status on insulin resistance, proinflammatory and anti-inflammatory cytokines after short-term HFD administration. Methodes: The study employed a pre-experimental design, specifically the one-group pre-test post-test design, conducted on adult male subjects of the Flores ethnicity residing in both urban and rural areas in 2015. Comparative analysis using non-parametric paired tests was performed on HOMA-IR and pro- and anti-inflammatory cytokines following short-term High-Fat Diet (HFD) intervention, utilizing the Wilcoxon test. Independent non-parametric comparative tests between delta HOMA-IR, pro-inflammatory cytokines, and anti-inflammatory cytokines were conducted using the Mann-Whitney test. The correlation between HOMA-IR, pro-inflammatory cytokines, and anti-inflammatory cytokines was assessed using the Spearman correlation test. A comparison of the TNF- α/IL-10 ratio made by comparing the pre- and post-short-term HFD administration ratios. Result: In our study, we included 34 subjects, with 17 subjects from the urban population and 17 subjects from the rural population. Following the administration of High-Fat Diet (HFD) there was an increase in HOMA-IR and IL-10, as well as a decrease in TNF-α, IL- 6, and IL-4 in the rural population. Conversely, in the urban population, there was an increase in HOMA-IR, IL-6, IL-4, and IL-10, along with a decrease in TNF-α after HFD administration. The Mann-Whitney test indicated a significant association between urban and rural status and TNF-α (p < 0.01), IL-6 (p 0.02), and IL-4 (p < 0.01) post-HFD administration. A negative correlation was observed between HOMA-IR and TNF-α with a Spearman correlation coefficient of -0.24 (p 0.04). The comparison of the TNF-α/IL-10 proportions before and after HFD administration showed a significant decrease in proportions using the Wilcoxon test (p < 0.01). Conclusion: The administration of HFD has an impact on the increase of HOMA-IR and IL-10 in both urban and rural population groups. There is a significant association between urban and rural statuses and the proinflammatory cytokine TNF-α, as well as the anti-inflammatory cytokines IL-4 and IL-10 after HFD administration. This study indicates that there is no significant difference in HOMA-IR values between rural and urban populations after HFD administration. There is a significant relationship between urban and rural statuses and the proinflammatory cytokines TNF-α, IL-6, and IL-4 after HFD administration. Additionally, a significant change in the ratio of TNF-α decrease and IL-10 increase is observed in both groups after HFD administration.
Key Words: Adult males, short-term high-fat, high-calorie diet, insulin resistance, proinflammatory, antiinflammatory