Tesis

Hubungan antara Testosteron dan Sarkopenia pada Pasien Sirosis Hati Laki-laki = Association of Testosterone and Sarcopenia in Male Patients with Liver Cirrhosis.

Latar Belakang. Kondisi sirosis hati dapat menyebabkan penurunan kadar testosteron dan dikaitkan dengan kejadian dekompensasi, infeksi dan mortalitas. Testosteron memiliki peranan penting dalam metabolisme otot. Penurunan massa dan kekuatan otot yang dikenal sebagai sarkopenia sering ditemukan pada kondisi sirosis hati dan dikaitkan dengan prognosis buruk. Mekanisme terjadinya sarkopenia pada sirosis hati sangat kompleks dan masih terus diteliti. Salah satu yang diduga berperan adalah rendahnya kadar hormon testosteron. Tujuan. Mengetahui hubungan antara testosteron dan sarkopenia pada pasien sirosis hati laki-laki Metode.Studi ini merupakan studi potong lintang yang dilakukan di poliklinik Hepatobilier RSCM-FKUI di Maret 2024. Pengukuran massa otot menggunakan BIA dan kekuatan otot diukur dengan hand dynamometer. Sarkopenia ditegakkan apabila SMI < 7kg/m2 dan kekuatan otot < 26kg. Seluruh subjek diperiksakan testosteron total di pagi hari. Analisis menggunakan uji univariat, bivariat dan regresi logistik untuk mendapatkan hubungan antara testosteron dan sarkopenia pada pasien sirosis hati laki-laki. Hasil. Dari 60 pasien sirosis hati laki-laki usia 18-60 tahun ,terdapat 6,7% dengan sarkopenia. Terdapat perbedaan bermakna kadar testosteron antara kelompok sarkopenia(14,25nmol/L, 4,99-26,61) dan non-sarkopenia (23,04nmol/L , 5,32-54,95). Pada analisis multivariat setelah memperhitungkan perancu (IMT dan Child-Pugh), testosteron secara independen berhubungan dengan sarkopenia OR 17,37 (1,16- 259,60; p < 0,005). Tidak didapatkan korelasi antara testosteron dengan massa otot (r= 0,018; p > 0,05;r2 0,024 ) maupun kekuatan otot (r=0,149;p > 0,05; r2=0) Kesimpulan. Terdapat hubungan bermakna antara testosteron dan sarkopenia pada pasien sirosis hati laki-laki.
Kata Kunci. Kekuatan otot, massa otot, sarkopenia, sirosis hati. testosteron


Background. Liver cirrhosis can lead to a decrease in testosterone levels and is associated with occurrences of decompensation, infection, and mortality. Testosterone plays an important role in muscle metabolism. The decrease in muscle mass and strength, known as sarcopenia, is often found in liver cirrhosis and is linked to poor prognosis. The mechanisms behind sarcopenia in liver cirrhosis are very complex and continue to be studied. One suspected contributing factor is low testosterone levels. Aim.Understanding the relationship between testosterone and sarcopenia in male patients with liver cirrhosis. Methods.This study is a cross-sectional study conducted at the Hepatobiliary clinic, RSCM-FKUI, in March 2024. Muscle mass was measured using BIA, and muscle strength was measured with a hand dynamometer. Sarcopenia was diagnosed if skeletal muscle index (SMI) < 7 kg/m2 and muscle strength < 26 kg. All subjects had their total testosterone levels measured in the morning. A bivariate analysis was carried out and followed by a logistic regression analysis on variables with p-value Result.Out of 60 male liver cirrhosis patients aged 18-60 years, 6.7% had sarcopenia. There was a significant difference in testosterone levels between the sarcopenia group (14.25 nmol/L, 4.99-26.61) and the non-sarcopenia group (23.04 nmol/L, 5.32-54.95). In multivariate analysis, after adjusting for confounders (BMI and Child-Pugh score), testosterone was independently associated with sarcopenia OR 17.37 (1.16-259.60, p < 0.005). No correlation was found between testosterone and muscle mass (r=0.018, p > 0.05; r2=0) or muscle strength (r=0.149, p > 0.05,r2=0.024). Conclusion.There is a significant relationship between testosterone levels and sarcopenia in male patients with liver cirrhosis.
Keywords. Cirrhosis, muscles mass, muscle strength,sarcopenia, testosterone