Tesis

“Proporsi Defisiensi 25-Hidroksivitamin D pada Pasien Adenokarsinoma Paru di Rumah Sakit Persahabatan” = "Proportion of 25-Hydroxyvitamin D Deficiency in Lung Adenocarcinoma Patients at National Respiratory Center Persahabatan Hospital”.

Latar Belakang: Kanker paru adalah keganasan yang memiliki angka mortalitas yang tinggi. Didapatkan bukti bahwa kadar 25(OH)D yang rendah meningkatkan risiko kanker paru dan defisiensi 25(OH)D memberikan prognosis yang buruk. Tujuan penelitian ini adalah mengetahui proporsi defisiensi 25(OH)D pada pasien adenokarsinoma paru dan mengetahui karakteristik yang berkontribusi pada kadar 25(OH)D. Metode: Penelitian merupakan penelitian potong lintang. Pasien dengan usia >18 tahun yang baru terdiagnosis dengan adenokarsinoma paru berdasarkan hasil histopatologi melalui tindakan biopsi jaringan di RS Persahabatan. Pasien secara konsekutif direkrut ke dalam penelitian ini. Pasien lalu dilakukan wawancara mengenai perjalanan penyakit, aktivitas harian dan konsumsi makanan harian menggunakan food frequency questionnaire. Pasien dilakukan pengambilan darah untuk pemeriksaan kadar 25(OH)D serum. Nilai 25(OH)D di bawah 20 ng/mL dinilai sebagai defisiensi 25(OH)D. Selanjutnya, dilakukan analisis bivariat proporsi defisiensi 25(OH)D berdasarkan variabel karakteristik dasar dan dilakukan regresi logistik untuk mengetahui faktor yang memengaruhi proporsi defisiensi 25(OH)D. Analisis statistik menggunakan SPSS versi 27. Hasil: Pada penelitian ini, didapatkan 82 subjek dengan rerata usia 60,2 (SD±10,26) tahun dan 46 (56,1%) di antaranya adalah laki-laki. Didapatkan defisiensi 25(OH)D pada penelitian ini adalah pada 50 subjek (61,0%), insufisiensi 25(OH)D pada 22 subjek (26,8%) dan kadar 25(OH)D normal pada 10 subjek (12,2%). Median kadar 25(OH)D pada penelitian ini adalah 17,2 (IQR 13,5) ng/mL. Berdasarkan analisis regresi logistik, didapatkan variabel jenis kelamin, indeks massa tubuh, asupan harian vitamin D dan aktivitas luar ruangan yang memengaruhi kejadian defisiensi 25(OH)D. Kesimpulan: Pasien KPKBSK jenis adenokarsinoma paru memiliki proporsi defisiensi 25(OH)D cukup besar, terutama pada pasien perempuan, IMT berlebih, asupan harian vitamin D rendah dan kurang aktivitas di luar ruangan. Diperlukan penapisan dan tata laksana defisiensi 25(OH)D pada pasien kanker paru karena memengaruhi kesintasan dan perjalanan penyakit.
Kata kunci: 25-hidroksivitamin D; defisiensi vitamin D; kanker paru; potong lintang


Background: Lung cancer is a malignancy that has a high mortality rate. There is evidence that low 25(OH)D levels increase the risk of lung cancer and 25(OH)D deficiency carries a poor prognosis. The aim of this study was to determine the proportion of 25(OH)D deficiency in lung adenocarcinoma patients and to determine the characteristics that contribute to 25(OH)D levels. Method: This research is a cross-sectional study. Adult patients aged over 18 years who have just been diagnosed with lung adenocarcinoma based on histopathology results through tissue biopsy at Persahabatan Hospital. Patients were consecutively recruited into the study. The patient was then interviewed regarding the course of the disease, daily activities and daily food consumption using a food frequency questionnaire. Next, the patient will have blood drawn to check serum 25(OH)D levels. Patients with 25(OH)D values below 20 ng/mL were assessed as 25(OH)D deficient. Next, a bivariate analysis was carried out on the proportion of 25(OH)D deficiency based on baseline characteristic variables Then, logistic regression was carried out to determine the factors that influenced the proportion of 25(OH)D deficiency. SPSS version 27 was used to run statistical analysis. Results: In this study, there were 82 subjects with a mean age of 60.2 (SD ± 10.26) years and 46 (56.1%) of them were men. It was found that 25(OH)D deficiency in this study was in 50 subjects (61.0%), 25(OH)D insufficiency in 22 subjects (26.8%) and normal 25(OH)D levels in 10 subjects (12, 2%). The median 25(OH)D level in this study was 17.2 (IQR 13.5) ng/mL. Based on logistic regression analysis, it was found that the variables gender, body mass index, daily intake of vitamin D and outdoor activities influenced the incidence of 25(OH)D deficiency. Conclusion: NSCLC patients with lung adenocarcinoma type have a fairly large proportion of 25(OH)D deficiency, especially in female patients, excessive BMI, low daily intake of vitamin D and lack of outdoor activities. Screening and management of 25(OH)D deficiency in lung cancer patients is necessary because it affects survival and disease course.
Key words: 25-hydroxyvitamin D; cross-sectional; lung cancer; vitamin D deficiency