Skripsi

Hubungan Aktivitas Penyakit dengan Indeks Lipid Accumulation Product (LAP) pada Pasien Lupus Eritematosus Sistemik = Association Between Disease Activity and Lipid Accumulation Product (LAP) in Patients with Systemic Lupus Erythematosus.

Latar Belakang Lupus eritematosus sistemik (LES) merupakan penyakit autoimun kronis dengan inflamasi sistemik yang kerap disertai perubahan metabolisme lipid. Inflamasi berkelanjutan dan penggunaan terapi jangka panjang dapat memengaruhi akumulasi lemak viseral, salah satunya dinilai dengan indeks lipid accumulation product (LAP). Meskipun LAP diketahui sebagai penanda risiko metabolik, hubungan aktivitas penyakit LES dengan nilai LAP masih belum banyak diteliti. Penelitian ini bertujuan untuk menganalisis hubungan antara aktivitas penyakit LES dengan indeks LAP. Metode Penelitian observasional potong lintang ini menggunakan data sekunder pasien LES dewasa di Divisi Alergi Imunologi Klinik FKUI/RSCM periode 2020–2022. Aktivitas penyakit diukur dengan skor Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI), sedangkan indeks LAP dihitung berdasarkan lingkar pinggang dan kadar trigliserida. Analisis dilakukan dengan uji bivariat (independent T-test atau Mann-Whitney) sesuai dengan distribusi data. Hasil Sebanyak 93 subjek memenuhi kriteria inklusi, terdiri atas kelompok remisi-ringan (n=71) dan sedang-berat (n=22). Seluruh subjek adalah perempuan dengan rerata (SD) usia 34,3 ± 9,2 tahun, menggunakan kortikosteroid, dan sebagian besar memiliki indeks massa tubuh normal [median (IQR): 22,7 (20,5–25,1)]. Sebanyak 65,6% menggunakan hidroksiklorokuin dan 58,1% mikofenolat sodium. Median dosis steroid adalah 5 (2,5– 8,9) mg per hari setara prednison. Tidak terdapat hubungan bermakna antara aktivitas penyakit LES dengan median (IQR) indeks LAP [22 (13–38) vs 25 (17,5–35,3); LES remisi-ringan vs sedang-berat; p = 0,581]. Kesimpulan Tidak didapatkan hubungan bermakna antara aktivitas penyakit LES dengan indeks LAP.
Kata Kunci: aktivitas penyakit, lipid accumulation product, lupus eritematosus sistemik


Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with systemic inflammation often accompanied by lipid metabolism alterations. Persistent inflammation and long-term therapy may affect visceral fat accumulation, which can be assessed using the lipid accumulation product (LAP) index. Although LAP is recognized as a marker of metabolic risk, the association between SLE disease activity and LAP values has not been widely investigated. This study aimed to analyze the relationship between SLE disease activity and the LAP index. Method A cross-sectional observational study utilized secondary data of adult SLE patients from the Clinical Allergy and Immunology Division, Faculty of Medicine Universitas Indonesia–Cipto Mangunkusumo Hospital, during 2020–2022. Disease activity was measured using the Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI), while LAP was calculated based on waist circumference and triglyceride levels. Bivariate analysis (independent T-test or Mann-Whitney) according to data distribution. Results A total of 93 subjects met the inclusion criteria, consisting of remission-mild (n=71) and moderate-severe (n=22) groups. All subjects were female with a mean (SD) age of 34.3 ± 9.2 years, receiving corticosteroids, and most had a normal body mass index [median (IQR): 22.7 (20.5–25.1)]. Hydroxychloroquine was used by 65.6% of subjects, and mycophenolate sodium by 58.1%. The median daily steroid dose was 5 (2.5–8.9) mg prednisolone equivalent. No significant association was found between SLE disease activity and median (Q1 –Q3) LAP [22 (13–38) vs 25 (17.5–35.3); remission-mild vs moderate-severe; p = 0.581]. Conclusion No significant association was found between SLE disease activity and LAP index.
Keywords: disease activity, lipid accumulation product, systemic lupus erythematosus