Fatonah, Siti (2011) Kadar Adiponektin dan Tumor Necrosis Factor-Alpha pada Subyek Metabolically Healthy Obese. Magister thesis, Universitas Brawijaya.
Abstract
Latar belakang. Obesitas sangat berkaitan dengan kelainan metabolik. Namun, terdapat obes tanpa kelainan metabolik yang disebut “Metabolically Healthy Obese” (MHO). Patogenesis MHO belum banyak diketahui. Adiponektin merupakan sitokin antiinflamasi yang disekresi secara spesifik oleh adiposit dan berperan meningkatkan sensitifitas reseptor insulin. Kadar adiponektin menurun pada obesitas. Tumor Necrosis Factor-Alpha (TNF-α) adalah sitokin proinflamasi yang menyebabkan terjadinya resistensi insulin. Tumor Necrosis Factor-Alpha meningkat pada obesitas. Penelitian ini bertujuan untuk menentukan kadar adiponektin dan TNF-α pada MHO dibandingkan dengan obes dengan kelainan metabolik serta hubungan antara kadar adiponektin dan TNF-α terhadap indek resistensi insulin pada MHO dan obes dengan kelainan metabolik. Metode. Penelitian ini menggunakan 20 subyek MHO, 20 pasien obes dengan sindroma metabolik dan 20 kontrol sehat secara cross sectional . Obesitas diukur melalui BMI dan lingkar pinggang. Resistensi insulin menggunakan rumus HOMA-IR. Pemeriksaan glukosa menggunakan metode heksokinase, sedangkan pemeriksaan insulin, adiponektin dan TNF-α menggunakan ELISA. Analisis data menggunakan uji komparatif t tidak berpasangan dan uji korelasi Pearson Product Moment . Dianggap bermakna jika p 0,05. Hasil. K adar adiponektin kelompok MHO tidak berbeda bermakna dari obes kelainan metabolik (7,30±1,42 dibanding 6,72±1,37; p = 0,201). Kadar TNF-α pada kelompok MHO lebih kecil secara signifikan dari obes kelainan metabolik (2,99±0,28 dibanding 3,68±0,46; p = 0,000). Hasil uji korelasi kadar adiponektin terhadap HOMA-IR pada MHO adalah r = -0,238, p = 0,067. Hasil uji korelasi kadar TNF-α terhadap HOMA-IR pada MHO adalah r = 0,793, p = 0,000. Hasil uji korelasi kadar adiponektin terhadap HOMA-IR pada obes kelainan metabolik adalah r = -0,391, p = 0,035. Hasil uji korelasi kadar TNF-α terhadap HOMA-IR pada obes dengan kelainan metabolik adalah r =0,830 dengan p = 0,000. Kesimpulan. Kadar adiponektin MHO tidak berbeda bermakna dibanding obes kelainan metabolik. Kadar TNFα MHO lebih rendah dibanding obes kelainan metabolik. Tidak terdapat hubungan antara kadar adiponektin terhadap indek resistensi insulin pada MHO. Terdapat hubungan antara kadar TNFα terhadap indek resistensi insulin pada MHO. Terdapat hubungan antara kadar adiponektin dan TNFα terhadap indek resistensi insulin pada obes kelainan metabolik.
English Abstract
Background. Obesity is related to metabolic syndrome. But , re are some obese patients that appear metabolically healthy and have been characterized as “ Metabolically Healthy Obese ” (MHO). pathogenesis of MHO individual is remain unexplained . Adiponectin is an antiinflammatory cytokine, it is exclusively secreted by adipocyte, and can improve insulin resistance. Serum level of adiponectin has been reported to be significantly reduced in obese humans. TNF-α is a pro inflammatory cytokine that can cause insulin resistance. Serum level of TNF-α has been increased in obesity. T he purpose of this study was to determine serum levels of adiponectin and TNF-α in MHO compared with obesity-related metabolic abnormalities and to determine relationship between serum levels of adiponectin and TNF-α with insulin resistance in MHO and obesity-related metabolic abnormalities. Method. study was a cross-sectional design using 20 subjects with MHO, 20 patients with obesity-related metabolic abnormalities and 20 subjects as healthy control. Obesity was measured with BMI and waist circumference. Insulin resistance was measured using HOMA-IR. Fasting serum glucose was measured with a hexokinase. Insulin, adiponectin, and TNF-α were measured by ELISA. Statistical analysis were performed by independent sample t tests and Pearson correlations. S ignificance was accepted at p 0.05. Results. Serum levels of adiponectin were higher but not significant in MHO compared with obesity-related metabolic abnormalities (7,30±1,42 vs 6,72±1,37; p = 0,201). Serum levels of TNF-α were significantly lower in MHO compared with obesity-related metabolic abnormalities (2,99±0,28 vs 3,68±0,46; p = 0,000). correlation between adiponectin level and HOMA-IR in MHO was r = -0,238, p = 0,067. correlation between TNF-α level and HOMA-IR in MHO was r = 0,793, p = 0,000. correlation between adiponectin level and HOMA-IR in obesity-related metabolic abnormalities was r = -0,391, p = 0,035. correlation between TNF-α level and HOMA-IR in obesity-related metabolic abnormalities wa
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.398/FAT/k/041104162 |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.3 Diseases of digestive system |
| Divisions: | Profesi Kedokteran > Spesialis THT Kepala dan Leher, Fakultas Kedokteran |
| Depositing User: | Endro Setyobudi |
| Date Deposited: | 29 May 2012 14:57 |
| Last Modified: | 29 May 2012 14:57 |
| URI: | http://repository.ub.ac.id/id/eprint/158350 |
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