Profil Klinis dan Terapeutik Anak Hiperplasia Adrenal Kongenital Terkait Gizi Lebih dan Obesitas
Sari
Latar belakang. Obesitas pada anak hiperplasia adrenal kongenital (HAK) dapat terjadi akibat penyakit dan terapi glukokortikoid. Di Indonesia, belum diketahui prevalensi gizi lebih dan obesitas pada anak HAK serta faktor-faktor yang berhubungan.
Tujuan. Mengetahui prevalensi gizi lebih dan obesitas anak HAK dan faktor yang berhubungan (faktor penyakit, faktor terapi, dan faktor umum).
Metode. Uji potong lintang pada anak HAK yang berobat di RSCM dan RS lain di Jabodetabek selama Maret-Juni 2013. Pencatatan data klinis, analisis diet, dan pemeriksaan kadar 17-hidroksiprogesteron (17-OHP) dilakukan pada setiap subjek.
Hasil. Empatpuluh sembilan subjek-38 perempuan dan 11 laki-laki, rentang usia 0,4-18,3 tahun-memenuhi kriteria inklusi dan eksklusi. Subjek tipe salt wasting (SW) 79,6% dengan median usia awal terapi 2,5 tahun lebih muda dibandingkan kelompok non-SW. Rerata dosis hidrokortison 17,2 (SB 6,4) mg/m2/hari dan median durasi terapi 5,7 (rentang 0,1-18,3) tahun. Sebagian besar subjek memiliki kontrol metabolik undertreatment (36/49) dengan median kadar 17-OHP 19 (rentang 0,2-876) nmol/L. Terdapat 19 subjek sudah pubertas, 6 di antaranya mengalami pubertas prekoks. Ditemukan prevalensi gizi lebih dan obesitas 5,3% pada kelompok usia balita dan 66,7% usia lebih dari 5 tahun. Subjek memiliki asupan gizi lebih dari 62,5%. Subjek dengan usia lebih dari 5 tahun, sudah pubertas, atau mengalami pubertas prekoks lebih berisiko mengalami gizi lebih dan obesitas. Durasi terapi glukokortikoid berkorelasi sedang (r=0,668; p=0,000) dengan indeks massa tubuh (IMT), sedangkan dosis terapi tidak menunjukkan korelasi dengan IMT.
Kesimpulan. Prevalensi gizi lebih dan obesitas pada anak HAK adalah 42,9%. Subjek dengan usia lebih dari 5 tahun, sudah pubertas, atau mengalami pubertas prekoks lebih berisiko mengalami gizi lebih dan obesitas. Terdapat korelasi sedang antara durasi terapi glukokortikoid dengan IMT
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DOI: http://dx.doi.org/10.14238/sp16.3.2014.201-9
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