Hubungan Ketebalan Tunika Intima Media Arteri Carotis dengan Obesitas pada Remaja
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Latar belakang. Obesitas pada anak adalah masalah yang kompleks dengan penyebab multifaktorial, sehingga menyulitkan tata laksananya. Permasalahan yang timbul akibat obesitas berpengaruh terhadap tekanan darah, fungsi metabolisme, diabetes, penyakit kardiovaskular, dan lain-lain.
Tujuan. Menilai ketebalan tunika intima-media (intima media thickness / IMT) arteri karotis sebagai petanda awal aterosklerosis pada anak remaja dengan obesitas dini dan faktor-faktor yang mempengaruhinya.
Metode. Penelitian observasional dengan rancang bangun cross sectional terhadap 43 remaja obes dan 21 remaja sehat sebagai kontrol. Data meliputi kadar kolesterol total, kolesterol LDL dan HDL, trigliserida dan apolipoprotein B. Penilaian ketebalan tunika intima-media arteri karotis dilakukan dengan alat ultrasonografik. Pengolahan data dengan uji t tidak berpasangan, chi-square atau uji Fisher dan Anova. Untuk hubungan antar variabel digunakan uji regresi linier.
Hasil. Terdapat perbedaan yang bermakna ketebalan tunika intima media arteri karotis remaja obes (rerata 0,41 mm; SB 0,05) dibandingkan kontrol 0,33 mm (SB 0,01) (p=0,001). Demikian juga kadar kolesterol total (p=0,001); kolesterol LDL (p=0,001), kolesterol HDL (p=0,004), trigliserida (p=0,017 ) dan apolipoprotein B (p=0,001). Tekanan darah sistolik anak obes rerata 118,2 mmHg (SB10,4), kontrol 109,5 mmHg (SB12,7) dan diastolik anak obes rerata 81,5 mmHg (SB 7,3); kontrol 68,6 mmHg (SB 7,4) berbeda bermakna dengan nilai p berturut-turut 0,004 dan 0,001. Dengan uji regresi linier terdapat hubungan ketebalan tunika intima media arteri karotis dengan indeks masa tubuh (r=0,640;p=0,001); dengan indeks BB/TB (r=0,627;p=0,001). Tetapi tidak terdapat hubungan ketebalan tunika intima media arteri karotis dengan kadar profil lipid. Kadar kolesterol HDL memiliki hubungan yang bermakna dengan ketebalan tunika intima media arteri karotis (r=-0,581; p=0,020).
Kesimpulan. Ketebalan tunika intima media arteri karotis, kadar profil lipid, tekanan darah sistolik dan diastolik pada remaja obes berbeda bermakna dibandingkan anak dengan BB normal. Terdapat hubungan peningkatan ketebalan tunika intima media arteri karotis dengan peningkatan indeks masa tubuh, indeks BB/TB, tekanan darah diastolik, dan kadar kolesterol HDL yang rendah.Â
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DOI: http://dx.doi.org/10.14238/sp11.3.2009.159-66
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