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Abstrak :
ABSTRAK
Latar Belakang : Kotinin merupakan hasil metabolit utama nikotin dan kadarnya pada urin merupakan indikator pajanan asap rokok. Penlitian ini untuk mengetahui kadar kotinin urin pada anak yang terpajan dan tidak terpajan asap rokok di lingkungan rumah. Metode : Penelitian potong lintang pada anak usia sekolah dasar yang tidak merokok. Subjek dikelompokkan menjadi kelompok terpajan dan tidak terpajan berdasarkan status pajanannya. Data yang diperoleh dari kuesioner dan sampel urin sewaktu yang diukur dengan metode ELISA. Hasil : Total subjek 128 anak usia 6-12 tahun yang terdiri dari 64 anak pada kelompok terpajan dan 64 anak yang tidak terpajan. Kadar kotinin urin pada kelompok terpajan lebih tinggi dibandingkan kelompok tidak terpajan (median 30,1 vs 8,45 ng/ml; p<0.05). Terdapat perbedaan kadar kotinin pada anak yang terpajan asap rokok dengan jumlah batang rokok yang dihisap oleh perokok di rumah (p<0.05). Status pajanan asap rokok berhubungan dengan keluhan batuk, infeksi saluran napas atas dan rawat inap karena keluhan respirasi pada anak. Nilai titik potong optimal kadar kotinin urin pada anak untuk menilai pajanan asap rokok yaitu 17,95 ng/ml (sensitifitas 81%, spesifisitas 81%, AUC 91,2%, p<0.05). Kesimpulan: Kadar kotinin urin dapat digunakan sebagai biomarker yang tidak invasif untuk evaluasi pajanan asap rokok pada anak. ABSTRACT
Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children.

Abstrak :
ABSTRAK Latar belakang: Penyakit paru obstruktif kronik merupakan penyebab utama morbiditas dan mortalitas di dunia. Penyakit komorbid pada PPOK berkontribusi terhadap rendahnya status kesehatan, mempengaruhi lama perawatan bahkan kematian. Osteoporosis merupakan komorbid yang cukup sering ditemukan pada PPOK. Di Indonesia khususnya di RSUP Persahabatan belum ada data prevalens osteoporosis pasien PPOK stabil. Objektif: Tujuan penelitian ini adalah mendapatkan angka prevalens osteoporosis pada pasien PPOK stabil di RSUP Persahabatan Jakarta. Metode: Disain penelitian ini adalah potong lintang. Pasien PPOK stabil yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi. Subjek diperiksa densitas mineral tulang menggunakan dual energy x-ray absorptiometry (DXA) dan diperiksa kadar vitamin D darah. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, penilaian status gizi. Selanjutnya dilakukan analisis dengan uji statistik. Hasil: Subjek terbanyak adalah laki-laki (90,6%) dengan kelompok usia 65-75 tahun (53,1%), riwayat merokok terbanyak (84,4%). Berdasarkan derajat PPOK terbanyak adalah GOLD II (46,9%) dan grup B (50%) dengan menggunakan kortikosteroid sebanyak (65,7%). Pada penelitian ini didapatkan prevalens osteoporosis sebesar 37,5%, artinya lebih dari sepertiga pasien mengalami osteoporosis. Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara grup PPOK, derajat PPOK, jenis kelamin, riwayat merokok, riwayat kortikosteroid, usia, kadar 25-OHD, faal paru dengan terjadinya osteoporosis pada pasien PPOK stabil (p>0,05). Pada penelitian ini didapatkan hubungan bermakna pada IMT yang rendah sebagai faktor risiko osteoporosis pada PPOK stabil (p<0,001). Kesimpulan: Prevalens osteoporosis pada pasien PPOK stabil di RSUP Persahabatan Jakarta adalah 37,5%. Terdapat hubungan yang bermakna secara statistik antara IMT dengan osteoporosis pada pasien PPOK stabil (p<0,001).

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ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Comorbid diseases in COPD contributing to low health status, affecting the duration of treatment and even death. Osteoporosis is a quite often comorbid that found in COPD. In Indonesia, particularly in Persahabatan Hospital there are no data of prevalence on osteoporosis in patient with stable COPD. Objective: The purpose of this research is to get the prevalence?s data of osteoporosis in patients with stable COPD at Persahabatan Hospital-Jakarta. Method: The studie?s design was cross-sectional. Patients with stable COPD who came to the Asthma/COPD policlinic at Persahabatan Hospital-Jakarta who meet the criteria of inclusion and exclusion. Subjects had an examined of bone mineral density using dual energy x-ray absorptiometry (DXA) and had an examined of vitamin D blood level. At the time of visit, conducted anamnesis of symptoms, exacerbations, history of smoking, used of corticosteroid (oral or inhaled), comorbid, assessment of nutritional status. Then we did statistical test for analysis. Results: Subjects were dominated with male (90.6%) in the age group 65-75 years old (53.1%), and smoking history (84.4%). The most degree of COPD of the subject were GOLD II (46.9%) and group B (50%) that using corticosteroid (65.7%). In this study we found prevalence of osteoporosis was 37.5%, meaning that approximately more than one third of the patients have had osteoporosis. There were no statistically significant relationship between COPD group, the degree of COPD, sex, smoking history, history of corticosteroid, age, levels of 25-OHD, pulmonary function with the occurrence of osteoporosis in patients with stable COPD (p>0.05). We found a significant relationship on low BMI as a risk factor for osteoporosis in stable COPD (p<0.001). Conclusion: The prevalence of osteoporosis in patients with stable COPD in Persahabatan Hospital-Jakarta is 37.5%. There are a statistically significant relationship between BMI with osteoporosis in patients with stable COPD (p <0.001).