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"ABSTRAKTujuan : Untuk mengetahui nilai pembatas indikator kelebihan lemak tubuh pada lansia.Tempat : Puskesmas Kecamatan Kotamadya Semarang yang mempunyai program lansia binaan.Bahan dan cara : Studi cross-sectional pada lansia 60 tahun ke atas(69 pria dan 173 wanita), subyek penelitian dipilih secara acak sederhana pada tingkat Puskesmas. Data yang dikumpulkan meliputi : data non nutrisi, data nutrisi, antropometri, kadar lipid serum data gula darah puasa .Penetapan nilai pembatas indikator kelebihan lemak tubuh (IMT, Lpe, rasioLPe/Lpa ,ML) ditetapkan pada nilai median. Sedangkan nilai indikator metabolik sebagai faktor risiko PJK ditetapkan pada batas diwaspadai (berdasarkan Konsensus Nasional Dislipidemia Indonesia, 1993).Hasil : Profil kol. total dan kol. HDL serum subyek wanita lebih tinggi daripada subyek pria (p = 0,001). Prevalensi faktor risiko PJK seperti dislipidemia pada subyek wanita lebih tinggi dibandingkan subyek pria (p < 0.05). Nilai-nilai pembatas indikator kelebihan lemak tubuh yang diperoleh pada penelitian ini yaitu IMT (pria 21 kg/m2; wanita 23 kg/m2 ), LPe (pria 79 cm; wanita> 80 cm), rasio LPe-LPa (pria) 0,91; wanita > 0,85), massa lemak tubuh (pria > 22 %; wanita > 35 %). Sensitifitasnya dikaitkan dengan profit lipid sebagai faktor risiko PJK yaitu 40 - 60 %, sedangkan spesifisitasnya 70 - 80 %. Terdapat perbedaan determinan komposisi tubuh terhadap gangguan metabolik pada subyek pria dan wanita. Pada subyek pria nilai pembatas indikator kelebihan lemak tubuh berkorelasi dengan TG dan GDP, sedangkan pada subyek wanita berkorelasi dengan kol. HDL, kol. total, kol. LDL dan TO.Kesimpulan : Nilai-nilai pembatas indikator kelebihan lemak tubuh yang didapat pada penelitian ini cenderung memberi spesifisitas yang lebih tinggi dibanding dengan sensitifitasnya (dikaitkan dengan dislipidemia). Pada subyek pria indikator kelebihan lemak tubuh lebih terkait pada TG den GDP. Sedangkan pada subyek wanita indikator kelebihan lemak tubuh lebih terkait pada dislipidemia.

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ABSTRACT

The Cut Off Point Determination Of Overfatness In Relation to Selected CHD Risks In Elderly In Semarang

Objective :

To determine cut off points of overfatness in the elderly using CHD risks factors as the end points.

Place :

Seven public health centers with elderly clubs in Semarang municipal.

Materials and Methods :

This cross-sectional study involved 242 elderly individuals (69 males & 173 females), aged 60 years and over. Simple random sampling was applied at the PHC level. Structured questionnaires were used to collect information on sosiodemography, life styles, food habits and practices Anthropometric assessments were done to estimate body compositional status. Serum lipids and fasting blood glucose were measured to identify metabolic disorders. High body mass index, high abdominal circumference, high abdominal hip ratio and high fat mass values were used as overfatness indicators. The Indonesian National Consensus on Dyslipidemia was used to identify dyslipidemic cut off values.

Results :

Mean serum total cholesterol and high density lipoprotein (HDL) cholesterol in females were higher than those in males (220.99 ± 46.66 vs 199.31 ± 35.71, p = 0.001 and 51.17 ± 11.58 vs 45.22 ± 12.52, p = 0.001, respectively). The prevalence of CHD risks (dyslipidemic profiles) in females were also higher than that in males (p < 0.05). With respect to CHD risks, cut-off points for overfatness using BM1 values were > 21 kglr2 and ) 23 kglm2 for males and females respectively. Cut off points for other overfatness indicators were AC) 79 cm and ) 80 cm; AHR > 0.91 and ) 0.85 and percent body fat 3 22% and ) 35% for males and females, respectively. Using these cut off values, the sensitivity ranged from 40 -- 60% and the specificity ranged from 70 -- 80%. There were gender differences in the determinants of metabolic disorders. In males, overfatness was more related to TG and fasting blood glucose values. On the other hand, in females, overfatness was more related to total cholesterol, HDL cholesterol, LDL cholesterol and TG.

Conclusion :

This study supports the findings reported by other investigators that cut off values for overfatness, in relation to metabolic disorders, are more specific than sensitive. Gender differences in the determinants of metabolic disorders indicate that interpretation on body compositional disorders in the elderly should be taken cautiously."

"ABSTRAKPrevalensi diabetes melitus (DM) di dunia semakin meningkat. Pada DM terjadipenurunan sensitivitas jaringan yang dikenal dengan resistensi insulin, di manasalah satu penyebabnya ialah akumulasi massa lemak (ML) tubuh. AkumulasiML, dapat terdistribusi di bagian subkutan abdomen (LSA) atau di antara ronggadalam abdomen (LVA). Rasio LVA terhadap LSA merupakan perbandingandistribusi ML pada kedua kompartemen tersebut. Masih menjadi kontroversikompartemen mana yang mempunyai korelasi dengan resistensi insulin. Tujuanpenelitian ini adalah untuk mengetahui korelasi antara distribusi ML tubuh denganresistensi insulin pada laki-laki usia produktif dengan aktivitas sedang diIndonesia. Penelitian dilakukan dengan rancangan potong lintang pada salah satupabrik di Bekasi dengan melibatkan 52 orang karyawan yang memenuhi kriteriapenelitian dan terpilih secara simple random sampling serta bersediamenandatangani informed consent. Waktu pengambilan data dilakukan pada bulanOktober 2014, meliputi data karakteristik demografi, status gizi, asupan makan,komposisi tubuh, distribusi ML tubuh, rasio LVA : LSA dan penilaian resistensiinsulin melalui pemeriksaan HOMA-IR. Hasil penelitian didapatkan subjekmempunyai rerata indeks massa tubuh (IMT) 25,36 kg/m2 dengan sebagian besarsubjek mempunyai IMT di atas normal. Rerata persentase ML tubuh subjeksebesar 20,03% dengan lebih dari separuh subjek (51,9%) mempunyai persentaseML dalam batas normal. Rerata luas LVA subjek sebesar 101,04 cm2 dan LSA163,83 cm2 sedangkan rasio LVA : LSA mempunyai rerata 0,62, di mana seluruhsubjek mempunyai nilai rasio LVA : LSA normal. Nilai tengah HOMA-IRsebesar 1,62. Terdapat korelasi yang cukup kuat antara LVA (r=0,381) denganHOMA-IR dan LSA (r=0,404) yang bermakna secara statistik (p<0,05) sedangkanpada rasio LVA : LSA terhadap HOMA-IR didapatkan korelasi cukup yangberlawanan arah (r=-0,222) namun tidak bermakna secara statistik (p>0,05).Berdasarkan hasil ini, dapat disimpulkan bahwa LSA lebih berperan untukterjadinya resistensi insulin pada laki-laki usia produktif dengan aktivitas fisiksedang di Indonesia.

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ABSTRACTPrevalence of diabetes mellitus (DM) in the world is steady growing. In DMpopulation less tissue sensitivity to insulin are well known, in which one of thecauses is the accumulation of fat mass. Fat mass distributed in the subcutaneousadipose tissue (SAT) or in the visceral adipose tissue (VAT). The ratio of VAT toSAT is a comparison of distribution of the fat mass in the both compartments,because it is still a matter of controversy, which compartment has correlation withinsulin resistance. The aim of this study is to determine body fat distribution inproductive age male with moderate activity in Indonesia and its correlation withinsulin resistance. The study was conducted with a cross-sectional design in onefactory in Bekasi, involving 52 employees who met the inclusion criteria andselected by simple random sampling and were willing to sign an informedconsent. Data collection was carried out in October 2014, included data ondemographic characteristics, nutritional status, nutrient intake, body composition,body fat distribution, ratio VAT : SAT and assessment of insulin resistance byHOMA-IR. The results showed subjects had a mean body mass index (BMI)25.36 kg / m2 with most subjects had a BMI above the normal. The meanpercentage of fat mass subject is 20.03% with more than half of the subjects(51.9%) had a percentage fat mass within normal values. Wide averages VATsubject of 101.04 cm2 and SAT 163.83 cm2 while ratio VAT : SAT has a mean of0.62, where the whole subject has normal values ratio VAT: SATwhile themedian of HOMA-IR is 1.62. There is a fairly strong correlation between VAT (r= 0.381) with HOMA-IR and SAT (r = 0.404) were statistically significant (p<0.05), while there were inverse correlation of VAT : SAT ratio with HOMA-IR(r=-0.222), but not statistically significant (p> 0.05). Based on these results, we conclude that the SAT has a role for the development of insulin resistance in menof productive age with moderate physical activity in Indonesia"