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Lubis, Siska Mayasari
Hubungan antara kadar aktivitas renin plasma dengan hipertensi pada penderita hiperplasia adrenal kongenital defisiensi enzim 21-hidroksilase = Association between plasma renin activity with hypertension in children with congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency
"Latar belakang: Hipertensi bukan merupakan manifestasi klinis pasien hiperplasia adrenal kongenital defisiensi enzim 21-hidroksilase (HAK 21-OHD), oleh karena itu perlu diketahui angka kejadian hipertensi pada pasien HAK 21-OHD serta kemungkinan penyebabnya. Tujuan: Mengetahui hubungan antara kadar aktivitas renin plasma (PRA) dengan hipertensi pada anak HAK 21-OHD. Metode: Suatu studi analitik observasional dengan rancangan penelitian potong lintang. Sampel penelitian adalah anak HAK 21-OHD yang berusia >6 bulan-18 tahun, dipilih secara consecutive sampling, kemudian dibandingkan antara 2 kelompok, hipertensi dan tidak hipertensi. Hasil: Sebanyak 40 anak dianalisis, 20 subjek di kelompok hipertensi dan 20 subjek tidak hipertensi. Hipertensi ditemukan pada 16 dari 27 subjek (59,3%) HAK tipe salt wasting dan 4 dari 13 subjek (30,8%) HAK tipe simple virilizing. Diperoleh perbedaan rerata yang bermakna kadar PRA antara kelompok hipertensi dengan tidak hipertensi pada tipe salt wasting p=0,016). Risiko mengalami hipertensi pada pasien HAK tipe salt wasting dengan kadar PRA rendah adalah 1,09 kali setelah dikontrol variabel jenis kelamin, kadar 17-OHP, dan dosis terakhir fludrokortison. Dosis terakhir hidrokortison memiliki hubungan yang signifikan terhadap kejadian hipertensi pada pasien HAK tipe salt wasting. Kesimpulan: Kejadian hipertensi pada pasien HAK 21-OHD saat penelitian berlangsung adalah 32%. Risiko hipertensi pada pasien HAK tipe salt wasting dengan kadar PRA rendah adalah 1,09 kali setelah dikontrol variabel jenis kelamin, kadar 17-OHP awal, dan dosis terakhir fludrokortison.
Background: Hypertension is an uncommon manifestation of congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency (21-OHD CAH), therefore it is necessary to estimate the incidence of hypertension in 21-OHD CAH patients and the possible causes. Objective: To evaluate the association between plasma renin activity levels (PRA) with hypertension in children with 21-OHD CAH. Methods: An observational analytic study with a cross sectional study design. The subjects were 21-OHD CAH children, aged >6 months to 18 years, selected by consecutive sampling and then compared between 21-OHD CAH with hypertension and non hypertension groups. Results: A total of 40 subjects were analyzed, 20 subjects in the hypertension and 20 subjects in non hypertension groups. There were 16 from 27 (59.3%) and 4 from 13 subjects (30.8%) with hypertension in CAH salt wasting and simple virilizing types, respectively. There was significant mean difference in PRA levels between hypertension and non hypertension groups in CAH salt wasting patients (p=0,016). The risk of hypertension in CAH salt wasting patients with low PRA levels was 1,09 times after controlling for sex variables, 17-OHP levels, and the last dose of fludrocortisone. The last dose of hydrocortisone had a significant relationship with the incidence of hypertension in CAH salt wasting type patients. Conclusion: The incidence of hypertension in 21-OHD CAH patients during the study period was 32%. The risk of hypertension in CAH salt wasting patients with low PRA levels was 1.09 times after being controlled by sex, 17 OHP level, and the last dose of fludrocortisone."
Depok: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tesis Membership  Universitas Indonesia Library
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Bina Akura
Hubungan kadar androsteron dan etiokolanolon urin dengan kadar 17-Hidroksiprogesteron pada pasien hiperplasia adrenal kongenital defisiensi 21-Hidroksilase dalam pemantauan tata laksana = Correlation between androsterone, etiocholanolone urine with 17-hydroxyprogesterone in congenital adrenal hyperplasia due to 21-hydroxylase deficiency in treatment monitoring.
"Hiperplasia adrenal kongenital (HAK) adalah gangguan yang ditandai dengan defek pada enzim jalur steroidogenesis adrenal. Lebih dari 90% disebabkan mutasi pada CYP21A2 yang mengkode enzim 21-hidroksilase (21-OH). Monitoring tata laksana pasien HAK cukup sulit dicapai dengan menjaga keseimbangan antara overtreatment dan undertreatment.
Penelitian bersifat cross sectional dilakukan di RSCM berlangsung selama 7 bulan (Juni-Desember 2020). Pemilihan sampel dilakukan dengan consecutive sampling dengan total 142 sampel. Sampel pasien HAK sebanyak 71 pasien, serta pemilihan sampel kontrol dilakukan dengan matching jenis kelamin dan usia. Kelompok HAK dilakukan pemeriksaan kadar 17-hidroksiprogesteron (17-OHP) serta androsteron, etiokolanolon urin dan rasio androsteron/etiokolanolon urin (A/E). Uji korelasi dilakukan antara androsteron, etiokolanolon, rasio A/E dengan 17-OHP. Kelompok kontrol dilakukan pemeriksaan androsteron, etiokolanolon urin dan rasio A/E. Hasil kedua kelompok dilakukan komparasi.
Dari 71 kelompok HAK dan 71 kelompok kontrol mempunyai karakteristik dasar yang sebanding. Kadar androsteron kelompok HAK dibandingkan dengan kelompok kontrol berbeda bermakna (683,89(29,42-61061,43) vs 123,97(30,16- 16463,05) ng/mL;p<0,001). Kadar etiokolanolon kelompok HAK berbeda bermakna dibandingkan dengan kelompok kontrol (235,88(12,77-78446,65) vs 70,96(12,61-17332,62)ng/mL;p<0,001). Rasio A/E kelompok HAK berbeda bermakna dibandingkan dengan kelompok kontrol (2,31(0,37-40,12) vs 1,99(0,52- 5,45); p0,003). Kadar androsteron, etiokolanolon, rasio A/E mempunyai korelasi positif dengan kadar 17-OHP (r=0,505; r=0,367; r=0,313).
Kesimpulan: Androsteron, etiokolanolon dan rasio A/E mempunyai kadar yang lebih tinggi pada pasien HAK. Androsteron mempunyai korelasi sedang, etiokolanolon dan rasio A/E mempunyai korelasi lemah terhadap 17-OHP.
Congenital adrenal hyperplasia (CAH) is a disorder characterized by defects in one of the enzymes of the adrenal steroidogenesis pathway. More than 90% of cases are due to mutations in CYP21A2, the gene coding for 21-hydroxylase (21-OH) enzyme. Treatment monitoring in CAH patients is quite difficult to achieve due to fine balance of overtreatment and undertreatment.
Cross sectional study was conducted in RSCM for 7 months (June-December 2020). Consecutive sampling was used with total 142 samples. There were 71 patients CAH were included in this study. Control samples were selected by matching age and sex. In CAH group, 17-hydroxyprogesterone (17-OHP), urine androsterone, etiocholanolone, and ratio androsterone/etiocholanolone (A/E) were measured. Correlations were measured between androsterone, etiocholanolone, ration A/E with 17-OHP. In control sample urine androsterone, etiocholanolone, and ratio androsterone/etiocholanolone (A/E) were also measured. These results were compared between two groups.
In 71 CAH group and 71 control group had almost same characteristics. Androsterone level in CAH group had a significant different compared to the control group (683.89(29.42-61061.43) vs 123.97(30.16-16463.05) ng/mL;p<0.001). Etiocholanolone level in CAH group had a significant different compared to the control group (235.88(12.77-78446.65) vs 70.96(12.61- 17332.62)ng/mL; p<0.001). Ratio A/E n CAH group had a significant different compared to the control group (2.31(0.37-40.12) vs 1.99(0.52-5.45); p=0.003). Androsterone, etiocholanolone and ratio A/E had positive correlation with 17-OHP level (r=0.5050; r=0.367; r=0.313).
Conclusions: Androsterone, etiocholanolone, and ratio A/E had higher level in CAH subjects. Androsterone had intermediate correlation with 17-OHP, meanwhile etiocholanolone and ratio A/E had weaker correlation."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tugas Akhir  Universitas Indonesia Library
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Hasibuan, Susi Natalia
Perbandingan CDC Chart dan Indonesian National Growth Chart untuk menilai tinggi badan anak SDN Nabire-Papua dan SDN Jakarta serta faktor yang memengaruhi = Comparison of CDC Chart and Indonesia National Growth Chart to assea Height in elementary school children Nabire-Papua with Jakarta, as well as Factors Influencing
"Latar belakang: Pertumbuhan dapat optimal, jika faktor nature maupun nurture berjalan harmonis. Berdasarkan kurva WHO, angka stunting Riskesdas tahun 2012, Papua lebih tinggi dibandingkan Jakarta. Anak Indonesia terbukti lebih pendek, tetapi BMI-nya tidak menunjukkan deviasi bermakna.
Obyektif: Membandingkan TB anak SDN Nabire-Papua dengan SDN Jakarta, faktor yang memengaruhi, menggunakan CDC dan Indonesian National Growth Chart.
Metodologi: Desain penelitian adalah analitik cross sectional, Desain I, membandingkan TB anak Nabire asli Papua dan non-Papua. Desain II, membandingkan TB anak SDN Nabire-Papua dan Jakarta, dengan CDC dan Indonesia National Growth Chart.
Hasil: Penelitian I, jumlah subyek 189, terdiri dari 115 anak Nabire-asli-Papua dan 71 non-Papua, didapatkan anak non-Papua, 2,7 cm lebih tinggi dibanding asli-Papua (p=0,0465). Penelitian II, SDN Nabire-Papua 1.829 subyek, sedangkan SDN Jakarta 1.283 subyek, didapatkan anak perempuan asli-Papua lebih pendek dibanding non-Papua (p=0,001), sebaliknya pada anak lelaki. Diasumsikan, perbedaan TB disebabkan faktor nurture. Terdapat hubungan signifikan pendidikan ibu dan pendapatan ayah terhadap TB anak SDN Jakarta. Namun, tidak terdapat hubungan terhadap BMI. Anak SDN Jakarta lebih tinggi dibanding SDN Nabire-Papua. Persentase anak SDN Nabire-Papua dan Jakarta yang stunted dan juga wasted dengan Indonesia National Growth Chart, lebih sedikit dibanding dengan CDC.
Kesimpulan: Anak pendek SDN Nabire-Papua bukan stunting. Telah terjadi trend sekuler positif TB anak SDN Jakarta.. Indonesia National Growth Chart lebih sesuai menggambarkan pertumbuhan anak Indonesia.
Background: Optimal growth achieved with harmonious nature and nurture factors. Riskesdas 2012 mentions, stunting rate in Papua is higher than Jakarta. WHO curve proves that Indonesian children shorter, but the BMI does not show deviations.
Objective: Comparing Heigh of Nabire-Papua to Jakarta elementary children and influencing factors using CDC and Indonesian National Growth Chart.
Methodology: Design of research is cross sectional analytic. Design I, to compare height of children Nabire-Papuanese and non-Papuanese. Design II, to compare height of Nabire-Papua and Jakarta elementary children, with CDC and Indonesia-National-Growth-Chart.
Results: Study I, Non-Papuanese children, 2.7 cm higher than Papuanese (p=0,0465). Research II, Height of Papuanese girls shorter than non-Papuanese (p=0.001), otherwise on boys. This assumptions, the difference of height due to nurture factors There is significant relationship maternal education and father's income to SDN Jakarta children´s height. However, no connection to BMI. Children of SDN Jakarta higher than Nabire-Papua. Percentage of Nabire-Papua and Jakarta elementary children´s were stunted and wasted with Indonesia National Growth Chart, fewer than CDC.
Conclusion: Nabire-Papua Children´s are not stunting. Secular positive trend of height Jakarta children. Indonesia National Growth Chart more suitable to describe growth of Indonesian children."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library