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ABSTRAK Nama : Purwo Setiyo Nugroho Program Studi : Magister Epidemiologi Judul : Hubungan Diabetes Melitus Dengan Penyakit Jantung Koroner (Analisis Data Baseline Kohor PTM Tahun 2011). Diabetes mellitus merupakan salah satu penyakit yang dapat menimbulkan komplikasi yang berakibat munculnya penyakit lainnya. Penyakit kardiovaskuler merupakan penyakit terbesar pada penderita diabetes mellitus. Penyakit jantung koroner merupakan penyakit kardiovaskuler terbanyak dibandingkan penyakit kardiovaskuler lainnya. Penelitian ini bertujuan untuk mengetahui hubungan diabetes mellitus dengan penyakit jantung koroner pada studi data Baseline Kohor PTM Kementrian Kesehatan. Analisis yang digunakan adalah Cox Regression yang mengestimasi nilai Prevalens Ratio. Hasil analisis multivariat dengan menggunakan analisis cox regression mengungkapkan bahwa orang yang menderita diabetes melitus memiliki prevalens rasio sebesar 1,094 kali (p value 0,929 CI 95 % 0,149 – 8,026) dibanding responden yang tidak menderita diabetes melitus. Namun, hasil analisis ini menunjukkan bahwa hubungan diabetes melitus terhadap penyakit jantung koroner tidak signifikan dengan mempertimbangkan nilai p value > 0,05 dan 95 % Confidence Interval yang rentangnya melewati angka 1. Dalam peneltian ini minim terjadinya bias seleksi karena tidak missing data pada sampel eligible sebanyak 1937 responden. Begitu pula minim terjadinya bias informasi karena pengukuran variabel penelitian menggunakan alat ukur yang baku. Namun penelitian ini memiliki kelemahan dalam temporality sehingga hasil penelitian tidak dapat di justifikasi bahwa diabetes mellitus merupakan penyebab penyakit jantung koroner. Serta nilai asosiasi prevalence ratio bukan merupakan nilai risiko yang sebenarnya. Kata Kunci : Diabetes Melitus, Penyakit Jantung Koroner, Baseline Kohor, Penyakit Tidak Menular
ABSTRACT Name : Purwo Setiyo Nugroho Program : Master of Epidemiology Title : Association of Diabetes Mellitus With Coronary Heart Disease (Baseline Data Analysis of Non-Communicable Disease, 2011). Diabetes mellitus is a disease that can cause complications that lead to the emergence of other diseases. Cardiovascular disease is the biggest disease in patients with diabetes mellitus. This study aims to determine the relationship of diabetes mellitus and coronary heart disease in the Baseline Data Non-Communicable Disease Cohort Study. The analysis is the Cox Regression estimate the Prevalence Ratio. Multivariate analysis using Cox regression analysis revealed that people suffering from diabetes mellitus have a prevalence ratio of 1.094 times (p value = 0.929 95% CI 0.149 to 8.026) than respondents who do not have diabetes mellitus. However, the results of this analysis showed that the association of diabetes mellitus against coronary heart disease is not significant considering p value <0.05 and 95% Confidence Intervals range is exceeded 1. This study the minimal selection bias because there is missing data on a sample of eligible total 1937 respondents. Similarly, the minimal bias variable measurement information for research using standard measurement tools. However, this study has weaknesses in temporality so that research results can not be justified that diabetes mellitus is a cause of coronary heart disease. Tthe value of association prevalence ratio is not the value of the actual risk. Keywords: Diabetes Mellitus, Coronary Heart Disease, Baseline Cohort, Non Communicable Disease
Kriteria utama obesitas menurut WHO adalah IMT namun obesitas sentral lebih berhubungan dengan risiko kesehatan dibanding obesitas umum Tujuan penelitian untuk mendapatkan cut off point dari ketiga indikator dalam mendeteksi terjadinya DMT2. Juga untuk mengetahui hubungan obesitas dengan indikator IMT, LP dan rasio LP-TB dengan terjadinya DMT2 dan menentukan indikator mana yang lebih baik dari ketiganya. Desain Cross Sectional. menggunakan data sekunder. Analisis menggunakan regresi logistic dan metode ROC.
Hasil : prevalensi DMT2 9,1% dan prevalensi obesitas berkisar 38,37 % - 41,98 % Nilai cut off obesitas umum IMT ≥ 25,72 kg/m2, LP laki-laki ≥ 80,65 cm perempuan ≥ 80,85 cm dan LP-TB laki-laki ≥ 0,51 perempuan ≥ 0,55.
Kesimpulan : orang dengan obesitas meningkatkan risiko terjadinya DMT2 setelah dikontrol faktor umur. Karena hasil ketiga indikator tidak jauh berbeda, maka penggunaanya tergantung keputusan praktisi kesehatan itu sendiri.
The WHO's major obesity criteria is BMI but central obesity is more associated to health risks than general obesity. The objective of the research is to define the cut off points of the three measurements in detecting the occurrence of T2DM. It is also aimed to examine the relationship of obesity indicators (BMI, WC, and WHtR) with T2DM and determine the best indicator of them. Design of Cross Sectional employs secondary data. Analysis apply logistic model and ROC method.
The result: prevalence of type 2 DM is about 9.1%, and obesity prevalence is about 38.37 % to 41.98 %. The cut off values of BMI general obesity, male WC, female WC, male WHtR, and female WHtR are ≥ 25.72 kg/m2, ≥ 80.65 cm, ≥ 80.85 cm, ≥ 0.5, and ≥ 0,55 respectively.
Conclusion: adjusted by age, obesity increases the risk of type 2 DM occurrence. Since there is no significantly different result, the use of obesity indicators depends on the health practitioner decisions.
Coronary Heart Disease (CHD) is a leading cause of death in the cardiovascular group. Obesity could increase a person's risk of progression from prediabetes to type 2 DM and increase the risk of cardiovascular disease. Prediabetes with obesity increases the risk of CHD events based on Cardiometabolic Disease Staging (CMDS). This study was used a retrospective cohort study design using secondary data on NCD Risk Factor Cohort Study in 2011-2018. The sample was 493 obese adult respondents in population of NCD Risk Factor Cohort Study whom met this study inclusion and exclusion criteria. The results of multivariate analysis using cox regression after being controlled by age and duration of obesity found that prediabetes had HR = 0.80 (95% CI: 0.462- 1.387), p = 0.429 which means the relationship between prediabetes with CHD events in obese adult respondents was not statistically significant.
ABSTRAK
Penyakit jantung koroner merupakan pembubuh utama di negara maju maupunnegara berkembang. Salah satu faktor risiko utama penyebab arterosclerosis adalahhiperkolesterolemia yang ditunjukkan dengan peningkatan kadar kolesterol LDL.Perubahan pola hidup yang ditandai dengan kurangnya mengkonsumsi buah dansayuran serta banyak mengkonsumsi makanan yang tinggi lemak, merupakan salahsatu risiko terjadinya peningkatan kadar kolesterol LDL. Penelitian ini bertujuanuntuk mengetahui hubungan asupan serat dengan kadar kolesterol LDL pendudukusia 25-65 tahun di Kelurahan Kebon Kalapa Bogor tahun 2013. Penelitian dilakukandengan desain cross sectional menggunakan data baseline Studi Kohor Faktor RisikoPenyakit Tidak Menular Badan Litbangkes tahun 2011. Analisis multivariatemenggunakan regresi logistik. Hasil analisis data diperoleh proporsi kolesterol LDLtinggi sebesar 78.3% dengan rata-rata kadar kolesterol 120 mg/dl. Rata-rata asupanserat sebesar 7 gram/hari dengan proporsi asupan serat <6.6 gram/hari sebesar 50.5%.Hasil multivariate menunjukkan asupan serat rendah merupakan faktor protektif (OR= 0.182) terhadap kadar kolesterol LDL tinggi setelah dikontrol oleh variabel umur,asupan lemak dan asupan protein nabati. Faktor determinan dalam model ini terhadapkadar kolesterol LDL adalah asupan protein nabati (OR = 13.356). Model ini mampumemprediksi kejadian kadar kolesterol LDL sebesar 79.4% dan sisanya dipengaruhioleh variabel lain yang tidak tercantun didalam model. Dengan melakukanpenyuluhan akan pentingnya mengkonsumsi makanan yang banyak mengandungserat merupakan salah satu upaya pencegahan terjadinya penyakit yang berhubungandengan arterocslerosis. Merubah pola makan dengan memperbanyak konsumsi buahakan mengurangi kadar kolesterol LDL dalam darah.
ABSTRACT
Coronary heart disease considers as one of the major killers both in developedand developing countries. One of the main risk factors that caused artherosclerosis ishypercholesterolemia which indicates by elevated LDL cholesterol level. Life stylechanging by lack of consuming fruits and vegetables while excess in consuming foodhigh in fat content considered one of risk to have elevated cholesterol level. The aimof this research is to identify the relationship between fiber consumption and thecontent of LDL cholesterol for the people of 25-65 years of age at Kebon KelapaVillage in Bogor on the Year of 2013. The research is conducted by Cross Sectional.The analytic design utilizes the baseline data from Cohort Study of ContagiousDisease Risk Factors of the Research and Development of Health Agency of theRepublic of Indonesia in the year of 2011. Stratification is used in analyzing data andcog regression is utilized in multivariate analysis. The analysis of the result obtainedthat the prevalence of LDL cholesterol is 78.3% with the average of cholesterolcontent 120 mg/dl. The average of daily fiber consumption is 7 gram/day with theproportion of fiber consumption <6.6 gram/day is 50.5%. The result of multivariateanalysis indicates that low fiber consumption considers as a protective factor(OR=0.182) toward high level of LDL cholesterol level after having controlled bysuch variables as age, consumptions of fat and vegetable protein. Determinant factorin this model toward LDL cholesterol content is the consumption of vegetable protein(OR=13.356). This model has the ability to predict in experiencing LDL cholesterollevel 79.4% and the remaining would be influenced by other factors that have notwritten down in the model. By educating the community about the important ofconsuming high fiber foods consider as one of the effort to prevent the occurrence ofdiseases relate with artherosclerosis. Changing the eating pattern by consuming morefiber will decrease the content of cholesterol level in the blood
Coronary Heart Disease (CHD) remains a major cause of morbidity and mortality in women in Indonesia. The global epidemic of obesity contributes to the increase of cardiovascular events. In Indonesia, there have not been many studies evaluate the association between abdominal obesity and CHD in women. Therefore, this study aims to determine the association between abdominal obesity and CHD in women aged 25-65 years in Bogor. This retrospective cohort study involves 2.451 respondents of FRPTM Cohort Study who met the inclusion and exclusion criteria with an observation period of 6 years. The main independent variable of this study was abdominal obesity based on Waist-to-Height-Ratio (WHtR), while outcome of the interest was CHD based on the results of interview and/or ECG results. Cox regression analysis was performed to estimated Hazard Ratio (HR) with a 95% Confidence Interval (95% CI). The results showed that the incidence rate of CHD in women was 19 per 1.000 person-years. Women with abdominal obesity were 1,38 times (95% CI 1,01-1,89) more likely to have CHD than those without abdominal obesity after adjustment for age, hypertension, and menopause status. Early detection of CHD risk factor, especially abdominal obesity, is important, so that prevention and lifestyle modification can be implemented immediately.
