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Relationship of Central Obesity to Type 2 Diabetes Mellitus In Ages Group ≥45 years (Analysis of Non-Communicable Disease Surveillance Data of Jakarta Capital City Special Region 2015). Diabetes mellitus type 2 is the leading cause of 1.6 million deaths worldwide, the prevalence of diabetes mellitus is increasing significantly throughout the world and in Indonesia. Central obesity has an important role in the pathophysiology of type 2 diabetes mellitus. This study aims to determine the prevalence of type 2 diabetes mellitus, central obesity and the relationship between central obesity to type 2 diabetes mellitus in the age group ≥ 45 years. The study design used was cross section with logistic regression for multivariate analysis. The data sources analyzed are non-communicable disease risk factor surveillance data in 2015. There are 2127 respondents who meet the criteria that can be analyzed. The results showed that the prevalence of type 2 diabetes was 12.5% and the prevalence of central obesity was 39.6%. The relationship of central obesity to type 2 diabetes mellitus with POR 2.14 (95% CI 1.62-2.81) that means respondents with central obesity are 2.14 times more likely to develop type 2 DM than non-obese central respondents. Efforts to prevent the increase in cases of type 2 diabetes mellitus is continuous education to the public against risk factor central obesity by counseling individuals at risk and in the central obesity group. Keywords: diabetes mellitus, central obesity, surveillance .
Diabetes Mellitus tipe 2 merupakan salah satu masalah kesehatan yang sangat serius akibat setiap tahun terjadi peningkatan dan salah satu kontributor terhadap angka kesakitan dan kematian akibat penyakit tidak menular di seluruh dunia. 90% Diabetes Mellitus yang di diagnosis adalah DM tipe 2. Perubahan pola hidup yang ditandai dengan meningkatnya obesitas khususnya obesitas sentral merupakan salah satu risiko terhadap terjadinya Diabetes Mellitus tipe 2. Penelitian ini bertujan untuk mengetahui hubungan obesitas sentral terhadap kejadian Diabetes Mellitus Tipe 2 di Kelurahan Johar Baru Kecamatan Johar Baru Jakarta Pusat. Penelitian dilakukan dengan desain Cross Sectional Analitik, dengan menggunakan data Program skrining Penyakit Tidak Menular (PTM) Direktorat PTM Dirjen P2PL Kemenkes RI tahun 2012. Responden dalam penelitian ini berusia 20 tahun keatas. Analisis data menggunakan stratifikasi dan analisis multivariat menggunakan cox regression.
Hasil analisis data diperoleh prevalensi DM tipe 2 sebesar 18,1% dan obesitas sentral sebesar 57,7%. Selain itu, hasil multivariat menunjukkan bahwa orang dengan obesitas sentral (Waist Circumference (WC) P>90 cm, dan W>80 cm) berisiko 1,47 kali (PR= 1,47; 95% CI 0,606 - 3,575) terhadap kejadian DM tipe2 setelah di kontrol variabel jenis kelamin, IMT, dan aktivitas fisik. Namun setelah mengikutkan efek interaksi antara obesitas sentral dan aktivitas fisik diketahui bahwa orang yang obesitas sentral dan beraktivitas rendah (< 300 Mets) berisiko 7,59 (PR=7,59; 95% CI, 1,656 - 34,77) kali terhadap kejadian diabetes mellitus tipe 2. Dengan melakukan intervensi atau mencegah obesitas sentral dapat mencegah 23,98 % kejadian diabetes mellitus tipe 2 di populasi studi. Usaha untuk deteksi dini dengan skrining pada orang obesitas khususnya obesitas sentral membantu dalam menjaring kasus DM tipe 2, dan pola hidup sehat dan peningkatan aktivitas fisik dapat mencegah terjadinya obesitas sehingga menurunkan angka kejadian diabetes mellitus tipe 2.
Diabetes Mellitus categorized into serious health problems due to the increasing of its prevalence every year. It is one of the contributors to the global burden of disease and mortality in the world, where 90% of this disease was type II Diabetes. Changing of people lifestyle was one of the risk factors to the increasing of the disease in community. The objective of this study was to investigate the association between abdominal obesity and type II DM in Johar Baru Sub-district, Central Jakarta. This is a cross sectional study, utilized the data from the result of screening by direktorat PTM dirjen P2PL kemenkes RI. The inclusion criteria was Johar baru resident whom their ages more than 20 years. The data analysis was performed with stratification and cox regression multivariate analysis.
The results of study showed the prevalence of type II DM was 18,1%, meanwhile the prevalence of abdominal obesity was 57,7%. The result of multivariate analysis showed that the people with abdominal obesity (waist circumference P> 90 CM and W> 80 cm) had 1,47 risk to get type II DM compared to the people who did not, after controlling for covariates, Included: Sex, IMT and Physical activity (PR= 1,47; 95% CI: 0,606-3,575). However, after including the interaction effect between abdominal obesity and physical activity, it is showed the people with abdominal obesity and light physical activity had the risk 7,59 (PR=7,59; 95% CI, 1,656 - 34,77) to get type II diabetes. The result of analysis showed, with intervention or prevention of abdominal obesity can prevent 23,98 % type II DM in community. Screening one of the strategies as the early detection of people with type II DM. Healthy life style and having more physical activity could prevent the obesity and it is expected to reduce the prevalence of type II DM.
Based on the results of Basic Health Research (Riskesdas) in Indonesia, the prevalence of central obesity continues to increase, namely 18.8% in 2007, 26.6% in 2013, and 31.0% in 2018. Central obesity in Indonesia is mostly found in women and aged ≥45 years. One of the factors that can influence the occurrence of central obesity is emotional mental disorders. Emotional mental disorders are a response to stressful or stressful events that affect the brain's work in carrying out physical activity, smoking status, and a person's eating behavior. This study aims to determine the relationship between emotional mental disorders and central obesity in women aged ≥45 years in Indonesia using 2018 Riskesdas data with a cross-sectional study design. The results of the analysis showed that the prevalence of central obesity in women aged ≥45 years in Indonesia was 54.5% and mental-emotional disorders were 13.3%. Results after multivariate analysis using cox-regression showed that emotional mental disorders had a relationship with central obesity controlled by physical activity, smoking status, and emotional mental disorders which interacted with physical activity, smoking, and consumption of risky foods (Pvalue=0.047; 95CI 0.93 -1.00). The need to consider emotional mental disorders in preventing and controlling the incidence of central obesity in Indonesia.
ABSTRAK Nama : Lisa Felina Program Studi : Epidemiologi Judul : Hubungan obesitas sentral dengan gangguan fungsi ginjal pada jemaah Haji penderita diabetes melitus tipe 2 (Analisis data sekunder Siskohatkes Shar’i tahun 1438 H / 2017 M) Latar belakang: Gangguan fungsi ginjal pada tahap awal sangat jarang diketahui karena belum memunculkan tanda dan gejala. Saat gangguan fungsi ginjal berkembang progresif dan muncul penyakit ginjal terminal hingga hemodialisis akan menyebabkan status kesehatan jemaah haji menjadi risiko tinggi dan dapat menjadi tidak memenuhi syarat istithaah. Perlu dilakukan evaluasi lebih awal dengan mengetahui faktor risiko yang berhubungan dengan gangguan fungsi ginjal seperti obesitas sentral untuk mendapatkan upaya pencegahan dan intervensi yang lebih menguntungkan. Tujuan: Mengetahui prevalensi gangguan fungsi ginjal dan hubungan obesitas sentral dengan gangguan gangguan fungsi ginjal pada jemaah haji penderita DM tipe 2. Metode: Penelitian ini menggunakan desain cross sectional terhadap 2.106 jemaah haji yang menderita DM tipe 2. Subyek diperoleh dari data sekunder Siskohatkes Shar’i Puskeshaji Kemenkes RI tahun 1438 H / 2017 M. Semua subyek dilakukan pemeriksaan kesehatan di puskesmas atau rumah sakit rujukan. Estimasi nilai LFG menggunakan persamaan CKD EPI untuk menentukan fungsi ginjal. Obesitas sentral ditentukan menggunakan indeks lemak visceral. Analisis menggunakan regresi logistik multivariat. Hasil: Nilai rata-rata estimasi LFG 78,63 ml/menit/1,72 m 2 . Prevalensi gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2 sebesar 39,55%. Prevalensi gangguan fungsi ginjal pada Jemaah haji penderita DM tipe 2 dengan obesitas sentral adalah 29,17%. Obesitas sentral berhubungan signifikan secara statistik dengan gangguan fungsi ginjal pada jemaah haji penderita DM tipe 2. Nilai adjusted OR sebesar 1,45 (95% CI 1,19 – 1,77). Kesimpulan: Prevalensi gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2 sebesar 39,55%. Obesitas sentral berhubungan secara signifikan dengan gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2. Kata kunci: gangguan fungsi ginjal, obesitas sentral, indeks lemak visceral, jemaah haji
ABSTRACT Nama : Lisa Felina Program Studi : Epidemiologi Judul : Association of central obesity with renal function impairment among Indonesian pilgrim with type 2 diabetes mellitus (Siskohatkes Shar’i secondary data analysis year 1438 H / 2017 M) Background: Impaired renal function in the early stages often not raised signs and symptoms. End-stage renal disease with hemodialysis will cause Indonesian pilgrims in high risk health status and does not meet istithaah requirements. Early detection of risk factors such as central obesity might be directed to benefit prevention dan intervention. Objective: to estimate the prevalence of renal function impairment in type 2 DM and the association of central obesity with renal function impairment among Indonesian pilgrim with type 2 DM based on Siskohatkes shar’i 1438 H / 2017 M. Methods: This cross sectional studi consisted of 2.106 Indonesian pilgrims with type 2 DM. The data was obtained from Siskohatkes 2017 of Pilgrimage Health Center, Ministry of Health. The variable data analyzed were creatinin serum, anthropometric, age, gender, smoking, family history of end-stage renal disease, blood pressure, HDL, LDL, trigliserida and uric acid. Renal function impairment was defined according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate Glomerulus Filtration Rate (eGFR). Central obesity was determined using visceral adiposity index (VAI). Multivariable logistic regression was used to analyze the association of central obesity and renal function impairment. Result: The prevalence of renal function impairment in Indonesia pilgrim with type 2 DM was 39,55%. The mean of eGFR was 78,63 ml/min/1,72 m 2 . Central obesity was associated with renal function impairment (adjusted OR = 1,45; 95% CI 1,19–1,77). Conclusion: The prevalence of renal function impairment in Indonesia pilgrim with type 2 DM was 39,55%. Central obesity was associated with renal function impairment. Kata kunci: renal function impairment, central obesity, visceral adiposity index, pilgrim
Angka prevalensi diabetes melitus dari tahun ke tahun cendenmg meningkat. Data Departemen Kesehatan menyebutkan jumlah pasien dan kematian diabetes melitus rawat inap maupun rawat jalan di rumah sakit menempati urutan pertama dad selumh penyakit endokrin. Tahun 2004 pasien rawat inap diabetes melitus 42.000 kasus CFR 7,9%; dan tahun 2006 meningkat menjadi 49.364 kasms CFR 8,42%. Dari 4 (cmpat) tipc diabetes melitus, maka diabetes melitus tipe 2 yang paling banyak. Prevalensi diabetes melitus tipc 2, tahun 1992 sebesar 5,69%, tahun 1993 meningkat menjadi 5,'7% dan tahun 2005 mcnjadi l4,7%. Penyakit tersebut merupakan masalah kesehatan yang sangat serius, dimana komplikasinya menimbulkan angka kematian yang cukup tinggi, dan beban biaya kesehatan yang cukup mahal. Untuk itu diperlukan usaha untuk mencegahnya. Tujuan penelitian ini untuk mengetahui hubungan antara obesitas sentral dengan kejadian diabetes melitus tipe 2 setelah dikontrol variabel kovariat. Beberapa faktor kovariat yang diduga meningkatkan jumlah penderita diabetes melitus tipe 2 antara Iain umur, jenis kelamin, pekerjaan, riwayat menderita DM, aktivitas fisik, konsumsi serat, konsumsi lemak, pola makan, konsumsi alkohol, dan merokok. Desain penelitian ini menggunakan rancangan kasus kontrol dengan jumlah responden 300 orang dimana masing-masing kasus dan kontrol sebanyak 150 responden. Analisis dilakukan secara bertahap mulai dan analisis univariat, bivariat, dan multivariat. Analisis multivariat menggunakan analisis regresi Iogistik ganda. Hasil pcnclitian menunjukkan hubungan yang signiiikan antara obesitas sentral dengan kejadian diabetes melitus tipe 2 dimana obesitas sentral memiliki resiko untuk tcrkcna diabetes melitus tipe 2 sebesar 3,16 kali dibanding tanpa obesitas sentral, setelah dikcndalikan faktor riwayat DM dalam keluarga, aktiiitas fisik, dan kcbiasaan mcrokok. Disarankan perlunya informasi mengenai faktor resiko diabetes melitus tipc 2 secara luas kepada masyarakat. Jika risiko DM dapat diketahui sedini mungkin, maka upaya pencegahan akan segera dapat dilakukan schingga prevalcnsi DM dapat ditekan.
Diabetes mellitus prevalence number of year goes to tend to increase. Health Depanmen data describes that the total of patient and diabetes melitus death, inpatient care and also outpatient care at hospital stays in the first range of all endocrine’s disease. On 2004 the diabetes melitus patient of inpatient care are 42,000 cases with CFR 7.9% and on 2006 become increase to 49,364 cases with CFR 8.42%. From 4 (four) diabetes melitus type, therefore diabetes melitus type 2 becomes most transmitted on patients. Diabetes melitus type 2 prevalence on 1992 as 5.69%, on 1993 increase becomes 5.7% and on 2005 becomes l4.7%. That disease was really serious health problem, where its complication caused high mortality and health charge which adequately expensive. For those reason required all effort to prevent it. The purposed of this research to describes relationship among central obesity with diabetes melitus type 2 after controlled by covariate variable. Several preconceived covariate factor increases diabetes melitus type 2 patient for example age, gender, occupation, diabetes mellitus history, physical activity, Ebcr consumption, fat consumption, food habit, alcohol and smoking. This observational design utilize case control design with 300 person respondent where every cases and controls as 150 respondents. Analysis is performing in several phased from univariate analysis, bivariate, and multivariate analysis. Multivariate analysis using a multiple logistics regression. The observational result indicated the significant relationship among central obesity and occurrence of diabetes melitus type 2 where central obesity has a risk and tend to strikes by diabetes mellitus type 2 as 3.16 times compared without central obesity, after controlled by diabetes mellitus history in family, physical activity and Smoking habitual. Sugggested to publicized the sufficient and properly infomation conceming diabetes melitus type 2 to community. If diabetes melitus type 2 risk can be detected and known early, therefore prevention effort will be performed so diabetes melitus type 2 prevalence can be controlled.
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.
Diabetes mellitus is a non-communicable disease that tends to increase. IDFAtlas 2015 data says, DM prevalence in Indonesia ranked 7th in the world. In Indonesia,Riskesdas data showed an increased prevalence of diabetes mellitus from 5.7% (2007)increased to 6.9% (2013). Central obesity is a strong predictor for the occurrence of type2 diabetes mellitus. The prevalence of central obesity based on Riskesdas 2007 data of18.8% increased to 26.6% (Riskesdas, 2013) The objective of the study was toinvestigate the relationship of central obesity to type 2 diabetes mellitus in thepopulation age ≥ 18 years in GERMAS launching area in 2016. Study design cross-sectional study, Analysis using logistic regression test. The analysis results obtainedproportion of type 2 diabetes mellitus by 6.1% and central obesity of 68.9%. In addition,multivariate results showed that the association of central obesity with diabetes mellitustype 2 was found to be POR 3,296 (95% CI 2,344-4,636) meaning that people withcentral obesity had a chance of 3,296 times (95% CI 2,344-4,636) had diabetes mellitustype 2 compared with non-obese residents after being controlled by physical activityand hipertension. Conclusions and suggestions for routine public health checks inPOSBINDU PTM, to perform early detection of central obesity and blood glucoseexamination to capture cases of type 2 diabetes mellitus as early as possible.Keywords:Diabetes mellitus Type 2, central obesity, GERMAS.
Bankground: Cardiovascular disease, including stroke, is a major health problem in the world. Every year, there are more than 13.7 million new cases and 5.5 million deaths from stroke that occur globally. Based on Riskesdas data in 2018, the prevalence of stroke in Indonesia reached 10.9 per mile. In DKI Jakarta Province, the prevalence of stroke based on doctor's diagnosis increased from 9.7 per mile (2013) to 12.2 per mile (2018). Based on IDF data in 2019, the prevalence of diabetes in Indonesia reached 10.7 million cases and made Indonesia the country with the seventh most cases globally. In addition, according to the Health Social Security Administration (BPJS), the funds used for stroke services continued to increase, namely 1.43 trillion (2016), 2.18 trillion (2017) and 2.56 trillion (2018) and decreased to 2. 1 Trillion (2020). Although there is a decline in 2020, stroke is still ranked third as a provider of BPJS social security funds. Diabetes mellitus which is a risk factor for stroke has increased prevalence in DKI Jakarta Province from 2.5% (2013) to 3.4% (2018). Objective: To determine the relationship between type 2 diabetes mellitus and the incidence of stroke in the population aged 18 years. In DKI Jakarta Province in 2018. Methods: The study was conducted with quantitative methods and used an analytical cross-sectional study. The data source used in this study is secondary data from Riskesdas 2018. There are 1,537 samples analyzed according to the inclusion and exclusion criteria. Results: Based on the results of the analysis, the prevalence of stroke was 1.6% and type 2 diabetes mellitus was 7.7%. There is a significant relationship between the variables of type 2 diabetes mellitus and the incidence of stroke. In addition, covariate variables such as age (POR=5.26; 95%CI: 2.28-12.12), occupation (POR=2.63; 95%CI: 1.12-6.19), hypertension ( POR=9.52; 95%CI: 2.83-32.06), and heart disease (POR=5.30; 95%CI: 1.75-16.04) were also significantly associated with the incidence of stroke. Based on the stratification analysis, it was found that the variables that became the interaction effect (modification) were education, hypertension, and heart disease. Meanwhile, the confounding variables were age, education, hypertension, and heart disease. Conclusion: Type 2 diabetes mellitus is an important risk factor to consider in the prevention and control of stroke in Indonesia.
