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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 .
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
Prevalence diabetes is increasing rapidly especially in low and middle- income countries, one of which is Indonesia. Based on Riskesdas in 2018, the prevalence of diabetes mellitus based on the diagnosis of doctors in the population of all ages by province reaches 1,5%. The incidence rate of kidney disease in the diabetic population does not decrease. Some large cross-sectional studies in the world reveal that the prevalence of chronic kidney disease in people with type 2 diabetes even reaches 50%. Duration suffering diabetes is a risk factor for chronic kidney disease that needs to be considered. This study aims to determine the relationship duration suffering from diabetes with chronic kidney disease in patients with type 2 diabetes mellitus in Indonesia. This type of research is quantitative, with cross-sectional study design. This study uses secondary data from the 2018 Riskesdas survey. The number of samples was 639 people, who met the inclusion and exclusion criteria in this study. The analysis used cox regression The prevalence of chronic kidney disease in patients with type 2 diabetes mellitus in Indonesia is 17.68%. There was a relationship duration suffering diabetes with chronic kidney disease in patient type 2 diabetes mellitus in Indonesia which is statistically significant with p = 0.0000. So, important to screening mass type 2 diabetes mellitus as early as possible and routine screening kidney function since type 2 diabetes mellitus diagnose by a doctor.
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.
Prevalensi hipertensi terus meningkat tajam, WHO memprediksi pada tahun 2025, sekitar 29% orang dewasa di seluruh dunia menderita hipertensi. Hipertensi telah mengakibatkan kematian sekitar 8 juta orang setiap tahun. Survei Riskesdas 2007 menunjukkan prevalensi hipertensi pada penduduk umur 18 tahun ke atas di Indonesia adalah sebesar 31,7%. Hipertensi stage 1 sebagai fase awal perlu ditemukan secara dini. Direkomendasikan untuk mencegah dan mengatasi hipertensi dengan diet sehat, aktivitas fisik teratur, menghindari konsumsi alkohol, mempertahankan berat badan dan lingkar pinggang ideal, serta hidup di lingkungan bebas asap rokok. Program pengendalian penyakit hipertensi perlu melakukan upaya pencegahan dan pengendalian agar tekanan darah tidak berlanjut menjadi tinggi dan mencegah komplikasi lebih lanjut.
Penelitian ini bertujan untuk mengetahui hubungan obesitas sentral terhadap kejadian Hipertensi stage 1 di Posbindu Kota Padang Panjang. Penelitian menggunakan desain Cross Sectional Analitik, terhadap data sekunder kegiatan skrining Pengendalian Penyakit Tidak Menular (PPTM) Direktorat PTM, Ditjen PP-PL, Kemenkes RI tahun 2011. Responden dalam penelitian ini berusia 18-64 tahun. Analisis data menggunakan analisis stratifikasi dan multivariat cox regression. Dari hasil analisis data diperoleh prevalensi Hipertensi stage 1 sebesar 25,1% dan obesitas sentral sebesar 59,7%.
Hasil analisis multivariat menunjukkan bahwa orang dengan obesitas sentral (Waist Circumference/WC laki-laki>90 cm, dan perempuan>80 cm) berisiko 1,5 kali (PR= 1,446; 95% CI 0,897 ? 2,329) terhadap kejadian Hipertensi stage 1 setelah di kontrol variabel umur, jenis kelamin, status pekerjaan, tingkat pendidikan dan stress. Kegiatan deteksi dini melalui skrining di Posbindu terutama pada orang yang obesitas sentral akan menjaring kasus hipertensi stage 1 (fase awal penyakit hipertensi). Pola hidup sehat, pengendalian stress dan mencegah terjadinya obesitas diharapkan menurunkan angka kejadian hipertensi stage 1.
The Prevalence of hypertension tends to be increase, WHO predict in 2025, approximatelly 29% adults all around the world suffer hypertension. Hypertension caused death approximatelly 8 million people every year. Basic Health Survey in 2007 showed the prevalence of hypertension in community age above 18 year old were 31,7%. Hypertension stage 1 due to initial phase should to be found earlier. Recommended to prevent and control hypertension with healthy diet, regular physical activities, avoid alcohol consumption, maintaining ideal body weight and waist circumtances, and life in the smoke free enviroment. Hypertension programme control integrated in prevention and control effort to prevent progressing blood tension higher and the complication.
The objectives of this study was to investigate the association between abdominal obesity and Hypertension stage 1 in Posbindu Padang Panjang. This is a cross sectional study, utilized the data from the result of screening by Directorate NCDC Directorate General DC & EH Ministry of Health, Republic of Indonesia. The inclusion criteria was Padang Panjang resident whom their ages 18-64 years. The data analysis was performed with stratification and cox regression multivariate analysis. The results of study showed the prevalence of Hypertension stage 1 was 25,1%, meanwhile the prevalence of abdominal obesity was 59,7%.
The result of multivariate analysis showed that the people with abdominal obesity (waist circumference man> 90 cm and women> 80 cm) had 1,5 risk to get Hypertension stage 1 compared to the people who did not, after controlling for covariates, age, sex, working status, education level, and stress level (PR= 1,446; 95% CI: 0,897-2,329). Early detection and screening in Posbindu NCDC specially people with abdominal obesity become one of the strategies as the early detection of people with Hypertension stage 1. Healthy life style, controling stress level and prevent the obesity expected to reduce the prevalence of Hypertension stage 1.
