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ABSTRAK Nama : Debri Rizki Faisal Program Studi : Epidemiologi (Field Epidemiology Training Program) Judul : Pengaruh Status Gizi Stunting Saat Balita dan Obesitas Ketika Dewasa Terhadap Risiko Hipertensi (Studi Longitudinal IFLS 1993 – 2014) Pembimbing : dr.Syahrizal Syarif, MPH, PhD. Stunting merupakan salah satu bentuk kekurangan gizi kronis yang ditandai dengan tinggi badan menurut usia kurang dari -2 SD (standar deviasi). Kondisi stunting pada usia balita berdampak jangka panjang terhadap dewasa yang pendek dan rentan terhadap penyakit tidak menular ketika dewasa. Penelitian ini bertujuan untuk mengetahui pengaruh efek gabungan kondisi stunting saat balita dan obesitas ketika dewasa terhadap risiko hipertensi. Desain penelitian cohort retrospective menggunakan data sekunder Indonesia Family Life Survey (IFLS) periode 1-5. Populasi target adalah balita usia 2-5 tahun pada tahun 1993 sebanyak 2.642 orang, kemudian di follow up hingga dewasa pada tahun 2014. Jumlah sampel yang memenuhi kriteria inklusi dan eksklusi adalah 588 orang. Analisis data menggunakan uji cox regression dengan 95%CI. Standar pengukuran sebagai berikut stunting (TB/U < -2 SD), obesitas (IMT ≥ 27 kg/m 2 ) dan hipertensi (≥ 140/90 mmHg). Hasil penelitian didapatkan bahwa dari 588 orang dimana 13.27% mengalami hipertensi dengan proporsi orang yang stunting saat balita dan obesitas ketika dewasa 27.27%. Analisis multivariate ditemukan bahwa responden dengan status gizi stunting dan obesitas berisiko 2.46 (95% CI; 1.23 - 4.90) kali; obesitas dan tidak stunting 2.25 (95% CI; 1.12 – 4.50) kali; stunting dan tidak obesitas berisiko 0.95 (95% CI; 0.55 – 1.62) kali, mengalami hipertensi dibandingkan dengan responden yang tidak mengalami stunting saat balita dan tidak obesitas ketika dewasa. Risiko kejadian hipertensi meningkat 10.56% akibat interaksi antara kondisi stunting saat balita dan obesitas ketika dewasa. Pentingnya pencegahan stunting pada 1000 Hari Pertama Kehidupan dan mengoptimalkan Posbindu PTM dalam melakukan skrining obesitas dan hipertensi serta pengendalian faktor risiko PTM untuk menurunkan prevalensi penyakit tidak menular terutama obesitas dan hipertensi. Kata kunci: Stunting, Obesitas, Hipertensi, Kohort, Efek Gabungan.
ABSTRACT Name : Debri Rizki Faisal Study Program : Epidemiology (Field Epidemiology Training Program) Title : The Effect Of Early Stunting And Adult Obesity To Increase Risk Of Hypertension (Longitudinal Study IFLS 1993 – 2014) Counsellor : dr.Syahrizal Syarif, MPH, PhD. Stunting due to chronic malnutrition condition that is characterized by Height for Age Z score less than -2 SD (standard deviation). The early stunting in children under five years has a long-term impact on adults are short stature and vulnerable to risk non-communicable diseases in later life. This study aims to determine the joint effect of early stunting conditions and adult obesity to risk for hypertension. This study design was a cohort retrospective using secondary data from the Indonesia Family Life Survey (IFLS) period 1-5. The target population was children aged 2-5 years in 1993 with numbers of 2,642 people and then follow up until adulthood in 2014. The number of samples that met the inclusion and exclusion criteria were 588 people. Data analysis used Cox regression test with 95% CI. Standard of measurements was stunting (HAZ <-2 SD), obesity (IMT ≥ 27 kg / m 2 ) and hypertension (≥ 140/90 mmHg). The results showed that of 588 people where 13.27% had hypertension where the proportion of respondent with early stunting and adult obese was 27.27%. Multivariate analysis found that respondents with nutritional status both early stunting and adult obesity have a risk of 2.46 (95% CI; 1.23 - 4.90) times; obese and not stunting 2.25 (95% CI; 1.12 - 4.50) times; stunting and not obese 0.95 (95% CI; 0.55 - 1.62) times, for having risk of hypertension compared to respondents neither experience stunting and obese. The risk of hypertension increases 10.56% due to the interaction between early stunting and obesity adults. The importance prevention of stunting in The First 1000 Days of Life and optimize Posbindu PTM in screening obesity, hypertension and controlling risk factors NCD to reduce the prevalence of non-communicable diseases, especially obesity and hypertension. Key words: Stunting, Obesity, Hypertension, Cohort, Joint Effects.
Coronary Heart Disease (CHD) is one of the leading causes of death globally with a mortality rate of nearly 17.5 million annually. Smoking accounts for 33% and hypertension accounts for 31% of all deaths from cardiovascular disease. Smoking and hypertension are major risk factors for CHD, which are a serious problem that needs to be addressed in Indonesia and the world. The purpose of this study was to determine the greater risk of smoking and hypertension with the incidence of coronary heart disease in Indonesia. The study used a retrospective cohort design. The data used are secondary data from the Indonesian Family Life Survey (IFLS-4 and IFLS-5 data for 2007-2014) with a total sample of 19,486 population respondents aged ≥18 years. Data analysis with cox regression and the amount of risk is expressed in risk ratio (RR) with a confidence interval (CI) of 95%. Data analysis using data processing software. The results of multivariate analysis after being controlled by sex and DM history showed that smoking individually was not related to CHD in Indonesia in 2007-2014 with a value (RR 1.08; 95% CI = 0.70- 1.67). Hypertension individually increases CHD risk (RR 1.19; 95% CI = 0.92-1.53). Smoking and hypertension together increase the risk of CHD compared to people who don't smoke and don't have hypertension in Indonesia in 2007-2014 (RR 1.66; 95% CI = 1.11-2.48) meaning that respondents who smoke and hypertension are at risk of experiencing CHD 1.66 times (95% CI; 1.11-2.48) compared to nonsmokers and those without hypertension.
Stunting is a malnutrition that is still a public health problem in Indonesia and causes various adverse effects on children's health. Besides caused by a chronic lack of nutrition, stunting can also be caused by recurrent of infectious diseases. Efforts to prevent infectious diseases, such as immunization, will play a role in increasing child growth, especially in developing countries. The purpose of this study was to examine the association between basic immunization status and the incidence of stunting in toddlers in Indonesia. This study used a cross-sectional study design using secondary data from SSGI 2021. The inclusion criteria for this study were that toddlers were aged 12–59 months at the time of data collection, their height was measured, were not experiencing severe or chronic illness, and had complete variable data. A total of 70,267 toddlers met the inclusion criteria, and all were taken as research samples. Data analysis was performed using the Cox regression to obtain a prevalence ratio (PR) with 95% of confidence interval. This study shows that the prevalence of stunting among children aged 12–59 months in Indonesia is 23.1%, and the proportion of children under five who have complete basic immunization status is 74.92%. The results of the multivariate analysis showed that basic immunization status had a statistically significant association with the incidence of stunting. Toddlers with incomplete basic immunization status are at risk 1.19 times higher for stunting compared to toddlers with complete basic immunization status [adjusted PR 1.19 (95% CI 1.15–1.23)]. Toddlers who are not immunized at all have an even higher risk of experiencing stunting, which is 1.27 times higher compared to toddlers with complete basic immunization status [adjusted PR 1.27 (95% CI 1.15–1.39)], after controlling for variables such as the mother's education, economic status, and the child's birth weight. Efforts are needed to complete the child's immunization status on time according to schedule and increase the mother's knowledge regarding the use of health services, the fulfillment of toddler nutrition, and the stimulation of child growth and development.