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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.
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
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.
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.
Background: Coronary heart disease is a non-communicable disease. Risk faktors for coronary heart disease include hypertension, smoking, high cholesterol, obesity, and low consumption of fruits and vegetables. According to Riskesdas data in 2013, the prevalence of coronary heart disease with a doctor's diagnosis was 0.5%. Meanwhile, in 2018 the prevalence of coronary heart disease with a doctor's diagnosis was 1.5%. Then there is an increase in respondents who suffer from coronary heart disease. Coronary heart disease is caused by the buildup of plaque on the walls of the arteries that supply blood to the heart and other parts of the body. The plaque consists of deposits of cholesterol and other substances in the arteries. Plaque buildup causes the inside of the arteries to narrow over time, which can partially or completely block blood flow. The purpose of this study was to determine the relationship between the combined effect of hypertension and obesity with the incidence of coronary heart disease Methods: This analysis uses univariate analysis to determine the proportion of research variables, bivariate analysis to determine the relationship between variables, stratification analysis to determine the presence of confounding and modification effects. Multivariate analysis to determine the final model. This study used a cross sectional design. Results: found coronary heart disease variables 1.44%, hypertension and obesity 9.77%, hypertension and not obesity 9.64%, not hypertension and obesity 22.04%, not hypertension and not obesity 58.55%. And the relationship of hypertension and obesity to coronary heart disease after being controlled by age and sex variables. Conclusion: The relationship of the combined effect of hypertension and obesity with the incidence of coronary heart disease after being controlled by age and sex variables
Prediabetes is a global public health issue. Prevalence of prediabetes isincreasing worldwide. Generally, it is high among adults and as a high risk statefor DM. Obesity has essential role in pathophysiology of prediabetes. This studyaimed to explore whether both of general obesity and abdominal obesity related toprediabetes on age group 20-65 years in Bogor tengah sub-district by familyhistory of DM, sex, age, smoking, hypertension, physical activity and stress. Thisstudy used the cross sectional design study with Cox Regression to multivariableanalysis. Data for this analysis were collected during the baseline stage of cohortstudy of risk factors of non-communicable disease in 2011-2012. There were3244 respondents from Bogor tengah were taken by random sample technique..The result indicated that obesity to prediabetes adjusted by age; general obesityalone PR 1,58 (95% CI: 1,17-2,15), abdominal obesity alone PR 1,45 (95% CI;1,19-1,87), general obesity and abdominal obesity jointly PR 1,92 (95% CI;1,62-2,28). Therefore, general obesity and abdominal obesity jointly contributedmost to the increase prevalence of prediabetes. Awareness raising and screeningof prediabetes of those at high risk group by assessing obesity by BMI and waistcircumference joinlty are essential to be considered as part of efforts for haltingthe epidemic of prediabetes in community.Keyword : general obesity, abdominal obesity, prediabetes.