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Heart failure is a clinical syndrome that occurs when the heart fails to meet the body’s demand for oxygen and nutrients. The prevalence and mortality rate of heart failure in Indonesia are relatively high compared to other Southeast Asian countries. The occurrence of heart failure in young adults increases the risk of premature death, recurrent rehospitalization, reduced quality of life, and a greater burden on the healthcare system. Several factors such as obesity, type 2 diabetes mellitus (T2DM), hypertension, smoking, dyslipidemia, family history of premature coronary artery disease (PCAD), and sex have been identified as being associated with heart failure. Developing a predictive model to identify the most influential risk factors for heart failure in young adults is crucial for preventive strategies and early interventions. This study employed a fixed retrospective cohort design involving patients aged 18–54 years who visited the cardiology outpatient clinic or were hospitalized at four tertiary hospitals in Indonesia (National Cardiovascular Center Harapan Kita, Jakarta; Hasan Sadikin Hospital, Bandung; Sebelas Maret University Hospital, Solo; and Adam Malik Hospital, Medan) in 2021. Patients without an initial diagnosis of heart failure were included, and their risk factors were recorded according to the study variables. The patients were followed monthly from 2021 until the end of observation in 2024 to determine whether they developed heart failure. Descriptive, bivariate, and multivariable analyses were conducted using the Poisson Generalized Linear Model (GLM) to estimate coefficients, incidence rate ratios (IRR) with 95% confidence intervals, and to construct the most accurate predictive model. Based on the model, a scoring system and probability value for the occurrence of heart failure were developed. A total of 321 participants met the inclusion and exclusion criteria, with a median age of 51 years (P25–P75: 46–52 years). After four years of observation, the cumulative probability of developing heart failure was 0.713 (95% CI: 0.661–0.760). The analysis identified three significant predictors for heart failure in young adults: obesity (IRR 1.87; 95% CI 1.31–2.68), dyslipidemia (IRR 2.58; 95% CI 1.87–3.56), and T2DM (IRR 2.79; 95% CI 2.01–3.87). The IDD Score (Body Mass Index–Dyslipidemia–Diabetes) was developed as a predictive scoring system for heart failure in young adults, with a total score of 13 corresponding to a 76.8% probability. Obesity, dyslipidemia, and T2DM were found to be significant risk factors for heart failure in young adults. The proposed IDD Score demonstrated good sensitivity and specificity in predicting the occurrence of heart failure within this population.
Kata kunci: tumor payudara, riwayat reproduksi, hormonal, estrogen, cross-sectional
Neoplasm or tumor generally means an abnormal cell growth in the body. Breast tumors can be a risk factor for breast cancer which is the most common cancer in women. The incindence increases every year in Indonesia. At present, breast tumors do not only attack the elderly, but also at young age. Some studies show factors associated with breast tumors. Therefore, this study aimed to study the association of the reproductive history with tumor incidence in young women in Indonesia in 2016. This study used a crosssectional study design using secondary data from the Riset PTM 2016 (Noncommunicable Disease Research 2016). The sample was 14,891 respondents aged under 40 years who meet the inclusion and exclusion criteria. The variables used in this study were independent variables consisting of age of menarche, age of first birth, marital status, breasfeeding history, the use of hormonal contraception; and the dependent variable is the incidence of breast tumors. The results showed an association between menarche age (OR = 1,294), marital status (OR = 1,568), age of first birth (OR = 1,570), breasteeding history (OR = 1,422), and the use of hormonal contraception (OR = 0,721) with breast tumors in young women in Indonesia This can be caused by the role of estrogen and progesterone reproductive hormones that result excessive proliferation.
Keywords: breast tumors, reproductive history, hormones, estrogen, cross-sectional
Body Mass Index BMI serves various purposes, including to measure the prevalence of obesity in a population, and also in formulating a patient rsquo s diet at a hospital. However, the BMI of an individual with difficulties in carrying their own weight or standing up straight can not necessarily be measured. The aim of this study was to form a prediction model for the BMI of young adult students of Public Health Faculty of University of Indonesia. This study used a cross sectional design, with a total sample of 132 respondents.