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Prevalensi diabetes melitus mengalami tren meningkat, baik di tingkat global maupun di
Indonesia. Prevalensi DM berdasarkan pemeriksaan kadar gula darah di Indonesia meningkat dari tahun 2013 (6,9%), 2018 (10,9%), hingga 2023 (11,7%). DM adalah salah satu penyakit tidak menular (PTM) yang bisa dicegah melalui perubahan gaya hidup, salah satunya adalah aktivitas fisik, yang menjadi kunci dalam pencegahan dan pengurangan beban PTM. Penelitian ini bertujuan untuk mengetahui hubungan antara aktivitas fisik dengan kejadian DM pada penduduk usia 15 tahun ke atas di Indonesia pada tahun 2023, dengan distratifikasi oleh variabel perancu usia, jenis kelamin, status obesitas, tempat tinggal, status pekerjaan, dan status ekonomi. Penelitian ini menggunakan data Survei Kesehatan Indonesia (SKI) 2023 dengan desain studi potong lintang. Analisis yang dilakukan adalah analisis univariat, bivariat, dan stratifikasi. Berdasarkan analisis bivariat, aktivitas fisik berhubungan signifikan dengan DM, dengan aktivitas fisik kurang lebih berpeluang (OR=1,36; 95% CI= 1,23 – 1,51) untuk memiliki DM. Variabel perancu usia, jenis kelamin, status obesitas, dan status pekerjaan berhubungan signifikan dengan DM dan digunakan untuk stratifikasi. Setelah distratifikasi, hubungan aktivitas fisik dengan DM tetap signifikan, tetapi nilai OR berbeda berdasarkan modifikasi efek dari variabel usia dan jenis kelamin. Penduduk usia 40 tahun ke atas (OR=1,52; 95% CI= 1,35 – 1,71) lebih berpeluang untuk memiliki DM jika kurang melakukan aktivitas fisik. Upaya intervensi pengelola program kesehatan perlu difokuskan untuk merancang dan mengimplementasikan kebijakan aktivitas fisik dan skrining DM yang komprehensif dengan bekerja sama dengan sektor luar kesehatan dan fokus untuk meningkatkan partisipasi aktivitas fisik pada penduduk berusia 40 tahun ke atas.
There is an upward trend of diabetes mellitus prevalency, both globally and in Indonesia. DM prevalency based on blood glucose examination in Indonesia shows an upward trend, from 2013 (6,9%), 2018 (10,9%), up to 2023 (11,7%). DM is a noncommunicable disease (NCD) that could be prevented by lifestyle change, which one of them is physical activity, a key in NCD prevention and burden reduction. This study aims to identify the association between physical activity and DM in Indonesia’s population aged 15 years and over in 2023, with stratification based on confounding variable age, sex, obesity status, residential area, employment status, and economic status. This study utilizes Survei Kesehatan Indonesia (SKI) 2023 data with cross-sectional study design. Univariate, bivariate, and stratification analysis were conducted. Based on bivariate analysis, physical activity is significantly associated with DM, with the less active group having higher odds (OR=1,36; 95% CI= 1,23 – 1,51) for developing DM. Confounding variables age, sex, obesity status, and employment status significantly associated with DM and will be used in stratification. After stratification, the association between physical activity and DM hold its significance, but the OR differs based on effect modification by age and sex variables. Population aged 40 years and over (OR=1,52; 95% CI= 1,35 – 1,71) higher odds to develop DM if they’re physically inactive. Interventions effort made by health program organizer needs to be focused on designing and implementing comprehensive physical activity and DM screening policy with partners outside the health sectors and focusing on increasing participation in physical activity among population aged 40 years and over.
Hypertension is one of the leading causes of death in Indonesia and contributes significantly to the burden of non-communicable diseases. This study aims to analyze the risk factors associated with hypertension among individuals aged ≥18 years in Indonesia using a probabilistic approach through Bayesian Network modeling. This research is a quantitative study utilizing secondary data from the fifth wave of the Indonesia Family Life Survey (IFLS-5). The sample consisted of 34,271 individuals who met the inclusion criteria after data cleaning and variable classification. The Bayesian Network structure was constructed manually based on bivariate analysis and theoretical references, then visualized using R (bnlearn) and Python (CausalNex). Conditional Probability Tables (CPTs) were generated to identify both direct and indirect risk pathways. The results indicate that smoking and abnormal BMI (imt_kat) are two primary risk factors that directly increase the probability of hypertension. The highest probability of hypertension (25.87%) was found among individuals who both smoke and have an abnormal BMI. Additionally, indirect pathways were also identified, such as income → education → stress → smoking → hypertension, as well as age, physical activity, and dietary patterns → BMI → hypertension. Behavioral and socioeconomic variables were shown to be interconnected in influencing hypertension risk cumulatively. In conclusion, this study demonstrates that the Bayesian Network approach is effective in revealing the probabilistic relationships among various risk factors. These findings highlight the importance of holistic public health interventions that consider social, behavioral, and physiological determinants as an integrated risk system.
Kata Kunci: Penyakit Jantung Koroner, Obesitas Sentral.
Coronary heart disease is a degenerative disease that remains a health problem in the world. One of the factors of coronary heart disease are central obesity. The percentage of central obesity status is increased from 2007 to 2013. This study was conducted to examine the relationship of central obesity to coronary heart disease. The study design used is cross sectional and use data Riskesdas 2013. Samples were all residents aged 45 years and over who meet the inclusion and exclusion criteria. The results of this study indicate that the prevalence of coronary heart disease was 1.2 and there is corelation between central obesity status of coronary heart disease at the age of 45 years and over in Indonesia in 2013 after being controlled by confounding variables. Confounding factors that are diabetes, hypertension, and smoking behavior. In addition, there is an interaction by confounding variables to central obesity, namely diabetes and smoking. Therefore, required health promotion ranging from coronary heart disease health promotion both primary prevention and secondary prevention.
Keywords: Coronary Heart Disease, Central Obesit
Penelitian ini bertujuan untuk mengetahui hubungan kegemukan atau obesitas yang dilakukan dengan pendekatan IMT dan RLPP terhadap kejadian hiperten.si stage 1. Penelitian -analitik dengan desain krosseksional dilakukan melalui pengumpulan data langsung terhadap penduduk diatas 18 tahun yang berkunjung ke Puskesmas di wilayah Kabupaten Aceh Tamiang pada bulan April sampal Mei 2008, dengan jumlah total sampel sebesar 648 responden. Dan i 648 responden yang diperiksa dan diukur terdapat 39,04% adalah hipertensi stage 1, dan IMT tergolong kurus atau underweight 5,09%, MT normal 64,20%, IMT gemuk 14,66% dan Eva tergolong obes sebesar 16,05% berdasar standart IMT Dep.Kes RI. Dengan RLPP diketahui 23,92% tergolong obesitas. Dan responden yang tergolong IMT kurus 27,27% adalah hipertensi stage 1, responden tergolong IMT normal 32,45% hipertensi stage 1, 34,74% responden tergolong Eva gemuk adalah hipertensi stage 1 serta 73,08% responden tergolong IMT obesitas adalah hipertensi stage 1. Pada pendekatan RLPP diperoleh hash l 63,87% responden tergolong obesitas adalah hipertensi stage 1. Hasil penelitian menunjukkan bahwa pada mereka dengan IMT tergolong gemuk beresiko 1,06, kali (95% Cl; 0,71-1,57) dan IMT tergolong obesitas beresiko 1,64 kali (95% CI; 1,20-2,24) untuk hipertensi stage 1 dibandingkan mereka yang tergolong IMT normal, setelah dikontrol oleh potensial konfounding; umur, jenis keIamin, pendidikan, riwayat keluarga hipertensi, riwayat keluarga gemuk, riwayat keluarga DM, rokok, konsumsi kopi, konsumsi lemak, konsumsi serat stress dan aktifitas fisik. Dengan RLPP diketahui mereka yang tergolong obesitas beresiko 1,62 kali (95% CI; 1,22-2,14) untuk hipertensi stage 1 dibandingkan mereka yang normal setelah dikontrol potensial konfounding yang sarna seperti IMT. Potensial konfounding yang mempunyai pengaruh dalam merubah efek secara signifikan dari hubungan tingkat kegemukan dengan kejadian hipertensi stage 1 pada pendekatan pengukuran IMT dan RLPP dari hash l analisa adalah riwayat keluarga hipertensi, tingkat konsurnsi lemak dan umur, yang metubah efek hubungan tingkat kegemukan pada IMT tergolong gemuk dari 1,07 (95% CI; 0,7-1,6) menjadi 1,06 (95% CI; 0,71-1,57).dan pada yang IMT obesitas dari 2,25 (95% CI; 1,7-2,9) menjadi 1,64 (95% CI; 1,20-2,24). Pada pendekatan RLPP dari 2,04 (95% CI; 1,58- 2,63) menjadi 1,62 (95% CI; 1,22-2,14). Berdasarkan hasil penelitian maka perlu dilakukan upaya pernasukan program pengendalian hipertensi dan kardiovaskuler pada Dinas Kesehatan dan upaya deteksi card melalui skrinin' g dengan melakukan pengukuran IMT ataupun RLPP terhadap masyarakat yang datang memeriksakan kesehatannya di Puskesmas. Disamping juga perlu dilakukan penelitian lanjutan berkaitan diet gizi seimbang, maupun berat tubuh ideal dalam pengendalian penyakit hipertensi dan kardiovaskuler.
This study is about to find out relationship between obesity and hypetension stage 1 wich conducted by Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR). This study used cross sectional design by direct data collecting taken from 18 years old visitors who visit Public Health Center in District of Aceh Tarniang from April to May 2008 and gained 648 respondents. From examination and measurement of all these 648 respondents, 39.04% respondents has hypertension stage 1, 5.09% has low BD& or underweight, 64.20% has normal BMI, 14.66% has above normal or everweight, and 16.05% has obese based on Department of Health standard. By using WHR, found out that 23.92% classified as obese. Those classified as lean BM1 with hypertension stage 1 is 27.27%, those who classified as normal BMI with hypertension stage 1 is 32.45%, those who classified as overweight BIVIl with hypertension stage 1 is 34.74% is 73.08% and those who classified as obese with hypertension stage 1. By WHR approaching 63.87% respondents are obese with hypertension stage 1. The results of this study shows that those who classified as fat and obese has 1,06 ties (95% CI;0,71-1,57) and 1,64 times (95% CI; 1,20-2,24) risk of hypertension stage 1 respectively, after controlled by potensial confounding which are : age, sex, education, family history of hypertension, family history of diabetes mellitus, smoking, coffe consumption, fat consumption, natural fibre consumption, stress and physical activities. By using WHR found out those who obese has risk 1,62 times (95% Cl; 1,22-2,14) of hypertension stage 1 compared to those in normal group after controlled by the same potensial confounding which have been use by BMI approaching. Potential confounding which has influence in relationship between obesity and hypertension stage I both with BMI and WHR significantly are family history of hypertension, age and fat consumption, these changes are ; in overweight group from 1,07 (95% Cl; 0,7-1,6) to 1,06 (95% Cl; 0,71-1,57) and in obese group from 2,25 (95% CI; 1,7-2,9) to 1,64 (95% CI;1,2-2,24) for BMI and 2,04 (95% CI; 1,58-2,63) to 1,62 (95% CI; 1,22-2,14) for WHR. Based on the result of this study, it is necessary to include hypertension and cardiovasculer controlling program in Health Office and early detection by conducting screening by BMI and WHR measurement to those who visit health center for examination. Also any advance researches on nutrition in daily consumption and promote ideal weight in communities in order to control hypertension and cardiovascular diseases.