KORELASI ASUPAN NUTRISI DENGAN DERAJAT KEPARAHAN AKNE VULGARIS

SCHANDRA PURNAMAWATI, Dr. Med. dr. Retno Danarti, Sp.KK (K).; dr. Kristiana Etnawati, MPH, Sp.KK (K)

2019 | Tesis-Spesialis | DERMATOLOGI DAN VENEREOLOGI

Akne vulgaris merupakan 3 besar penyakit kulit tersering dengan potensi dampak negatif yang besar terhadap kualitas hidup pasien. Terapi akne kerap menggunakan antibiotik, dimana tingginya resistensi dan kekambuhan meningkatkan kebutuhan pendekatan non medikamentosa untuk akne. Perbaikan asupan nutrisi menarik untuk diteliti karena diharapkan dapat menjadi terapi adjuvan akne yang aman dan bebas efek samping. Penelitian terdahulu menunjukkan asupan nutrisi memiliki efek signifikan dalam patogenesis akne vulgaris, dimana pola asupan Barat disinyalir sebagai pemicu epidemi akne, sementara pola asupan paleolitikum ditengarai dapat memperbaiki keparahan akne. Penelitian ini merupakan penelitian potong lintang yang bertujuan untuk mengetahui korelasi asupan nutrisi muatan glikemik, protein whey, protein kasein, asam lemak jenuh, vitamin A, C dan E, mineral zink dan asam lemak omega 3 terhadap derajat keparahan akne vulgaris. Sampel terdiri dari 160 pria penderita akne usia 19-24 tahun. Sebanyak 63,2% subyek dengan riwayat keluarga akne, 73,6% subyek menggunakan sabun/ pembersih wajah dan 16% menggunakan obat jerawat. Analisis multivariat data 24 hours recall dan SQ-FFQ menunjukkan asupan asam lemak jenuh berkorelasi negatif bermakna terhadap derajat keparahan akne, lesi non inflamasi dan komedo terbuka. Derajat keparahan akne tidak memburuk meski terpapar oleh asupan asam lemak jenuh yang tinggi, kemungkinan disebabkan penggunaan sabun wajah dan obat jerawat, dimana analisis menunjukkan hubungan negatif penggunaan sabun wajah terhadap lesi non inflamasi dan komedo terbuka, sementara penggunaan obat jerawat berhubungan negatif dengan komedo tertutup. Analisis multivariat data SQ-FFQ terhadap komedo tertutup menunjukkan hubungan positif bermakna asupan kasein terhadap lesi komedo tertutup, sesuai hasil penelitian sebelumnya yang menyatakan bahwa asupan protein susu (whey dan kasein) dapat merubah poros somatotropik dan menyebabkan awitan serta perburukan lesi akne. Kami menyarankan bahwa asupan kasein perlu dibatasi serta perbaikan asupan nutrisi perlu diikuti dengan upaya menjaga higiene kulit dan pengobatan akne secara tepat.

Acne vulgaris is top three of the most frequent dermatoses with great potency for significant negative impact on patients quality of life. Mainstay for acne mostly involve antibiotic therapy, with which the high incidence of resistency and reccurency calls for non medical approach for acne. Nutrition impact on acne is an exciting study, as it is expected to be a safe non medical approach which is side effect free. Previous studies revealed that nutrition intake brought significant effects in acne vulgaris pathogenesis, where Western diet is suspected to trigger acne epidemic and paleolithicum diet is assumed to reduce acne. This is a cross sectional study, aimed to reveal the correlation between intake of glycaemic load, whey, casein, saturated fatty acid, vitamin A, C and E, zinc and omega 3 fatty acid towards severity of acne vulgaris. Sample consist of 160 male with acne vulgaris aged 19-24 year old. As much as 63,2% of subjects have family history of acne, 73,6% subjects were using facial wash/ cleanser and 16% were using acne remedies. Multivariate analysis from 24 hours recall and SQ-FFQ data showed saturated fatty acid intake had a significant negative correlation to acne severity, non inflammatory lesion and open comedones. The reason behind the acne severity improvement despite exposure to high saturated fatty acid intake may strongly be influenced by the use of facial soap and acne remedies, as further analysis revealed negative association between the use of facial soap towards non inflammatory lesion and open comedones as well as negative association between acne remedies towards closed comedones. Multivariate analysis from SQ-FFQ data revealed significant positive correlation between casein intake and closed comedones, similar to previous study which mention that whey and casein intake may alter somatotrophic axis, which leads to onset and worsening of acne lesion. We are suggesting that casein intake should be restricted in acne cases and this measure should also be followed by proper skin higiene and acne therapeutic measures.

Kata Kunci : asupan, nutrisi, akne vulgaris, nutrition intake, acne vulgaris