RASIO PREVALENSI ADANYA KONDISI NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) PADA WANITA OBESE BERDASARKAN KADAR FIBRONEKTIN

DEWI SUSPOLITA, Dr.dr. Siti Muchayat P., MS, Sp.PK(K). ; Dr.dr. Tri Ratnaningsih., M.Kes., Sp.PK(K)

2020 | Tesis-Spesialis | PATOLOGI KLINIK

Latar belakang: Non-Alcoholic Fatty Liver Disease (NAFLD) adalah perlemakan hati yang bukan disebabkan konsumsi alkohol berlebih, ditandai dengan kerusakan dan peradangan kronis hati yang terjadi pada 40% pasien obesitas berat. Penanda inflamasi sekarang tidak spesifik, sehingga fibronektin diharapkan mampu mendeteksi dini inflamasi kronis pada obesitas yang berlanjut menjadi NAFLD. Tujuan penelitian ini adalah untuk mengetahui rasio prevalensi adanya kondisi Non-Alcoholic Fatty Liver Disease (NAFLD) pada wanita obese berdasarkan kadar fibronektin. Metode: Penelitian ini merupakan studi observasional analitik dengan desain cross sectional. Subjek penelitian adalah wanita obese >17 tahun dengan IMT >25 kg/m2. Pemeriksaan kadar fibronektin menggunakan metode kuantitatif sandwich Enzyme Linked Immuno Sorbent Assay (ELISA). Diagnosis NAFLD ditegakkan dengan USG abdomen. Analisis beda proporsi fibronektin antar kelompok dengan Chi-square, kemudian dihitung rasio prevalensinya. Hasil: Subjek penelitian ini sebanyak 48 wanita obese dengan IMT >25 kg/m2. Berdasarkan USG abdomen didapatkan 27 subjek pada kelompok wanita obese dengan NAFLD dan 21 subjek pada kelompok wanita obese tanpa NAFLD. Rerata umur 49,9±9,6 tahun dan rerata IMT 30,75 kg/m2. Kadar fibronektin pada cut-off 508,27 ng/ml menunjukkan adanya NAFLD pada wanita obese dengan rasio prevalensi (RP) 4,4 (95% CI: 1,99-9,68), p <0,001. Simpulan: Kadar fibronektin dapat menggambarkan adanya kondisi NAFLD pada wanita obese. Kadar fibronektin 508,27 ng/ml memiliki rasio prevalensi adanya kondisi NAFLD sebanyak 4,4 kali pada populasi wanita obese.

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a fatty liver condition without history of excessive consumption of alcohol, characterized by damage and chronic inflammation of the liver and occurs in 40% of patients with severe obesity. Current inflammatory markers are not specific, so fibronectin is expected to be a marker that allows early detection of chronic inflammation in obese patients potentially evolve to NAFLD. The purpose of this study was to determine the prevalence ratio of Non-Alcoholic Fatty Liver Disease (NAFLD) in obese women based on fibronectin levels Method: This study was an observational analytic study with cross-sectional design. Subjects were obese women aged > 17 years old with BMI >25 kg/m2. Fibronectin levels were analyzed using a quantitative sandwich Enzyme Linked Immuno Sorbent Assay (ELISA) method. The diagnosis of NAFLD is confirmed by an abdominal ultrasound. Chi-square analysis was carried out to find the difference in the proportions of fibronectin between groups, and then the prevalence ratio was calculated. Results: The subjects of this study were 48 obese women with a BMI 25 kg/m2. Based on abdominal ultrasound, 27 subjects had NAFLD and 21 subjects didnt. The mean age was 49.9 ± 9.6 years and the mean BMI was 30.75 kg/m2. Fibronectin levels at the cut-off 508.27 ng/ml could be used as a predictor of NAFLD in the group of obese women with a prevalence ratio (PR) of 4.4 (95% CI: 1,99-9,68), p <0.001. Conclusion: Fibronectin levels can be a marker of NAFLD in obese women. Fibronectin levels of 508.27 ng/ml have a prevalence ratio of NAFLD as much as 4,4 times in the population of obese women.

Kata Kunci : Obese, IMT, USG, Fibronektin, NAFLD, Rasio Prevalensi,