VALIDITAS DIAGNOSTIK INDEKS TERKAIT LIPID DAN OBESITAS UNTUK DETEKSI SINDROM METABOLIK PADA TENAGA MEDIS

Auliya Nisa, Pembimbing Utama: Dr. dr. Tri Ratnaningsih, M.Kes, Sp.PK. Subsp.B.D.K.T (K), Subsp.H.K (K); Pembimbing Pendamping: dr. Windarwati, M.Sc, Sp.PK, Subsp.E.M.(K)

2026 | Tesis | S2 Kedokteran Klinik

Latar Belakang:

Sindrom metabolik merupakan kumpulan kelainan metabolik yang meliputi obesitas sentral, hipertensi, dislipidemia, dan gangguan metabolisme glukosa yang meningkatkan risiko diabetes melitus tipe 2 dan penyakit kardiovaskular. Diagnosis sindrom metabolik memerlukan kombinasi berbagai parameter klinis dan laboratorium sehingga diperlukan metode skrining yang lebih sederhana dan praktis. Indeks berbasis lipid dan antropometri, seperti Lipid Accumulation Product (LAP) dan Triglyceride-Glucose Waist-to-Height Ratio (TyG-WHtR), berpotensi digunakan sebagai metode skrining sindrom metabolic, namun performa diagnostik dan cut-off optimal kedua indeks tersebut dapat bervariasi antar-populasi dan belum tervalidasi secara spesifik pada populasi tenaga medis di Indonesia.

Tujuan:
Mengetahui validitas diagnostik indeks LAP dan TyG-WHtR dalam mendeteksi sindrom metabolik pada tenaga medis.

Metode:
Penelitian ini menggunakan desain observasional potong lintang dengan pendekatan uji diagnostik. Sebanyak 183 tenaga medis berusia ?30 tahun yang menjalani pemeriksaan kesehatan diikutsertakan dalam penelitian. Sindrom metabolik ditentukan berdasarkan Harmonized Criteria. Analisis diagnostik dilakukan menggunakan kurva receiver operating characteristic (ROC) untuk menentukan area under the curve (AUC), sensitivitas, spesifisitas, dan cut-off optimal berdasarkan indeks Youden.

Hasil:
Sebanyak 56 subjek (30,6%) mengalami sindrom metabolik, sedangkan 127 subjek (69,4%) tidak mengalami sindrom metabolik. Kedua indeks menunjukkan kemampuan diagnostik yang baik dengan nilai AUC LAP dan TyG-WHtR masing-masing adalah 0,885 dan 0,872 dengan p<0>Cut-off optimal LAP sebesar 35,66 memiliki sensitivitas 92,86%, spesifisitas 74,02%, dan akurasi 79,78%, sedangkan TyG-WHtR dengan cut-off 4,79 memiliki sensitivitas 87,50%, spesifisitas 76,98%, dan akurasi 80,22%. LAP memiliki sensitivitas dan indeks Youden yang lebih tinggi, sedangkan TyG-WHtR memiliki spesifisitas dan akurasi yang sedikit lebih tinggi secara numerik.

Kesimpulan:
LAP dan TyG-WHtR memiliki validitas diagnostik yang baik untuk mendeteksi sindrom metabolik pada tenaga medis. LAP dengan cut-off 35,66 dan TyG-WHtR dengan cut-off 4,79 berpotensi digunakan sebagai metode skrining sederhana dan praktis untuk mendeteksi sindrom metabolik pada populasi tenaga medis.

Background:

Metabolic syndrome is a cluster of metabolic abnormalities comprising central obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which increase the risk of type 2 diabetes mellitus and cardiovascular disease. The diagnosis of metabolic syndrome requires a combination of various clinical and laboratory parameters; therefore, simpler and more practical screening methods are needed. Lipid- and anthropometry-based indices, such as Lipid Accumulation Product (LAP) and Triglyceride-Glucose Waist-to-Height Ratio (TyG-WHtR), have the potential to be used as screening methods for metabolic syndrome. However, the diagnostic performance and optimal cut-off values of these indices may vary across populations and have not been specifically validated in Indonesian physicians.

Objective:
To determine the diagnostic validity of LAP and TyG-WHtR indices for detecting metabolic syndrome among Indonesian physicians.

Methods:
This study used a cross-sectional observational design with a diagnostic test approach. A total of 183 healthcare workers aged ?30 years who underwent medical examinations were included in the study. Metabolic syndrome was determined based on the Harmonized Criteria. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis to determine the area under the curve (AUC), sensitivity, specificity, and optimal cut-off values based on the Youden index.

Results:
A total of 56 subjects (30.6%) had metabolic syndrome, while 127 subjects (69.4%) did not. Both indices demonstrated good diagnostic performance, with AUC values for LAP and TyG-WHtR of 0.885 and 0.872, respectively (p<0>cut-off value for LAP was 35.66, with a sensitivity of 92.86%, specificity of 74.02%, and accuracy of 79.78%, whereas the optimal cut-off value for TyG-WHtR was 4.79, with a sensitivity of 87.50%, specificity of 76.98%, and accuracy of 80.22%. LAP demonstrated higher sensitivity and Youden index, whereas TyG-WHtR showed slightly higher specificity and accuracy.

Conclusion:
LAP and TyG-WHtR demonstrated good diagnostic validity for detecting metabolic syndrome among healthcare workers. LAP with a cut-off value of 35.66 and TyG-WHtR with a cut-off value of 4.79 have the potential to be used as simple and practical screening methods for detecting metabolic syndrome in the medical workforce population.

Kata Kunci : Sindrom metabolik, LAP, TyG-WHtR, validitas diagnostik, tenaga medis.