HUBUNGAN KADAR ESTRADIOL SERUM, INDEKS MASSA TUBUH (IMT) DAN UMUR DENGAN DENSITAS TULANG PADA WANITA PERIMENOPAUSE DAN PASCA MENOPAUSE

NURDIANASARI DEWI, Prof. dr. H.M. Sulchan Soefowan, Ph.D,SpOG(K)

2013 | Tesis | S2 Ilmu Kebidanan dan Penyakit Kandungan

Latar belakang: Osteoporosis menyebabkan lebih dari 2,3 juta kejadian fraktur tiap tahunnya. Perempuan Indonesia memiliki risiko tertinggi di Asia untuk berpotensi terkena osteoporosis. BMI rendah, kadar estradiol rendah serta usia lanjut dipercaya sebagai faktor yang menyebabkan densitas massa tulang rendah. Tujuan: Untuk mengetahui hubungan antara kadar estradiol dan BMI terhadap kejadian densitas massa tulang rendah. Metode: Penelitian dilakukan di RSUP Dr. Sardjito Jogjakarta, dari bulan Juni sd Agustus 2011. Kriteria inklusi adalah wanita perimenopause dan pasca menopause atau wanita usia 45-90 tahun. Kriteria eksklusi adalah penderita keganasan, gagal ginjal, penyakit kelainan metabolisme, hipertiroid, hiperparatiroid, ooforektomi, pemakai terapi pengganti hormon. Pemeriksaan densitas tulang diperiksa pada daeral lumbal (L1-L4) dan tulang panggul dengan dual X-ray absorptiometry (DXA) sedangkan kadar estradiol diperiksa dengan metode ECLIA. Outcome yaitu densitas mineral tulang. Disebut massa tulang rendah jika T-score kurang dari -1. Analisis data menggunakan chi-squire, koefisien korelasi, regresi linier berganda, serta menggunakan SPSS 17. Hasil: Diperoleh 85 responden yang memenuhi kriteria kelayakan. Didapatkan 60 (70,6%) responden yang mengalami densitas massa tulang rendah. Umur menunjukkan korelasi negatif yang kuat terhadap densitas massa tulang (r = -0,61; p<0,001), sedangkan BMI dan kadar estradiol menunjukkan korelasi positif terhadap densitas massa tulang ( r = 0,49; p<0,001 dan r = 0,39; p<0,001). Umur mempunyai korelasi yang terkuat diikuti oleh BMI dan kadar estradiol. Persamaan regresi linier yang dihasilkan yaitu densitas massa tulang (y) = 0,294 + 0,100 (BMI) + 0,005 ( kadar estradiol) – 0,077 (umur). Kesimpulan: Kejadian BMD rendah lebih banyak terjadi pada wanita usia menopause. Umur, BMI dan kadar estradiol mempunyai korelasi terhadap densitas massa tulang dan bermakna secara statistik, dimana umur menunjukkan korelasi yang terkuat. Umur terhadap BMD menunjukkan korelasi negatif, sedangkan faktor BMI dan estradiol terhadap BMD menunjukkan korelasi positif.

Background: Osteoporosis has been responsible for 2.3 million fractures yearly in the world, and among Asian women, the Indonesian have the greatest risk for suffering from osteoporosis. Low body mass index (BMI), low estradiol level and higher age are predisposing factors for low bone mineral density (BMD). Objective: The study was undertaken to find out the relationship between menopausal status, age, estradiol level, and BMI to BMD. Method: The study was carried out at Sardjito Hospital from June to August 2011. Women during the peri-menopausal and postmenopausal period (age 45 to 90 years) were included into the study. Those with malignancy, hyperthyroidism, kidney diseases and those who had been done oophorectomy or under steroid hormonal therapy were excluded. BMD examination was done on Lumbar I to IV and pelvic bones using dual X-rays absorptiometry (DXA) at the Department of Radiology. Estradiol was examined using ECLIA methods. Low BMD was determined if the T-score was less than minus one (-1). Chi square test, correlation and multivariate linear regressions analysis were used for statistical analysis while SPSS was used for data processing Results: Among 85 women being eligible to the study, 72 (84,7%) were had been undergoing menopause and 60 (70.6%) had low BMD. The risk of getting low BMD was highest among menopausal compared to non-menopausal women (RR 3.43; 95% CI 1.26-9.32). Age showed strong negative correlation to BMD (r= - 0.61; P < 0.001), while BMI and estradiol level showed positive correlation (r=0.49 and 0.39 respectively, and P=0,001). The regression line was BMD (Y) = 0.294 – 0,77 (Age) + 0.005 (Estradiol) + 0.100 (BMI). Conclusion: The risk of getting low BMD was higher among menopausal women. There was negative correlation between age and BMD, but there were positive correlations between estradiol and BMI to BMD.

Kata Kunci : densitas massa tulang rendah, DXA, T-score.