Obesitas sentral berhubungan dengan toleransi glukosa terganggu pada remaja perempuan

https://doi.org/10.22146/ijcn.18206

Lucia Mawarti Dwi Astuti(1*), Endy Paryanto Prawirohartono(2), Noormanto Noormanto(3), Madarina Julia(4)

(1) Bagian Anak Rumah Sakit Umum Pusat Dr. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada
(2) Bagian Anak Rumah Sakit Umum Pusat Dr. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada
(3) Bagian Anak Rumah Sakit Umum Pusat Dr. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada
(4) Bagian Anak Rumah Sakit Umum Pusat Dr. Sardjito/Fakultas Kedokteran Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: Obesity in adolescents has become health problem in Indonesia. Central obesity is associated with insulin resistance.Theoretically, insulin resistance will cause impaired glucose tolerance (IGT) and could develop into type 2 diabetes.

Objective: The aim of this study were to evaluate the difference in IGT prevalence between central and non central obesity and to identify the risk factors associated with IGT. 

Method: A cross sectional study was conducted at 3 private secondary schools in Yogyakarta and recruited 62 obese female students aged 12-18 years.The subjects were classified into central obesity (BMI/U> +2SD and waist circumference > p90) and non central obesity based on anthropometric data. Fasting glucose and 2 hours after loading were measured in all subjects. Differences in the proportion of IGT between the two groups was calculated by Chi-square test and risk factors associated with IGT were calculated by multivariate logistic regression with 95% confidence interval.

Result: Of 62 subjects, 14 of them have IGT and the prevalence of IGT was significantly higher in the central obesity group compared to non central obesity group (11/31 vs 3/31, p=0.03). Central obesity was found to be the only risk factor of IGT (OR=4.6; 95%CI: 1.04 to 20.24). Twenty one of the subjects were found to have impaired fasting glucose (IFG) (34%) and one subject (1.6 %) had IFG+IGT. There were no differences in the proportion of IFG between central and non central obesity groups. 

Conclusion: The prevalence of IGT in female students with central obesity was higher compared to those with non central obesity. A female student with central obesity had 4.6-fold risk of having IGT compared to those with non central obesity.


Keywords


central obesity; impaired glucose tolerance; female student; prevalence; cross sectional study; impaired fasting glucose

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References

World Health Organization. Obesity: 1. preventing and managing the global epidemic. Geneva: Report of a WHO Consultation; 2000.

Huriyati E. Studi kohort prevalensi obesitas siswa-siswi sekolah lanjutan tingkat pertama (SLTP) Kota Yogyakarta. Jurnal Gizi Klinik Indonesia 2006;3(1):1-5.

McCarthy HD, Ellis SM, Cole TJ. Central overweight and obesity in British youth aged 11-16 years: cross sectional surveys of waist circumference. BMJ 2003;326(7390):624.

Moreno LA, Fleta J, Mur L, Sarria A, Bueno M. Fat distribution in obese and nonobese children and adolescents. J Pediatric Gastroenterol Nutr 1998;27(2):176-80.

Alberti KGMM, Zimmet P, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S. The IDF consensus definition of the metabolic syndrome in children and adolescent, International Diabetes Federation [serial online] 2007 [cited 2010 March 03]. Available from: http:///www.idf.

Wajchenberg BK. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000;21(6):697-738.

Freemark M. Metabolic consequences of obesity and their management. In: BrookCGD,Clayton PE, BrownRS. Clinical pediatric endocrinology, 5th edition. London: Blackwell Publishing; 2005.

Weiss R, Duforu S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, Boselli L, Barbetta G, Allen K, Rife F, Savoye M, Dziura J, Sherwin R, Shulman GI, Caprio S. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocelluller and abdominal fat partitioning. Lancet 2003;362(9388):951-7.

Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis, edisi ketiga. Jakarta: CV Sagung Seto; 2008.

Damanik SM. Klasifikasi bayi menurut berat lahir dan masa gestasi. Dalam: Kosim MS, Yunanto A, Dewi R, Sarosa GI, Usman A. Buku Ajar Neonatologi, edisi pertama. Jakarta: Badan Penerbit IDAI; 2008.

Ryha NH. Hubungan antara lingkar pinggang dan rasio lingkar pinggang-panggul dengan resistensi insulin pada remaja putri obes di Yogyakarta [Skripsi]. Yogyakarta: Fakultas Kedokteran Universitas Gadjah Mada; 2009.

Wiegand S, Maikowski U, Blankenstein O, Biebermann H, Tarnow P, Gruters A. Type 2 diabetes and impaired glucose tolerance in European children and adolescents with obesity – a problem that is no longer restricted to minority groups. Eur J Endocrinol 2004;51:199–206.

Cali AMG, Bonadonna RC, Trombetta M, Weiss, Caprio S. Metabolic abnormalities underlying the different prediabetic phenotypes in obese adolescents. J Clin Endocrinol Metab 2008;93:1767-73.

Bacha F, Lee SJ, Gungor N, Arslanian SA. From prediabetes to type 2 diabetes in obese youth:

pathophysiological characteristic along the spectrum of glucose dysregulation. Diabetes Care 2010;33:2225-31.

Tfayli H, Arslanian SA. Pathophysiology of type 2 diabetes mellitus in youth: the evolving chameleon. Arq Bras Endocrinol Metab 2009;53(2):165-74.



DOI: https://doi.org/10.22146/ijcn.18206

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