ABSTRAK
Latar Belakang: Obesitas merupakan faktor risiko utama osteoartritis (OA).Penelitian terdahulu mendapatkan bahwa faktor mekanik saja tidak cukup untukmenjelaskan hubungan OA dengan obesitas. Saat ini faktor metabolik yangberkaitan dengan massa lemak tubuh dianggap memiliki peranan penting, tetapilemak mana yang paling berperan masih kontroversial apakah lemak viseral ataulemak subkutan. Tujuan penelitian ini untuk mendapatkan korelasi antaradistribusi lemak tubuh dengan lebar celah sendi tibiofemoral medialMetode: Penelitian ini merupakan studi potong lintang pada penderita OA lututdengan obesitas yang berobat di poliklinik Reumatologi, Geriatri dan PenyakitDalam RSCM periode Januari-Maret 2016. Diagnosis OA lutut berdasarkankriteria American College of Rheumatology (ACR) 1986. Pemeriksaan distribusilemak tubuh menggunakan bioelectrical impedance analysis (BIA). Pemeriksaanradiologi lutut menggunakan radiologi konvensional (foto polos) untuk menilailebar celah sendi tibiofemoral medial. Analisis statistik bivariat digunakan untukmendapatkan korelasi antara distribusi lemak tubuh dengan lebar celah senditibiofemoral medial.Hasil: Sebanyak 56 orang pasien yang memenuhi kriteria inklusi dan bersediaikut dalam penelitian, mayoritas subjek berjenis kelamin perempuan (73,2%).Median kadar lemak viseral adalah 12% (7.5-16,5) median lemak subkutan adalah30,2% (16,5-37,9) dan median rasio lemak viseral/subkutan adalah 0,40(0,26-0,80). Rerata lebar celah sendi tibiofemoral medial adalah 2,34 mm(SB 0,78). Korelasi antara lemak viseral dengan lebar celah sendi tibiofemoralmedial (r: -0,474 p: < 0,001). Tidak didapatkan korelasi antara lemak subkutandengan lebar celah sendi tibiofemoral medial (r: -0,187 p: 0,169) serta tidakdidapatkan korelasi antara rasio lemak viseral/subkutan dengan lebar celah senditibiofemoral medial (r: -0,225 p: 0,09)Simpulan: Lemak viseral berkorelasi negatif sedang dengan lebar celah senditibiofemoral medial (r: -0,474 p: < 0,001). Tidak didapatkan korelasi antara lemaksubkutan dan rasio lemak viseral/subkutan dengan lebar celah sendi tibiofemoral
ABSTRACT
Background: Obesity is a major risk factor for knee osteoarthritis. Therelationship between obesity and OA may not simply due to mechanical factor.Evidence suggests that metabolic factors related to body fat play important roles,but the specific type of fat that contributes to OA is unclear. The objective of thisstudy was to examine the possible correlation between body fat distributions withknee OAMethod: This study was a cross sectional study in OA patients with obesityvisiting Rheumatology, Geriatric, Internal Medicine clinics in CiptoMangunkusumo Hospital between January-March 2016. Samples were collectedusing consecutive sampling method. Knee OA was diagnosed from clinical andradiologic evaluation based on American College of Rheumatology 1986 criteria.Body fat distribution was measured by bioelectrical impedance analysis (BIA).Radiographs of the knee was measured by conventional radiography to evaluatejoint space narrowing (JSN). The correlation between body fat distributions withjoint space width was analyzed by bivariate analysisResult: A total of 56 subjects were recruited, with majority of subjects werewomen (73,2%). Median of visceral fat was 12% (7.5-16,5), median ofsubcutaneous fat was 30,2% (16,5-37,9) and median of visceral to subcutaneousfat ratio was 0,40 (0,26-0,80). Mean of medial tibiofemoral joint space width was2,34 mm (SB 0,78). In bivariate analysis we found correlation between visceralfat and medial tibiofemoral joint space width (r: -0,474 p: < 0,001). There is nocorrelation between subcutaneous fat and medial tibiofemoral joint space width(r: -0,187 p: 0,169) and also visceral to subcutaneous fat ratio and medialtibiofemoral joint space width (r: -0,225 p: 0,09).Conclusion: Visceral fat is correlated with medial tibiofemoral joint space width(r: -0,474 p: < 0,001). There is no correlation between neither subcutaneous fatnor visceral to subcutaneous fat ratio and medial tibiofemoral joint space width. |
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