Analisis Nilai Clothing Time, Prothrombine Time dan Activated Partial Thromboplastine Time pada Remaja Obes

Nelly Nelly(1*), Mansyur Arief(2), Ilham Jaya Patellongi(3)


(1) FK UNISMUH, Makassar
(2) RSUP Dr Wahidin Sudirohusodo, Makassar
(3) FK Universitas Hasanuddin, Makassar
(*) Corresponding Author

Abstract


Berdasarkan estimasi WHO, obesitas menjadi masalah kesehatan di dunia. Selain karena insidennya meningkat,juga karena obesitas menimbulkan berbagai komplikasi penyakit metabolik dan vaskuler  seperti sindrom metabolik, penyakit jantung, stroke dan gangguan pembekuan darah. Mengingat insiden obesitas pada saat ini telah mengalami pergeseran dari dewasa ke usia anak dan remaja serta berbagai komplikasi yang ditimbulkan oleh obesitas itu sendiri  maka dianggap perlu dilakukan deteksi dini adanya gangguan hemostasis pada obesitas usia anak dan remaja untuk mencegah komorbiditas obesitas dikemudian hari. Desain penelitian ini adalah cross sectional study yang dilakukan di SMA Katolik Rajawali  Makassar dengan menggunakan sampel  siswa yang berumur sekitar 10-18 tahun. Dilakukan pemeriksaan antropometrik dan pemeriksaan nilai Clothing Time (TT), Prothrombine Time (PT) dan Activated Partial Thromboplastine Time(aPTT). Obesitas dinyatakan berdasarkan Kategori IMT yang ditentukan berdasarkan ambang batas Z-Score sedangkan kategori lingkar pinggang ditentukan berdasarkan Waist Circumfrence for Hong Kong Chinese Children (2008). Data dianalisis dengan independent t-test untuk menilai perbedaan nilai CT, PT dan aPTT pada remaja obes dan berat badan normal sedangkan  uji korelasi pearson digunakan untuk melihat adanya hubungan antara IMT dan LP dengan nilai CT, PT dan aPTT pada remaja obes. Subyek adalah siswa siswi SMA Katolik Rajawali Makassar dengan rerata umur 15 tahun terdiri dari 33 orang laki-laki (22 obesitas,11 normal) dan 16 perempuan (5 obesitas,11 normal). Didapatkan perbedaan bermakna antara nilai CT, PT dan aPTT pada remaja obes dan berat badan normal. Nilai rata-rata CT, PT dan  pada kelompok normal adalah masing-masing aPTT 11±1,23; 13,86 ± 0,63 detik ; 32,90 + 1,77 detik dan pada kelompok obes adalah nilai CT,PT dan aPTT adalah 9 ±1,7; 13,11 + 0,59 detik dan 31,92+3,82 detik. Selain itu, terdapat korelasi negatif antara nilai CT,PT dan LP pada remaja obes namun tidak ditemukan adanya korelasi antara IMT dan LP dengan nilai aPTT pada remaja obes. Nilai CT, PT dan aPTT pada remaja obes cenderung memendek dibandingkan dengan berat badan normal.
Semakin tinggi nilai IMT dan LP, maka nilai CT, PT dan aPTT semakin memendek. 

 

Based on World Health Organization estimation, obesity has been a world health problem. Aside from the increased incident, also because obesity causes various vascular and metabolic disease complications such as metabolic syndrome, heart disease, stroke and blood coagulation disorder. Considering that the obesitysyndrome now has shifted from adults to kids and adolescent along with the complications of obesity, it is necessary to get an early detection in haemostaticdisorder in kids and adolescent obesity to prevent obesity co morbidity in the future.The design of the research is cross sectional study which was carried out the population of Katolik Rajawali High School student in Makassar, ranging in age from ten to eighteen years old. An anthropometric examination was done, as well as examination of Clothing Time (TT), Prothrombine Time (PT) and Activated Partial Thromboplastine Time (PTT) value. Obesity is declare based on Body Mass Index (BMI) Category which was determined based on Z-Score threshold whereas waist line category was determined based on Waist Circumference (WC) for Hong Kong Chinese Children (2008). Data was analyzed using an independent t-test to assess the difference in CT, PT and aPTT value in obese adolescent and normal weight whereas the Pearson correlation test was used to see the relation between BMI and WC with CT, PT and aPTT in obese adolescent. Subjects were the high school students with the average age of 15 years old, consisting of 33 boys (22 obese, 11 normal) and 16 girls (5 obese, 11 normal). The results showed significance different between CT, PT and aPTT value in obese adolescent and normal weight. The mean CT, PT and aPTT in the normal group were each 11 ± 1.23; 13.86 ± 0.63 seconds; 32.90 + 1.77 seconds and in the obese group the CT value, PT and aPTT were 9 ±1.7; 13.11 + 0.59 seconds and 31.92 + 3.82 seconds.Besides that, there was a negative correlation between CT, PT and WC value in obese adolescent but there was no correlation between BMI and WC with aPTT value in obese adolescent. Clothing Time, PT and aPTT value in obese adolescent tends to shorten compared to normal weight. The higher BMI and WC values, the shorter CT, PT and aPTT values. Keywords : Obesity, adolescent,CT, PT,aPTT




Keywords


obesitas; remaja;CT; PT; aPTT

Full Text:

PDF

References


Mexitalia,M., Agustini Utari, Sakundarno M, Taro Yamauchi, Hertanto Wahyu Subagio, Agustinus Soemantri. Sindrom Metabolik pada Remaja Obesitas, Dalam : Media Medika Indonesiana, Jawa Tengah, Fakultas Kedokteran Universitas Diponegoro dan Ikatan Dokter Indonesia Wilayah Jawa Tengah. 2011.

Ferguson MA, Gutin B, Owens S, Litaker M, Tracy RP, Allison J. Fat Distribution and Hemostatic Measures in Obese Children. Am J Clin Nutr 1998; 67: 1136–40

Dietz WH, Suskind,RM,, Suskind L(Eds). Childhood Obesity. In : Textbook of Pediatric Nutrition. 2nd ed., New York, Raven Press,1993;279-84.

Cole TJ, Bellizi MC, Flegal KM, Dietz WH., 2000 : Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey.BMJ ;320:1240-1243

Lawrence GS. Implikasi Klinis Disfungsi Endotel dan Radikal Bebas. Unit Riset Vaskuler, Bagian patologi, Makassar, FKUH RSUP dr.Wahidin Sudirohusodo, 2006.

Verma S, Buchanan MR, Anderson TJ.Endothelial Function Testing as a Biomarker of Vascular Disease. Circulation 2003;108:2054-9.

Hajer GR, Timo W.Van Haeften and Frank LJ Visseren. Adipose Tissue Dysfunction in Obesity, Diabetes and Vascular Disease. Departement of Vascular Medicine, The Netherlands University Medical Center Urecht, European Heart Journal (2008) 29, 2959–7

Heru Cahjono, Anak Agung Gde Budhiarta. Hubungan Resistensi Insulin dengan Kadar Nitric Oxide pada Obesitas Abdominal. Bagian / SMF Ilmu Penyakit Dalam FK Unud / RS UP Sanglah, Denpasar Bali. Hal:23-6

Steven E. Shoelson, Laura Herrero, And Afia Naaz. Obesity, Inflammation, and Insulin Resistance. Joslin Diabetes Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts.Journal of Gastroenterology. 2007;132:2169–21

Ruhbeck G, Ambrosi JG, Muruzabal FJ, Burrell MA. The Adipocyte: a Model for Intergration of Endocrine and Metabolic Signaling in Energy Metabolism Regulation. Am J Physiol Endocrinol Metab 2001; 280: 827-47.

Iiao JK. Endothelium and Acute Coronary Syndrome. Clin Chem 1998;44(8):1799-808.

Hu SK, Wang ZM, Shen W, Heymsfield SB, Heshka S. Percentage Body Fat Ranges Associated with Metabolic Syndrome Risk : Results Based on The Third National Health and Nutrition Examination Survey. Am J Clin Nutr 2003; 78: 228-35. 13.Fernandez-Real JM, Ricart W. Insulin Resistance and Chronic Cardiovascular Inflammatory Syndrome. Endocrine Reviews 2003;24(3):278-301.

Hsueh WA, Jackson S, Law RE. Control of Vascular Cell Proliferation and Migration by Ppar-X-A New http://jurnal.unimus.ac.id

Analisis Nilai Clothing Time, Prothrombine Time dan Activated Partial Thromboplastine Time pada Remaja Obes 43 Vol. 1 No.5 Agustus 2018Approach to The Macrovascular Complication of Diabetes. Diabetes Care 2001;24;392-7.

Cohn JN, Quyyumi AA, Hollenberg NK, Jamerson KA. Surrogate Markers for Cardiovascular Disease - Functional Markers. Circulation 2004;109(suppl IV):IV31-46.

Sfinger Link. Metabolic, Inflamatory, Endhothelial and Haemostatic Markers in a Group of Italian Obese Children an Adolescent. European Journal of Pediatric. 2011; 170 (7) :845-50

I Made Bakta, Thrombosis pada Usia Lanjut. Denpasar,Bali,Universitas Udayana RS.Sanglah, 2007; 8 (2) : 147-58

Mira Dewi. Resistensi Insulin Terkait Obesitas. Dalam : Mekanisme Endokrin dan Intrinsik Sel. Jurnal Gizi dan Pangan Pergizi Pangan Indonesia. Bogor Indonesia. Juli 2007;1978(2) :49-54

Grey A. The Reductive Hotspot Hypothesis: An Update. Arch Biochem Biophys 2000; 373: 295-301.

Irène Juhan-Vague MD, Marie-Christine Alessi MD. Abdominal Obesity,Insulin Resistance, and Alterations in Hemostasis. Laboratoire d’Hématologie, Faculté de Médecine, Université de la Méditer- ranée, Inserm UMR 626, Marseille,France. ijuhan@ap-hm.fr. 2008:11-16

Koletzko B, Girardet JP, Klish W, Tabacco O. Obesity in Children and Adolescents Worldwide : Current Views and Future Directions, Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr.2002 ; 35:S205-12.

Darvall KAL, Silveman SH,et al. Obesity and Thrombosis. Department of Vascular Surgery. City Hospital, Birmingham UK and University Department of Vascular Surgery, Birmingham Heartlands Hospital, UK. 2007 ; 223-233

Eckel R, Grundy S. Insensitivity to Insulin and Obesity: The Underlying Cause. Diabetes Voice 2006;51:28-30.


Article Metrics

Abstract view : 990 times
PDF - 187 times

DOI: https://doi.org/10.26714/magnamed.1.5.2018.36-43

Refbacks

  • There are currently no refbacks.




Indexed by

 

      

 

Creative Commons License

MAGNA MEDIKA by APKKM is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.