Efek Rasio Kolesterol Total/Kolesterol High Density Lipoprotein (HDL) terhadap Nilai Ankle Brachial Index (ABI) pada Populasi dengan Risiko Penyakit Arteri Perifer (PAP)
DOI:
https://doi.org/10.29303/jku.v6i4.154Kata Kunci:
Kolesterol Total, HDL, Rasio Kolesterol Total/HDL, ABI, PAPAbstrak
Latar Belakang: Prediktor utama terjadinya penyakit kardiovaskular ialah penyakit arteri perifer (PAP) yang patogenesis utamanya adalah aterosklerosis. Beberapa penelitian menelitian menunjukan bahwa terdapat hubungan yang kuat antara rasio kolesterol total/kolesterol high density lipoprotein (HDL) dan PAP. Ankle brachial index (ABI) merupakan rasio antara tekanan darah sistolik pada tungkai bawah dengan lengan atas dan merupakan tes skrining non invasif untuk mendeteksi terjadinya PAP.
Tujuan: Untuk mengetahui hubungan rasio kolesterol total/HDL terhadap nilai ABI pada populasi dengan faktor risiko PAP.
Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode cross sectional. Pengambilan data penelitian dilakukan di RSUD Provinsi NTB, RS Harapan Keluarga, dan RS Risa Sentra Medika. Kadar kolseterol total dan HDL didapatkan melaui hasil pemeriksaan laboratorium.
Hasil: Total responden adalah 92, 17,4% memiliki nilai kolesterol total abnormal, 44,6% HDL abnormal dan 51,1% rasio kolesterol total/HDL abnormal. Hasil uji chi-square kolesterol total, HDL, dan rasio kolesterol total/HDL dengan nilai ABI (p=0,525), (p=0,397), (p=0,278). Hasil uji Rasio Odds kolesterol total, HDL, dan rasio kolesterol total/HDL dengan nilai ABI (RO=1,465), (RO=1,505), (RO=1,697).
Kesimpulan: Tidak terdapat hubungan yang signifikan antara kadar kolesterol total, HDL, dan rasio kolesterol total/HDL terhadap nilai ABI karena sebagian besar responden merupakan penderita dislipidemia yang telah mengonsumsi obat anti-dislipidemia dan abnormalitas nilai ABI dipengaruhi oleh banyak faktor risiko. Individu dengan kadar kolesterol total, kolesterol HDL, dan rasio kolesterol total/HDL abnormal mempunyai risiko 1,465, 1,505, dan 1,697 kali untuk memiliki nilai ABI abnormal.
Referensi
2. Kementerian Kesehatan Republik Indonesia. Situasi Kesehatan Jantung. Jakarta: Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia; 2014. Available from: http://www.depkes.go.id/download.php?file=download/pusdatin/infodatin/infodatin-jantung.pdf.
3. Hennion DR, Siano KA. Diagnosis and Treatment of Peripheral Arterial Disease. American Family Physician. 2013;88(5):306–10. Available from: https://www.aafp.org/afp/2013/0901/p306.html.
4. Thendria T, Toruan I, Natalia D. Hubungan Hipertensi dan Penyakit Arteri Perifer Berdasarkan Nilai Ankle-Brachial Index. eJournal Kedokteran Indonesia. 2014;2(1). Available from: http://journal.ui.ac.id/index.php/eJKI/article/view/3188/3406.
5. Zhou Q, Wu J, Tang J, Wang JJ, Lu CH, Wang PX. Beneficial Effect of Higher Dietary Fiber Intake on Plasma HDL-C and TC/HDL-C Ratio among Chinese Rural-to-Urban Migrant Workers. International Journal of Environmental Research and Public Health. 2015 May;12(5):4726–4738. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454936/.
6. Arifnaldi MS. Hubungan Kadar Trigliserida Dengan Kejadian Stroke Iskemik Di RSUD Sukoharjo [s1]. Universitas Muhammadiyah Surakarta; 2014. DOI: http://eprints.ums.ac.id/28323/10/BAB IV.pdf. Available from: http://eprints.ums.ac.id/28323/.
7. Zhang Y, Huang J, Wang P. A Prediction Model for the Peripheral Arterial Disease Using NHANES Data. Medicine. 2016 Apr;95(16). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845850/.
8. WOCN Clinical Practice Wound Subcommittee. Ankle Brachial Index: Quick Reference Guide for Clinicians. Journal of Wound Ostomy & Continence Nursing. 2012 Apr;39(2S):S21. Available from: https://journals.lww.com/jwocnonline/Fulltext/2012/03001/Ankle_Brachial_Index_Quick_Reference_Guide_for.6.aspx.
9. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and Interpretation of the Ankle-Brachial Index: A Scientific Statement From the American Heart Association. Circulation. 2012 Dec;126(24):2890–2909. Available from: http://circ.ahajournals. org/content/126/24/2890.
10. Dahlan MS. Statistik untuk Kedokteran dan Kesehatan. 5th ed. Jakarta: Salemba Medika; 2013.
11. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery,* Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006 Mar;113(11):e463–e654. Available from: http://circ.ahajournals.org/content/113/11/e463.
12. Kumar, Cotran, Robbins. Buku Ajar Patologi. 7th ed. Jakarta: EGC;.
13. Nair D, Carrigan TP, Curtin RJ, Popovic ZB, Kuzmiak S, Schoenhagen P, et al. Association of total cholesterol/ high-density lipoprotein cholesterol ratio with proximal coronary atherosclerosis detected by multislice computed tomography. Preventive Cardiology. 2009;12(1):19–26.
14. Huang H, Zeng C, Ma Y, Chen Y, Chen C, Liu C, et al. Effects of Long-Term Statin Therapy in Coronary Artery Disease Patients with or without Chronic Kidney Disease. Disease Markers. 2015;2015. Available from: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC4617877/.
15. Mitu F, Mitu O, Leon MM, Jitaru A. The correlation between the ankle-brachial index and the metabolic syndrome. Revista Medico-Chirurgicala a Societatii De Medici Si Naturalisti Din Iasi. 2014 Dec;118(4):965–970.
16. Lee IT, Huang CN, Lee WJ, Lee HS, Sheu WHH. High total-to-HDL cholesterol ratio predicting deterioration of ankle brachial index in Asian type 2
diabetic subjects. Diabetes Research and Clinical Practice. 2008 Mar;79(3):419–426.
17. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman Tatalaksana Dislipidemia. Jakarta: Perhimpunan Dokter Spesialis Kardiovaskular Indonesia; 2013. Available from: http://www.inaheart.org/upload/file/Pedoman_tatalksana_Dislipidemia.pdf.
18. Takashima H, Ozaki Y, Yasukawa T, Waseda K, Asai K, Wakita Y, et al. Impact of Lipid-Lowering Therapy With Pitavastatin, a New HMG-CoA Reductase Inhibitor, on Regression of Coronary Atherosclerotic Plaque. Circulation Journal. 2007;71(11):1678–1684. Available from: https://www.jstage.jst.go.jp/article/circj/71/11/71_11_1678/_article.
19. Yildiz A, Cakar MA, Baskurt M, Okcun B, Guzelsoy D, Coskun U. The effects of atorvastatin therapy on endothelıal function in patients with coronary artery disease. Cardiovascular Ultrasound. 2007 Dec;5:51. Available from: https://doi.org/10.1186/1476-7120-5-51.
