Hubungan Kadar Plasma Chemerin dengan Homeostasis Model Assessment Insulin Resistance pada Remaja Obesitas

Silvy Dioni, Eka Agustia Rini, Eti Yerizel

Sari


Latar belakang. Obesitas pada anak berhubungan dengan meningkatnya risiko sindrom metabolik, seperti resistensi insulin. HOMA-IR merupakan marker yang sering digunakan untuk menilai resistensi insulin. Chemerin merupakan protein 18 kDa yang dihasilkan jaringan adiposa, berfungsi sebagai chemoatractant memegang peran penting berkontribusi terhadap perkembangan inflamasi dan resistensi insulin.
Tujuan. Untuk mengetahui hubungan kadar chemerin dengan HOMA-IR pada remaja obesitas.
Metode. Penelitian ini merupakan penelitian cross sectional yang dilakukan pada 3 sekolah menengah umum (SMU) di kota Padang. Jumlah sampel berjumlah 28 remaja obesitas dan 28 remaja dengan IMT normal. Obesitas ditentukan berdasarkan nilai IMT, HOMA-IR dihitung berdasarkan rumus yang menggunakan nilai glukosa dan insulin puasa. Glukosa diukur dengan metode glucose hexokinase fotometrik, insulin diperiksa dengan metode chemiluminessence immunoassay dan kadar plasma chemerin dengan metode ELISA. Data dianalisis dengan sistem komputerisasi dengan uji korelasi.
Hasil. Kadar plasma chemerin lebih tinggi pada kelompok obesitas dibandingkan kontrol 121,52 (SD 2,09) ng/ml vs 97,23(SD 2,41) ng/ml, p: 0,001 dan pada kelompok obesitas dengan resistensi insulin dibandingkan non resistensi insulin 133,1(SD 19,24) vs 115,09 (SD 19,52), p=0,001. Terdapat hubungan lemah kadar chemerin dengan nilai HOMA-IR pada obesitas
(r=0,382;p=0,045) dan hubungan lemah kadar chemerin dengan nilai HOMA-IR pada obesitas resistensi insulin (r=0,297;p=0,405).
Kesimpulan. Terdapat hubungan lemah kadar chemerin dengan nilai HOMA-IR pada remaja obesitas, dan hubungan lemah kadar chemerin dengan nilai HOMA-IR pada obesitas resistensi insulin.


Kata Kunci


Remaja obesitas, resistensi insulin, plasma chemerin.

Teks Lengkap:

PDF

Referensi


Barness LA. Obesity. Dalam: Behrman RE, Kliegman RM, Arvin AM, penyunting. Nelson texbook of pediatrics. Edisi ke-15. Philadelphia: Saunder;1996.h.169-72.

WHO. Obesity: preventing and managing the global epidemic, WHO Technical Report Series. Geneva: WHO; 2000.

WHO. Population based strategies for prevention of childhood obesity : theory and practice. Report of a WHO forum and technical meeting. Geneva: WHO; 2010.

Hassink GS, penyunting. Epidemiology of Childhood obesity. A clinical guide to pediatric weight management and obesity. Edisi pertama. Lippincott Williams & Wilkins;2007.h.8-17.

Kementrian Kesehatan Republik Indonesia. Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta: Kemkes RI, 2013.

Aycan Z. Obesity in childhood: definition and epidemiology. J Clin Res Ped Endo 2009;1:44-53.

Lioyd LJ, Langley-Evans SC, McMullen S. Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obesity 2012;36:1-11.

Druet D, Dabbas M, Baltakse V, Payen C, Jouret B, Baud C, dkk. Insulin resistance and the metabolic syndrome in obese French children. Clin Endocrinol 2006;64:672-8.

Lee JM, Okumura MJ, Davis MM, Herman WH, Gurney JG. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care 2006;29:2427-32.

Pulungan BA, Puspitadewi A, Sekartini R. Prevalence of insulin resistance in obese adolescents. Paediatr Indonesiana 2013;53:167-72.

Lestari R. Hubungan nilai homeostasis model assesment of insulin resistance dengan acanthosis nigricans dan tekanan darah pada remaja obesitas di Kota Padang. Padang: Andalas; 2011.

Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Cevat. Homeostasis model assesment is more reliable than fasting glukose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatric 2005;115:500-3.

Viner RM, Segal TY, Lichtarowicz-Krynska E, Hidmarsh P. Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child 2005;90:10-4.

Wellen KE, Hotamisligil GS. Obesity –induced inflammatory changes in adipose tissue. J Clin Invest 2003;112:1785-88.

Bluher M. Clinical relevance of adipokines. Diabetes Metab J 2012;36:317-37.

Goralski, KB, McCarthy TC, Hanniman EA, Zabel BA, Butcher EC, Parlee SD, dkk. Chemerin, a novel adipokine that regulates adipogenesis and adipocyte metabolism. J Biol Chem 2007;282: 28175-88.

Takahashi M, Takahashi Y, Takahashi K, Zolotaryov FN, Hong KS, Kitazawa R. dkk. Chemerin enhances insulin signaling and potentiates insulin-stimulated glucose uptake in 3T3-L1 adipocytes. FEBS Lett 2008; 582:573-8.

Bozaoglu K, Bolton K, McMillan J, Zimmet P, Jowett J, Collier G, dkk. Chemerin is a novel adipokine associated with obesity and metabolic syndrome. Endocrinology 2007;148:4687-94.

Sledzinski T, Korczynskal J, Hallmanl. A. The increased of serum chemerin concentration is mainly associated with the increase of BMI in obese, non-diabetic subjects. 2012;56-8

Stejskal D, Karpisek M, Hanulova Z, Svestak M. Chemerin is an independent marker of the metabolic syndrome in a Caucasian population--a pilot study. Biomed Pap Med 2008;152: 217-21.

Florinela A, Catoi, Suciu S, Parvu AE, Copaescu C, Galea RF, dkk. Increased chemerin and decreased omentin-1 levels in morbidly obese patients are correlated with insulin resistance, oxidative stress, and chronic inflammation. Clujul Medical 2014;87:19-26.

Sell H, Laurencikiene J, Taube A, Eckardt K, Cramer A.Chemerin is a novel adipocyte-derived factor inducing insulin resistance in primary human skeletal muscle cells. Diabetes 2009;58:2731-40.

Landgraf, K, Friebe D, Ullirch T, Kratzsch J, Dittrich K, Herberth G, dkk. Chemerin as a mediator between obesity and vascular inflammtion in Chidren. J Clin Endocrinol Metab 2012;97:559-63.

Sell H, Divoux A, Poitou C, Basdevant A, Bouillot JL, Bedossa P, dkk, Chemerin correlates with markers for fatty liver in morbidly obese patients and strongly decreases after weight loss induced by bariatric surgery. J Clin Endocrinol Metab 2010;95:2892-6.




DOI: http://dx.doi.org/10.14238/sp22.1.2020.24-9

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.