Penyakit Arteri Perifer pada Sindroma Metabolik

Abstract

Background : Peripheral arterial disease (PAD) is caused by atherosclerotic occlusion of the arteries to the leg, and increases the risk of cardiovascular (CVD) event. Metabolic syndrome (mets) is not a specific disease but a cluster of factors (central obesity, insulin resistance, hypertension, glucose intolerance and dyslipidemi), often occurring together in the same person, that put one at risk for developing cardiovascular disease . Aim : To investigate the incidence PAD in mets patients, and to find the implication of component mets in PAD. Method : 208 Patients were recruited for this cross-sectional study from outpatient clinic hospitals in Medan. Metabolic syndrome was diagnosed by IDF 2005 criteria. In the order to evaluated the PAD, the Fukuda Vascular Screening system VaSera VS-1000TM (Fukuda Denshi) was used. Criteria for the diagnosis of PAD was an ABI ? 0,9. Result : A total of 208 patients (112 mets and 96 non-mets) ware screened for PAD. PAD was significantly higher in women (22; 78,6%) than man (6; 21,4%) in both groups (p= 0,03). Comparison ABI in both leg was statistic significant (p= 0,0001). PAD was negatively correlated with fasting blood glucose ( r= -0,483; p= 0,009 ). Highest mets component for PAD except central obesity was hypertension (23 ; 24,7%), follow with HDL-C, TG and fasting blood glucose [ 22 (27,5%); 16 (21,9%) and 15 (25,9%) respectively].Incidence of PAD was significant higher in mets than non-mets (25 % vs 15,6 %; RP 1,6; CI 95% 0,910 – 2,815) Conclusion : There were increased incidence PAD in mets, the highest component was hypertension.

Latar Belakang : Penyakit arteri perifer (PAP) disebabkan adanya oklusi aterosklerosis pada daerah tungkai, dan akan meningkatkan resiko kardiovaskuler. Sindroma metabolik bukan merupakan penyakit tertentu, tetapi sekelompok faktor (obesitas sentral, resistensi insulin, hipertensi, intoleransi glukosa dan dislipidemia) yang timbul secara bersamaan, dan menjadi resiko kelainan kardiovaskuler. Tujuan : Untuk mengetahui peningkatan angka kejadian PAP pada sindroma metabolik dan pengaruh komponen sindoma metabolik pada PAP Metode : Penelitian dilakukan dengan metode potong lintang pada 208 orang yang melakukan pemeriksaan kesehatan rawat jalan di berbagai poliklinik RS di Medan. Diagnosa sindroma matabolik ditegakkan berdasarkan kriteria IDF 2005. PAP ditegakkan dengan mengukur ankle-brachial index (ABI) menggunakan Vasera VS-1000 TM (Fukuda Denshi). Nilai ABI ? 0,9 dianggap abnormal. Hasil : Dari 208 pasien didapati 112 sindroma metabolik dan 96 non sindroma metabolik. Wanita 22 orang (78,6%) lebih banyak mendapat PAP dibanding pria 6 orang (21,4%) pada kedua kelompok (p= 0,03). Perbandingan ABI tungkai kanan dan kiri menunjukkan perbedaan bermakna (p= 0,0001). PAP berkorelasi negatif dengan KGD puasa ( r= -0,483; p= 0,009 ). Komponen sindroma metabolik selain obesitas sentral adalah hipertensi 23 orang (24,7%) penyebab PAP terbanyak, diikuti HDL, TG dan KGD puasa [ 22 (27,5%); 16 (21,9%) dan 15 (25,9%)]. Insidensi PAP secara signifikan lebih tinggi pada sindroma metabolik dibanding non sindroma metabolik (25 % vs 15,6 %; RP 1,6; IK 95% 0,910 – 2,815). Kesimpulan : Adanya peningkatan insiden PAP pada sindroma metabolik, dimana komponen terbanyak adalah hipertensi.