Hubungan Mikroalbuminuria dan Latihan Fisik Terhadap Tekanan Darah Anak Obes
Hubungan mikroalbuminuria dan latihan fisik terhadap tekanan darah anak obes
Oke Rina Ramayani
Departemen IImu Kesehat.an Anak FK USU
Abstrak Latar belakang. Obesitas berhubungan dengan morbiditas dan mortalitas akibat penyakit kardiovaskular, hipertensi dan penyakit ginjal. Penanda awal terjadinya penyakit ginjal kronik adalah mikroalbuminuria sehingga merupakan target potensial untuk pencegahan awal penyakit. Latihan fisik yang dilakukan secara teratur dan berkesinambungan membantu kecepatan penurunan be rat badan dan hipertensi pada anak obes. ｦｬＮｫｾｪ｢ｏｴ＠ mengetahui kejadian mikroalbuminuria dan peranan latihan fisik terhadap penurunan tekanan darah sistol dan atau diastol anak obes. Metode.Kami melakukan studi eksperimental sebelum dan sesudah latihan fisik pada penderita obes yang datang dari sekolah kota Medan ke poliklinik Nefrologi Anak. Sampel diberikan latihan fisik dengan treadmill tiga kali seminggu selama ｾ＠ bulan. Luaran yang dinilai adalah berat badan, indeks massa tubuh, mikroalbuminuria, tekanan darah sistol dan ｮｾ＠ｴ･｡ｫ darah diastol. HasiLEmpat puluh persen anak laki-Iaki obes dan 35% anak perempuan obes mengalami peninggian tekanan darah . Delapan dari 50 anak obes (16%) mengalami mikroalbuminuria. Rerata tekanan darah sistolik dan diastolik sebelum latihan fisik adalah 107,5 ± 11,1 dan 75,4 ± 6,7. Rerata tekanan darah sistolik dan diastolik sesudah latihan fisik adalah 105,6 ± 10,9 dan 73,4 ±5,8. Kesimpulan.Penurunan tekanan darah sistolik dan diastolik dijumpai setelah latihan fisik namun kejadian mikroalbuminuria tidak berbeda bermakna. Rerata tekanan darah sistolik dan diastolik pada anak obes dengan mikroalbuminuria lebih tinggi dibandingkan normoalbuminuria .
Kata kunci : obesitas, indeks massa tubuh, tekanan darah, mikroalbuminuria
Abstract Background. Obesity in childhood has relationship with morbidity and mortality of cardiovascular, hypertension and renal disease. Early marker to have chronic renal disease is microalbuminuria therefore it is a potential target to - prevent this disease. Physical exercises that have been done regularly can help reduced hypertension and weight gain. Objective. To evaluate the relationship among microalbuminuria, physical exercises, and blood pressure in obese children. Method.We examined experimental study before and after physical exercise in obese school children that attend pediatric nephrology clinic. Sample had given physical exercise with treadmill three times a week for three months. Outcomeswere body weight, body mass index, microalbuminuria, systolic and diastolic blood pressure . Result. Forty percent boy obese and 35% girl obese had hypertension. Eight from 50 obese children had microalbuminuria. Mean systolic and diastolic blood pressure before physical exercise were 107,5 ± 11,1 and 75,4 ± 6,7. Mean systolic and diastolic blood pressure after physical exercise were 105,6 ± 10,9 and 73,4 ±5,8. Conclusion. Reduced of systolic and diastolic blood pressure were found different significantly after physical exercise. Prevalence microalbuminuria was not found different significantly between before and after physical exercise. Mean systolic and diastolic blood pressure obese children with microalbuminuria were higher significantly compare with normoalbuminuria .
Keywords : obesity, body mass index, blood pressure, microalbuminuria
12 Majalah Kedokteran Nusantara Volume 44 No.1 * April 2011
Oke Rina Ramayani
Hubungan mikroalbuminuria dan latihanfisik terhadap...
Daftar Pustaka 1. Kristensen Pl, Wedderkopp N, Moller NC,
Anderson lB, Bai CN, Froberg K. Tracking and prevalence of cardiovascular disease risk factors across socio-econonic classes: a longitudinal sub study of the European Youth Heart Study. BMC Public Health 2006;6:20 2. Basi S, Lewis JB. Microalbuminuria as a target to improve cardiovascular and renal outcomes. Am JKidney Dis 2006;47(6} :927-46 3. lenders CM, Hoppin AG . Evaluation and management of obesity. Dalam : Walker WA, Watkins JB, Duggan C, penyunting. Nutrition in Pediatrics Basic Science and Clinical Application . Edisi ke-3. London : BC Decker Inc;2003.h.917-31 4. Montani JP, Antic V, Yang Z, Dullo A. Pathway from obesity to hypertension : from the perspective of a vicious triangle. Int JObes 2002;SuppI2:S28-38 5. Srinivasan SR, Myers L, Berenson GS. Changes in metabolic syndrome variables since childhood in prehypertensive and hypertensive subjects. The Bogalusa Heart Study. Hypertension 2006;48:33-9 6. Nur Iman M. Pengaruh latihan fisik terhadap tekanan darah anak obes di tiga SO swasta Kotamadya Medan. [Tesisj. Medan : Program Magister Kedokteran Klinik Spesialis IImu Kesehatan Anak FK USU;2008 7. Kuczmarski RJ, Ogden Cl, Grummer-Strawn LM, Flegal KM, Guo SS, Wei Ret al. CDC growth charts : United States. National Centre for Health and Statistic, Hyattsville,2000 8. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescent. The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescent. Pediatrics 2004;114:555-73
9. American College of Spor t M edicine. Guidelines for exercise tes ti ng and prescription. Dalam: Soegiarto B, Suyono YJ, Anggra ini 0, editor. Panduan uji latihanjasman i dan peresepannya. Edisi ke 5. Jakarta : EGC;2004.h.185-8
10. Tumbelaka G. Pedoman olah raga untuk usia sekolah (usia 6-18 tahun). Buletin IDAI .2007;52:XXVII.h.40-46
11. Torok K, Palfi A, Szelenyi Z, Molnar D. Circadian variability of blood pressure in obese children . Nutr Metab Cardiovasc Dis 2008;18:429-3 5
12. McGavock JM, Torrance B, McGuire KA, Wozny P, Lewanczuk RZ. The relationship between weight gain and blood pressure in children and adolescents. Am JHypertens 2007;20:1038-44
13. Nguyen S, McCulloch C, Brakeman P, Portale A, Hsu C. Being overweight modifies the association between cardiovascular risk factors and microalbuminuria in adolescents. Pediatrics 2008;121:37-45
14. Nenov VD, Taal MW, Sakharova OV, Brenner BM . Multi hit nature of chronic renal disease. Curr Opin Nephrol Hypertens 2000;9:85-97
15. Miller Jl, Silverstein JH . Management approaches for pediatric obesity. Nat Clin Pract Endocrinol Metab 2007;3(12}:810-8
16. lIyas EI. Aspek kebugaran pada obesitas anak. Dalam Samsudin, Nasar SS, Sjarif DR, penyunting. Masalah gizi ganda dan tumbuh kembang anak. Pendidikan Kedokteran Berkelanjutan Ilmu Kesehatan Anak XXXV, 1112 Agustus 1995, Jakarta .BP.FKUI,1995 .h.89102 '.
17. Aguilar A, Ostrow V, De Luca ' F, Suarez E. Elevated ambu latory blood pressure in a multi ethnic population of obese children and adolescents. JPediatr 2010;156:930-?
"=,=:; edokteron Nusontora Volume 44 No.1 * April 2011
15
Oke Rina Ramayani
Departemen IImu Kesehat.an Anak FK USU
Abstrak Latar belakang. Obesitas berhubungan dengan morbiditas dan mortalitas akibat penyakit kardiovaskular, hipertensi dan penyakit ginjal. Penanda awal terjadinya penyakit ginjal kronik adalah mikroalbuminuria sehingga merupakan target potensial untuk pencegahan awal penyakit. Latihan fisik yang dilakukan secara teratur dan berkesinambungan membantu kecepatan penurunan be rat badan dan hipertensi pada anak obes. ｦｬＮｫｾｪ｢ｏｴ＠ mengetahui kejadian mikroalbuminuria dan peranan latihan fisik terhadap penurunan tekanan darah sistol dan atau diastol anak obes. Metode.Kami melakukan studi eksperimental sebelum dan sesudah latihan fisik pada penderita obes yang datang dari sekolah kota Medan ke poliklinik Nefrologi Anak. Sampel diberikan latihan fisik dengan treadmill tiga kali seminggu selama ｾ＠ bulan. Luaran yang dinilai adalah berat badan, indeks massa tubuh, mikroalbuminuria, tekanan darah sistol dan ｮｾ＠ｴ･｡ｫ darah diastol. HasiLEmpat puluh persen anak laki-Iaki obes dan 35% anak perempuan obes mengalami peninggian tekanan darah . Delapan dari 50 anak obes (16%) mengalami mikroalbuminuria. Rerata tekanan darah sistolik dan diastolik sebelum latihan fisik adalah 107,5 ± 11,1 dan 75,4 ± 6,7. Rerata tekanan darah sistolik dan diastolik sesudah latihan fisik adalah 105,6 ± 10,9 dan 73,4 ±5,8. Kesimpulan.Penurunan tekanan darah sistolik dan diastolik dijumpai setelah latihan fisik namun kejadian mikroalbuminuria tidak berbeda bermakna. Rerata tekanan darah sistolik dan diastolik pada anak obes dengan mikroalbuminuria lebih tinggi dibandingkan normoalbuminuria .
Kata kunci : obesitas, indeks massa tubuh, tekanan darah, mikroalbuminuria
Abstract Background. Obesity in childhood has relationship with morbidity and mortality of cardiovascular, hypertension and renal disease. Early marker to have chronic renal disease is microalbuminuria therefore it is a potential target to - prevent this disease. Physical exercises that have been done regularly can help reduced hypertension and weight gain. Objective. To evaluate the relationship among microalbuminuria, physical exercises, and blood pressure in obese children. Method.We examined experimental study before and after physical exercise in obese school children that attend pediatric nephrology clinic. Sample had given physical exercise with treadmill three times a week for three months. Outcomeswere body weight, body mass index, microalbuminuria, systolic and diastolic blood pressure . Result. Forty percent boy obese and 35% girl obese had hypertension. Eight from 50 obese children had microalbuminuria. Mean systolic and diastolic blood pressure before physical exercise were 107,5 ± 11,1 and 75,4 ± 6,7. Mean systolic and diastolic blood pressure after physical exercise were 105,6 ± 10,9 and 73,4 ±5,8. Conclusion. Reduced of systolic and diastolic blood pressure were found different significantly after physical exercise. Prevalence microalbuminuria was not found different significantly between before and after physical exercise. Mean systolic and diastolic blood pressure obese children with microalbuminuria were higher significantly compare with normoalbuminuria .
Keywords : obesity, body mass index, blood pressure, microalbuminuria
12 Majalah Kedokteran Nusantara Volume 44 No.1 * April 2011
Oke Rina Ramayani
Hubungan mikroalbuminuria dan latihanfisik terhadap...
Daftar Pustaka 1. Kristensen Pl, Wedderkopp N, Moller NC,
Anderson lB, Bai CN, Froberg K. Tracking and prevalence of cardiovascular disease risk factors across socio-econonic classes: a longitudinal sub study of the European Youth Heart Study. BMC Public Health 2006;6:20 2. Basi S, Lewis JB. Microalbuminuria as a target to improve cardiovascular and renal outcomes. Am JKidney Dis 2006;47(6} :927-46 3. lenders CM, Hoppin AG . Evaluation and management of obesity. Dalam : Walker WA, Watkins JB, Duggan C, penyunting. Nutrition in Pediatrics Basic Science and Clinical Application . Edisi ke-3. London : BC Decker Inc;2003.h.917-31 4. Montani JP, Antic V, Yang Z, Dullo A. Pathway from obesity to hypertension : from the perspective of a vicious triangle. Int JObes 2002;SuppI2:S28-38 5. Srinivasan SR, Myers L, Berenson GS. Changes in metabolic syndrome variables since childhood in prehypertensive and hypertensive subjects. The Bogalusa Heart Study. Hypertension 2006;48:33-9 6. Nur Iman M. Pengaruh latihan fisik terhadap tekanan darah anak obes di tiga SO swasta Kotamadya Medan. [Tesisj. Medan : Program Magister Kedokteran Klinik Spesialis IImu Kesehatan Anak FK USU;2008 7. Kuczmarski RJ, Ogden Cl, Grummer-Strawn LM, Flegal KM, Guo SS, Wei Ret al. CDC growth charts : United States. National Centre for Health and Statistic, Hyattsville,2000 8. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescent. The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescent. Pediatrics 2004;114:555-73
9. American College of Spor t M edicine. Guidelines for exercise tes ti ng and prescription. Dalam: Soegiarto B, Suyono YJ, Anggra ini 0, editor. Panduan uji latihanjasman i dan peresepannya. Edisi ke 5. Jakarta : EGC;2004.h.185-8
10. Tumbelaka G. Pedoman olah raga untuk usia sekolah (usia 6-18 tahun). Buletin IDAI .2007;52:XXVII.h.40-46
11. Torok K, Palfi A, Szelenyi Z, Molnar D. Circadian variability of blood pressure in obese children . Nutr Metab Cardiovasc Dis 2008;18:429-3 5
12. McGavock JM, Torrance B, McGuire KA, Wozny P, Lewanczuk RZ. The relationship between weight gain and blood pressure in children and adolescents. Am JHypertens 2007;20:1038-44
13. Nguyen S, McCulloch C, Brakeman P, Portale A, Hsu C. Being overweight modifies the association between cardiovascular risk factors and microalbuminuria in adolescents. Pediatrics 2008;121:37-45
14. Nenov VD, Taal MW, Sakharova OV, Brenner BM . Multi hit nature of chronic renal disease. Curr Opin Nephrol Hypertens 2000;9:85-97
15. Miller Jl, Silverstein JH . Management approaches for pediatric obesity. Nat Clin Pract Endocrinol Metab 2007;3(12}:810-8
16. lIyas EI. Aspek kebugaran pada obesitas anak. Dalam Samsudin, Nasar SS, Sjarif DR, penyunting. Masalah gizi ganda dan tumbuh kembang anak. Pendidikan Kedokteran Berkelanjutan Ilmu Kesehatan Anak XXXV, 1112 Agustus 1995, Jakarta .BP.FKUI,1995 .h.89102 '.
17. Aguilar A, Ostrow V, De Luca ' F, Suarez E. Elevated ambu latory blood pressure in a multi ethnic population of obese children and adolescents. JPediatr 2010;156:930-?
"=,=:; edokteron Nusontora Volume 44 No.1 * April 2011
15