Indeks Massa Tubuh Berhubungan dengan Hiperurisemia pada Pasien Tuberkulosis Paru

Oki Nugraha Putra, Syagafa Mufarridan, Muhammad Arif Saifudin, Shafira Maulida Fitria U, Aisyah Fitri Kurniawati

Abstract


Pirazinamid merupakan salah satu obat antituberkulosis yang digunakan pada fase intensif. Salah satu efek samping pirazinamid yaitu peningkatan kadar asam urat yang seringkali disertai dengan nyeri sendi. Penelitian ini bertujuan untuk menganalisis faktor yang berhubungan dengan hiperurisemia dan faktor-faktor yang berpengaruh terhadap nyeri sendi pada pasien tuberkulosis (TB) paru fase intensif. Penelitian ini menggunakan desain kohort prospekif. Penelitian ini dilakukan di Puskesmas Perak Timur dan Puskesmas Wonokusomo, Surabaya selama bulan Februari hingga Juli 2023. Tiga ml darah pasien TB paru diambil untuk pemeriksaan kadar asam urat sebelum dan setelah dua bulan pengobatan fase intensif. Dua puluh pasien TB paru yang memenuhi kriteria inklusi dimasukkan ke dalam penelitian. Sebanyak 13 (65%) pasien mengalami peningkatan kadar asam urat yang signifikan di akhir fase intensif, dari 5,25 ± 1,98 mg/dl menjadi 9,43 ± 1,98 mg/dl, p-value 0,000. Delapan (61,5%) dari 13 pasien dengan peningkatan kadar asam urat disertai dengan nyeri sendi. Indeks massa tubuh (IMT) berhubungan dengan hiperurisemia (p-value 0,024, r = 0,624). Kadar asam urat ≥ 6,5 mg/dl secara signifikan berpengaruh terhadap terjadinya nyeri sendi, p-value 0,017. IMT berhubungan dengan hiperurisemia pada pasien TB. Kadar asam urat ≥ 6,5 mg/dl menjadi satu-satunya variabel yang berpengaruh terhadap terjadinya nyeri sendi pada pasien TB yang menjalani pengobatan pada fase intensif. Pengukuran asam urat secara periodik diperlukan terutama pada pasien TB dengan IMT yang besar (gemuk atau obesitas).

Pyrazinamide is one of the antituberculosis drugs used in the intensive phase. One of the side effects of pyrazinamide is an increase in uric acid levels, often accompanied by joint pain. This study aims to analyze the factors associated with hyperuricemia and the factors that affect joint pain in pulmonary tuberculosis (TB) patients in the intensive phase. It was a prospective cohort study. This study was conducted at Puskesmas Perak Timur and Puskesmas Wonokusomo, Surabaya, from February to July 2023. Three ml of blood from pulmonary TB patients was withdrawn to measure uric acid levels before and after two months of intensive phase treatment. Twenty pulmonary TB patients who met the inclusion criteria were included in the study. Thirteen (65%) patients significantly increased uric acid levels at the end of the intensive phase, from 5.25 ± 1.98 mg/dl to 9.43 ± 1.98 mg/dl, P-value 0.000. Eight (61.5%) of the 13 patients with elevated uric acid levels were accompanied by joint pain. Body mass index (BMI) was associated with hyperuricemia (p-value 0.024, r = 0.624). Uric acid levels ≥ 6.5 mg/dl significantly influenced the occurrence of joint pain, with a P-value of 0.017. BMI is associated with hyperuricemia in TB patients. A uric acid level ≥ 6.5 mg/dl is associated with joint pain in TB patients undergoing treatment in the intensive phase. Periodic uric acid measurements are needed, especially in TB patients with a high BMI (overweight or obese).


Keywords


Tuberkulosis; asam urat; nyeri sendi; intensif

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DOI: http://dx.doi.org/10.52365/jecp.v4i2.1106

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