Mean differences of level tumor necrosis factor alpha in children of obesity with or without hypertension

TESIS

Abstract

By : Ni Komang Tri Apriastini

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Faculties : Fakultas Kedokteran

Department : PS. ILMU KESEHATAN ANAK

Obesity is an excessive accumulation of fat that poses a risk to health. The most common comorbidities in obesity were dyslipidemia (88.4%), hypertension (49%), and metabolic syndrome (19.6%). Hypertension in obesity has decreased the bioavailability of nitric oxide (NO) resulting in endothelial dysfunction, so this condition increases TNF-?. The purpose of this study was to prove that the incidence of hypertension in obese children will be found endothelial dysfunction due to decreased bioavailability of nitric oxide characterized by elevated levels of TNF-?. This was an observational analytic study with cross-sectional study design. Performed in five elementary schools in Denpasar and implemented in August 2015-March 2016. Children with obesity checked blood pressure and TNF-? levels. An independent t-test was performed to assess whether there was a relationship between the incidence of hypertension and serum TNF-? levels. Calculated mean difference of serum TNF ? levels between groups with hypertension and no hypertension, with significance level p <0.05, precision at 95% confidence interval. A multivariate analysis use general linear model univariate was performed between the various confounding variables. In this study, 49 subjects with 32 subjects (65.30%) were male. Obtained 15 subjects with hypertension (30.60%). The mean of TNF-? levels in both groups was 2.28 pg / ml (SD= 0.84). Based on the analysis using independent t-test, there was significant difference of mean TNF-? level in obese children with hypertension compared with non-hypertensive obese children, mean the level of TNF-? in hypertension was higher than no hypertension (95% CI; 0.67 (0.18-1.17); P=0,008). After multivariate analysis of confounding factor, blood pressure was found to have an effect on the increase of TNF-?, with variant difference of 6.397, P = 0.015, with 13.00% coefficient eta.

Keyword : tumor necrosis factor alpha, hypertension, obesity, children

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