Hubungan Antara HbA1c Dengan LDL-K dan Albuminuria pada Penderita DM dengan Riwayat Komplikasi Jantung Koroner

jbmi managerxot; Srilaning Driyah; Banundari Rachmawati; Herniah Asti

doi:10.22435/jbmi.v5i2.1673

jbmi managerxot
Srilaning Driyah
Banundari Rachmawati
Herniah Asti

DOI: https://doi.org/10.22435/jbmi.v5i2.1673

Keywords: DM, CHD, HbA1C, LDL-C and albuminuria.

Abstract

Abstract

The prevalence of Diabetes Mellitus (DM) globally is elevated continually. Poor blood glucose control to diabetes patients caused both macrovascular complications (ex.coronary heart disease/CHD) and microvascular complications (ex.nephropathy). Blood glucose controlled is need to be done in every 3 months regularly using HbA1C as a diabetic parameter, regarding to the high risk mortality of the complications. Low density lipoprotein cholesterol (LDL-C) is dyslipidemia characteristics and LDL-C is a lipoprotein proatherogenic. Albuminuria test is also needed as an early marker of micro and macrovascular disorders, which reflects the general process of endothelial damages (vascular dysfunction).The aim of this study is to prove any relationship between HbA1C levels with LDL-C and albuminuria levels in diabetic patients with history of coronary heart complications.This study is performed an analytical observational study with cross sectional approach. Thirty diabetic patients with any history of CHD complications were enrolled, then laboratory analysis of HbA1C by ion exchange HPLC, LDL-C levels were using colorimetric enzymatic method and albuminuria test with the photometric method. Differences between variables were analyzed using by Spearman correlation-testHbA1C levels in 10 patients (33,3 %) are <7% and in 19 patients are ≥ 7% (66,7 % ). LDL-C (<100mg/dl) in 13 patients (43,3%), LDL-C (≥100mg/dl) in 17 patients (56,7%), Normoalbuminuria (< 20 mg/L ) in 11 patients (36.7%), albuminuria (≥20 mg/L) in 19 patients (63,3%).There is a moderate positive relationship between HbA1C and LDL-C levels (r=0.385, p=0.014) and a positive strong relationship between HbA1C and albuminuria levels (r=0.52, p=0.004).Conclusions: The higher HbA1C levels, the higher LDL-C and albuminuria levels would be.

Keywords: DM, CHD, HbA1C, LDL-C and albuminuria.

Abstrak

Secara global prevalensi diabetes melitus (DM) terjadi peningkatan terus menerus. Rendahnya kontrol glukosa darah pada pasien DM dapat menimbulkan komplikasi makrovaskuler seperti jantung koroner (PJK) dan mikrovaskuler seperti nefropati. Pengontrolan glukosa darah penting dilakukan setiap 3 bulan sekali secara rutin dengan parameter HbA1C sebagai petanda regulasi DM, mengingat tingginya risiko kematian akibat komplikasi. Low density lipoproteinl kolesterol (LDL-K) merupakan salah salah karakteristik dislipidemia dan sebagai lipoprotein proaterogenik, sedangkan albuminuria sebagai petanda dini dari kelainan mikro dan makrovaskuler sebagai cerminan proses luas dan merata dari kerusakan endotel (disfungsi vaskuler). Membuktikan adanya hubungan HbA1C dengan LDL-K dan albuminuria pada penderita DM dengan riwayat komplikasi jantung koroner . Desain observasional analitik dengan pendekatan belah lintang (cross sectional). Responden 30 orang DM dengan riwayat komplikasi PJK diperiksa kadar HbA1C melalui metoda ion-Exchange HPLC, kadar LDLK dengan metode kolometrik enzimatik dan albuminuria secara fotometrik. Perbedaan antar variabel dianalisis dengan uji korelasi Spearman.Pemeriksaan kadar HbA1C < 7% sebanyak 10 responden (33,3%) dan ≥ 7% sebanyak 20 responden (66,7%). Hasil pemeriksaan LDL-K <100 mg/dl 13 responden (43,3%), LDL-K ≥100 mg/dl 17 responden (56,7%). Normoalbuminuria (< 20mg/L) sebanyak 11 responden (36,7%), albuminuria ( ≥ 20 mg/L) sebanyak 19 responden (63,3%). Terdapat hubungan positif sedang antara HbA1C dengan LDL-K (r=0.385; p=0,018).Terdapat hubungan positif kuat antara kadar HbA1C dan albuminuria (r=0.52, p=0,004).Semakin tinggi kadar HbA1C semakin tinggi kadar LDL-K dan albuminuria.

Kata Kunci: DM, CHD, HbA1C, LDL-C and albuminuria.

Author Biography

Srilaning Driyah

Abstract

The prevalence of Diabetes Mellitus (DM) globally is elevated continually. Poor blood glucose control to diabetes patients caused both macrovascular complications (ex.coronary heart disease/CHD) and microvascular complications (ex.nephropathy). Blood glucose controlled is need to be done in every 3 months regularly using HbA1C as a diabetic parameter, regarding to the high risk mortality of the complications. Low density lipoprotein cholesterol (LDL-C) is dyslipidemia characteristics and LDL-C is a lipoprotein proatherogenic. Albuminuria test is also needed as an early marker of micro and macrovascular disorders, which reflects the general process of endothelial damages (vascular dysfunction).The aim of this study is to prove any relationship between HbA1C levels with LDL-C and albuminuria levels in diabetic patients with history of coronary heart complications.This study is performed an analytical observational study with cross sectional approach. Thirty diabetic patients with any history of CHD complications were enrolled, then laboratory analysis of HbA1C by ion exchange HPLC, LDL-C levels were using colorimetric enzymatic method and albuminuria test with the photometric method. Differences between variables were analyzed using by Spearman correlation-testHbA1C levels in 10 patients (33,3 %) are <7% and in 19 patients are ≥ 7% (66,7 % ). LDL-C (<100mg/dl) in 13 patients (43,3%), LDL-C (≥100mg/dl) in 17 patients (56,7%), Normoalbuminuria (< 20 mg/L ) in 11 patients (36.7%), albuminuria (≥20 mg/L) in 19 patients (63,3%).There is a moderate positive relationship between HbA1C and LDL-C levels (r=0.385, p=0.014) and a positive strong relationship between HbA1C and albuminuria levels (r=0.52, p=0.004).Conclusions: The higher HbA1C levels, the higher LDL-C and albuminuria levels would be.

Keywords: DM, CHD, HbA1C, LDL-C and albuminuria.

Abstrak

Secara global prevalensi diabetes melitus (DM) terjadi peningkatan terus menerus. Rendahnya kontrol glukosa darah pada pasien DM dapat menimbulkan komplikasi makrovaskuler seperti jantung koroner (PJK) dan mikrovaskuler seperti nefropati. Pengontrolan glukosa darah penting dilakukan setiap 3 bulan sekali secara rutin dengan parameter HbA1C sebagai petanda regulasi DM, mengingat tingginya risiko kematian akibat komplikasi. Low density lipoproteinl kolesterol (LDL-K) merupakan salah salah karakteristik dislipidemia dan sebagai lipoprotein proaterogenik, sedangkan albuminuria sebagai petanda dini dari kelainan mikro dan makrovaskuler sebagai cerminan proses luas dan merata dari kerusakan endotel (disfungsi vaskuler). Membuktikan adanya hubungan HbA1C dengan LDL-K dan albuminuria pada penderita DM dengan riwayat komplikasi jantung koroner . Desain observasional analitik dengan pendekatan belah lintang (cross sectional). Responden 30 orang DM dengan riwayat komplikasi PJK diperiksa kadar HbA1C melalui metoda ion-Exchange HPLC, kadar LDLK dengan metode kolometrik enzimatik dan albuminuria secara fotometrik. Perbedaan antar variabel dianalisis dengan uji korelasi Spearman.Pemeriksaan kadar HbA1C < 7% sebanyak 10 responden (33,3%) dan ≥ 7% sebanyak 20 responden (66,7%). Hasil pemeriksaan LDL-K <100 mg/dl 13 responden (43,3%), LDL-K ≥100 mg/dl 17 responden (56,7%). Normoalbuminuria (< 20mg/L) sebanyak 11 responden (36,7%), albuminuria ( ≥ 20 mg/L) sebanyak 19 responden (63,3%). Terdapat hubungan positif sedang antara HbA1C dengan LDL-K (r=0.385; p=0,018).Terdapat hubungan positif kuat antara kadar HbA1C dan albuminuria (r=0.52, p=0,004).Semakin tinggi kadar HbA1C semakin tinggi kadar LDL-K dan albuminuria.

Kata Kunci: DM, CHD, HbA1C, LDL-C and albuminuria.