Korelasi Kontrol Glikemik dengan HDL dan Small-Dense LDL pada Penderita Diabetes Melitus dengan Komplikasi Jantung Koroner di RSUP Dr. Kariadi Semarang, Jawa Tengah

Abstract

Abstract

Blood glucose level could be measured before 2-3 months using glycated haemoglobin (HbA1c). In diabetes mellitus (DM) the size of low-density lipoprotein (LDL-K) often changes to a small size, called small dense LDL-K sdLDL) which is atherogenic and low high-density lipoprotein (HDL) level. High HbA1c indicates uncontrolled glucose levels and often cause complications of coronary heart disease (CHD). This is a further investigation from the previous one about ”The Relationship between HbA1c with LDL and Apo B in DM patients with cardiac complications." This study used analytical, cross-sectional design. Thirty patients DM with CHD complications were examined for HbA1C levels via the Exchange-HPLC ion methods, HDL-K and LDL-K by enzymatic colourimetric methods and apo B by the immunoturbidimetry methods. The relationship between variables was analyzed by the Pearson correlation test.The mean level of HbA1c was 8.72%, male HDL was 35.67 mg / dl, female was 39.57 mg / dl, LDL-K was 110.64 mg / dl, apo B was 111.88 mg / dl and sd-LDL was 1, 02. A strong negative relationship between HbA1c and HDL levels for both men and women with r = - 0.647; r = - 0.675 with significance level p = 0.017; p = 0.008. Whereas HbA1c with sd-LDL has a weak negative relationship, but not significant (r = -0.352; p = 0.057). Hence, lipid profile measurement can be considered to monitor risk of cardiovacular diseases, particularly in those with abnormal blood glucose metabolism.

Abstrak
Pemantauan kadar gula 2-3 bulan sebelumnya dapat diukur menggunakan glycated hemoglobin (HbA1c). Pada diabetes melitus (DM) ukuran low density lipoprotein (LDL-K) sering berubah menjadi kecil, yang dinamakan small dence LDL-K (sd-LDL) yang bersifat aterogenik, dan kadar high density lipoprotein (HDL) sering rendah. HbA1c yang tinggi menandakan kadar glukosa tidak terkontrol dan sering menyebabkan salah satu komplikasi ke penyakit jantung koroner (PJK). Penelitian ini merupakan penelitian lanjutan dari penelitian berjudul “ Hubungan HbA1c dengan trigliserida dan Apo B pada penderita DM dengan komplikasi penyakit jantung” Studi ini menggunakan desain analitik potong lintang. Tiga puluh pasien DM dengan komplikasi PJK diperiksa kadar HbA1c melalui metoda ion-Exchange HPLC, HDL-K dan LDL-K dengan metoda kolometrik enzimatik dan apo B dengan metoda imunoturbidimetri. Hubungan antar variabel dianalisis dengan uji korelasi Pearson.Hasil penelitian didapatkan laki laki 16 dan perempuan 14 pasien. Kadar rerata HbA1c 8,72%, HDL laki laki 35,67 mg/dl, perempuan 39,57 mg/dl, LDL-K 110,64 mg/dl, apo B 111,88 mg/dl dan sd-LDL 1,02. Hubungan negatif kuat antara kadar HbA1c dan HDL baik laki laki maupun perempuan dengan r = - 0,647 ; r = - 0,675 dengan tingkat kemaknaan p = 0,017; p = 0,008. Sedangkan HbA1c dengan sd-LDL terdapat hubungan negatif lemah, tetapi tidak bermakna (r=-0,352 ; p = 0,057). Karena itu, pemeriksaan profil lipid dapat dipertimbangkan untuk memantau risiko penyakit kardiovaskular khususnya bagi mereka dengan gangguan metabolisme gula darah