Hubungan Antara TG/HDL-C dengan Kontrol Glikemik pada Pasien Diabetes di Puskesmas Lebdosari Kota Semarang

  • Cynthia Tjitradinata Departemen Patologi Klinik, Fakultas Kedokteran Unika Soegijapranata, Jalan Pawiyatan Luhur Sel. IV No.1, Bendan Duwur, Kec. Gajahmungkur, Kota Semarang, Jawa Tengah 50234, Indonesia
  • Perigrinus Hermin Sebong Departemen Kesehatan Masyarakat, Fakultas Kedokteran Unika Soegijapranata, Jalan Pawiyatan Luhur IV/1, Kota Semarang, Jawa Tengah 50234, Indonesia
Keywords: glycated hemoglobin, high density lipoprotein cholesterol, high-performance liquid chromatograph.

Abstract

Abstrak

Prevalensi diabetes melitus meningkat setiap tahun di seluruh dunia. Kontrol glikemik merupakan hal penting dalam pengelolaan pasien Diabetes Mellitus (DM) karena mengurangi risiko komplikasi. Pemeriksaan Glycated Haemoglobin (HbA1C) sebagai gold standard kontrol glikemik dengan target pencapaian HbA1C <7%. Petanda lain faktor risiko terhadap penyakit kardiovaskuler pada pasien DM tipe 2 adalah dislipidemia. Rasio trigliserid terhadap high-density lipoprotein cholesterol (TG/HDL-C) diketahui sebagai indeks atherogenic plasma, yang merupakan faktor risiko utama pada penyakit kardiovaskuler dan sindrom metabolik. Tujuan penelitian ingin mengetahui hubungan antara TG/HDL-C dengan kontrol glikemik pada pasien DM. Penelitian ini merupakan penelitian observasional dengan rancangan penelitian cross sectional yang dilakukan selama 3 bulan (September – November 2020). Subjek penelitian diklasifikasikan berdasarkan kadar HbA1c menjadi 2 grup: 40 pasien DM tipe 2 HbA1c <7% dan 40 pasien DM tipe 2 HbA1c ≥7 %. Analisis statistik menggunakan Mann Whitney dengan signifikansi p ≤ 0,05. Terdapat perbedaan signifikan rasio TG/HDL-C pada kelompok Hb1c < 7% dan kelompok HbA1 c≥ 7% (p=<0,011). Rasio TG/HDL-C pasien DM tipe 2 HbA1c ≥ 7% lebih rendah signifikan dibandingkan DM tipe 2 HbA1c<7 % membuktikan bahwa rasio TG/HDL-C dapat digunakan sebagai alternatif pemeriksaan status pengendalian glukosa darah pada pasien DM tipe 2.

Kata kunci: diabetes melitus, glycated hemoglobin, high density lipoprotein cholesterol, high-performance liquid chromatograph.

Abstract

The prevalence of diabetes is increasing every year all over the world. Glycemic control is important to managing patients with Diabetes Mellitus (DM) because it could decrease complication risk. Glycated Haemoglobin (HbA1C) examination is a gold standard for studying glycemic control with its target of less than 7%. the other risk factor sign of cardiovascular disease in a patient with type 2 DM is dyslipidemia. Trygliserida/high-density lipoprotein cholesterol ratio is known as atherogenic plasma index and is a primary risk factor in cardiovascular disease and metabolic syndrome. An analytic observational study with a cross-sectional approach was conducted in 3 months (September – November 2020). The sample size in this study was 80 patients. They were divided into 2 groups, involving 40 patients with type 2 DM HbA1c <7% and 40 patients with type 2 DM HbA1c ≥7% at Diabetic Clinic, Semarang. TG and HDL-C levels between groups were analyzed using Mann Whitney, p<0.05 were considered significant. There are significant differences in levels of TG/HDL-C ratio between the 2 groups (p =0.001). TG/HDL-C ratio levels were higher in group hbA1c > 7% compared to group HbA1c < 7% can be used as glycemic control in type 2 DM.

Keyword: diabetes melitus, glycated hemoglobin, high density lipoprotein cholesterol, high-performance liquid chromatograph.

References

Perkumpulan Endokrinologi Indonesia (PERKENI). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. Jakarta: PB PERKENI;2021.

Indonesia, Kementerian Kesehatan. Laporan Provinsi Jawa Tengah RISKESDAS 2018. Jakarta; 2019.

Yeh WC, Tsao YC, Li WC, Tzeng IS, Chen LS, Chen JY. Elevated triglyceride-to-HDL cholesterol ratio is an indicator for insulin resistance in middle-aged and elderly Taiwanese population: A cross-sectional study. Lipids in Health and Disease. 2019 Oct 11;18(1).

Babic N, Valjevac A, Zaciragic A, Avdagic N, Zukic S, Hasic S. The Triglyceride/HDL Ratio and Triglyceride Glucose Index as Predictors of Glycemic Control in Patients with Diabetes Mellitus Type 2. Med Arch. 2019;73(3):163-168. doi:10.5455/medarh.2019.73.163-168.

Zheng D, Li H, Ai F, Sun F, Singh M, Cao X, et al. Association between the triglyceride to high-density lipoprotein cholesterol ratio and the risk of type 2 diabetes mellitus among Chinese elderly: The Beijing Longitudinal Study of Aging. BMJ Open Diab Res Care.2020 Mar 22;8(1).doi: 10.1136/bmjdrc-2019-000811.

Quispe R, Martin SS, Jones SR. Triglycerides to high-density lipoprotein-cholesterol ratio, glycemic control and cardiovascular risk in obese patients with type 2 diabetes. Curr Opin Endocrinol Diabetes Obes. 2016;23(2):150-156. doi:10.1097/MED.0000000000000241.

Ren X, Chen Z, Zheng S, Han T, Li Y, et al. (2016) Association between Triglyceride to HDL-C Ratio (TG/HDL-C) and Insulin Resistance in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus. PLOS ONE. 11(4): e0154345. doi:10.1371/ journal.pone.0154345

Sun GZ, Li Z, Guo L, Zhou Y, Yang HM, Sun YX. High prevalence of dyslipidemia and associated risk factors among rural Chinese adults. Lipids Health Dis. 2014;13:189. Published 2014 Dec 12. doi:10.1186/1476-511X-13-189

He S, Wang S, Chen X, Jiang L, Peng Y, Li L, et al. Higher ratio of triglyceride to high-density lipoprotein cholesterol may predispose to diabetes mellitus: 15-year prospective study in a general population. Metabolism. 2012;61(1):30-36. doi:10.1016/j.metabol.2011.05.007

Bacopoulou F, Efthymiou V, Landis G, Rentoumis A, Chrousos GP. Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents. BMC Pediatr. 2015;15:50. Published 2015 May 4. doi:10.1186/s12887-015-0366-z

Lee EY, Yang HK, Lee J, Kang B, Yang Y, Lee SH, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids Health Dis. 2016;15(1):155. Published 2016 Sep 15. doi:10.1186/s12944-016-0324-2

Mclaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of Metabolic Markers To Identify Overweight Individuals Who Are Insulin Resistant Background: Insulin resistance is more common in overweight. Ann Intern Med. 2003;139(10):802-809. doi:10.7326/0003-4819-139-10-200311180-00007

Hirschler V, Maccallini G, Sanchez M, Gonzalez C, Molinari C. Association between triglyceride to HDL-C ratio and insulin resistance in indigenous Argentinean children. Pediatr Diabetes. 2015;16(8):606-612. doi:10.1111/pedi.12228

Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR. Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes. 2006;55(6):1832-1839. doi:10.2337/db05-1620

Gale E.A.M GKM. Diabetes and gender. Diabetologia. 2001;44(1):3-15. doi:10.1007/s001250051573

Sung KC, Park HY, Kim MJ, Reaven G. Metabolic markers associated with insulin resistance predict type 2 diabetes in Koreans with normal blood pressure or prehypertension. Cardiovasc Diabetol 15, 47 (2016). doi:10.1186/s12933-016-0368-7

Published
2021-08-30
How to Cite
Tjitradinata, C., & Sebong, P. (2021). Hubungan Antara TG/HDL-C dengan Kontrol Glikemik pada Pasien Diabetes di Puskesmas Lebdosari Kota Semarang. Jurnal Penelitian Dan Pengembangan Pelayanan Kesehatan, 5(2), 11-16. https://doi.org/10.22435/jpppk.v5i2.5333
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Articles