ABSTRAKLatar belakang : Penyakit jantung koroner (PJK) dan stroke merupakan penyebab
kematian utama baik di negara Barat maupun di Indonesia terutama di daerah
perkotaan. Setiap tahun lebih banyak orang meninggal karena penyakit
kardiovaskular dibandingkan penyakit lain. Diabetes melitus merupakan faktor
risiko independen untuk penyakit kardiovaskular. Gangguan aliran darah yang
mengakibatkan PJK maupun stroke disebabkan oleh trombosis arteri. Aktivasi
trombosit diduga terjadi pada pasien diabetes melitus. Ketika trombosit teraktivasi
akanterjadi beberapa perubahan diantaranya pelepasan kandungan granula dan
pembentukan tromboksan A2. Pengukuran tromboksan A2 sulit dilakukan karena
sifatnya yang tidak stabil, maka dilakukan pengukuran terhadap metabolitnya 11-
dehidro tromboksan B2. tujuan penelitian ini adalah menukur kadar 11 dehidro
TxB2 di urin pada pasien diabetes melitus sebagai suatu petanda dini aktivasi
trombosit dan mengkorelasikannya dengan hemoglobin A1c (HbA1c).
Metoda : Empat puluh lima pasien diabetes melitus tipe 2 dan 30 non diabetes
sebagai kontrol diambil pada penelitian ini. Pengukuran kadar 11 dehidro TxB2 di
urin dengan tehnik competitive EIA menggunakan reagen dari Cayman Chemical.
Kadar 11-dehidro tromboksan B2 urin disajikan dalam bentuk rasio dengan
kreatinin urin. Pengukuran HbA1c dilakukan dengan metode akfinitas boronik
menggunakan NycocardR.
Hasil : Pada kelompok diabetes melitus median kadar 11 dehidro TxB2 di urin
1216,56 pg/mg kreatinin (70,53 – 12167,72 pg/mg kreatinin). Terdapat perbedaan
bermakna dibanding kelompok non diabetes dengan median 200,55pg/mg kreatinin
(57,19-602,46 pg/mg kreatinin). Terdapat korelasi yang kuat antara kadar 11
dehidro TxB2 pada kelompok diabetik dengan indeks glikemik (HbA1c).
Kesimpulan : 11 dehidro TxB2 di urin dapat dipakai sebagai petanda dini aktivasi
trombosit pada pasien diabetes melitus dan mempunyai korelasi yang kuat dengan
HbA1c.
ABSTRACTBackground: It is widely known that heart disease and stroke are the main cause of
death in Western countries. This issue found in Indosesia especially in the urbam ares.
Diabetes mellitus is one of the independentbrisk faktor for cardiovaskular. Cirulatory
disorder that result in coronary heart disease and stroke is arterial thrombosis. Platelet
play an important role in the pathogenesis of arterial thrombosis. Some report stated
that platelet activation occurred in diabetes mellitus. When platelet are activated, some
change happened, i.e : released of granule content and thromboxane A2 (TxA2)
formation. Measurement of TxA2 as a marker for platelet activation was hampered by
the instability of this substance. Therefore it is preferred to measure their stable
metabolite 11-dehydro thromboxane B2 in urine. The aim of this study is to measure
urine 11-dehydro thromboxane B2 in diabetes mellitus as an early of platelet activation
and to correlate this value with hemoglobin A1c.
Methode: Forty five patients with type 2 diabetes mellitus and 30 non diabetic as
control group were enrolled in this study. Measurement of urine 11 dehidro TxB2 was
done by competitive EIA using reagent from Cayman Chemical. The level of urine 11-
dehydro TxB2 was expressed as ratio with urine creatinine. Measurement of HbA1c
was performed by boronic affinity method using NycocardR.
Result : In diabetics group the median rate for urine 11 dehydro TxB2 was 1216,56
pg/mg creatinine ( 70,53 - 12167,72 pg/mg creatinine). It was significantly higher than
that of non diabetic group, which median was 200,55 pg/mg creatinine ( 57,19 -
602,46 pg/ mg creatinine). the level of urine 11-dehydro TxB2 in diabetics group
showed a strong correlation with HbA1c as glycemic index.
Conclusion: Urine 11-dehydro TxB2 can be used as an early marker of platelet
activation in diabetes mellitus patients and there was a strong correlation with HbA1c.