ABSTRAKLatar Belakang. Lupus Eritematosus Sistemik (LES) merupakan penyakit
autoimun multisistem mengenai multiorgan akibat produksi antibodi dan kompleks
imun. Memiliki mortalitas 3 kali lebih tinggi dibandingkan populasi umum dimana
saat awal berkaitan dengan infeksi dan inflamasi, sedangkan jangka panjang
berkaitan dengan aterosklerosis. Adapun aterosklerosis yang terjadi timbul lebih
cepat dan faktor risiko tradisional (diabetes melitus, hipertensi, hiperkolesterol,
obesitas, merokok dan lainnya) dan terapi steroid belum dapat menjelaskan hal ini.
Diduga kompleks OxLDL/β2GP1 memainkan peranan dalam proses imunopatologi
terjadinya aterosklerosis dan trombosis yang dimediasi oleh adanya penyakit
autoimun.
Metode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalah
pasien LES poliklinik Imunologi RSUPN Ciptomangunkusomo Jakarta yang telah
dilakukan pemeriksaan Carotid Duplex dan Transcranial Doppler, serta memenuhi
kriteria inklusi dan eksklusi. Subyek diperoleh secara konsekutif. Pada subyek
dilakukan wawancara, pengisian kuesioner, pemeriksaan fisik umum dan neurologi,
dan pengambilan darah vena untuk diperiksa kompleks OxLDL/β2GP1. Dilakukan
analisis data menggunakan perangkat SPSS 17.0
Hasil. Diperoleh 40 subyek pasien LES wanita tanpa drop out. Kadar kompleks
OxLDL/β2GP1 pada pasien LES dengan aterosklerosis dan tanpa aterosklerosis
masing-masing meannya 0,37 unit/ml dan 0,31 unit/ml. Berdasarkan beberapa faktor
risiko tradisional aterosklerosis (usia, LDL, DM, hipertensi dan obesitas) didapatkan
kadar kompleks OxLDL/β2GP1 pada pasien aterosklerosis maupun tidak, memiliki
mean >0,25 unit/ml.
Kesimpulan. Pasien LES dengan atau tanpa aterosklerosis memiliki kadar kompleks
OxLDL/β2GP1 lebih dari 0,25 unit/ml namun tidak terdapat perbedaan bermakna.
Demikian pula pada aterosklerosis yang disertai atau tanpa disertai faktor risiko
tradisional.
ABSTRACTBackground. Systemic Lupus Erythematous (SLE) is a multisystem autoimmune
disease that can affect various organs due to production of antibodies and immune
complexes. The mortality rate of SLE patients is three times higher than the general
population. In early disease, mortality is related to infection and inflammation,
whereas in advanced stage it is related to atherosclerosis. In SLE, atherosclerosis
occurs faster; however the traditional risk factors (diabetes mellitus (DM),
hypertension, hypercholesterolemia, obesity, smoking, etc.) and steroid therapy
have not been able to explain this phenomenon. It is hypothesized that the
OxLDL/β2GP1 complexes play roles in the immunopathological process of
atherosclerosis and thrombosis that is mediated by the presence of autoimmune
disease.
Method. A cross-sectional study was conducted. The study subjects were SLE
patients from immunology clinic of Cipto Mangunkusumo Hospital, Jakarta who
previously have underwent carotid duplex and transcranial Doppler examination and
also met the inclusion and exclusion criteria. Subjects were obtained consecutively;
they were interviewed, asked to fill questionnaire, underwent general and
neurological physical examination, and their venous blood samples were collected.
Data analysis were done by using SPSS 17.0.
Result. A total of 40 SLE patients were included in this study; all subjects were
female and there were no drop out cases. The mean of OxLDL/β2GP1 complexes
level in SLE patients with and without atherosclerosis were 0,37 unit/ml and 0,31
unit/ml, consecutively. Based on several traditional risk factors for atherosclerosis
(age, LDL, DM, hypertension and obesity), the mean of OxLDL/β2GP1 complexes
level in patients with and without atherosclerosis is > 0,25 unit/ml.
Conclusion. SLE patients with or without atherosclerosis have level of
OxLDL/β2GP1 complexes of more than 0,25 unit/ml, but there were no significant
difference. Similar results were found in atherosclerosis with or without traditional
risk factors.