Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKLatar Belakang:Obesitas merupakan salah satu masalah kesehatan utama yang banyak ditemukandi negara maju maupun negara berkembang. Obesitas menjadi salah satu faktorrisiko timbulnya penyakit kardiovaskular. Diketahui bahwa populasi obesitasmemiliki kadar plasma BNP yang rendah dibanding kelompok normal. BNPadalah suatu hormon yang disintesis oleh miosit atrium yang berperan dalammeregulasi hemodinamik tubuh. Selain itu BNP memiliki efek anti fibrosis dan anti hipertrofi pada jantung. Dipikirkan bahwa adanya gangguan sintesis BNP di miosit jantung sebagai salah satu penyebab. Maka, penelitian ini bertujuan untukmelihat profil ekspresi mRNA BNP, NPR-A dan NPR-C pada populasi obesitas.Metode:Studi potong lintang dilakukan di Rumah Sakit Jantung dan Pembuluh DarahHarapan Kita (RSJPDHK). Jaringan miosit tersimpan yang sudah dilakukanekstraksi RNA dibagi menjadi 2 kelompok berdasarkan IMT, kelompok obesitas(IMT ≥27) dan kelompok normal (IMT <27) dan sesuai kriteria inklusi daneksklusi. RNA kedua kelompok dilakukan sintesis cDNA, ekstraksi protein danReal-Time PCR untuk mendapatkan mean ΔCt. Kemudian dilakukanpenghitungan menggunakan metode Livak untuk mendapatkan nilai ekspresirelatif mRNA. Data kemudian di analisis statistik menggunakan SPSS 20.Hasil Penelitian:Sebanyak 48 pasien diikutsertakan dalam penelitian ini dengan jumlah kelompoknormal 34 orang dan kelompok obesitas 14 orang. Hasil ekspresi mRNA BNP,NPR-A dan NPR-C lebih rendah pada kelompok obesitas dibanding kelompoknormal. Namun, tidak didapatkan perbedaan bermakna ekspresi mRNA BNP (p0,768), NPR-A (p 0,838) dan NPR-C (p 0,768) antara kelompok obesitas dibanding kelompok normal. Kesimpulan:Penelitian ini tidak menemukan perbedaan ekspresi mRNA BNP, NPR-A dan NPR-C yang bermakna antara kelompok obesitas dengan kelompok normal.

---

ABSTRACTBackground:Obesity is presenting as a significant health problem across the world. Obesity is arisk factor for cardiovascular diseases. The plasma level of B-type natriureticpeptide (BNP) has been identified to be lower in obese people compare to normal.As we know, BNP is one of the cardiac hormones synthesized by atrial myocytethat plays a role in hemodynamic regulations. In addition, BNP exerts its antifibrotic and anti hypertrophic effects in the heart. It has been hypothesized thatone of the possible mechanism responsible for this inverse relationship is theimpaired synthesize of BNP by cardiomyocytes. Therefore, the aim of our study isto evaluate the mRNA expression profile of BNP, Natriuretic peptide receptortype-A (NPR-A) and Natriuretic peptide receptor type-C (NPR-C) incardiomyocytes of obese population. Method:A cross-sectional study was conducted in Rumah Sakit Jantung dan PembuluhDarah Harapan Kita (RSJPDHK). Cardiomyocytes that have been performed theRNA extraction proses were divided into 2 groups, Obese group (BMI ≥27) andNormal group (BMI <27), according to BMI and inclusion and exclusion criteria.Synthesize cDNA, protein extraction and Real-Time PCR were performed inorder to have the mean of ΔCt. Livak method was used to determine the relativeexpression mRNA value. SPSS 20 for Windows was used for the purpose ofstatistical analyses. Results:48 patients were included in this study that consist of 34 patients in normal groupand 14 patients in obese group. The mRNA expression of BNP, NPR-A and NPRCwerelower in obese group compared to normal group. However, there was nosignificant difference between groups.Conclusion:In conclusion, there is no significant difference of mRNA expression of BNP, NPR-A and NPR-C between obese and normal group.;Background:Obesity is presenting as a significant health problem across the world. Obesity is arisk factor for cardiovascular diseases. The plasma level of B-type natriureticpeptide (BNP) has been identified to be lower in obese people compare to normal.As we know, BNP is one of the cardiac hormones synthesized by atrial myocytethat plays a role in hemodynamic regulations. In addition, BNP exerts its antifibrotic and anti hypertrophic effects in the heart. It has been hypothesized thatone of the possible mechanism responsible for this inverse relationship is theimpaired synthesize of BNP by cardiomyocytes. Therefore, the aim of our study isto evaluate the mRNA expression profile of BNP, Natriuretic peptide receptortype-A (NPR-A) and Natriuretic peptide receptor type-C (NPR-C) incardiomyocytes of obese population. Method:A cross-sectional study was conducted in Rumah Sakit Jantung dan PembuluhDarah Harapan Kita (RSJPDHK). Cardiomyocytes that have been performed theRNA extraction proses were divided into 2 groups, Obese group (BMI ≥27) andNormal group (BMI <27), according to BMI and inclusion and exclusion criteria.Synthesize cDNA, protein extraction and Real-Time PCR were performed inorder to have the mean of ΔCt. Livak method was used to determine the relativeexpression mRNA value. SPSS 20 for Windows was used for the purpose ofstatistical analyses. Results:48 patients were included in this study that consist of 34 patients in normal groupand 14 patients in obese group. The mRNA expression of BNP, NPR-A and NPRCwerelower in obese group compared to normal group. However, there was nosignificant difference between groups.Conclusion:In conclusion, there is no significant difference of mRNA expression of BNP, NPR-A and NPR-C between obese and normal group."

"Latar Belakang: Gagal jantung adalah salah satu bentuk komplikasi kardiovaskular dan merupakan salah satu penyebab utama mortalitas dan morbiditas pada pasien DMT2. Disfungsi diastolik merupakan bentuk awal dari gagal jantung yang tidak bergejala dan seringkali terlambat terdiagnosis, sehingga deteksi dini penting untuk dilakukan. Guideline gagal jantung dari AHA merekomendasikan pemeriksaan NTproBNP dengan nilai batas >125 pg/ml sebagai salah satu upaya deteksi dini pada populasi berisiko. Penelitian-penelitian faktor klinis yang ada mayoritas dilakukan pada populasi kaukasia dengan hasil yang heterogen. Diketahui populasi DMT2 di Asia memiliki indeks massa tubuh lebih rendah, usia lebih muda, dan nilai dasar NTproBNP lebih rendah, namun memiliki prevalensi gagal jantung yang lebih tinggi. Belum ada penelitian yang meneliti hubungan faktor klinis dan kadar NTproBNP pada populasi DMT2 di IndonesiaTujuan: Penelitian ini dibuat untuk mengetahui hubungan faktor klinis dan kadar NTproBNP dengan kejadian disfungsi diastolik pada populasi DMT2 di IndonesiaMetode: Penelitian ini merupakan studi potong lintang (cross sectional study), menggunakan data sekunder dari follow up ke-30 Studi Kohort PTM Litbangkes. Subyek berusia dibawah 65 tahun yang terdiagnosis DMT2 selama pengamatan dan memenuhi kriteria inklusi dicatat, dilakukan pemeriksaan NTproBNP dan dilakukan analisis dengan kejadian disfungsi diastolik yang didapatkan dari ekhokardiografi. Uji bivariat dilakukan dengan uji chi square dan uji multivariat menggunakan uji regresi multipel. Kadar NTproBNP yang diperiksakan dilakukan penentuan titik potong menggunakan Receiver Operating Characteristics (ROC).Hasil: Subyek yang terinklusi didapatkan sebesar 91 orang. Uji multivariat menunjukkan baik kadar NTproBNP>125 pg/ml dan titik potong NTproBNP baru >62,5 pg/ml berhubungan bermakna dengan kejadian disfungsi diastolik dengan PRadj 2,791 (95% IK; 1,937-4,021; p<0,0001) dan PRadj 2,587 (IK 95%; 1,554 – 4,645; p:<0,0001) dengan Area under curve (AUC) 0,76. Pada penelitian kami, tidak ada faktor klinis yang berhubungan secara bermakna pada uji statistikSimpulan: Peningkatan kadar NTproBNP >125 pg/ml berhubungan dengan kejadian disfungsi diastolik pada populasi DMT2 di Indonesia.

---

Background: Diastolic dysfunction is an early form of heart failure that is asymptomatic and often diagnosed late in T2DM patients, so early detection is encourage. The AHA heart failure guideline recommends NTproBNP testing with a cut-off value of >125 pg/ml as one of the early detection strategies. The majority of existing clinical factor studies have been conducted in Caucasian populations with heterogeneous results and it is known that T2DM populations in Asia have lower body mass index, younger age, lower baseline NTproBNP values with higher heart failure prevalence. To date, there have been no research determining the association between clinical factors and NTproBNP levels in the T2DM population in Indonesia.

Objective: This study was designed to determine the association of clinical factors and NTproBNP levels with the incidence of diastolic dysfunction in the T2DM population in Indonesia

Methods: This study is a cross sectional study, using secondary data from the 30th follow up of the Bogor NCD Cohort Study. Subjects under 65 years of age who are diagnosed with T2DM during observation and meet the inclusion criteria were being recorded, We will determine the association between clinical factors and NTproBNP examination results with the incidence of diastolic dysfunction obtained from echocardiography. Bivariate tests were performed using the chi square test and multivariate tests using multiple regression tests. The new NTproBNP cut off points were determined using Receiver Operating Characteristics (ROC).

Results: 91 subjects were included. Multivariate test showed that both NTproBNP level >125 pg/ml and new cut off >62,5 pg/ml was significantly associated with the incidence of diastolic dysfunction with PRadj 2,791 (95% IK; 1,937-4,021; p<0,0001) and PRadj 2.587 (95% CI; 1.554 - 4.645; p: <0.0001) respectively, with Area under curve (AUC) 0.76. In our study, No clinical factors were associated significantly with diastolic dysfunction incidence.

Conclusions: NTproBNP levels >125 pg/ml are associated with the incidence of diastolic dysfunction in the T2DM population in Indonesia."