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Sylvia
Abstrak :
[ABSTRAK
Penelitian mengenai efektivitas pengobatan diabetes melitus dan kaitannya dengan pencegahan komplikasi masih menujukkan hasil yang beragam. Penelitian ini bertujuan untuk membandingkan efektivitas hipoglikemik dan fungsi ginjal dari sulfonilurea, kombinasi sulfonilurea dan biguanid serta injeksi insulin. Disain penelitian adalah kohort retrospektif pada pasien diabetes melitus tipe 2 rawat jalan yang mengkonsumsi obat yang sama selama empat bulan terakhir di RSK Dr. Sitanala Tangerang. Penelitian ini dilaksanakan pada kurun waktu April-Juni 2015, dan sudah mendapatkan lulus kaji etik dari Komite Etik rumah sakit ini. Subyek penelitian dibagi kedalam tiga kelompok yaitu yang menggunakan injeksi insulin (n = 30), yang menggunakan obat sulfonilurea tunggal (n = 30), dan kombinasi sulfonilurea dan biguanid (n = 45). Efektivitas hipoglikemik dilihat dari nilai HbA1C pasien dan komplikasi nefropati diabetik dilihat dari nilai eLFG yang dihitung dari angka serum kreatinin. Rerata usia keseluruhan pasien adalah 54,98±7,47, sebagian besar adalah wanita (72%) dan cenderung overweight (rerata IMT 25,47±4,77). Ada perbedaan yang bermakna (p = 0,042 ) pada nilai HbA1C pasien kelompok kombinasi sulfonilurea-biguanid (rerata HbA1C 7,28±0,09) dibandingkan dengan kelompok insulin (rerata HbA1C 8,10±0,09), sementara dengan kelompok sulfonilurea tunggal tidak ada perbedaan yang bermakna. Sedangkan nilai eLFG untuk setiap kelompok obat tidak ditemukan perbedaan yang bermakna. Subyek yang memiliki riwayat diabetes melitus dalam keluarga mempunyai peluang 4,512 kali (interval kepercayaan 95%, p = 0,010) lebih besar dibandingkan dengan yang tidak memiliki riwayat diabetes dalam keluarga untuk memiliki nilai HbA1C lebih dari 7%. Pasien dengan IMT >30 kg/m2 mempunyai peluang sebesar 21,631 (p = 0,012) dibandingkan pasien dengan IMT < 18,5 kg/m2 untuk memiliki nilai HbA1C yang tidak terkontrol atau diatas 7%. Pengobatan dengan kombinasi antidiabetik oral sulfonilurea dan biguanid lebih efektif dalam menurunkan nilai HbA1C pasien DM tipe 2 dibandingkan dengan insulin atau sulfonilurea tunggal, dan tidak ada perubahan bermakna dalam penurunan fungsi ginjal ABSTRACT Research on effectiveness of therapy on diabetes mellitus associated with prevention of its complication still remain varied in results. The hypoglycemic effectiveness and the kidney function were compared between sulfonylurea, sulfonylurea and biguanide combination and insulin, with the retrospective cohort study design, on patients that use those agents in last four months and came to out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical Clearance from the Ethical Committee of this hospital. Subjects were classify into three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and sulfonylurea and biguanide combination group (n = 45). Hypoglycemic effectiveness is measured with the HbA1C level and diabetic nephrophaty with the eGFR which calculated from the measured serum creatinin. Mean age of all subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042) with those from the insulin group (8,10±0,09), and there was no significant difference with the sulfonylurea group. There was no significant difference in diabetic nephropathy between groups. Subject with diabetic family history has 4,512 times chance to have the HbA1C level > 7% compare to those without diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea and biguanide combination was more effective compare to insulin or sulfonylurea monotherapy on decreasing HbA1C level of type 2 DM patients, without significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with prevention of its complication still remain varied in results. The hypoglycemic effectiveness and the kidney function were compared between sulfonylurea, sulfonylurea and biguanide combination and insulin, with the retrospective cohort study design, on patients that use those agents in last four months and came to out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical Clearance from the Ethical Committee of this hospital. Subjects were classify into three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and sulfonylurea and biguanide combination group (n = 45). Hypoglycemic effectiveness is measured with the HbA1C level and diabetic nephrophaty with the eGFR which calculated from the measured serum creatinin. Mean age of all subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042) with those from the insulin group (8,10±0,09), and there was no significant difference with the sulfonylurea group. There was no significant difference in diabetic nephropathy between groups. Subject with diabetic family history has 4,512 times chance to have the HbA1C level > 7% compare to those without diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea and biguanide combination was more effective compare to insulin or sulfonylurea monotherapy on decreasing HbA1C level of type 2 DM patients, without significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with prevention of its complication still remain varied in results. The hypoglycemic effectiveness and the kidney function were compared between sulfonylurea, sulfonylurea and biguanide combination and insulin, with the retrospective cohort study design, on patients that use those agents in last four months and came to out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical Clearance from the Ethical Committee of this hospital. Subjects were classify into three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and sulfonylurea and biguanide combination group (n = 45). Hypoglycemic effectiveness is measured with the HbA1C level and diabetic nephrophaty with the eGFR which calculated from the measured serum creatinin. Mean age of all subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042) with those from the insulin group (8,10±0,09), and there was no significant difference with the sulfonylurea group. There was no significant difference in diabetic nephropathy between groups. Subject with diabetic family history has 4,512 times chance to have the HbA1C level > 7% compare to those without diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea and biguanide combination was more effective compare to insulin or sulfonylurea monotherapy on decreasing HbA1C level of type 2 DM patients, without significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with prevention of its complication still remain varied in results. The hypoglycemic effectiveness and the kidney function were compared between sulfonylurea, sulfonylurea and biguanide combination and insulin, with the retrospective cohort study design, on patients that use those agents in last four months and came to out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical Clearance from the Ethical Committee of this hospital. Subjects were classify into three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and sulfonylurea and biguanide combination group (n = 45). Hypoglycemic effectiveness is measured with the HbA1C level and diabetic nephrophaty with the eGFR which calculated from the measured serum creatinin. Mean age of all subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042) with those from the insulin group (8,10±0,09), and there was no significant difference with the sulfonylurea group. There was no significant difference in diabetic nephropathy between groups. Subject with diabetic family history has 4,512 times chance to have the HbA1C level > 7% compare to those without diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea and biguanide combination was more effective compare to insulin or sulfonylurea monotherapy on decreasing HbA1C level of type 2 DM patients, without significant difference in effect of lowering kidney functionH, Research on effectiveness of therapy on diabetes mellitus associated with prevention of its complication still remain varied in results. The hypoglycemic effectiveness and the kidney function were compared between sulfonylurea, sulfonylurea and biguanide combination and insulin, with the retrospective cohort study design, on patients that use those agents in last four months and came to out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical Clearance from the Ethical Committee of this hospital. Subjects were classify into three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and sulfonylurea and biguanide combination group (n = 45). Hypoglycemic effectiveness is measured with the HbA1C level and diabetic nephrophaty with the eGFR which calculated from the measured serum creatinin. Mean age of all subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042) with those from the insulin group (8,10±0,09), and there was no significant difference with the sulfonylurea group. There was no significant difference in diabetic nephropathy between groups. Subject with diabetic family history has 4,512 times chance to have the HbA1C level > 7% compare to those without diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea and biguanide combination was more effective compare to insulin or sulfonylurea monotherapy on decreasing HbA1C level of type 2 DM patients, without significant difference in effect of lowering kidney functionH]
Fakultas Farmasi Universitas Indonesia, 2015
T42968
UI - Tesis Membership  Universitas Indonesia Library
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Rizky Mutiara Mahani
Abstrak :
ABSTRAK
Stres oksidatif berperan dalam kerusakan fungsi ginjal pada pasien diabetes melitus tipe 2. Hingga saat ini belum ada penanda yang dapat mendeteksi kerusakan ginjal sejak awal. Penelitian ini bertujuan menganalisis kadar hidrogen peroksida pada urin sebagai penanda stres oksidatif dan mengungkap hubungan dengan estimasi laju filtrasi glomerulus sebagai parameter fungsi ginjal. Kadar hidrogen peroksida urin dan nilai eLFG juga dibandingkan antara dua kelompok pengobatan untuk mengetahui efektivitas pengobatan pada pasien diabetes melitus tipe 2. Desain penelitian yang digunakan adalah cross sectional dengan jumlah sampel keseluruhan sebanyak 84 orang. Pengambilan sampel dilakukan di puskesmas kecamatan Pasar Minggu. Nilai hidrogen peroksida urin diperoleh dengan pengukuran menggunakan metode Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) dan dinormalisasi dengan nilai kreatinin urin. Pengukuran kreatinin urin dilakukan dengan metode kinetik Jaffe. Perhitungan nilai eLFG diperoleh dengan 3 tiga rumus yaitu Cockroft-gault, MDRD, dan CKD-EPI. Kadar hidrogen peroksida urinpada dua kelompok pengobatan tidak berbeda bermakna (p = 0,545. Hasil uji beda nilai eLFG pada dua kelompok juga tidak berbeda bermakna (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Hasil analisis hubungan kadar hidrogen peroksida urin dengan ketiga nilai eLFG tidak menunjukkan hubungan yang bermakna (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703).
ABSTRACT
Oxidative stress plays a major role in renal dysfunction caused by type 2 diabetes melitus. Up to now, there is no biomarker can be used in early detection of renal dysfunction. This study aims to analyze of urinary hydrogen peroxide concentration as biomarker of oxidative stress and correlated it with estimated Glomerular Filtration Rate as parameters of renal function. Urinary hydrogen peroxide and value of eGFR were also compared between the two groups of treatment to find out the effectiveness of treatment in type 2 diabetic patients. Design of this study was cross sectional with 84 sample that was taken in Puskesmas Pasar Minggu. Concentration of urinary hydrogen peroxide were measured with Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) method and normalize with urine creatinine that measured with kinetic Jaffe method. Three formulations used to measure value of eGFR were Cockroft-gault, MDRD, dan CKD-EPI. Concentration of urinary hydrogen peroxide in two groups of treatment have no significant difference (p = 0,545), while value of eGFR also didn?t have significant different (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Results of correlation analysis urinary hydrogen peroxide with eGFR showedno significant correlation (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703).
2016
S64783
UI - Skripsi Membership  Universitas Indonesia Library
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Rahmaningtyas Nurifahmi
Abstrak :
ABSTRAK
Gangguan fungsi ginjal merupakan komplikasi yang sering terjadi pada pasien diabetes melitus tipe 2 yang dapat ditandai oleh senyawa 8-iso-Prostaglandin F2a. Pada penelitian ini, dilakukan analisis hubungan antara kadar 8-iso-Prostaglandin F2a dengan estimasi Laju Filtrasi Glomerulus (eLFG). Sampel yang dianalisis adalah 50 pasien diabetes melitus tipe 2 di RSK Dr. Sitanala Tangerang yang terbagi menjadi dua yaitu kelompok sulfonilurea dan kombinasi biguanid-sulfonilurea dengan teknik total sampling. Penelitian ini merupakan penelitian observasional dengan metode kohort retrospektif. Nilai eLFG diperoleh berdasarkan kadar kreatinin serum, sedangkan kadar 8-iso-Prostaglandin F2a diukur dengan metode Enzyme Linked Immunosorbent Assay (ELISA). Uji beda dilakukan terhadap nilai eLFG antara kedua kelompok, yaitu Cockroft Gault (p = 0,961), MDRD (p = 0,567), CKD-EPI (p = 0,443), serta pada kadar 8-iso-Prostaglandin F2a (p = 0,070). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dianalisis pada seluruh sampel (n=48), yaitu Cockroft-Gault (r = 0,329; p = 0,023), MDRD (r = 0,231; p = 0,115) dan CKD-EPI (r = 0,256; p = 0,079). Sehingga, tidak terdapat perbedaan nilai eLFG dan kadar 8-iso-Prostaglandin F2a di antara kedua kelompok. Terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2a dengan nilai eLFG berdasarkan Cockroft-Gault, namun tidak terdapat hubungan pada nilai eLFG MDRD dan CKD-EPI.
ABSTRACT
Renal dysfunction is a common complication in type 2 diabetes mellitus patient that can be characterized by 8-iso-prostaglandin F2a compound. The aim of this study was to analyze the correlation between the level of 8-iso-prostaglandin F2a and estimated Glomerular Filtration Rate (eGFR). Samples analyzed were 50 patients with type 2 diabetes mellitus in Dr. Sitanala Tangerang Hospital were divided into two groups of sulfonylurea and combination of biguanide-sulfonylurea using total sampling technique. This study was an observasional study using cohort retrospective method. The value of eGFR obtained by serum creatinine levels, while the level of 8-iso-Prostaglandin F2a measured by the method of Enzyme Linked Immunosorbent Assay (ELISA). Different test carried out on eGFR values ​​between the two groups, those were Cockroft-Gault (p = 0,961), MDRD (p = 0,567), CKD-EPI (p = 0,443), as well as on the level of 8-iso-prostaglandin F2a (p = 0.070). The correlation between the levels of 8-iso-prostaglandin F2a with eGFR was analyzed on all samples (n=48), those are Cockroft-Gault (r = 0,329; p = 0,023), MDRD (r = 0,231; p = 0,115) and CKD-EPI (r = 0,256; p = 0,079). Thus, there was no difference in eGFR values ​​and levels of 8-iso-Prostaglandin F2a between the two groups. There was significant correlation between the levels of 8-iso-Prostaglandin F2a and eGFR values were calculated by Cockroft-Gault equation, meanwhile there was no correlation in eGFR values were calculated by MDRD and CKD-EPI equation.
2015
S60238
UI - Skripsi Membership  Universitas Indonesia Library
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Raja Andriany
Abstrak :
ABSTRAK
Nefropati diabetika dapat dideteksi melalui nilai UACR. Di sisi lain, 8-iso- Prostaglandin F2α sedang diteliti perannya sebagai penanda awal disfungsi ginjal. Penelitian ini bertujuan untuk menganalisis kadar 8-iso-Prostaglandin F2α, UACR serta hubungan 8-iso-Prostaglandin F2α dan UACR pada 72 orang pasien diabetes melitus tipe 2 (usia 33-75 tahun) di Puskesmas Kecamatan Pasar Minggu. Sampel penelitian dibagi menjadi 2 kelompok, yaitu kelompok biguanid (n = 36) dan kelompok biguanid-sulfonilurea (n = 36). Kadar 8-iso-Prostaglandin F2α urin diukur menggunakan ELISA dan albumin urin diukur menggunakan kit BCG Albumin. Hasil uji beda rata-rata menunjukkan tidak terdapat perbedaan kadar 8-iso- Prostaglandin F2α (p = 0,083) dan UACR (p = 0,509) pada kedua kelompok sampel. Hasil uji beda rata-rata pada kelompok sampel dengan albuminuria (n = 33) juga menunjukkan tidak terdapat perbedaan kadar 8-iso-Prostaglandin F2α (p = 0,532) dan UACR (p = 0,067). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan UACR pada seluruh sampel (r = 0,120; p = 0,315), sedangkan antara 8-iso- Prostaglandin F2α dengan UACR pada kelompok albuminuria (r = 0,534; p = 0,001). Jadi, tidak terdapat hubungan yang signifikan antara kadar 8-iso-Prostaglandin F2α dengan UACR pada seluruh sampel, tetapi terdapat hubungan yang cukup kuat dan signifikan antara kadar 8-iso-Prostaglandin F2α dengan UACR pada sampel dengan albuminuria.
ABSTRACT
Diabetic nephropathy can be detected by UACR value. Meanwhile, 8-iso- Prostaglandin F2α is being studied for its role as early marker for renal dysfunction. This study were to analize 8-iso-Prostaglandin F2α, UACR, and the correlation between 8-iso-Prostaglandin F2α and UACR on 72 type 2 diabetes mellitus patient (from ages: 33-75 years) at Pasar Minggu Community Health Center. Samples were divided into two groups, which was biguanid group (n = 36) and biguanidsulfonylurea group (n = 36). Urinary 8-iso-Prostaglandin F2α was measured by ELISA and urinary albumin by BCG Albumin kit. The results of mean different test showed there were no difference for 8-iso-Prostaglandin F2α (p=0,083) and UACR (p=0,509) in two group samples. The results of mean different test showed there were also no difference for 8-iso-Prostaglandin F2α (p=0,532) and UACR (p=0,067) in group samples with albuminuria (n=33). The correlation between 8-iso- Prostaglandin F2α and UACR on total samples (r = 0,120; p = 0,315), meanwhile the correlation between 8-iso-Prostaglandin F2α with UACR on samples with albuminuria (r = 0,534; p = 0,001). So, there was no significant correlation between 8-iso-Prostaglandin F2α and UACR on total samples, meanwhile there was strong enough and significant correlation between 8-iso-Prostaglandin F2α and UACR on samples with albuminuria.
2016
S64767
UI - Skripsi Membership  Universitas Indonesia Library
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Fitri Wulandari
Abstrak :
[ABSTRAK Gangguan fungsi ginjal yang sering terjadi pada pasien diabetes melitus tipe 2 diperankan oleh stres oksidatif. Belum diketahui efektivitas pengobatan diabetes melitus tipe 2 terhadap gangguan fungsi ginjal. Penelitian ini membandingkan dan menganalisis hubungan hidrogen peroksida urin yang merupakan produk stress oksidatif dan estimasi Laju Filtrasi Glomerulus (eLFG) pada kelompok pengobatan sulfonilurea dan kombinasi biguanid-sulfonilurea. Penelitian ini menggunakan desain penelitian kohort retrospektif dengan jumlah sampel 50 orang yang diambil di RSK Dr. Sitanala Tangerang dengan teknik total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang diukur menggunakan metode kinetik Jaffe, sedangkan hidrogen peroksida urin menggunakan metode FOX (Ferrous ion Oxidation Xylenol Orange) 1. Nilai hidrogen peroksida urin pada dua kelompok pengobatan tidak memiliki perbedaan yang bermakna (p = 0,69). Sedangkan nilai eLFG pada dua kelompok juga tidak memiliki memiliki perbedaan yang bermakna dengan Cockroft Gault adalah p = 0,884; MDRD p = 0,886; dan CKDEP p= 0,490. Analisis hubungan hidrogen peroksida urin dengan eLFG berdasarkan persamaan MDRD dan CKDEPI menghasilkan hubungan positif bermakna (r = 0,326; p = 0,021) dan (r = 0,282; p = 0,047).
ABSTRACT , Renal dysfunction which frequently occurs in type 2 diabetes mellitus patients caused by oxidative stress. The effectiveness of the type 2 diabetes mellitus treatment to renal dysfunction is unknown. This study compare and analyze the correlation between urinary hydrogen peroxide which is a product of oxidative stress and estimated glomerular filtration rate (eGFR) in the treatment groups of sulfonylurea and combination biguanide-sulfonylurea. This study used a retrospective cohort study design with 50 sampels that was taken in Dr. Sitanala Tangerang hospital with total sampling technique. Estimated GFR value obtained based on serum creatinine values were measured using a kinetic Jaffe method, while the urinary hydrogen peroxide using FOX (Ferrous ion Oxidation Xylenol Orange) 1. Value of urinary hydrogen peroxide in the two treatment groups did not have significant difference (p = 0.69) , While the value eGFR the two groups did not have significant differences with the Cockroft Gault is p = 0.884; MDRD p = 0.886; and CKDEP p = 0.490. Analysis of urinary hydrogen peroxide and eGFR based on the MDRD equation and CKDEPI generate significant positive correlation (r = 0.326; p = 0.021) and (r = 0.282; p = 0.047). ]
2015
S61099
UI - Skripsi Membership  Universitas Indonesia Library