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"ABSTRAK Latar belakang: disglikemia adalah keadaan intoleransi glukosa berupa peningkatan kadar gula darah yang berhubungan dengan risiko penyakit kardiovaskular. Seiring dengan waktu, pada akhirnya diabetes akan menimbulkan kerusakan pada target organ, salah satu yang penting adalah pada sistem organ kardiovaskular, dapat berupa penyakit jantung koroner, kardiomiopati diabetes, penyakit serebrovaskuler, dan penyakit arteri perifer. Diabetes juga meningkatkan risiko terjadinya gagal jantung. Pada kardiomiopati diabetes, proses fibrosis yang masih reversibel sudah mulai terjadi bahkan ketika penderita masih asimtomatik. Pemeriksaan baku emas untuk mendeteksi terjadinya fibrosis miokard secara dini adalah pemeriksaan histopatologi jaringan miokardium melalui biopsi. Akan tetapi pemeriksaan ini sangat invasif dan tidak nyaman bagi subjek. Pemeriksaan yang kemudian berkembang adalah pencitraan menggunakan Cardiac Magnetic Resonance Imaging (CMRI). Akan tetapi pemeriksaan ini cukup mahal, dan tidak tersedia pada semua fasilitas kesehatan. Sementara itu, ST2 adalah penanda enzim jantung yang menggambarkan derajat proses fibrosis yang sedang terjadi pada miokard, terutama pada keadaan gagal jantung. Pemeriksaan menggunakan penanda enzim dapat menjadi alternatif dengan keuntungan lebih murah, dapat terjangkau luas dan mudah tersedia. Tujuan: Mengetahui hubungan antara kadar ST2 serum dengan fibrosis miokard interstisial pada penderita disglikemia. Metode: Pasien disglikemia yang lolos kriteria eksklusi berupa komorbid kardiovaskular akan menjalani pemeriksaan kadar ST2 serum dan T1 relaxation time menggunakan Cardiac MRI. Selanjutnya dilakukan analisis hubungan antara kadar ST2 serum dan T1 relaxation time. Hasil penelitian: Sebanyak 34 pasien diikutsertakan ke dalam penelitian ini. Didapatkan kisaran nilai kadar ST2 serum antara 12.40-53.22 ng/dL (median 19.95 ng/dL). Rerata nilai T1 relaxation time didapatkan sebesar 443.39 ± 113.35 ms. Terdapat korelasi bermakna antara kadar ST2 serum dengan fibrosis diffuse miokardium (Spearman correlation r = -0,547, p < 0.01). Pada analisa multivariat hubungan antara kadar ST2 serum dan T1 relaxation time tidak dipengaruhi oleh faktor perancu yang telah ditetapkan (r = -0,44, p = 0,033). Kesimpulan: Hasil penelitian ini menunjukkan kadar ST2 serum berkolerasi dengan fibrosis diffuse miokardium pada populasi disglikemia.ABSTRACT Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.;Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.;Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.;Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population."

"Latar Belakang: Diabetes melitus (DM) merupakan penyakit kronik umum yang terjadi pada masyarakat modern. Setelah penyakit jantung dan kanker, penyakit DM mewakili penyebab kematian ketiga pada manusia. Diabetes melitus tipe 2 merupakan jenis yang paling umum dari penyakit DM dan DM tipe 2 dapat menyebabkan komplikasi pada jantung yang disebut sebagai diabetic cardiomyopathy. Metformin adalah obat yang meningkatkan sensivitas terhadap insulin dan banyak digunakan sebagai terapi untuk diabetes melitus tipe 2 namun metformin memiliki berbagai macam efek samping yang merugikan. Maka dari itu diperlukan suatu obat alternatif yang lebih aman untuk terapi diabetes melitus tipe 2 yaitu seperti alfa mangostin karena alfa mangostin memiliki efek antidiabetik dan kardioprotektif. Tujuan dari penelitian ini adalah menganalisa efek terapi alfa mangostin pada tikus dengan diabetic cardiomyopathy.Metode: Hewan percobaan yang digunakan berupa tikus jantan galur wistar. Hewan coba dibagi jadi 6 kelompok yaitu kelompok 1 diberikan pakan normal, kelompok 2 diberikan pakan normal dan senyawa alfa mangostin sebesar 200 mg/kg BB tikus,kelompok 3 diberikan pakan tinggi lemak, kelompok 4 diberikan makanan tinggi lemak dan diberikan suntikan streptozotocin lalu diberikan metformin 200 mg/kg BB tikus, kelompok 5 diberikan makanan tinggi lemak dan diberikan suntikan streptozotocin lalu diberikan alfa mangostin 100 mg/kg BB tikus dan kelompok 6 diberikan makanan tinggi lemak dan diberikan suntikan streptozotocin lalu diberikan alfa mangostin 200 mg/kg BB tikus. Gula darah diukur setiap minggu, tekanan darah dan berat badan dan berat jantung diukur pada minggu saat hewan disacrifice. Semua sampel organ jantung dan plasma dari semua kelompok hewan uji yang telah disacrifice di minggu ke 11 akan dianalisa kadar HOMA-IR, MCP-1, TNF-α, IL-6, IL-1β dan dilakukan pemeriksaan histopatologi.Hasil Penelitian : Pemberian streptozotocin dan diet tinggi lemak menyebabkan gula darah tinggi, tekanan darah tinggi, nilai HOMA-IR tinggi, nilai rasio BB/BJ tinggi, kadar MCP-1, TNF-α, IL-6, IL-1β tinggi dan ukuran sel kardiomiosit besar. Tetapi dengan pemberian metformin dan alfa mangostin dapat merendahkan nilai gula darah , tekanan darah , nilai HOMA-IR, nilai rasio BB/BJ, kadar MCP-1, TNF-α, IL-6, IL-1β.Kesimpulan : Alfa mangostin memperlihatkan efek anti-inflamasi dan antidiabetik terhadap kadar gula darah dan jantung hewan coba yang diberikan diet tinggi lemak dan disuntik STZ.

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Background : Diabetes mellitus (DM) is a common chronic disease that occurs in modern society. After heart disease and cancer, DM represents the third leading cause of death in humans. Diabetes mellitus type 2 is the most common type of DM disease and type 2 diabetes can cause heart complications called diabetic cardiomyopathy. Metformin is a drug that increases insulin sensitivity and is widely used as a therapy for type 2 diabetes mellitus but metformin has a variety of adverse side effects. Therefore we need a safer alternative drug for the treatment of type 2 diabetes mellitus, such as alpha mangostin because alpha mangostin has antidiabetic and cardioprotective effects. The purpose of this study was to analyze the effects of alpha mangostin therapy in rats with diabetic cardiomyopathy.

Method : Test animals or experimental animals used in the form of male wistar strain rats. Experimental animals were divided into 6 groups: group 1 was given normal food, group 2 was given normal food and alpha mangostin compound was 200 mg / kg BW rat, group 3 was given high fat food, group 4 was given high fat food and given streptozotocin injection and then given metformin 200 mg / kg body weight rat, group 5 given high fat food and given streptozotocin injection then given alpha mangostin 100 mg / kg body weight rat and group 6 given high fat food and given streptozotocin injection then given alpha mangostin 200 mg / kg body rat. Blood sugar is measured every week, blood pressure and body weight and heart weight are measured on the week when the animal is disacrifice. All cardiac organ and plasma samples from all groups of test animals that were sacrificed at week 11 will be analyzed for HOMA-IR, MCP-1, TNF-α, IL-6, IL-1β levels and histopathological examination.

Result : Administration of streptozotocin and high-fat diets causes high blood sugar, high blood pressure, high HOMA-IR values, high BB / BJ ratio values, MCP-1 levels, TNF-α, IL- 6, high IL-1β and large cardiomyocyte cell sizes . But by giving metformin and alpha mangostin can lower blood sugar values, blood pressure, HOMA-IR values, BB / BJ ratio values, MCP-1 levels, TNF-α, IL-6, IL-1β.

Conclusion : Alfa mangostin exhibits anti-inflammatory and antidiabetic effects on blood sugar and heart of experimental animals which are given a high-fat diet and STZ injections."