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"[ABSTRAKSaat ini belum ada penanda biologis yang dapat digunakan untuk mendeteksi PGK sejak dini. Rasio albumin terhadap kreatinin urin (UACR) dan estimasi laju filtrasi ginjal (eLFG) digunakan sebagai penanda gangguan fungsi ginjal. Penelitian ini bertujuan untuk mengetahui hubungan antara UACR dengan eLFG pada pasien DM tipe 2 dengan normoalbuminuria dan mikroalbuminuria. Sampel yang dianalisis adalah urin dan serum 90 orang pasien DM tipe 2 di Puskesmas Pasar Minggu yang dikumpulkan tahun lalu, dengan teknik total sampling. Kreatinin urin diukur dengan metode kinetic jaffe. Albumin urin diukur dengan metode bromkresol hijau. eLFG diperoleh dari nilai kreatinin serum. Hasil rerata UACR yang didapatkan (15,60±1,93). Hasil rerata eLFG Cockroft Gault (95,65±4,17), MDRD (89,71±3,65) dan CKD-EPI (87,00±2,62). Hasil hubungan antara UACR dengan eLFG rendah MDRD (p= 0,004,r= -0,422); Cockroft (p= 0,083,r= -0,261); CKD-EPI (p= 0,006,r= -0,404), sedangkan dengan LFG tinggi MDRD (p= 0,020, r= 0,346); Cockroft (p= <0,0-01, r= 0,540); CKD (p= 0,002, r= 0,449). Kesimpulan yang didapatkan yaitu hubungan bermakna antara UACR dengan eLFG rendah dan tinggi. Tidak ditemukan hubungan yang bermakna antara UACR normoalbuminuria dan mikroalbumnuria dengan eLFG.

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ABSTRACTDiabetes mellitus type 2 is one of the causes complication of chronic kidney disease (CKD). Currently there are no biological markers that can be used to detect CKD early. Urinary albumin to creatinine ratio (UACR) and estimated kidney filtration rate (eLFG) is used as a marker of impaired kidney function. This study aimed to determine the relationship between UACR with eLFG in patient type 2 diabetes mellitus with normoalbuminuria and microalbuminuria. Samples were urine and serum of 90 patients with type 2 diabetes mellitus in Puskesmas Pasar Minggu which were collected last year, with total sampling technique. Urinary creatinine was measured by Jaffe kinetic method. Urine albumin was measured by the method bromkresol green. eLFG obtained from serum creatinine values. UACR results obtained (15.60 ± 1.93). Results eLFG Cockroft Gault (95.65 ± 4.17), MDRD (89.71 ± 3.65) and CKD-EPI (87.00 ± 2.62). Results relationship between UACR with low eLFG MDRD (p = 0.004, r = -0.422); Cockroft (p = 0.083, r = -0.261); CKD (p = 0.006, r = -0.404), while the high eLFG MDRD (p = 0.020, r = 0.346); Cockroft (p = <0.001, r = 0.540); CKD (p = 0.002, r = 0.449) so there is a significant relationship between UACR with low and high eLFG. There is no significant relationship between UACR normoalbuminuria and microalbuminuria with eLFG., Diabetes mellitus type 2 is one of the causes complication of chronic kidney disease (CKD). Currently there are no biological markers that can be used to detect CKD early. Urinary albumin to creatinine ratio (UACR) and estimated kidney filtration rate (eLFG) is used as a marker of impaired kidney function. This study aimed to determine the relationship between UACR with eLFG in patient type 2 diabetes mellitus with normoalbuminuria and microalbuminuria. Samples were urine and serum of 90 patients with type 2 diabetes mellitus in Puskesmas Pasar Minggu which were collected last year, with total sampling technique. Urinary creatinine was measured by Jaffe kinetic method. Urine albumin was measured by the method bromkresol green. eLFG obtained from serum creatinine values. UACR results obtained (15.60 ± 1.93). Results eLFG Cockroft Gault (95.65 ± 4.17), MDRD (89.71 ± 3.65) and CKD-EPI (87.00 ± 2.62). Results relationship between UACR with low eLFG MDRD (p = 0.004, r = -0.422); Cockroft (p = 0.083, r = -0.261); CKD (p = 0.006, r = -0.404), while the high eLFG MDRD (p = 0.020, r = 0.346); Cockroft (p = <0.001, r = 0.540); CKD (p = 0.002, r = 0.449) so there is a significant relationship between UACR with low and high eLFG. There is no significant relationship between UACR normoalbuminuria and microalbuminuria with eLFG.]"

"Nefropati diabetik merupakan komplikasi DM tipe 2 yang umumnya ditandai dengan kondisi albuminuria dari hasil penilaian UACR. TGF-β1 urin merupakan faktor pertumbuhan yang banyak dikaitkan dengan patologis dari kerusakan ginjal pada nefropati diabetik. Tujuan dari penelitian ini yaitu untuk mengetahui hubungan nilai UACR dengan kadar TGF-β1 urin pada pasien DM tipe 2. Desain studi pada penelitian ini yaitu cross sectional dimana pengambilan sampel menggunakan teknik consecutive sampling. Sampel yang diperoleh berjumlah 99 subjek penelitian (62 pasien DM normolbuminuria, 27 pasien DM albuminuria, dan 10 subjek non DM sebagai kontrol) di Puskesmas Kecamatan Pasar Minggu. Kadar TGF-β1 urin diukur menggunakan ELISA, sedangkan nilai UACR diperoleh dari hasil uji laboratorium klinik. Hasil dari uji beda rerata pada kadar TGF-β1 urin menunjukkan tidak terdapat perbedaan bermakna (p = 0,790) pada ketiga kelompok sampel. Hasil analisis hubungan kadar TGF-β1 urin dengan nilai UACR pada kelompok DM normoalbuminuria dan albuminuria juga menunjukkan tidak adanya hubungan yang bermakna (r = -0,079; p = 0,462). Hal ini diduga adanya pengaruh tekanan darah dan konsumsi obat antihipertensi yang berpotensi mempengaruhi kadar TGF-β1 urin. Oleh karena itu, dapat disimpulkan bahwa kadar TGF-β1 urin dengan nilai UACR tidak terdapat hubungan yang signifikan pada pasien DM tipe 2.

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Diabetic nephropathy is one of type 2 DM complication that can be detected by UACR (Urine Albumin Creatinine Ratio) as a marker for albuminuria condition. Urinary transforming growth factor β1 (TGF-β1) is a growth factor related to pathology of kidney disease in nepropathy diabetic. The aim of the present study was to know the correlation between TGF-β1 and UACR in type 2 DM patients. Design study was using cross sectional with consecutive sampling method. The study was performed in 99 subjects (62 DM normolbuminuria patients, 27 DM albuminuria patients, and 10 non DM subject as controls) at Pasar Minggu Community Health Center. Urinary TGF-β1 level was measured by ELISA, and UACR was measured in clinical laboratory. The result of mean difference test showed that urinary TGF-β1 level (p = 0,790) difference were not present in three group samples. Analysis correlation urinary TGF-β1 level and UACR in DM normoalbuminuria and albuminuria groups did not show correlation (r = -0,079; p = 0,462), and the result might influenced by blood pressure and received antihypertention medication that potent to reduce urinary TGF-β1 level. In conclusion, urinary TGF-β1 level and UACR did not have significant correlation in type 2 DM patients."

"ABSTRAKNefropati 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, UACRserta hubungan 8-iso-Prostaglandin F2α dan UACR pada 72 orang pasien diabetesmelitus tipe 2 (usia 33-75 tahun) di Puskesmas Kecamatan Pasar Minggu. Sampelpenelitian dibagi menjadi 2 kelompok, yaitu kelompok biguanid (n = 36) dankelompok biguanid-sulfonilurea (n = 36). Kadar 8-iso-Prostaglandin F2α urin diukurmenggunakan 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) jugamenunjukkan tidak terdapat perbedaan kadar 8-iso-Prostaglandin F2α (p = 0,532)dan UACR (p = 0,067). Hubungan antara kadar 8-iso-Prostaglandin F2α denganUACR 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 F2αdengan UACR pada seluruh sampel, tetapi terdapat hubungan yang cukup kuat dansignifikan antara kadar 8-iso-Prostaglandin F2α dengan UACR pada sampel denganalbuminuria.

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ABSTRACTDiabetic 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 correlationbetween 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 weredivided into two groups, which was biguanid group (n = 36) and biguanidsulfonylureagroup (n = 36). Urinary 8-iso-Prostaglandin F2α was measured byELISA and urinary albumin by BCG Albumin kit. The results of mean different testshowed 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 therewere 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), meanwhilethe correlation between 8-iso-Prostaglandin F2α with UACR on samples withalbuminuria (r = 0,534; p = 0,001). So, there was no significant correlation between8-iso-Prostaglandin F2α and UACR on total samples, meanwhile there was strongenough and significant correlation between 8-iso-Prostaglandin F2α and UACR onsamples with albuminuria."

"Diabetes mellitus DM dapat menyebabkan kerusakan ginjal dan nefropati diabetik merupakan penyebab gagal ginjal tersering. Penelitian ini bertujuan untuk mengetahui jumlah sel epitel tubulus ginjal dalam sedimen urin yang dapat dijadikan penanda kerusakan ginjal pada penderita DM. Penelitian ini juga bertujuan mencari nilai cut off jumlah sel epitel tubulus ginjal sebagai penanda kerusakan ginjal pada penderita DM, korelasi antara jumlah sel epitel tubulus ginjal dengan urine albumin/creatinine ratio UACR dan ?2-microglobulin urin serta korelasi antara ?2-microglobulin serum dengan UACR. Desain penelitian adalah potong lintang deskriptif analitik dengan 90 subjek, penelitian berlangsung selama Juni hingga Oktober 2017. Sampel menggunakan urin dan serum penderita diabetes mellitus. Jumlah sel epitel tubulus ginjal diperiksa dengan Sysmex UF-4000. Kadar albumin urin diperiksa dengan NycoCard. Kadar ?2-microglobulin serum dan urin serta kreatinin urin diperiksa dengan Cobas C501. Hasil penelitian didapatkan perbedaan bermakna jumlah sel epitel tubulus ginjal pada kelompok nefropati diabetik dengan non nefropati diabetik 2,4 sel /?L vs 1,6 sel /?L . Tidak ada korelasi antara jumlah sel epitel tubulus ginjal dengan UACR dan ?2-microglobulin urin. Korelasi antara ?2-microglobulin serum dengan UACR adalah lemah dan bermakna.

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Diabetes mellitus DM can cause kidney damage and diabetic nephropathy is the most common cause of renal failure. This study aimed to determine the number of renal tubular epithelial cells in urine sediments that could be used as a marker of kidney damage in patients with DM. This study also aimed to determine cut off point of renal tubular epithelial cells as a marker of kidney damage in patients with DM, the correlation between the renal tubular epithelial cells with urine albumin creatinine ratio UACR and 2 microglobulin urine and the correlation between serum 2 microglobulin and UACR.

The study design was cross sectional, descriptive analytic with 90 subjects, the study took place during June to October 2017. The sample used urine and serum of diabetic patients. The renal tubular epithelial cells was examined with Sysmex UF 4000. Urinary albumin levels are determined with NycoCard. Serum 2 microglobulin and urine and urinary creatinine levels were determined with Cobas C501.

The results showed significant differences in number of renal tubular epithelial cells in the diabetic nephropathy group with non diabetic nephropathy 2.4 cells L vs. 1.6 cells L . There was no correlation between the number of renal tubular epithelial cells with UACR and urine 2 microglobulin. The correlation between serum 2 microglobulin with UACR was weak and significant."

"Malondialdehida merupakan produk peroksidasi lipid yang diduga bertanggung jawab sebagai penyebab terjadinya nefropati diabetik. Penelitian ini menilai hubungan antara kadar malondialdehida serum dengan UACR dan laju filtrasi glomerulus sebagai parameter fungsi ginjal. Penelitian ini menggunakan 54 pasien diabetes melitus tipe 2 sebagai sampel (3 laki-laki dan 51 perempuan, rentang usia 42-74 tahun). Kadar malondialdehida serum diukur secara spektrofotometri menggunakan asam tiobarbiturat. Laju filtrasi glomerulus diperoleh dari nilai kreatinin serum. Kreatinin urin diukur dengan metode Jaffe dan albumin urin diukur dengan metode bromkresol hijau. Kadar malondialdehida pasien diabetes diperoleh sebesar 2,46 ± 2,58 nmol/mL; nilai UACR sebesar 42,32 ± 76,67; dan nilai laju filtrasi glomerulus sebesar 104,75 ± 46,16 (Cockroft-Gault); 89,52 ± 25,86 (MDRD study); dan 99,49 ± 46,11 (CKD-EPI). Hasil analisis hubungan antara malondialdehida dengan Cockroft-Gault (p = 0,491, r = -0,096); MDRD study (p = 0,618, r = -0,069); CKD-EPI (p = 0,611, r = -0,071); UACR (p = 0,583, r = 0,076). Ditemukan hubungan yang bermakna antara nilai UACR dengan laju filtrasi glomerulus Cockroft-Gault (p = 0,019, r = -0,318); MDRD study (p = 0,007, r = -0,361); CKD-EPI (p = 0,010, r = -0,348). Tidak ditemukan hubungan yang bermakna antara malondialdehida dengan laju filtrasi glomerulus dan UACR.

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Malondialdehyde is a product of lipid peroxidation that is suspected as a cause of diabetic nephropathy. This study assessed the relation between malondialdehyde level with UACR and glomerular filtration rate as renal function parameters. This study is using 54 patients type 2 diabetes mellitus as samples (3 men and 51 women, age range 42-74 years).

Malondialdehyde was measured by spectrophotometry using tiobarbiturat acid. Glomerular filtration rate was obtained from serum creatinine value. Urine creatinine was measured based on Jaffe method and urine albumin was measured with bromcressol green. Malondialdehyde level of diabetic patients was 2.46 ± 2.58 nmol/mL; UACR was 42.32 ± 76.67; and glomerular filtration rate were 104.75 ± 46.16 (Cockroft-Gault); 89.52 ± 25.86 (MDRD study); and 99.49 ± 46.11 (CKD-EPI).

The analysis result of the relationship between malondialdehyde and Cockroft-Gault (p = 0.491, r = -0.096); MDRD study (p = 0.618, r = -0.069); CKD-EPI (p = 0.611, r = -0.071); and UACR (p = 0.583, r = 0.076) . There were significant correlation between UACR and glomerular filtration rate Cockroft-Gault (p = 0.019, r = -0.318); MDRD study (p = 0.007, r = -0.361 ); CKD-EPI (p = 0.010, r = -0.348). There were no significant correlation between malondialdehyde level and glomerular filtration rate or UACR."

"Pasien Diabetes Mellitus, akan menimbulkan masalah gangguan  fisik yaitu nyeri akut/kronis, dan gangguan psikologis (kecemasan,) bila tidak ditanganii dengan baik.Tujuan dari penelitian ini menerapkan terapi penghentian pikiran, relaksasi otot progresif, dan psikoedukasi keluarga pada kelompok kontrol dan intervensi. Penelitian ini mengunakan desain penelitian operasional research dengan jumlah sampel 38 individu dibagi menjadi 18 induvidu kelompok kontrol dan 22 kelompok intervensi. Hasil analisis Mann-whitney menunjukkan bahwa terdapat perbedaan antara kelompok kontrol yang diberikan TKN, edukasi keluarga, pendampingan, dan latihan mandiri dengan kelompok intervensi yang diberikan TKN, edukasi keluarga, pendampingan, dan latihan mandiri, terapi penghentian pikiran, terapi otot progresif dan psikoedukasi keluarga  secara bermakna (p value < 0,05). Penerapan TKN, edukasi keluarga, pendampingan, dan latihan mandiri, terapi penghentian pikiran, terapi otot progresif dan psikoedukasi keluarga direkomendasikan karena dapat menurunkan nyeri dan ansietas pada klien diabetes melitus, meningkatkan kemampuan pasien dan kemampuan keluarga dalam merawat nyeri dan ansietas dengan diabetes melitus.

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Diabetes Mellitus patients will cause physical problems, namely acute/chronic pain, and psychological disorders (anxiety) if not treated properly. The aim of this research is to apply thought stopping therapy, progressive muscle relaxation, and family psychoeducation in the control and intervention groups. This research used an operational research design with a sample size of 38 individuals divided into 18 control groups and 22 intervention groups. The results of the Mann-Whitney analysis showed that there were differences between the control group which was given TKN, family education, assistance and independent training and the intervention group which was given TKN, family education, assistance and independent training, thought stopping therapy, progressive muscle therapy and family psychoeducation significantly (p value < 0.05). The application of TKN, family education, mentoring and independent training, thought stopping therapy, progressive muscle therapy and family psychoeducation are recommended because they can reduce pain and anxiety in clients with diabetes mellitus, increase the patient's ability and the family's ability to treat pain and anxiety with diabetes mellitus."

"Latar Belakang: Pegawai kantor dengan obesitas memiliki risiko tinggi mengalami diabetes melitus (DM) tipe 2. Pemeriksaan sensitivitas insulin jarang dilakukan karena kendala teknis dan biaya. Berbagai studi sebelumnya menunjukkan adanya hubungan negatif antara massa lemak tubuh dengan HOMA-IR, namun hasil penelitian di Indonesia menunjukkan hasil yang tidak konsisten. Indeks TyG disebut sebagai penanda resistensi insulin yang lebih akurat jika dibandingkan dengan HOMA-IR pada populasi Asia. Belum ada penelitian yang menilai hubungan massa lemak tubuh dengan Indeks TyG di Indonesia.Metode: Studi potong lintang dilakukan pada 89 pekerja kantor dengan obesitas (IMT ≥25 kg/m2) tanpa riwayat DM di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Agustus hingga Oktober tahun 2022. Dilakukan pengambilan data demografis (usia, jenis kelamin, riwayat DM, kebiasaan merokok), antropometri, analisis asupan menggunakan 24-hour food recall 3x24 jam, serta penilaian tingkat aktivitas fisik berdasarkan Global Physical Activity Questionnaire Score. Pengukuran persentase lemak tubuh total dan massa lemak viseral menggunakan multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Sensitivitas insulin dinilai menggunakan kadar HOMA-IR dan Indeks TyG serum. Analisis korelasi menggunakan uji Spearman dan dilakukan analisis multivariat untuk menilai faktor-faktor yang paling berhubungan dengan sensitivitas insulin.Hasil: Didapatkan sebanyak 89 subjek dengan proporsi perempuan:laki-laki sekitar 2:1, median usia 40 (21-59) tahun, dan mayoritas memiliki tingkat aktivitas sedang, tidak memiliki riwayat DM pada keluarga, tidak merokok, serta memiliki persentase kecukupan asupan melebihi kebutuhan energi individual dengan persentase makronutrien masih masuk dalam rentang normal. Korelasi persentase lemak tubuh total dengan HOMA-IR menunjukkan korelasi positif lemah yang bermakna (r=0,262, p=0,013). Korelasi massa lemak viseral dengan Indeks TyG menunjukkan korelasi positif lemah yang bermakna (r=0,234, p=0,027). Hasil korelasi persentase lemak tubuh total dengan indeks TyG dan korelasi massa lemak viseral dengan HOMA-IR menunjukkan hasil yang tidak signifikan secara statistik. Persentase lemak tubuh total tidak berhubungan signifikan dengan HOMA-IR setelah disesuaikan dengan variabel jenis kelamin, tingkat aktivitas fisik, indeks massa tubuh, lemak viseral, trigliserida, HDL, lingkar pinggang, dan persentase asupan karbohidrat. Massa lemak viseral tidak berhubungan signifikan dengan Indeks TyG setelah disesuaikan dengan variabel usia, jenis kelamin, lemak viseral, persentase asupan protein, dan HDL.Kesimpulan: Didapatkan korelasi positif lemah antara persentase lemak tubuh total dengan HOMA-IR dan korelasi positif lemah antara massa lemak viseral dengan Indeks TyG pada pegawai kantor obesitas di RSUPN Cipto Mangkunsumo.

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Background: Obese office workers have a high risk of developing type 2 diabetes mellitus (DM). Insulin sensitivity tests are rarely performed due to technical and cost constraints. Previous studies have shown a negative relationship between body fat mass and HOMA-IR. However, the results of research in Indonesia have shown inconsistent results. No study has assessed the relationship between body fat mass and the TyG index in Indonesia. In contrast, some research showed that The TyG index is a more accurate marker of insulin resistance in Asian populations.

Methods: A cross-sectional study was conducted on 89 office workers with obesity (BMI ≥25 kg/m2) without a history of DM at RSUPN Dr. Cipto Mangunkusumo, Jakarta, on August-October 2022. Demographic data were collected (age, gender, history of DM, smoking habits), anthropometry, analysis of energy intake and macronutrients using a 3- days 24-hour food recall, as well as an assessment of the level of physical activity based on the Global Physical Activity Questionnaire Score. The total body fat percentage and visceral fat mass were measured using a multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Insulin sensitivity was assessed using HOMA-IR levels and serum TyG Index. Correlation analysis used the Spearman test, and multivariate analysis was performed to assess the factors most related to insulin sensitivity.

Results: There were 89 subjects with a proportion of women: men around 2:1, the median age was 40 (21-59) years, and the majority had moderate activity levels, had no family history of DM, did not smoke, and had intakes exceeding individual energy needs with the percentage of macronutrients within normal range. The total body fat percentage correlation with HOMA-IR showed a significant positive correlation with weak strength (r=0.262, p=0.013). The correlation of visceral fat mass with the TyG index showed a significant positive correlation with weak strength (r=0.234, p=0.027). The results of the correlation of total body fat percentage with the TyG index and the correlation of visceral fat mass with HOMA-IR showed results that were not statistically significant. The total body fat percentage was not significantly related to HOMA-IR after adjusting for variables such as gender, level of physical activity, body mass index, visceral fat, triglycerides, HDL, waist circumference, and percentage of carbohydrate intake. Visceral fat mass did not have a significant relationship with the TyG index after adjusting for age, sex, visceral fat, percentage of protein intake, and HDL.

Conclusion: A weak positive correlation was found between the percentage of total body fat and HOMA-IR and a weak positive correlation between visceral fat mass and the TyG index in obese office workers at Cipto Mangkunsumo General Hospital."

"Penyakit Ginjal Diabetes (PGD) dapat menyebabkan albuminuria, yang berkembang menjadi insufisiensi ginjal. Namun, sekitar 20-40% kasus PGD merupakan PGD normoalbuminuria, yaitu gangguan fungsi ginjal dengan kadar albumin normal. Penelitian ini untuk membandingkan metabolit urin pada pasien penyakit ginjal diabetes dengan normoalbuminuria dan albuminuria yang mengonsumsi metformin-glimepirid. Desain penelitian potong lintang dengan metode consecutive sampling di Puskesmas Kecamatan Pasar Minggu dan RSUD Jati Padang. Sampel urin dan darah dikumpulkan untuk pengukuran HbA1c, UACR, dan analisis metabolit urin. Sebanyak masing-masing 16 pasien dibagi menjadi kelompok PGD normoalbuminuria dan PGD albuminuria, serta dianalisis metabolit urinnya menggunakan metabolomik tidak tertarget dengan Quadruple Time of Flight Liquid Chromatography-Mass Spectrometry. Metabolit yang berbeda signifikan divisualisasi dengan Projections to Latent Structures Discriminant Analysis (PLS-DA). Lalu, dianalisis nilai Variable Importance for the Projection (VIP) > 1.0; Fold Change (FC) >1,2 (p<0,05); dan Area Under the Receiver Operating Characteristic Curve (AUROC). Metabolit dengan nilai Area Under Curve (AUC) > 0,65 dinilai sebagai biomarker potensial. Tidak ada perbedaan bermakna pada karakteristik dasar dan klinis pada kedua kelompok, kecuali HbA1c (p<0,001). Terdapat 20 metabolit urin yang berbeda signifikan pada kelompok PGD normoalbuminuria dan albuminuria. Dari analisis jalur metabolisme pada metabolit tersebut ditemukan empat jalur metabolisme, yaitu metabolisme gliserofosfolipid, eter lipid, fenilalanin, dan triptofan. Dari keempat jalur metabolisme tersebut, ditemukan tiga metabolit biomarker potensial, yaitu glycerophosphocholine, hippuric acid, dan 2-aminobenzoic acid. Ketiga metabolit tersebut berkurang secara signifikan dari kondisi normoalbuminuria ke albuminuria. Oleh karena itu, diperlukan studi lanjut mengenai ketiga metabolit tersebut pada perkembangan PGD normoalbuminuria dan albuminuria.

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Diabetic Kidney Disease (DKD) leads to albuminuria and gradually progresses to renal insufficiency. However, about 20-40% of DKD are normoalbuminuric DKD, which has impaired kidney function with normal albumin levels. This study compared urine metabolites in patients consuming metformin-glimepiride with normoalbuminuric and albuminuria DKD. The research design was cross-sectional with consecutive sampling method at Pasar Minggu District Public Health Centre and Jati Padang Hospital. Urine and blood samples were collected for measurement of HbA1c, UACR, and metabolite analysis. There were each 16 samples divided into normoalbuminuric DKD group and albuminuria DKD group. All subjects were analysed using non-targeted metabolomics with Quadruple Time of Flight Liquid Chromatography-Mass Spectrometry. The signature metabolites were determined by Projections to Latent Structures Discriminant Analysis (PLS-DA) with Variable Importance for the Projection (VIP) > 1.0; Fold Change (FC) >1.2 (p<0.05); and Area Under the Receiver Operating Characteristic Curve (AUROC). Metabolites with an Area Under Curve (AUC) value > 0.65 are considered potential biomarkers. There were no significant differences in baseline and clinical characteristics of two groups, except for HbA1c (p<0.001). There were 20 metabolites identified between two groups. The metabolic pathway analysis of these metabolites found that four metabolic pathways were glycerophospholipid, ether lipid, phenylalanine, and tryptophan metabolism. There were three potential biomarkers, glycerophosphocholine, hippuric acid, and 2-aminobenzoic acid, enriched in these four metabolic pathways. Compared between normoalbuminuric and albuminuria groups these three metabolites were significantly reduced. Therefore, further studies are needed regarding these three metabolites in the development of normoalbuminuric and albuminuria DKD."