ABSTRAK
Latar belakang : Penyakit jantung koroner (PJK) dan stroke merupakan penyebabkematian utama baik di negara Barat maupun di Indonesia terutama di daerahperkotaan. Setiap tahun lebih banyak orang meninggal karena penyakitkardiovaskular dibandingkan penyakit lain. Diabetes melitus merupakan faktorrisiko independen untuk penyakit kardiovaskular. Gangguan aliran darah yangmengakibatkan PJK maupun stroke disebabkan oleh trombosis arteri. Aktivasitrombosit diduga terjadi pada pasien diabetes melitus. Ketika trombosit teraktivasiakanterjadi beberapa perubahan diantaranya pelepasan kandungan granula danpembentukan tromboksan A2. Pengukuran tromboksan A2 sulit dilakukan karenasifatnya yang tidak stabil, maka dilakukan pengukuran terhadap metabolitnya 11-dehidro tromboksan B2. tujuan penelitian ini adalah menukur kadar 11 dehidroTxB2 di urin pada pasien diabetes melitus sebagai suatu petanda dini aktivasitrombosit dan mengkorelasikannya dengan hemoglobin A1c (HbA1c).Metoda : Empat puluh lima pasien diabetes melitus tipe 2 dan 30 non diabetessebagai kontrol diambil pada penelitian ini. Pengukuran kadar 11 dehidro TxB2 diurin dengan tehnik competitive EIA menggunakan reagen dari Cayman Chemical.Kadar 11-dehidro tromboksan B2 urin disajikan dalam bentuk rasio dengankreatinin urin. Pengukuran HbA1c dilakukan dengan metode akfinitas boronikmenggunakan NycocardR.Hasil : Pada kelompok diabetes melitus median kadar 11 dehidro TxB2 di urin1216,56 pg/mg kreatinin (70,53 – 12167,72 pg/mg kreatinin). Terdapat perbedaanbermakna dibanding kelompok non diabetes dengan median 200,55pg/mg kreatinin(57,19-602,46 pg/mg kreatinin). Terdapat korelasi yang kuat antara kadar 11dehidro TxB2 pada kelompok diabetik dengan indeks glikemik (HbA1c).Kesimpulan : 11 dehidro TxB2 di urin dapat dipakai sebagai petanda dini aktivasitrombosit pada pasien diabetes melitus dan mempunyai korelasi yang kuat denganHbA1c.
ABSTRACT
Background: It is widely known that heart disease and stroke are the main cause ofdeath in Western countries. This issue found in Indosesia especially in the urbam ares.Diabetes mellitus is one of the independentbrisk faktor for cardiovaskular. Cirulatorydisorder that result in coronary heart disease and stroke is arterial thrombosis. Plateletplay an important role in the pathogenesis of arterial thrombosis. Some report statedthat platelet activation occurred in diabetes mellitus. When platelet are activated, somechange happened, i.e : released of granule content and thromboxane A2 (TxA2)formation. Measurement of TxA2 as a marker for platelet activation was hampered bythe instability of this substance. Therefore it is preferred to measure their stablemetabolite 11-dehydro thromboxane B2 in urine. The aim of this study is to measureurine 11-dehydro thromboxane B2 in diabetes mellitus as an early of platelet activationand to correlate this value with hemoglobin A1c.Methode: Forty five patients with type 2 diabetes mellitus and 30 non diabetic ascontrol group were enrolled in this study. Measurement of urine 11 dehidro TxB2 wasdone by competitive EIA using reagent from Cayman Chemical. The level of urine 11-dehydro TxB2 was expressed as ratio with urine creatinine. Measurement of HbA1cwas performed by boronic affinity method using NycocardR.Result : In diabetics group the median rate for urine 11 dehydro TxB2 was 1216,56pg/mg creatinine ( 70,53 - 12167,72 pg/mg creatinine). It was significantly higher thanthat of non diabetic group, which median was 200,55 pg/mg creatinine ( 57,19 -602,46 pg/ mg creatinine). the level of urine 11-dehydro TxB2 in diabetics groupshowed a strong correlation with HbA1c as glycemic index.Conclusion: Urine 11-dehydro TxB2 can be used as an early marker of plateletactivation in diabetes mellitus patients and there was a strong correlation with HbA1c. |
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