Perbedaan Kadar Osteoprotegerin Serum Penderita Diabetes Melitus Tipe 2 tanpa dan dengan Penyakit Jantung Koroner

Ratri Dwitiya Nestiti, - Noormartany, Nina Susana Dewi, Sylvia Rachmayati

Abstract


Diabetes melitus (DM) tipe 2 merupakan diabetes yang disebabkan oleh resistensi insulin dan atau gangguan sekresi insulin sehingga menyebabkan hiperglikemia yang merupakan penyebab disfungsi endotel. Disfungsi endotel merupakan proses awal aterosklerosis dan merupakan salah satu faktor risiko yang menyebabkan penyakit jantung koroner (PJK). Sampai saat ini angiografi koroner digunakan sebagai baku emas PJK. Pemeriksaan osteoprotegerin (OPG) merupakan pemeriksaan alternatif sebagai penanda disfungsi endotel, kurang invasif, lebih dini, dan murah. Osteoprotegerin berhubungan dengan perkembangan plak arteri pada penderita DM tipe 2. Tujuan penelitian ini mengetahui perbedaan kadar OPG dalam serum penderita DM tipe 2 tanpa dan dengan PJK. Penelitian dilakukan pada September–Desember 2012 di Poliklinik Endokrin dan Instalasi Gawat Darurat RSUP Dr. Hasan Sadikin Bandung. Subjek penelitian sebanyak 102 orang, 51 orang penderita telah didiagnosis oleh klinisi sebagai penderita DM tipe 2 dengan PJK dan 51 orang penderita DM tipe 2 tanpa PJK, berusia 35–75 tahun. Pemeriksaan OPG menggunakan metode enzyme linked immunosorbent assay (ELISA). Bentuk penelitian adalah observasional komparatif dengan rancangan penelitian studi perbandingan potong lintang. Analisis statistik menggunakan uji Shapiro Wilk’s, independent T, dan Mann Whitney. Nilai median kadar OPG serum untuk penderita DM tipe 2 dengan PJK lebih tinggi, yaitu sebesar 6,1 pmol/L dan penderita DM tipe 2 tanpa PJK, yaitu sebesar 2,6 pmol/L (p=0.0001). Simpulan, terdapat perbedaan kadar OPG serum antara kelompok DM tipe 2 tanpa dan dengan PJK. [MKB. 2015;47(4):218–23]

Kata kunci: Disfungsi endotel, DM tipe 2, osteoprotegerin

Differences of Osteoprotegerin Levels in Patients with Type 2 Diabetes Mellitus with and without Coronary Arterial Disease

Abstract

Type 2 diabetes mellitus (DM) is caused by insulin resistance and/or impaired insulin secretion, thus causing hyperglycemia leading to endothelial dysfunction. Endothelial dysfunction is an early process of atherosclerosis and is one of the risk factors for coronary arterial disease (CAD). Currently, coronary angiography is used as the gold standard for diagnosing CAD. Examination of osteoprotegerin (OPG) is an alternative assay for endothelial dysfunction marker which is less invasive, has the ability to detect earlier, and less expensive. Osteoprotegerin is associated with the development of arterial plaque in patients with type 2 DM. The aim of this study was to determine the differences in serum OPG levels in patients with type 2 DM with and without CAD. The study was conducted in September–December 2012 in the Endocrine Clinic and Emergency Unit of Dr. Hasan Sadikin General Hospital Bandung on 102 patients aged between 35–75 years, with 51 subjects type 2 DM patients with CAD and 51 subjects with type 2 DM without CAD, both diagnosed by clinician. The method used was, OPG enzyme linked immunosorbent assay (ELISA) examination method. The study was an observational cross-sectional comparative study. Statistical analysis was performed using normality test with Shapiro Wilk’s, independent T and Mann Whitney test. The median value for patients with type 2 DM with CAD equaled to 6.1 pmol/L and the value for type 2 diabetic patients without CAD was 2.6 pmol/L. In this study, the OPG levels obtained in patients type 2 DM with CAD were higher than those without CAD. In conclusion, there is a significant difference in OPG levels between type 2 DM with and without CAD groups. [MKB. 2015;47(4):218–23]

Key words: Endothelial dysfunction, type 2 diabetes, osteoprotegerin

 

DOI: 10.15395/mkb.v47n4.616


Keywords


Disfungsi endotel, DM tipe 2, osteoprotegerin

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