Hypercoagulable State dan Diabetes Melitus Tipe 2: Korelasi antara Fibrinogen dan HbA1c

Abstract

Hiperkoagulabilitas merupakan penyebab kelainan vaskular pada diabetes melitus tipe 2 (DM tipe 2). Fibrinogen merupakan petanda hiperkoagulabilitas akibat inflamasi sistemik. Kadar HbA1c dipakai untuk menilai kadar gula darah jangka panjang dan berhubungan dengan petanda inflamasi. Terdapat perbedaan hasil penelitian terdahulu tentang bagaimana hubungan antara kadar fibrinogen dan HbA1c. Ada yang menyatakan hubungan bermakna dan ada pula yang tidak. Tujuan penelitian ini untuk melihat adakah korelasi antara fibrinogen dan HbA1c. Penelitian ini merupakan penelitian potong lintang pada penderita rawat jalan DM tipe 2 di RS Dr. Hasan Sadikin Bandung selama Januari−Juli 2010. Kriteria inklusi penderita DM tipe 2 yang baru didiagnosis, normotensi, kadar hemoglobin normal, serta tes fungsi hati dan ginjal normal. Dilakukan pemeriksaan kadar fibrinogen, trigliserida, dan HbA1c. Kriteria eksklusi yaitu mendapat obat antiagregasi trombosit, obat antidiabetik oral, atau menderita penyakit autoimun. Analisis statistik berupa Spearman dan regresi digunakan pada penelitian ini. Terdapat 63 subjek yang diikutkan dalam penelitian. Semua subjek memiliki kadar HbA1c lebih dari 6,5% (rata-rata 8,21±2,5%). Terdapat 33 penderita (53%) dengan kadar fibrinogen di atas harga normal (rata-rata 416,75±102,7 mg/dL). Tidak terdapat korelasi yang bermakna antara kadar fibrinogen dan HbA1c. Simpulan, tidak terdapat korelasi antara kadar fibrinogen dan HbA1c. Meskipun demikian subjek dengan diabetes melitus cenderung mempunyai kadar fibrinogen yang tinggi. [MKB. 2014;46(1):48–51]

Kata kunci: Diabetes melitus tipe 2, fibrinogen, HbA1c, hypercoagulable state

Hypercoagulable State and Type 2 Diabetes Mellitus: the Correlation between Fibrinogen and HbA1c

Hypercoagulability has been suggested as a result of type 2 diabetic mellitus vascular disease. Fibrinogen is a marker of hypercoagulability due to systemic inflammation. HbA1c level is used to measure long-term blood glucose level. There was inconsistent findings about the correlation between fibrinogen level and HbA1c. Previous study found a significant correlation between fibrinogen levels and HbA1c, while other study showed different results for this finding. The aim of this study was to determine the correlation between fibrinogen and HbA1c. A cross-sectional study was performed in outpatients type 2 diabetes mellitus (DM) in Dr. Hasan Sadikin General Hospital Bandung during January−July 2010. Patients with newly diagnosed type 2 DM, normotension, normal hemoglobin level, normal liver function test and normal kidney function test were included in this study. Fibrinogen, trigliseride, and HbA1c levels were examined. The exclusion criteria were patients taking antiplatelet drugs or oral antidiabetic and had autoimmune diseases. Spearman and regression analysis were used in this study. Sixty three subjects were included in this study. All subjects had HbA1c level more than 6.5% (mean 8.21±2.5%). Thirty three patients (53%) had fibrinogen level of more than the normal limit (mean 416.75±102.7 mg/dL). The mean of trigliseride level was 235.32±131.3 mg/dL. No significant correlation between fibrinogen and HbA1c. In conclusion, there is no correlation between the fibrinogen levels and HbA1c. However, subjects with diabetes mellitus tend to have high fibrinogen levels. [MKB. 2014;46(1):48–51]

Key words: Fibrinogen, HbA1c, hypercoagulable state, type 2 diabetes mellitus

DOI:  10.15395/mkb.v46n1.227