PERBANDINGAN KADAR NERVE GROWTH FACTOR SERUM ANTARA PAINFUL DIABETIC NEUROPATHY DAN NON PAINFUL DIABETIC NEUROPATHY

DWI ANANDA P., Dr. dr. Ahmad Asmedi, M.Kes, Sp.S(K).; dr. Abdul Gofir, M.Sc,SpS(K).

2016 | Tesis-Spesialis | SP ILMU PENYAKIT SYARAF

Kontroversi tentang peran nerve growth factor (NGF) terhadap patogenesis nyeri membatasi pengembangan terapi neuropati diabetika berbasis NGF. Beberapa penelitian menyebutkan bahwa NGF menimbulkan efek antinosiseptik, sementara yang lainnya menyebutkan NGF menimbulkan efek pronosiseptik. Diperlukan suatu penelitian yang dapat membantu memahami peran NGF terhadap patogenesis nyeri neuropati diabetika (painful diabetic neuropathy). Penelitian ini bertujuan untuk membandingan kadar NGF serum antara painful dan non painful diabetic neuropathy. Penelitian ini menggunakan rancangan cross sectional, dengan subjek penelitian pasien DM tipe 2 yang telah tegak diagnosis neuropati diabetika berdasarkan klinis dan pemeriksaan elektroneuromiografi (ENMG) yang kontrol ke Poliklinik Saraf RSUP Dr. Sardjito. Painful diabetic neuropathy ditentukan berdasarkan skor ID pain. Kadar NGF serum diperiksa dengan kit reagen NGF manusia ELISA produk Abnova. Analisis statistik dengan uji t digunakan untuk menilai signifikansi dari perbandingan yang muncul. Nilai p <0,05 dianggap sebagai signifikan. Tiga puluh enam pasien neuropati diabetika berperan dalam penelitian ini, terdiri dari 21 kasus painful diabetic neuropathy dan 15 kasus non painful diabetic neuropathy. Hasil uji statistik menunjukkan tidak terdapat perbedaan rerata kadar NGF serum antara painful dan non painful diabetic neuropathy. Meskipun demikian, terdapat korelasi negatif antara kadar NGF serum dengan skor ID pain yang berarti semakin rendah kadar NGF serum maka semakin tinggi skor ID pain (p <0,05 dan r = -0,414). Tidak terdapat perbedaan kadar NGF serum yang signifikan antara painful dan nonpainful diabetic neuropathy.

Controversy about the role of nerve growth factor (NGF) in the pathogenesis of pain restricts the development of NGF based therapeutics in diabetic neuropathy. Some studies suggest that NGF has antinociceptive effects, while others discover that NGF has pronociceptive effects. Further research is needed to help understanding the role of NGF in the pathogenesis of painful diabetic neuropathy. This study aimed to compare serum NGF levels between painful and non painful diabetic neuropathy. This study used a cross sectional design, with research subjects type 2 diabetes mellitus patients who had been diagnosed diabetic neuropathy based on clinical examination and electroneuromyography (ENMG) who underwent outpatient in Neurology departement of Dr. Sardjito General Hospital. Painful diabetic neuropathy was determined based on the ID pain score. Serum NGF levels were examined by human NGF ELISA, Abnova reagent kit. Statistical analysis by t-test was used to assess the significance of comparison that appears. A p value of <0.05 was considered as significant. Thirty-six patients with diabetic neuropathy were included in this study, consisted of 21 cases of painful diabetic neuropathy and 15 cases of non painful diabetic neuropathy. Statistical analysis showed no difference in the mean of serum NGF levels between painful and non painful diabetic neuropathy. However, there is a negative correlation between serum NGF levels with ID pain score, which means the lower serum NGF levels, the higher ID pain score (p <0.05 and r = -0.414). There was no significant difference in serum NGF levels between painful and non painful diabetic neuropathy.

Kata Kunci : diabetic neuropathy, pain, nerve growth factor