KADAR HIGH SENSITIVITY C-REACTIVE PROTEIN (hs-CRP) SEBAGAI PREDIKTOR KEJADIAN PREDIABETES & DIABETES MELITUS TIPE 2

Rastro Aryandono, dr. Windarwati, M.Sc, Sp.PK(K).; Dr. dr. Tri Ratnaningsih, M.Kes, Sp.PK(K)

2016 | Tesis-Spesialis | SP ILMU PATOLOGI KLINIK

Latar belakang. Diabetes dapat disebabkan proses inflamasi kronik derajat rendah. Peran hs-CRP sebagai prediktor kejadian diabetes masih terbatas dan hasilnya belum konsisten. Tujuan. Mengetahui apakah kadar hs-CRP >=3 mg/L merupakan prediktor kejadian prediabetes & DM tipe 2. Cara penelitian. Penelitian observasional analitik kasus kontrol pendekatan potong lintang. Kasus diambil dari subyek prediabetes & DM tipe 2 yang baru pertama kali didiagnosis di 3 kecamatan di Yogyakarta. Masing-masing kasus akan dicarikan kontrolnya yang sesuai umur, jenis kelamin dan indeks massa tubuh. Analisis univariat terhadap faktor risiko prediabetes & DM tipe 2 dilakukan dengan menghitung Odds Ratio (OR) dengan 95% CI, p <0,05. Analisis multivariat dilakukan dengan uji regresi logistik. Hasil. Penelitian ini menganalisis 32 pasang kasus prediabetes & kontrol, serta 25 pasang kasus DM tipe 2 & kontrol. Rerata umur, indeks massa tubuh, dan proporsi faktor risiko lain tidak berbeda bermakna antara kelompok kasus dan kontrol. Median kadar hs-CRP pada kelompok DM tipe 2 lebih tinggi bermakna dibandingkan kontrol, tetapi distribusi hs-CRP pada batasan >=3 mg/L pada kelompok diabetes & kontrol tidak berbeda bermakna. Berdasarkan analisa kurva ROC, batasan kadar hs-CRP yang sesuai adalah >=2,25 mg/L. Pada uji multivariat, variabel hs-CRP >=2,25 mg/L bermakna & independen secara statistik sehingga dapat digunakan sebagai prediktor kejadian prediabetes maupun DM tipe 2. Simpulan. Kadar hs-CRP >=3 mg/L tidak bermakna secara statistik pada kejadian prediabetes & DM tipe 2. Mempertimbangkan nilai normal hs-CRP yang bervariasi antar etnis, hs-CRP >=2,25 mg/L merupakan prediktor kejadian prediabetes & DM tipe 2.

Background. Diabetes can be due to low-grade chronic inflammation. The role of hs-CRP as a predictor for incident diabetes is still limited and the results have not been consistent. Aim. Knowing whether hsCRP levels >=3 mg/L is a predictor for incident prediabetes and DM. Methods. Analytic observational case control study with cross-sectional approach, the case was taken from the subjects with newly diagnosed of diabetes in districts in Yogyakarta. Each case will be age-, sex- and body mass index-matched with control. The univariate & multivariate analysis were performed by calculating the odds ratio with 95% CI, p <0.05 and followed by logistic regression. Results. This study analyzed 32 pairs of prediabetes cases and control, as well as 25 pairs of DM cases and controls. The mean of age, body mass index, and the proportion of other risk factors were not significantly different between cases and controls. Median hs-CRP levels in type 2 DM group was significantly higher than controls, but the distribution of hs-CRP on the cut-off >=3 mg/L between DM group and control was not significantly different. Based on the ROC curve analysis, the appropriate hs-CRP cut-off is >=2,25 mg/L. On multivariate analysis, hs-CRP >=2,25 mg/L were statistically significant and independent, so that it can be used as a predictor of the incidence of prediabetes and type 2 DM. Conclusions. High sensitivity CRP >=3 mg/L was not statistically significant in the incident of diabetes. Considering normal values of hs-CRP that vary between ethnic groups, hs-CRP >=2,25 mg/L is a predictor for incident prediabetes and type 2 DM

Kata Kunci : high sensitivity c-reactive protein, prediabetes, DM tipe 2,high sensitivity c-reactive protein, prediabetes, type 2 DM,