Hubungan Nilai Neutrophil-to-Lymphocyte Ratio (NLR) dengan Kejadian Tuberkulosis Paru pada Pasien Diabetes Melitus tipe 2 dengan Komplikasi Ulkus Kaki Diabetes di Rumah Sakit dr. Sardjito, Yogyakarta
Hervina Widyaningtyas, dr. Hemi Sinorita, Sp.PD-KEMD, FINASIM; dr. Heni Retno Wulan, M.Kes, Sp.PD-KP
2026 | Skripsi | PENDIDIKAN DOKTER
Latar Belakang: Neutrophil-to-Lymphocyte Ratio (NLR) merupakan penanda inflamasi
sistemik yang mencerminkan keseimbangan antara imunitas bawaan (neutrofil) dan
adaptif (limfosit). Peningkatan NLR berhubungan dengan kondisi inflamasi
kronis, termasuk diabetes mellitus tipe 2 (DM tipe 2) dan komplikasinya. Pasien
DM tipe 2 dengan ulkus kaki diabetes (Diabetic Foot Ulcer/DFU) memiliki risiko
lebih tinggi mengalami infeksi, termasuk tuberkulosis (TB), akibat disregulasi
imun akibat hiperglikemia kronis dan disfungsi sel imun
Objectives:
Mengetahui
hubungan antara NLR terhadap luaran TB pada pasien DM tipe 2 dengan komplikasi
DFU.
Metode: Penelitian ini menggunakan desain
kohort retrospektif dengan data sekunder dari registry diabetes Divisi
Endokrinologi Departemen Penyakit Dalam RSUP dr. Sardjito periode Januari
2018–Desember 2023. Analisis univariat dilakukan untuk mendeskripsikan
karakteristik subjek. Uji Chi-Square digunakan pada analisis bivariat,
sedangkan regresi logistik multivariat digunakan untuk mengontrol variabel
perancu seperti usia, jenis kelamin, dan komorbiditas (CKD, hipertensi, CAD,
dsb). Nilai p<0>
Hasil : Sebanyak 510 pasien DM tipe 2 dengan ulkus kaki
diabetes dianalisis, terdiri dari 74 (14,5%) pasien dengan TB dan 436 (85,5%)
tanpa TB. Hasil analisis bivariat menunjukkan variabel yang berhubungan
signifikan dengan TB adalah usia ?60 tahun (p=0,008), Chronic Kidney Disease
(p=0,010), dan NLR tinggi ?14,53 (p<0>0,05). Pada analisis multivariat, NLR tinggi (?14,53) secara independen
berhubungan dengan peningkatan risiko TB (OR=17,931; 95% CI: 7,917–43,405;
p<0 OR=7,641; p=0,010), OR=0,560; p=0,048).>
Background: The Neutrophil-to-Lymphocyte Ratio (NLR) is a systemic inflammatory marker that reflects the balance between innate (neutrophils) and adaptive (lymphocytes) immune responses. Elevated NLR is associated with chronic inflammatory conditions, including type 2 diabetes mellitus (T2DM) and its complications. Patients with T2DM and diabetic foot ulcers (DFU) are at a higher risk of developing infections, including tuberculosis (TB), due to immune dysregulation resulting from chronic hyperglycemia and impaired immune cell function (Buonacera et al., 2022a; Istiqomah, Suhariyadi & Woelansari, 2024).
Objectives: To determine the association between NLR and tuberculosis outcomes among patients with type 2 diabetes mellitus complicated by diabetic foot ulcers.
Methods: This retrospective cohort study utilized secondary data from the diabetes registry of the Endocrinology Division, Department of Internal Medicine, Dr. Sardjito General Hospital, Yogyakarta, from January 2018 to December 2023. Univariate analysis was performed to describe patient characteristics. Bivariate analysis was conducted using the Chi-Square test, while multivariate logistic regression was applied to control confounding factors such as age, sex, and comorbidities (CKD, hypertension, CAD, etc.). A p-value <0>
Results: A total of 510 patients with type 2 diabetes mellitus and diabetic foot ulcers were analyzed, consisting of 74 patients with TB (14.5%) and 436 without TB (85.5%). Bivariate analysis showed that age ?60 years (p=0.008), chronic kidney disease (p=0.010), and a high NLR ?14.53 (p<0>0.05). In multivariate analysis, a high NLR (?14.53) remained independently associated with an increased risk of TB (OR=17.931; 95% CI: 7.917–43.405; p<0 OR=7.641; p=0.010), OR=0.560; p=0.048).>
Kata Kunci : Neutrophil-to-Lymphocyte Ratio (NLR), Type 2 Diabetes Mellitus (T2DM), Diabetic Foot Ulcer (DFU), Pulmonary Tuberculosis
