Hubungan antara kadar fraksi lipid dengan Malondialdehide pada penderita diabetes mellitus tipe 2
MISLIHAR, Nurfaita, Prof.dr. Paulus Wiyono, PhD.,SpPD-KEMD
2005 | Tesis | PPDS I Ilmu Penyakit DalamLatar belakang. Kelainan metabolik yang menyertai diabetes berupa hiperglikemia kronik dan dislipidemia akan meningkatkan stres oksidatif. Malondialdehide (MDA). merupakan salah satu hasil peroksidasi lipid yang sering digunakan untuk mengukur stres oksidatif. Terjadinya komplikasi kronik pada DM tidaklah terlepas dari adanya stres oksidatif. Banyak dilaporkan bahwa kadar MDA meningkat pada penderita diabetes mellitus (DM). Salah satu penelitian melaporkan kadar MDA serum pada penderita diabetes mellitus tipe 2 dengan dan tanpa hiperlipidemia lebih tinggi dibanding grup kontrol, sedangkan kadar MDA penderita DM hiperlipidemia lebih tinggi dibanding DM normolipidemia. Penelitian ini tidak mendapatkan korelasi positif antara kadar MDA serum dengan trigliserid (TG), tetapi mendapatkan korelasi positif dengan kolesterol total dan very low density lipoprotein (VLDL). Penelitian yang lain mendapatkan korelasi positif antara kadar MDA plasma dengan TG, tetapi tidak pada kolesteral total. Adanya kontroversi hasil penelitian ini mendorong untuk diteliti hubungan fraksi lipid yang terdiri dari kadar kolesterol total, low density lipoprotein (LDL), TG dan high density lipoprotein (HDL) terhadap kadar MDA pada penderita DM tipe 2. Tujuan. Mengetahui bahwa peningkatan salah satu dari fraksi lipid (kolesterol total, LDL, TG) atau penurunan HDL akan menaikkan kadar MDA pada penderita DM tipe 2. Subyek dan metode. Penelitian dilakukan secara potong lintang pada penderita DM tipe 2 yang kontrol di Poliklinik RS DR Sardjito, RSU Kota Yogyakarta dan RS Dr. Soeradji Tirtonegoro, Klaten pada bulan Maret sampai bulan September 2004. Hasil. Didapatkan 69 subyek, terdiri dari 28 orang (40,6%) laki-laki dan 41 orang (59,4%) perempuan, dimana dislipidemia 66 subyek dan normolipidemia hanya 3 subyek. Rerata umur subyek 58,57 ± 9,96 tahun, lamanya menderita DM 64,65 ± 54,91 bulan, kadar gula darah puasa 167,07 ± 84,15 mg/dl, kadar HbA1c 8,36 ± 2,59%, kadar kolesterol total 205,40 ± 33,78 mg/dl, LDL 124,62 ± 26,70 mg/dl, TG 121,30 ± 50,89 mg/dl, HDL 56,38 ± 28,38 mg/dl, dan MDA plasma 3,86 ± 0,45 nmol/ml. Tidak ada korelasi antara kadar MDA dengan kadar kolesterol total (r=0,031; p=0,8894), LDL (r=0,043; p=0727), HDL (r=-0,062; p=0,615) dan TG (r=- 0,197; p=0,104) Selain itu juga tidak ada korelasi antara kadar MDA plasma dengan HbAIC (r=0,198; p=0,104) dan glukosa puasa (r=0,047; p=0,572). Kesimpulan. Tidak terdapat korelasi antara fraksi lipid (kolesterol total, LDL, HDL, TG) dengan kadar malondialdehide pada penderita DM tipe 2.
Background. Metabolic disorders accompanying diabetes in the forms of chronic hyperglycaemia and dyslipidemia will increase oxidative stress. .Malondialdehyde (MDA) is one of the lipid peroxidation products frequently used to determine oxidative stress in diabetic patients. Increasing oxidative stress contributes to the development of complication in diabetes mellitus (DM). Many studies reported the increasing oxidative stress in diabetic patients. One study found serum MDA level were significantly higher in type 2 DM with and without hyperlipidemia than those of the normal subjects, whereas serum MDA level was significantly higher in hyperlipidemic diabetic than that of normolipidemic diabetic. This study did not found the positive correlation between plasma MDA level and triglyceride (TG), but found positive correlation between plasma MDA level and total cholesterol, very low density lipoprotein (VLDL). However, another study found positive correlation between plasma MDA level and TG, but not at total cholesterol. This controversy urged us to study the relationship between lipid fractions consisting of the total cholesterol level, low density lipoprotein (LDL), TG and high density lipoprotein (HDL) with plasma MDA level in type 2 DM. Objective. To know whether the increase in one of lipid fractions (total cholesterol, LDL, TG) or the decrease in HDL will increase the plasma MDA level in type 2 DM. Method. Cross-sectional study in patients with type 2 DM recruited from 3 hospitals: (RS Dr. Sardjito, RSU Kota Yogyakarta, RS dr. Soeradji Tirtonegoro, Klaten) between March to September 2004. Result. Sixty nine (69) patients consisting of 28 (40.6%) males and 41 (59.4%) females were included in this study. Dyslipidemia and normolipidemic diabetic patients were 66 and 3 patients, respectively. Mean of age was 58.57 ± 9.96 years, duration of DM was 64.65 ± 54.91 months, fasting glucose was 167,07 ± 84,15 mg/dl, HbA1C was level 8.36 ± 2.59 %, total cholesterol was 205.40 ± 33.78 mg/dl, LDL was 124.62 ± 26.70 mg/dl, TG was 121.30 ± 50.89 mg/dl, HDL was 56.38 ± 28.38 mg/dl, plasma MDA level was 3.86 ± 0.45 nmol/ml.There were no correlation between plasma MDA level and total cholesterol ( r=0.031; p=0.8894), LDL (r=0.043; p=0.727), HDL (r=-0.062; p=0.615) and TG (r=-0.197; p=0.104). There were also no correlation between plasma MDA level with HbA1c (r=0.198; p=0.104) and fasting glucose (r=0.047; p=0.572). Conclusion. There were no correlation between plasma MDA level and the lipid fraction (total cholesterol, LDL, HDL, TG) in type 2 DM.
Kata Kunci : hiperglikemia, fraksi lipid, malondialdehide, DM tipe 2, hyperglycemia, lipid fraction, malondialdehyde, type 2 DM
