Kadar besi dan malondialdehid plasma pada preeklamsia

KADRI, Husnil, Prof.Dr.dr. Sri Rahajoe Asj'ari

2006 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Latar Belakang: Besi (Fe) merupakan logam transisi yang banyak terdapat dalam plasenta. Iskemia plasenta yang mengawali terjadinya preeklampsia menyebabkan terlepasnya besi dan produk-produk stres oksidatif ke dalam sirkulasi maternal. Akibatnya terjadi akumulasi spesies oksigen reaktif (ROS) yang dapat mencetuskan lipid peroksida yang salah satu produk akhirnya ialah malondialdehid (MDA). Tetapi seberapa besar peranan besi terhadap terjadinya lipid peroksida masih belum jelas. Tujuan: Mengkaji bagaimana hubungan antara kadar besi total plasma terhadap kadar MDA plasma pada subjek preeklampsia dan hamil normal. Metode: Penelitian ini adalah observasional analitik dengan desain studi potong lintang (cross sectional study). Subjek penelitian terdiri dari dua kelompok, yaitu 24 preeklampsia dan 24 hamil normal dengan usia kehamilan yang sama (matching). Sampel plasma dari semua subjek diperiksa kadar Fe total plasma dengan menggunakan AAS (Atomic Absorption Spectrofotometre) . Sedangkan kadar MDA plasma diperiksa dengan metode TBARS C18 spektrofotometer. Hasil: Kadar Fe total plasma pada preeklampsia lebih tinggi daripada hamil normal (161,69+81,01 vs 110,24+37,08 μg/dl., p<0,05). Sedangkan kadar MDA plasma preeklampsia juga lebih tinggi daripada hamil normal (2,50+0,20 vs 0,90+0,12 μmol/l., p<0,05). Tetapi tidak terdapat korelasi antara Fe total dengan MDA plasma preeklampsia (r = -0,182., p>0,05). Tetapi pada hamil normal didapatkan korelasi negatif rendah tidak bermakna (r = -0,300., p>0,05) . Walaupun tidak bermakna, terdapat kecenderungan korelasi negatif pada kedua kelompok. Hasil analisis variabel perancu (kadar hematokrit dan leukosit) didapatkan hanya kadar leukosit kelompok hamil normal yang berkorelasi positif terhadap MDA (r = 0,457., p < 0,05). Sedangkan pada preeklampsia ditemukan kadar leukosit berkorelasi rendah tidak bermakna terhadap MDA (r = 0,221., p>0,05). Kesimpulan: Iskemia plasenta menyebabkan kadar besi total dan MDA plasma subjek preeklampsia lebih tinggi daripada hamil normal. Tidak adanya korelasi antara kadar besi total dengan MDA plasma karena besi yang dapat mencetuskan lipid peroksida hanya besi bebas (Fe++), bukan besi total plasma.

Background: Iron (Fe) is transitional metals which is abundant in the plasenta. Placental ischemia could result in release of iron and products of oxidative stress in to maternal circulation which then initiate preeclampsia. An increased oxidative stress could lead to production of Reactive Oxygen Species (ROS). Accumulation of ROS can initiate a lipid peroxidation to final end product such as Malondialdehyde (MDA). The magnitude of iron role in induced lipid peroxidation is still unclear. Objective: This study tries to explain correlation between plasma total iron and MDA level in preeclamptic women and normal pregnancy. Method: This investigation was carried out an analytic observational with cross sectional study. Twenty-four preeclamptic patients were matched in gestational age with healthy pregnant women. Plasma samples from all of subjects were determined level of total iron with a Atomic Absorption Spectrofotometre (AAS). Plasma MDA were measured on a TBARS C18 spectrofotometre’s method. Result: Plasma total iron was significantly higher in the preeclamptic patients than in normal pregnancies (161,69+81,01 vs 110,24+37,08 μg/dl., p<0,05). Plasma MDA also was significantly higher in preeclamptic patients than in normal pregnancies (2,50+0,20 vs 0,90+0,12 μmol/l., p<0,05). No correlation was found between plasma iron and MDA in preeclamptic patient (r = -0,182., p>0,05). Furthermore, low negative correlation was detected in normal pregnacy (r = -0,300., p>0,05). Although there is no significant correlation in each group, the relationship tend to negative correlation. The result from confounding variables (hematocrit and leukocytes) analyses was found only leukocytes from normal pregnancy which has positive corelation with MDA (r = 0,457., p<0,05). No correlation between leukocytes and MDA in preeclamptic patients (r = 0,221., p>0,05). Conclusion: Placental ischemia could lead to plasma total iron and MDA in preeclamptic patients are higher than normal pregnancies. There is no correlation between total iron and MDA, because iron which has capability to initiate lipid peroxidation only free iron (Fe++), not plasma total iron.

Kata Kunci : Preeklamsia,Kadar besi dan Malondialdehid Plasma