PENGARUH PEMBERIAN METFORMIN DAN VALSARTAN TERHADAP KADAR ADIPONEKTIN PADA PENDERITA SINDROMA METABOLIK DENGAN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD)
Wawan Triharjanto, Prof. dr. Siti Nurdjanah, M.Kes, SpPD, KGEH(K)
2014 | Tesis | S2 Ilmu Penyakit DalamLATAR BELAKANG: Non-alcoholic fatty liver diseases (NAFLD) merupakan manifestasi hepatik sindroma metabolik. Resistensi insulin menyebabkan terjadinya NAFLD melalui akumulasi lemak dihati yang berasal dari pelepasan asam lemak bebas. Sampai saat ini modalitas pengobatan masih sangat terbatas. Beberapa penelitian melaporkan bahwa metformin dan valsartan memberikan perbaikan terhadap resistensi insulin dan histologi hati. Hal ini dihubungkan dengan kenaikan serum adiponektin. Adiponektin memegang peranan penting pada sensitivitas insulin, inflamasi, metbolisme lipid dan atherogenesis. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian metformin dan valsartan terhadap kadar adiponektin pada pasien sindroma metabolik dengan NAFLD. METODE : merupakan penelitian eksperimental dengan before and after design. Penelitian dilakukan di poliklinik penyakit dalam sub bagian endokrinologi RSUP Dr. Sardjito Yogyakarta. Subyek penelitian adalah pasien yang memenuhi diagnosis sindroma metabolik berdasar IDF 2005, hipertensi dan NAFLD. Subyek diberikan terapi metformin dan valsartan selama 12 minggu. Dilakukan pengukuran kadar adiponektin sebelum dan sesudah terapi. Rerata kenaikan kadar adiponektin diuji dengan paired-t test jika data terdistribusi normal atau uji Wilcoxon jika data tidak terdistribusi normal. Kemaknaan p<0,05 dianggap bermakna. HASIL : jumlah sampel penelitian 15 subyek dan bisa menyelesaikan penelitian. Hasil penelitian didapatkan peningkatan kadar adiponektin yang bermakna setelah pemberian metformin dan valsartan selama 12 minggu, p=0,001. KESIMPULAN: terdapat kenaikan kadar adiponektin yang bermakna setelah terapi metformin dan valsartan selama 12 minggu.
BACKGROUND: Non-alcoholic fatty liver diseases (NAFLD) is the hepatic manifestation of metabolic syndrome. The insulin resistance causes NAFLD through fat accumulation in liver which is derived from the release of free fatty acid. Nowadays, the treatment modality is still very limited. Some previous studies have reported that Metformin and Valsartan give an improvement towards the insulin resistance and liver histology. These outcomes are related to the increased serum adiponectin levels. Adiponectin has important roles in the insulin sensitivity, inflammation, lipid metabolism, and atherogenesis. The aim of this research is to understand the effect of Metformin and Valsartan on adiponectin levels in metabolic syndrome patients with NAFLD. METHODS : this is an experimental study using before and after design. The research was done at Endocrinology Division polyclinic of Department of Internal Medicine in Central General Hospital Dr. Sardjito Yogyakarta. The subjects of this research were the patients who met the metabolic syndrome criterias according to IDF 2005, hypertension, and NAFLD. Subjects were treated with Metformin and Valsartan for 12 weeks. The adiponectin levels was analyzed before and after treatment. The average of the increased adiponectin levels was analyzed by using paired t-test if the data was normally distributed and Wilcoxon if the data was not normally distributed. The significance of p<0,05 was assumed as statistically significant. RESULT : there were 15 subjects in this research and all were able to finnish the research process. In this study there is statistically significant increased adiponectin levels after 12 weeks treatment Metformin and Valsartan (p=0,001). CONCLUSION: the result of this study suggests that there is statistically significant increased adiponectin levels after 12 weeks treatment with Metformin and Valsartan.
Kata Kunci : sindroma metabolik, NAFLD,metformin, valsartan, adiponektin
