PENGARUH PEMBERIAN VALSARTAN DAN METFORMIN TERHADAP PROFIL LIPID PADA PASIEN SINDROMA METABOLIK
ANDREAS, dr. Hemi Sinorita, SpPD-KEMD; dr. M. Robhikul Ikhsan, MKes, SpPD-KEMD
2015 | Tesis | SP Ilmu Penyakit DalamLATAR BELAKANG: Sindroma metabolik merupakan masalah kesehatan global di dunia. Sindroma metabolik terdiri dari obesitas sentral, dislipidemia, hipertensi dan gangguan toleransi glukosa yang meningkatkan risiko komplikasi kardiovaskular dan diabetes melitus (DM). Resistensi insulin dan obesitas sentral menjadi dasar patogenesis sindroma metabolik. Target utama dalam pengelolaan sindroma metabolik meliputi lingkar pinggang, profil lipid, tekanan darah dan kadar gula darah puasa (GDP). Penanganan sindroma metabolik meliputi modifikasi gaya hidup dan terapi farmakologi. Beberapa penelitian menyatakan bahwa valsartan dan metformin dapat memperbaiki resistensi insulin yang dihubungkan dengan perbaikan kadar profil lipid. Tujuan penelitian ini adalah untuk mengetahui berapa besar pengaruh pemberian valsartan dan metformin terhadap profil lipid pasien sindroma metabolik. METODE : merupakan penelitian eksperimental dengan one group before and after design. Penelitian dilakukan di klinik endokrin SMF penyakit dalam RSUP dr. Sardjito Yogyakarta. Subyek penelitian adalah pasien yang memenuhi diagnosis sindroma metabolik berdasar IDF 2006. Subyek diberikan terapi valsartan dan metformin selama 12 minggu. Dilakukan pemeriksaan profil lipid, yaitu trigliserida, low density lipoprotein (LDL) dan high density lipoprotein (HDL) sebelum dan sesudah terapi. Nilai rerata profil lipid 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 dapat menyelesaikan penelitian. Hasil penelitian didapatkan penurunan kadar trigliserida (p<0,0001) dan LDL (p<0,0001) yang bermakna serta peningkatan kadar HDL (p=0,09), setelah pemberian valsartan dan metformin selama 12 minggu. KESIMPULAN : Pemberian valsartan dan metformin selama 12 minggu pada pasien sindroma metabolik dapat menurunkan kadar trigliserida dan kolesterol LDL secara bermakna. Kata kunci : sindroma metabolik, valsartan, metformin, profil lipid.
BACKGROUND: Metabolic syndrome is a global health problem in the world. Metabolic syndrome consists of central obesity, dyslipidemia, hypertension and impaired glucose tolerance that increases the risk of cardiovascular complications and diabetes mellitus (DM). Insulin resistance and central obesity becomes a basic pathogenesis of metabolic syndrome. The main target in the management of metabolic syndrome include waist circumference, lipid profile, blood pressure and fasting blood sugar levels (GDP). Treatment of metabolic syndrome include lifestyle modifications and pharmacologic therapy. Some studies suggest that valsartan and metformin may improve insulin resistance associated with improved lipid profile levels. The purpose of this study was to determine how large the effect of valsartan and metformin on the lipid profile of metabolic syndrome patients. METHODS: an experimental study with one group before and after design. The study was conducted in the endocrinology clinic of internal medicine departement in dr. Sardjito hospital. Subjects were patients who met the diagnosis of metabolic syndrome based on IDF 2006. The subject of valsartan and metformin therapy for 12 weeks. Lipid profile examination, namely triglycerides, low density lipoprotein (LDL) and high density lipoprotein (HDL) before and after therapy. The average value of lipid profiles were tested with paired-t test if normally distributed data or Wilcoxon test if the data were not normally distributed. Significance of p <0.05 was considered significant. RESULT : number of sample 15 subjects and all of them can complete the study. The results showed a decrease in triglyceride levels (p<0,0001) and LDL levels (p<0,0001) were significant and increasing levels of HDL (p=0.09), after administration of valsartan and metformin for 12 weeks. CONCLUSION : Provision of valsartan and metformin for 12 weeks in patients with metabolic syndrome can significant reduce levels of triglycerides and LDL cholesterol. Key words: metabolic syndrome, valsartan, metformin, lipid profile
Kata Kunci : sindroma metabolik, valsartan, metformin, profil lipid
