Faktor risiko disfungsi endotel pada prediabetes

Fatimah Eliana, Pradana Suwondo, Lukman Hakim Makmun, Dante Saksono Harbuwono

Abstract


Prevalensi kasus prediabetes di Indonesia pada saat ini cukup tinggi, dan oleh karena itu proporsi wanita berisiko penyakit kardiovaskular meningkat. Penelitian ini bertujuan untuk mengetahui faktor risiko disfungsi endotel pada wanita prediabetes melalui pemeriksaan kadar asymmetric dimethylarginine (ADMA) serum. Penelitian ini dilakukan dengan desain case control pada populasi wanita prediabetes berusia 30-55 tahun. Kriteria prediabetes ditentukan dari pemeriksaan toleransi glukosa oral (TTGO) dengan pemberian 75 gram glukosa. Selanjutnya dilakukan pemeriksaan kadar kolesterol total, LDL, HDL, trigliserida dan HbA1c sebagai variabel independen, serta ADMA sebagai variabel dependen. Terdapat 41 subjek wanita prediabetes yang memenuhi kriteria inklusi dan dimasukkan dalam kelompok kasus, dan 39 subjek yang dimasukkan dalam kelompok kontrol. Terdapat hubungan yang bermakna dan korelasi yang kuat antara peningkatan kadar ADMA dengan glukosa darah puasa, glukosa darah pasca pemberian glukosa 75 gram dan HbA1c. Namun hasil analisis multivariat membuktikan bahwa faktor yang menentukan kadar ADMA adalah HbA1c.Probabilitas subjek prediabetes dengan HbA1c lebih dari 6% untuk mendapatkan kadar ADMA yang tidak normal adalah 96,03%. Faktor risiko terjadinya disfungsi endotel pada wanita prediabetes adalah peningkatan HbA1c lebih dari 6%.

Keywords


Prediabetes; Disfungsi endotel; ADMA

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References


Anderson JL, Carlquist JF, Roberts WL, Horne BD, May HT, Schwarz EL, et al. 2007. Asymmetric dimethylarginine, cortisol/cortisone ratio, and Cpeptide: Markers for diabetes and cardiovascular risk?. American Heart Journal.;153:67-73.

Anderssohn M, Schwedhelm E, Lüneburg, Ramachandran S. Vasan RS, Böger RH 2010. Asymmetric dimethylarginine as a mediator of vascular dysfunction and a marker of cardiovascular disease and mortality: an intriguing interaction with diabetes mellitus. Diab and Vasc Dis Res. 7;105-18.

Celermajer DS, Sorensen KE, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Deanfield JE 1994. Aging is associated with endothelial dysfunction in healthy men years before the age- related decline in

women. J Am Coll Cardiol; 24:471-6.

Cooke JP 2000. Does ADMA cause endothelial dysfunction? Biol. 20:203.

De Vriese AS, Verbeuren TJ, Van der Voorde J, Lameire NH, Vanhoutte PM 2000. Endothelial dysfunction in diabetes. Br J Pharmacol; 130(5):963-7.

Devangelio E, Santili F, Formosa G, Ferroni P, Bucciarelli L, Micheti N, et al. 2007. Soluble RAGE in type 2 diabetes: association with oxidative stress. Free Radic Biol Med. 15:511-8

Furchgott RF 1996. The discovery of endotheliumderived relaxing factor and its importance in the identification of nitric oxide. JAMA; 276:1186-8.

Garber AJ, Handelsman Y, Einhorn D, Bergman DA, Bloomgarden ZT et al. 2008. Diagnosis and management of prediabetes in the continuum of hyperglycemia. When do the risk of diabetes begin? A consensus statement from the American College of Endocrinology and The American Association of Clinical Endocrinologist. Endocrine Practice.;14:93348.

Gender difference in all-cause and cardiovascular mortality related to hyperglycemia and newlydiagnosed diabetes 2003. The Decode Study Group. Diabetologia. 46:608-17

Hadi AR, Carr CS, Al Suwaidi J 2005. Endothelial dysfunction: cardiovascular risk factors, therapy and outcome. Vasc Health and Risk Management;1(3):18398.

Inoue S, and Zimmet P 2000. The Asia-Pacific perspective: redefining obesity and its treatment. International association for the study of obesity (IASO). International obesity taskforce. WHO Western Asia Pacific region:17-20

Juonala M, Viikari JSA, Alfthan G, Marniemi J, Kähönen K, Taittonen L, Laitinen T, Raitakari OT 2007. Brachial artery flow-mediated dilation and asymmetrical dimethylarginine in the cardiovascular risk in young Finns study. Circulation.; 116:1367-73.

Kocaman SA 2009. Asymmetric dimethylarginine, NO and collateral growth. Ana do lu Kar di yol Derg. 9:417-20.

Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I, Purwanto SH 2008. Perkiraan besar sampel. Dalam: Sastroasmoro S, Ismael S, ed. Dasar-dasar metodologi penelitian klinis edisi ke-3.:302-331

Mihardja L, Delima, Siswoyo H, Ghani L, Soegondo S 2009. Prevalence and determinants of diabetes mellitus and impaired glucose tolerance in Indonesia (a part of basic health research/ Riskesdas). Acta Med Indones-Indones J Intern Med.;41(4):181-5.

Miyazaki H, Matsuoka H, Cooke JP, Usui M, Ueda S, Okuda S, et al. 1999. Endogenous nitric oxide synthase inhibitor: a novel marker of atherosclerosis. Circulation.;99:1141-6.

Nakhjavani M, Karimi-Jafari H, Esteghamati A, Khalilzadeh O, Asgarani F, Ghadiri-Anari A 2010. ADMA is a correlate of insulin resistance in earlystage diabetes independent of hs-CRP and body adiposity. Ann Endocrinol Paris.;71:303-8.

Nathan DN, Davidson MB, DeFronzo R, Heine RJ, Henry, RH, Pratley R, et al. 2007. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care.;30(3):753-9.

Neunteufl T, Katzenschlager R, Hassan A, Klaar U, Schwarzacher S, Glogar D, et al. 1997. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis;129:111-8.

Ryden L, Standl E, Bartnik M, Van den Berghe G, Betterridge J, de Boer MJ, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases 2007. European Society of Cardiology (ESC).

Schulze F, Lenzen H, Hanefeld C, Bartling A, Osterziel KJ, Goudeva L, et al. 2006. Asymmetric dimethylarginine is an independent risk factor for coronary heart disease: results from the multicenter Coronary Artery Risk Determination investigating the influence of ADMA concentration (CARDIAC) study. Am Heart J.; 152(3):493-8.

Standards of medical care in diabetes 2010. American Diabetes Association. Diabetes Care.;33:S11-61.

Sydow K, Schwedhelm E, Arakawa N, Bode-Boger SM, Tsikas D, Hornig B, Frolich JC, et al. 2003. ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocyst(e) inemia: effects of L-arginine and B vitamins. Cardiovascular Research; 57:244-52.

Verma S, Buchanan MR, Anderson TJ 2003. Endothelial function testing as a biomarker of vascular disease. Circulation; 108:2054-9

Wang Z, Tang W, Cho L, Brennan DM, Hazen SL 2009. Targeted metabolomic evaluation of arginine methylation and cardiovascular risks. Potential mechanisms beyond nitric oxide synthase Inhibition. Arterioscler Thromb Vasc Biol.;29:1383-91.

Yan Xiong, Minxiang Lei, Sihai Fu, Yunfeng Fu 2005. Effect of diabetic duration on serum concentrations of endogenous inhibitor of nitric oxide synthase in patients and rats with diabetes. Life Sciences.;77:149–59.

Yunir E, Waspadji S, Rahajeng E 2009. The pre-diabetic epidemiological study in Depok, West Java. Acta Med Indones-Indones. J Intern Med.;41(4):170-4.




DOI: https://doi.org/10.33476/jky.v17i3.211

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