KADAR HOMOSISTEIN PLASMA PADA PENDERITA DM TIPE II DENGAN GANGGUAN VASKULER PERIFER

Abstract

Background. Hyperhomocysteinemia is a major and independent risk factor of vascular disease. One of the vascular diseases in DM type II is peripheral vascular disturbance, which linally becomes diabetic foot as a terrible diabetic complication. Objective. To determine the pattern of plasma total homocysteine concentration in DM type 11 patients with peripheral vascular disease ( PVD ) and to find whether there is an association between plasma homocysteine and cholesterol with various stage of PVD. Methods. A cross sectional study had been conducted at Dr. Kariadi Hospital Semarang, during Oktober 2000 to April 2001. Thirty DM type 11 patients with PVD — who were diagnosed with low ankle to brachial pressure index ( API ) score < 0,9. Age between 40 — 80 years, had suffered DM more than 5 years and had no severe renal dysfunction were enrolled in this study. API was examined using Doppler, and Floureseence Polarisation lininunoassay analyser was used to measure homocysteine using Abbott / IMX as reagen / tool. Statistical analysis descriptive presentation were ; range, median, mean & standard deviasi; Pearson correlation coeficient was measured using SPSS 10,0 programme; Correlation was significant if p< 0,05. Result. From 30 eligible respondents, the average of plasma homocysteine concentration was 14,3 ± 6,9 i.tm/I, and 12 ( 40% ) among them were hyperhomocysteineme ( > 15 p.m/L ). We found strong association between plasma homocystein concentration with API score, which in an inverse linear relationship between API score and plasma homocysteine concentration (r = -0,82 and p = 0,0001). There was no association between plasma cholesterol and API score (r = 0,29 and p = 0,115 ). Conclusion. There was strong inverse linear relationship between API score and plasma homocysteine concentration. We found no association between cholesterol and API score. ABSTRAK Latar belakang : Hiperhomosisteinemia merupakan faktor risiko major dan independen terhadap penyakit vaskuler, termasuk gangguan vaskuler perifer pada DM tipe II, yang pada akhirnya akan menjadi kaki diabetik, sebagai komplikasi DM yang ditakuti. Obyektif : Mengetahui pola kadar homosistein plasma pada penderita DM tipe 2 dengan gangguan vaskuler perifer, dan hubungannya homosistein dan kolesterol dengan b6rbagai derajat gangguan vaskuler perifer. Metodologi : Studi ini bersi fat 'cross sectional' yang mengikutkan 30 responden penderita DM tipe 2 dengan gangguan vaskuler perifer, yang ditentukan dengan API < 0,9. Usia responden antara 40 — 80 tahun dan lama menderita DM lebih 5 tahun. Penderita dengan gangguan funsi ginjal berat diekslusi. Kami rnelakukannya di RSDK Semarang, dad bulan oktober 2000 sampai bulan april 2001. API diperiksa dengan Doppler. Honiosistein diperiksa dengan metode Eloureseenee Polarisation Immunoas•ay, dengan reagen/alat Abbott / IMX. Analisis statistik yang digunakan pada penelitian ini adalah : untuk sajian diskriptif adalah range, median, rerata dan simpang baku ( SB ); koefesien korelasi Pearson dihitung dengan program SPSS 10,0. Dinyatakan bermakna bila p < 0,05. Hasil': Dart 30 responden didapatkan rerata kadar homosistein plasmanya 14,3 ± 6,9 jamol/L. Hiperhomosisteinemia ( 15 umol/L ) terdapat pada 12 ( 40% ) responden. Terdapat hubungan yang kuat antara kadar homosistein plasma dengan nilai API, dimana makin rendah nilai API makin tinggi kadar hornosistein plasmanya, dan hubungan ini secara statistik bennalcna dengan r = - 0,82 dan p = 0,0001. Tidak terdapat hubungan antara API dan kolesterol (r = 0,29 and p = 0,115 ). Kesimpulan : adanya hubungan yang kuat antara kadar hornosistein plasma dengan API, dimana makin rendah nilai API makin tinggi kadar homoosisteinnya. Hubungan antara kolesterol dan nilai API tidak bermakna.