POLA KADAR GLUKOSA DARAH PUASA, KOLESTEROL DAN TRIGLISERID PADA PENDERITA SIROSIS HATI

Abstract

Background. Patients with liver cirrhosis are ones of the health problem in In-donesia. An impared carbohydrate, protein and lipid metabolisms are often found in patients with liver cirrhosis. There are a lot of studies of blood glucose levels in patients with liver cirhhosis, unfortunately, few studies are available concerning serum cholesterol and triglyceride levels in patients with liver cir-rhosis. Objectives Understanding the pattern of fasting blood glucose level, choles-terol and triglyceride in liver cirrhosis patients, according to the clinical severity of diseases; Child-Pugh classification. Methode. We used 'cross sectional observational study' and measured fasting blood glucose level, cholesterol and triglyceride in 48 patients with liver cirrho-sis ( 39 (81.3%) and 9 (18,7%) women. Child-Pugh classes: 9 (18,7%) mean [+ SD] age, 50.1 + 7,4 years; in A ; 23 pts (47,9%) mean [± SD] age, 51.3 + 12.5 years in B; and 16 pts (33.4%) mean [± SD] age, 50.5 + 8.8 years in C). Result. In patients with liver cirrhosis there were highest level fasting blood glu-cose and trygliceride in Child-Pugh C, 124 + 56.4 mg% and 99.3 + 35 mg% respectively; in Child-Pugh A 110 + 13.7 mg% and 83.3 + 24.2 mg% respec-tively. Statitiscally there were no signicantly increasing of fasting glucose and trygliceride level in the three classes A, B and C (p=0.427 and p=0.607). High-est serum cholesterol level was found in Child-Pugh A, ie 137 + 47.1 mg%, but there was no significantly decreasing level in B (93.1 + 35.0 mg%) and C (108.3 + 50.0 mg%); p=0.179. Conclusions: In this study, more severe liver cirrhosis disease there were in-creasing fasting blood glucose level and trygliceride level and decreasing choles-terol level, but statistically were not significant. Latar Bekkang : Penderita sirosis hati masih menjadi salah satu problem ke-sehatan di Indonesia. Pada sirosis hati terjadi gangguan fungsi hati Adanya gangguan thngsi hati maka akan terjadi gangguan metabolisme karbohidrat, protein dan lemak. Cukup banyak penelitian mengenai glukosa darah pada si-rosis hati, sayangnya masih sedikit sekali penelitian yang terkait dengan me-tabolisme kolesterol dan trigliserid pada penderita sirosis hati. Tujuan : Mengetahui pola kadar glukosa darah puasa, kolesterol dan trigli-send pada penderita sirosis hati sesuai dengan derajat keparahan penyakit ber-dasar ldasifikasi Child-Pugh. Bahan dan Cara : Rancangan penelitian 'cross sectional observational study'. Data yang diambil: glukosa darah puasa, kolesterol dan trigliserid pada 48 penderita sirosis hafi terdiri dari 39 (81,3%) laki-laki dan 9 (18,7%) wanita. Sesuai derajat keparahan penyakit (kriteria Child-Pugh) didapatkan 9 penderita (18,8%) sirosis hati ringan (A) dengan rata-rata umur 50,1 + 7,4 th; 23 penderita (47,9%) sirosis hati sedang (B) dengan rata-rata umur 51,3 + 12,5 th; dan 16 penderita (33,3%) sirosis hati berat (C) dengan rata-rata umur 50,5 + 8,8 th). Hasil : Rata-rata kadar Glukosa Darah Puasa (GDP), trigliserid pada kelom-pok C adalah yang paling tinggi, masing-masing 124,9 + 56,4 mg% dan 99,3 ± 35 mg%, sedang pada kelompok A masing-masing 110 ± 13,7 mg% dan 83,3 + 24,2 mg% Tidak ada perbedaan bermakna kadar GDP dan trigliserid diantara ketiga kelompok A, B, dan C (p=0,427 dan p=0,607). Sedangkan kadar kolesterol paling tinggi justru kelompok A yaitu 137,1 + 47,1 mg%, tetapi tidak menunjukkan perbedaan bermakna dibanding kadar kolesterol klas B (93,1 + 35,0 mg%) dan C (108,3 + 50,0 mg%) dengan p=0,179). Kesimpulan : Makin berat tingkat keparahan sirosis hati kadar GDP dan trigliserid cenderung makin tinggi, sebaliknya kadar kolesterol cenderung makin rendah. Tidak ada korelasi antara kadar GDP, kolesterol dan trigliserid dengan derajat keparahan sirosis hati.