Skip to main content Skip to main navigation menu Skip to site footer

Hubungan kadar TNF-α dengan HOMA-IR pada pasien diabetes mellitus tipe-2 di Rumah Sakit Umum Pusat Haji Adam Malik, Medan, Indonesia

  • Poltak Poltak ,
  • Santi Syafril ,
  • Ratna Akbari Ganie ,


Background: The homeostatic assessment (HOMA) of the first cell-β (B) and insulin (IR) function is used to determine insulin sensitivity and cell-β function of insulin plasma concentrations and fasting glucose. High extracellular glucose levels will trigger an increase in ROS production (which in turn will increase the formation of Reactive Oxygen Species) expression of TNF α (Tumor Necrosis Factor-α) and exacerbate oxidative stress. The study aimed to determine the relationship between TNF α and HOMA-IR in type 2 DM.

Method: A cross sectional study was conducted at the H. Adam Malik General Hospital Medan from December-February 2018 in 43 patients with type 2 DM. Fasting insulin levels were examined using Celuminescence Microparticle Immunoassay and fasting glucose levels with Enzymatic and TNF α methods with the Elisa method. The relationship of the characteristics of TNF α levels with HOMA-IR in type 2 DM using the Kolmogorov Smirnov test used the Spearman's rank correlation test with SPSS version 20 for windows.

Results: The total sample was 43 samples of patients with type 2 diabetes mellitus. Most of the respondents were male (62.8%) and had a median age of 57 (39-87) years. In this study, the TNF-alpha levels were 87.28 (18.43-846.05) pg/ml. While the HOMA-IR level was 3.36 (0.41-25.82). There was no significant correlation between serum TNF α levels and HOMA-IR in type 2 DM patients (P> 0.05).

Conclusion: There is no significant relationship between TNF α levels and HOMA-IR in type 2 DM patients.


  1. Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon). 2014; 42(12): 698–702
  2. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88-98.
  3. Yuniarti E. Perbedaan kadar Tumor Necrosis Factor-Alfa antara diabetes mellitus tipe 2 terkontrol dan tidak terkontrol. Bioscience. 2017;1(1):18-29
  4. Shepherd PR, Kahn BB. Glucose transporters and insulin action--implications for insulin resistance and diabetes mellitus. N Engl J Med. 1999;22;341(4):248-57.
  5. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487-95.
  6. Akash MSH, Rehman K, Liaqat A. Tumor Necrosis Factor-Alpha: Role in Development of Insulin Resistance and Pathogenesis of Type 2 Diabetes Mellitus. J Cell Biochem. 2018;119(1):105-110.
  7. Swaroop JJ, Rajarajeswari D, Naidu JN. Association of TNF-α with insulin resistance in type 2 diabetes mellitus. Indian J Med Res. 2012;135:127-30.
  8. Fan N, Sun H, Wang Y, Zhang L, Xia Z, Peng L et al. Midkine, a potential link between obesity and insulin resistance. PLoS One. 2014 Feb 7;9(2):e88299.
  9. Bluher M, Kratzsch J, Paschke R. Plasma levels of tumor necrosis factor alpha, angiotensin II, Growth harmone, and IGF- 1 are not elevated in insulin resistant obese individuals with impaired glucose tolerance. Diabetes Care. 2013;24:328–34.
  10. Lukic L, Lalic MN, Rajkovic N, Jotic A, Lalic K, Milicic T, et al. Hypertension in obese type 2 diabetes patients is associated with increases in insulin resistance and il-6 cytokine levels: potential targets for an efficient preventive intervention. Int. J. Environ. Res. Public Health. 2014;11(4):3586-3598
  11. Al-Shukaili A, Al-Ghafri S, Al-Marhoobi S, Al-Abri S, Al-Lawati J, Al-Maskari M. Analysis of inflammatory mediators in type 2 diabetes patients.Int J Endocrinol. 2013;2013:976810
  12. Bertin E, Nguyen P, Guenounocu M, Durlach V, Potron G, Leutenegger M. Plasma levels of tumor necrosis factor-alpha (TNF-alpha) are essentially dependent on visceral fat amount in type 2 diabetic patients. Diabetes Metab. 2013;26(3):178–82
  13. Mishima Y, Kuyama A, Tada A, Takahashi K, Ishioka T, Kibata M. Relationship between tumor necrosis factor-alpha and insulin resistance in obese men with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2014;52(2):119–23.

How to Cite

Poltak, P., Syafril, S., & Ganie, R. A. (2019). Hubungan kadar TNF-α dengan HOMA-IR pada pasien diabetes mellitus tipe-2 di Rumah Sakit Umum Pusat Haji Adam Malik, Medan, Indonesia. Intisari Sains Medis, 10(3).




Search Panel