Research Article

Analisis rasio profil lipid kolesterol total, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), dan trigliserida pada pasien Diabetes Melitus Tipe 2 (DM-2) dengan dan tanpa komplikasi ulkus kaki diabetik

Putri Hidayasyah Purnama Lestari , Nurahmi Nurahmi, Tenri Esa, Liong Boy Kurniawan

Putri Hidayasyah Purnama Lestari
Program Pendidikan Dokter Spesialis Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia. Email: putriummighazi@gmail.com

Nurahmi Nurahmi
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSUD Kota Makassar, Indonesia

Tenri Esa
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSKD Dadi Makassar, Indonesia

Liong Boy Kurniawan
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSPTN Universitas Hasanuddin, Makassar, Indonesia
Online First: December 01, 2020 | Cite this Article
Lestari, P., Nurahmi, N., Esa, T., Kurniawan, L. 2020. Analisis rasio profil lipid kolesterol total, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), dan trigliserida pada pasien Diabetes Melitus Tipe 2 (DM-2) dengan dan tanpa komplikasi ulkus kaki diabetik. Intisari Sains Medis 11(3): 1333-1340. DOI:10.15562/ism.v11i3.764


Background: One of the serious macrovascular complications in type 2 diabetes mellitus is a diabetic foot ulcer. Besides causing chronic complications of diabetes, poor glycemic control can also cause dyslipidemia, which plays a role in diabetic foot ulcers' pathophysiology. The ratio of total cholesterol/HDL cholesterol, LDL cholesterol/HDL cholesterol, and triglyceride/HDL ratio play a role in the pathophysiology of endothelial dysfunction closely related to diabetic foot ulcers.

Methods: A retrospective study was performed at the DR. Wahidin Sudirohusodo Hospital, Makassar, by taking secondary data from type 2 DM patient medical records from January 2018 to September 2019. The study sample consisted of forty-seven patients with diabetic foot ulcer complications and 50 patients without diabetic foot ulcers. Chi-Square, Independent T test, and Mann-Whitney test were used as statistical analysis by SPSS version 17 for Windows.

Results: Total cholesterol to HDL ratio and LDL to HDL ratio are significantly greater in type 2 DM patients with diabetic foot ulcer compare to those without diabetic foot ulcers (7.70±6.62 vs. 5.21±1.55, p=0.040 and 4.93±4.75 vs. 3.21±1.16, p=0.014, respectively). There is no significant difference in triglycerides to HDL ratio in type 2 DM with and without diabetic foot ulcers (7.73±8.82 vs. 4.43±3.44, p=0.053). Receiver Operating Curve (ROC) analysis has found cut-off of Total Cholesterol to HDL ratio is 7.13 and LDL to HDL ratio is 3.58.

Conclusion: Total cholesterol to HDL ratio and LDL to HDL ratio are show more relationship with diabetic foot ulcer events.

 

 

Latar Belakang: Komplikasi makrovaskuler yang serius dari dari diabetes melitus tipe 2 salah satunya adalah ulkus kaki diabetik. Kontrol glikemik yang buruk, selain dapat menyebabkan komplikasi kronik dari diabetes, juga dapat menyebabkan dislipidemia yang berperan dalam patofisiologi terjadinya ulkus kaki diabetik. Rasio kolesterol total/kolesterol HDL, kolesterol LDL/kolesterol HDL, dan rasio trigliserida/HDL berperan dalam patofisiologi disfungsi endotel yang erat kaitannya dengan komplikasi ulkus kaki diabetik.

Metode: Penelitian retrosepektif ini dilakukan pada Rumah Sakit DR. Wahidin Sudirohusodo Makassar dengan mengambil data rekam medis pasien diabetes melitus tipe 2 periode Januari 2018 sampai September 2019. Sampel penelitian terdiri dari empat puluh tujuh pasien diabetes melitus dengan komplikasi ulkus kaki diabetik dan lima puluh pasien tanpa komplikasi ulkus kaki diabetik. Uji statistik yang digunakan adalah Chi Square, uji T tidak berpasangan, dan uji Mann-Whitney dengan SPSS versi 17 untuk Windows.

Hasil: Rasio kolesterol total/HDL dan LDL/HDL berturut-turut lebih besar pada pasien DM tipe 2 dengan ulkus kaki diabetik dibandingkan tanpa ulkus kaki diabetik (7,70±6,62 vs 5,21±1,55, p = 0,040 dan 4,93±4,75 vs 3,21±1,16, p=0,014). Tidak terdapat perbedaan bermakna rasio trigliserida/HDL pasien DM tipe 2 dengan ulkus kaki diabetik (7,73±8,82 vs 4,43±3,44, p=0,053). Menurut analisis Receiver Operating Curve (ROC) cutoff rasio kolesterol total/HDL sebesar 7,13 sedangkan untuk rasio LDL/HDL dipilih cutoff 3,58.

Kesimpulan: Rasio Kolesterol total/HDL dan rasio LDL/HDL menunjukkan hubungan dengan kejadian ulkus kaki diabetik.

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