Hubungan antara Asymmetric Dimethylarginine (ADMA) dan Ankle-Brachial Index (ABI) dengan Tingkat Keparahan Ulkus Kaki Diabetes

Abstract

Introduction: Approximately 50% of inpatient cases for diabetic complications are diabetic foot ulcers (DFU). Peripheral artery defect is one of the mechanism which are characterized by increased asymmetric dimethylarginine (ADMA). Severe diabetic foot ulcers are found in populations with low ankle-brachial index (ABI) values. This study aims find the relationship between ADMA and ABI in predicting risk for DFU. Methods: Observational study with a cross-sectional method was conducted at Haji Adam Malik General Hospital Medan collaborate with Clinical Laboratory from Faculty of Medicine, Universitas Sumatera Utara. Forty-two patients with DFU from September 2023 to April 2024, were registered with following information of anthropometric, gender, history of drug use, comorbidities, ABI, ADMA, complete blood count, lipid profile and fasting blood glucose. Results: In grade II DFU, the average ADMA value was 87.6 ng/dl, grade III 231.3 ng/dl, grade IV 444.9 ng/dl and grade V 652.3 ng/dl. ABI value using Sokoye classification shows grade II DFU has an average ABI value of 1.08 (Normal), grade III 0.74 (Mild), Grade IV 0.61 (Moderate) and grade V 0.5 (Moderate). Conclusion: There is a relationship between the severity of DFU (Wagner scale) with ADMA levels (P = 0.001) and ABI values (P = 0.001). There is a relationship between ADMA and ABI values with DFU (P = 0.001).