Hubungan Kadar Glycated Haemoglobin (HbA1c) dan Atherogenic Index Of Plasma (AIP) pada Pasien Diabetik Nefropati Di RS Adam Malik

Abstract

Introduction: Diabetic nephropathy occurs in 25% to 40% of diabetic patients, and is the leading cause of kidney failure worldwide and the incidence of diabetic nephropathy is recognized as equivalent to the risk of Cardiovascular Disease (CVD). Abnormal urinary albumin excretion and decreased eGFR are strong predictors of CVD where macrovascular complications of CVD are still the main cause of death in diabetic patients. Atherogenic Index of Plasma (AIP) is an independent marker and predictor of CVD, and may indicate risk even when other atherogenic risk parameter components appear normal, with low results (AIP < 0.11), intermediate (AIP 0.11 - 0.21), and high atherogenic risk (AIP > 0.21). Objective: The purpose of this study was to see the relationship between Glycated Haemoglobin (HbA1c) levels and Atherogenic Index of Plasma (AIP) in diabetic nephropathy patients, so that the risk of CVD complications in diabetic nephropathy patients can be seen. Method: This study is a prospective analytical study with a cross-sectional design conducted at Adam Malik Hospital Medan from February - May 2025. There were 43 Diabetic Nephropathy patients from the endocrine polyclinic of Adam Malik Hospital who met the criteria and were examined for HbA1c levels (turbidimetric inhibition immunoassay (TINIA)), Triglycerides and HDL (enzymatic colorimetric test), Alb / Cr Urine (reflective photometry) while AIP was obtained by calculating log (triglycerides / high density lipoprotein; TG / HDL). The results of the examination will be analyzed using the Pearson correlation test Results: Of the 43 patients (22 men, 21 women), with the majority aged 46–59 years (48.8%), the results showed a significant positive relationship between HbA1c and AIP (r = 0.670, p = 0.000), a significant positive relationship between HbA1c and triglycerides (r = 0.398, p = 0.008) and a significant negative relationship between HbA1c and HDL (r = - 0.648, p = 0.000). Furthermore, no significant correlation was found between HbA1c and ACR and AIP values (p > 0.05). Conclusion: The study found that increased HbA1c levels (poor glycemic index) are associated with increased AIP levels, which increases the risk of CVD, characterized by increased triglycerides and a subsequent decrease in HDL.