Hubungan Nilai Mean Platelet Volume to Lymphocyte Ratio (MPVLR) dengan Kejadian Nefropati Diabetik pada DM Tipe 2

Abstract

Introduction: Diabetic nephropathy is a microvascular complication of uncontrolled Diabetes Mellitus (DM) with the underlying pathogenesis being inflammation. Inflammation causes fibrosis, increased vascular permeability and podocytopathy leading to albuminuria. Mean Platelet Volume (MPV) is a parameter assessing platelet size. Large platelet size indicates platelets are more active metabolically and enzymatically. An absolute decrease in lymphocytes results from increased inflammation-induced apoptosis. MPVLR values can assess low-grade inflammation in the incidence of diabetic nephropathy in type 2 DM patients. Objective: To determine the association of MPVLR values with the incidence of diabetic nephropathy in type 2 DM. Methods: This study was a cross sectional study involving patients with type 2 DM in the Endocrine outpatient clinic of Adam Malik Hospital aged ≥ 18 years. A total of 60 patients who met the inclusion and exclusion criteria had complete blood, creatinine and Albumin Creatinine Ratio (ACR) examinations. Complete blood test using Sysmex Analyzer XN 1500, creatinine test using Cobas pro, ACR test using Sysmex Urine Chemistry Analyzer UC 3500. The collected data were then analyzed, p value < 0,05 was statistically significant. Results: There was a significant difference in age between diabetic nephropathy and non nephropathy. There were significant differences in absolute lymphocyte values, Hb, HbA1C, renal parameters such as estimated Glomerular Filtration Rate (eGFR), creatinine between diabetic nephropathy and non-nephropathy. There was a significant relationship between MPVLR and eGFR and Hb (r = -0.325, p = 0.011) indicating an increase in MPVLR in line with a decrease in eGFR and Hb. There was no significant association between MPVLR and the incidence of diabetic nephropathy based on semi-quantitative ACR with p = 0.139. Conclusion: MPVLR has no correlation to the incidence of diabetic nephropathy in type 2 DM patients.