Profil Lipid Sebagai Faktor Resiko Terjadinya Ulkus Diabetikum di RSUP Haji Adam Malik Medan

Abstract

Background. Type 2 diabetes mellitus (DM) is a chronic metabolic disorder and an increasing global pandemic. DM leads to various complications, including diabetic ulcers (DUs). DUs can cause disability, decreased quality of life, and high economic burden. One of the key aspects of DM and its vascular complications is diabetic dyslipidemia. Objective. This study aimed to determine the plasma lipid profile and evaluate its association and relative risk with the occurrence of diabetic ulcers among DM patients at Haji Adam Malik General Hospital, Medan. Methods. This was an analytical observational study with a cross-sectional design. Secondary data were obtained from medical records using consecutive sampling. Subjects were divided into two groups with equal numbers: DU and non-DU. Data were analyzed using descriptive statistics, Chi-square, and Odds Ratio (OR) analysis. Results. A total of 80 type 2 DM patients were included. Most were male (53.7%), aged over 55 years (60%), and had DM for more than five years (60%). The predominant lipid profile was total cholesterol (80%), normal triglycerides (65%), optimal LDL (80%), and low HDL (63.7%). There was no significant association between DU and sex (p=0.823), DU and age (p=0.068) or DU and TG (p=0,348). However, significant associations were found for duration of DM (p<0.001; OR=0.095), total cholesterol (p=0.005; OR=5.938), LDL (p<0.001; OR=10.231), and HDL (p<0.001; OR=7.667). Conclusion. No association was observed between DU occurrence and sex, age, or triglyceride levels. Total cholesterol and LDL were associated with DU, though in an inverse pattern. Paradoxical improvement in lipid profile likely reflects a progressive systemic disease state. Duration of DM over five years and low HDL levels significantly increased the risk of diabetic ulcer occurrence by 10.5 and 7.6 times, respectively.