Korelasi Kadar HS-CRP (High-Sensitivity C-Reactive Protein) dan Kadar BDNF (Brain Derived Neurotrophin Factor) Urin Menopause dengan Overactive Bladder)

Abstract

Latar Belakang : Terdapat setidaknya 50-100 juta pasien dengan overactive bladder tersebar di seluruh dunia dan wanita menopause memiliki risiko lebih tinggi terkena overactive bladder. Overactive bladder lebih rentan pada wanita dengan kadar C-reactive protein (CRP). Selain itu, telah digunakan Brain Derived Neurothropic Factor (BDNF) sebagai penanda yang lebih spesifik. Tujuan : Penelitian ini diharapkan dapat menilai korelasi antara kadar High- Sensitivity-C-reactive protein (hs-CRP) dengan kadar Brain Derived Neurotrophic Factor (BDNF) urin menopause dengan overactive bladder. Metode : Penelitian analitik observasional dengan desain penelitian case control pada wanita paramedis menopause yang mengalami overactive bladder dan tidak mengalami overactive bladder di RSUP H Adam Malik Medan pada bulan januari 2019. Sampel penelitian diambil dengan metode non probability dengan teknik consecutive sampling. Dilakukan anamnesis untuk menentukan derajat OAB dengan skor OAB dan diukur kadar hs-CRP dan BDNF di laboratorium terpadu. Jika data terdistribusi normal digunakan uji korelasi Pearson dan jika data tidak terdistribusi normal digunakan uji korelasi Spearman. Hasil : Didapatkan nilai rerata hs-CRP pada pasien OAB adalah 1,33± 0,23, sementara pada pasien tanpa OAB, nilai reratanya adalah 0,66 ± 0,34. Pada pasien dengan OAB, nilai rerata BDNF adalah 430,87± 73,58, dan pada pasien tanpa OAB adalah 230,97 ± 29,88. Kadar hs-CRP urin pada pasien OAB adalah >1,04 mg/L sebanyak 38 pasien (100%) dan pada pasien tidak OAB adalah <1,04 mg/L sebanyak 37 pasien (97,3%) dengan p = 0,001. Sementara kadar BDNF pada pasien OAB > 305,5 pg/L sebanyak 38 pasien (100%) dan tidak OAB dengan kadar > 305,5 pg/L sebanyak 38 pasien (100%), dengan nilai p = 0,001. Korelasi antara hs-CRP dan BDNF pada pasien dengan OAB, didapatkan korelasi positif sedang dengan r = 0,525 dan p < 0,001. Sedangkan korelasi antara hs-CRP dan BDNF pada pasien tanpa OAB, didapatkan korelasi yang tidak signifikan dengan r = 0,128 dan p = 0,442 (p<0,001). Kesimpulan : Dari penelitian ini terdapat peningkatan kadar hs-CRP dan kadar BDNF urin menopause dengan OAB dibandingkan dengan non OAB. Terdapat peningkatan rerata kadar hs-CRP dan BDNF urin menopause dengan OAB dibandingkan non OAB. Terdapat korelasi positif sedang yang signifikan antara kadar hs-CRP dan kadar BDNF urin pada menopause dengan overactive bladder.

Background : There are at least 50-100 million patients with overactive bladder spread throughout the world and menopausal women have a higher risk of overactive bladder. Overactive bladder is more susceptible to women with levels of C-reactive protein (CRP). In addition, the Brain Derived Neurothropic Factor (BDNF) has been used as a more specific marker. Aim : This research is expected to be able to assess the correlation between levels of High sensitivity-C-reactive protein (hs-CRP) and Brain Derived Neurotrophic Factor (BDNF) in the urine of postmenopausal women who experience overactive bladder. Methods : An observational analytic reserach with case control design in menopausal paramedic women who experienced overactive bladder and did not experience overactive bladder at H Adam Malik General Hospital Medan in January 2019. The research sample was taken by non-probability method with consecutive sampling technique. Anamnesis was performed to determine the degree of OAB with an OAB score and measured hs-CRP and BDNF levels in an integrated laboratory. If the data is normally distributed, the Pearson correlation test is used and if the data are not normally distributed, the Spearman correlation test is used. Results: The hs-CRP mean value in OAB patients was 1.33 ± 0.23, while in patients without OAB, the mean value was 0.66 ± 0.34. In patients with OAB, the mean BDNF was 430.87 ± 73.58, and in patients without OAB it was 230.97 ± 29.88. hs-CRP level in OAB patients was >1,04 mg/L in 38 patients (100%), and in non OAB patient, hs-CRP level was < 1,04 mg/L in 37 patient (97,3%) with p value = 0,001. BDNF level in OAB patient was > 305,5 pg/L in 38 patients (100%) and in nonOAB patient was > 305,5 pg/L in 38 patients (100%). There was a moderate positive correlation between hs-CRP and BDNF in patients with OAB with r = 0.525 and p <0.001. While there was no significant correlation between hs-CRP and BDNF in patients without OAB with r = 0.128 and p = 0.442 (p <0.001). Conclusion : From this research, hs-CRP level and urine BDNF in were increased in menopausal OAB patient than nonOAB patient. There is significant increase in mean of hs-CRP and urine BDNF in menoapausal OAB than nonOAB. This research shows a significant correlation of hs-CRP and urine BDNF in menopausal OAB patients.