Hubungan Kadar Brain Derived Neurotrophic Factor (BDNF) dan Glial Cell Line Derived Neurotrphic Factor (GDNF) Urin Terhadap Derajat Keparahan Overactive Bladder pada Paramedis Wanita di RSUP H. Adam Malik Medan

Abstract

Latar Belakang : Overactive bladder (OAB) memiliki prevalensi yang tinggi dan diperkirakan menyerang sekitar 10,7% dari seluruh populasi dunia (sekitar 455 juta orang) dan 31% adalah wanita pada usia >75 tahun. Kadar derivate neurotropik yaitu Brain derived neurotrophic factor (BDNF) dan Glial cell line Derived Neurotropic Factor (GDNF) dalam urin dilaporkan meningkat pada kelompok yang menderita OAB. Tujuan : Penelitian ini diharapkan dapat menunjukkan hubungan antara kadar BDNF dan GDNF urin terhadap derajat keparahan OAB pada paramedis wanita di RSUD H. Adam Malik Medan. Metode : Penelitian analisa korelasi logistik dengan rancangan penelitian Cross Sectional pada paramedis wanita yang mengalami OAB dan tanpa OAB di RSUP H. Adam Malik Medan dari bulan Januari 2019 sampai 37 sampel terpenuhi. Dilakukan anamnesis (usia pasien, riwayat paritas), pemeriksaan fisik, pencatatan antopometri, seperti tinggi badan dan berat badan. Kemudian dilakukan pemeriksaan kadar BDNF dan kadar GDNF pada urin dengan analisis Enzyme linked immunosorbent assay (ELISA) menggunakan sistem sandwich Kit. Untuk menilai karakteristik dilakukan analisa statistik Bivariat dengan menggunakan T-Test independen bila data berdistribusi normal atau dilakukan uji Mann Whitney U test bila distribusi data tidak normal. Penelitian ini memakai tingkat kepercayaan 95%. Hasil : Mayoritas karakteristik subjek penelitian OAB umumnya dengan umur ≥52 tahun (73%), overweight (78,4%), multipara (62,1%) dan derajat ringan (51,4%). Rerata kadar BDNF urin kelompok OAB lebih tinggi daripada non OAB (430,11 ± 71,26 vs 230,84±30,29 ng/mL). Mann-Whitney test menunjukkan ada perbedaan yang bermakna kadar BDNF antara kelompok OAB dengan non OAB (p<0,05). Rerata kadar GDNF urin kelompok OAB lebih tinggi dari kelompok non OAB (1318,38 ± 279,53 vs 836,86±119,16 ng/mL). T-test menunjukkan ada perbedaan yang bermakna kadar GDNF antara kelompok overactive bladder dengan non overactive bladder (p<0,05). Kadar BDNF <389,5 dan GDNF <1321,5 cukup tinggi pada penderita OAB derajat ringan, tetapi secara keseluruhan meningkat pada penderita OAB. Kesimpulan : Tidak ditemukan perbedaan antara kadar BDNF dan GDNF urin pada wanita yang mengalami OAB dan yang tidak mengalami OAB namun ditemukan hubungan antara kadar BDNF dan kadar GDNF terhadap derajat keparahan dari OAB.

Background : Overactive bladder (OAB) has a high prevalence and is estimated to affect around 10.7% of the entire world population (around 455 million people) and 31% are women aged > 75 years. Neurotropic derivative levels, namely Brain derived neurotrophic factor (BDNF) and Glial cell line Derived Neurotropic Factor (GDNF) in urine, have been reported to increase in groups suffering from OAB. Aim : This research is expected to explained the relationship between urinary BDNF and GDNF levels to the severity of OAB in female paramedics at the H. Adam Malik Hospital in Medan. Methods : The research is logistic correlation analysis with Cross Sectional study design on female paramedics who had OAB and without OAB at H. Adam Malik Hospital Medan from January 2019 to 37 samples was fulfilled. History taking (patient age, parity history), physical examination, anthropometric records, such as height and weight, were carried out. Then the urinary BDNF and GDNF levels were examined by the enzyme linked immunosorbent assay (ELISA) analysis using the Kit Kit system. To assess the characteristics, Bivariate statistical analysis were carried out by using an independent T-Test if the data is normally distributed or the Mann Whitney U test is carried out if the data isn’t normally distributed. This research uses a confidence level of 95%. Results : The majority characteristics of the OAB research subjects were generally ≥52 years old (73%), overweight (78.4%), multiparas (62.1%) and mild degrees (51.4%). The mean urinary BDNF level in the OAB group was higher than non OAB (430.11 ± 71.26 vs 230.84 ± 30.29 ng / mL). Mann-Whitney test showed a significant difference in BDNF levels between the OAB group and non OAB (p <0.05). The mean urinary GDNF levels in the OAB group were higher than the non OAB group (1318.38 ± 279.53 vs 836.86 ± 119.16 ng / mL). The T-test showed significant differences in the levels of GDNF between the overactive bladder group and non overactive bladder (p <0.05). BDNF levels <389.5 and GDNF <1321.5 were quite high in patients with mild OAB, but overall increased in patients with OAB. Conclusion : There was no difference between urinary BDNF and GDNF levels in women with OAB and those without OAB but has found an association between BDNF levels and GDNF levels to the severity of OAB.