Pengaruh Penurunan HbA1C terhadap Kadar Adiponektin pada Penderita DM Tipe 2

Abstract

Chronic hyperglicaemia in diabetic is relationship with organ damage in a long time. Controlled of diabetic is as a prime diabetic management. Adiponectin is a specific protein, its secreted by adipose organ and play a role as insulin sensitizing, in function and vascular structure, and anti inflammation. Adiponectin level is inversely correlate with insulin resistance, type 2 diabetic, obesity, cardiovascular disease, and inflammation. Controlled of diabetic may expect to increase adiponectin level in type 2 diabetic patients. Objective To determine the difference of adiponectin level between pre and post decrease HbA1C level and to determine the correlate of decreased HbA1C with adiponectin level. Materials and Methods Experimental study had been done in 14 patients with type 2 diabetic (consists of 7 women and 7 men) who visit in Endocrinology policlinic H. Adam Malik Hospital from September 2010 until January 2011. Anamnesis, physical and laboratory examination (HbA1C and adiponectin level) in pre therapy were measured and then after 3 months therapy with insulin and or anti diabetic, HbA1C and adiponectin level were measured again. Statistic analysis with paired t test and pearson correlation test. Result From 14 samples, there was significance difference (decrease) in mean of HbA1C level between before and after therapy (10,792 ± 2,696 vs 8,328 ± 1,741, p = 0,001) and there was siginficance difference (increase) in mean of adiponectin between before and after therapy (2,112 ± 0,573 vs 2,584 ± 1,014, p = 0,012). If the samples divided in the group therapy of insulin, insulin plus anti diabetics, or anti diabetics only, there was no significance difference in mean of HbA1C or adiponectin level. Furthermore, there was no significance correlation between decrease of HbA1C level with adiponectin level (r = 0,157, p = 0,592) and the same result if the samples divided in to the group therapy of insulin, insulin plus anti diabetics and anti diabetics only. Conclusion There was significance difference (increase) adiponectin level between pre and post decreased of HbA1C level and there was no significance correlate between decreased of HbA1C level with adiponectin level.

Hiperglikemia kronik pada diabetes berhubungan dengan kerusakan organ dalam jangka panjang. Pengendalian DM merupakan langkah utama dalam penanganan DM. Adiponektin merupakan protein spesifik yang disekresikan oleh jaringan adipose dan berperan sebai insulin sensitizing, fungsi dan struktur vaskuler dan anti inflamasi. Kadar adiponektin berhubungan terbailk dengan resistensi insulin, DM tipe 2, obesitas, penyakit kardiovaskuler, dan inflamasi. Adanya pengendalian DM diharapkan dapat meningkatkan kadar adiponektin pada penderita DM tipe 2. Tujuan Untuk mengetahui perbedaan kadar adiponektin sebelum dan setelah turunnya HbA1C serta korelasi penurunan HbA1C terhadap kadar adiponektin. Bahan dan Cara Penelitian eksperimental dilakukan terhadap 14 orang penderita DM tipe 2 (terdiri dari 7 pria dan 7 wanita) yang berkunjung ke poliklinik Endokrinologi RSUP. HAM Medan dari bulan September 2010 hingga Januari 2011. Dilakukan anamnesis, pemeriksaan fisik, laboratorium HbA1C dan adiponektin sebelum terapi. Setelah diterapi selama 3 bulan dengan insulin dan atau OHO, HbA1C dan adiponektin diperiksa kembali. Penilaian statistik dengan menggunakan uji t berpasangan dan uji korelasi Pearson. Hasil Dari 14 sampel yang diperiksa, diperoleh rerata HbA1C mengalami penurunan secara bermakna setelah terapi (10,792 ± 2,696 vs 8,328 ± 1,741, p = 0,001) diikuti dengan peningkatan rerata kadar adiponektin secara bermakna (2,112 ± 0,573 vs 2,584 ± 1,014, p = 0,012). Bila dibagi berdasarkan kelompok terapi insulin, insulin plus OHO dan OHO saja, tidak dijumpai penurunan kadar HbA1C maupun peningkatan kadar adiponektin yang bermakna. Sementara untuk uji korelasi, tidak dijumpai korelasi bermakna antara penurunan kadar HbA1C terhadap perubahan kadar adiponektin (r = 0,157, p = 0,592). Begitu juga bila dibagi berdasarkan kelompok terapi insulin, insulin plus OHO, dan OHO saja. Kesimpulan Terdapat peningkatan bermakna kadar adiponektin antara sebelum dengan setelah penurunan HbA1C dan tidak terdapat korelasi yang bermakna antara penurunan kadar HbA1C dengan perubahan kadar adiponektin.