Kadar Glutathion Peroksidase (Gpx) Sebagai Penanda Derajat Keparahan Keluhan Menopause pada Paramedis Wanita Menopause di Rsup. H. Adam Malik Dan Rs. Jejaring Medan

Abstract

BACKGROUND : The number of postmenopausal women is expected to increase each year and will cause problems of its own with the advent of complaints during menopause. Although not fatal, it can cause discomfort and lead to disruption in the day-to- day employment which can degrade the quality of life . Menopause Rating Scale ( MRS ) is a scale that is associated with quality of life health during menopause, to measure the severity of menopausal complaints and to assess a number of specific symptoms. Oxidative stress is also involved in the pathogenesis of complaints of menopause, such as vasomotor disturbances. During menopause, recurrent vasomotor disturbances episodes resulted in an increase in the long-term metabolic problems. This increase has demonstrated the contribution to the formation of oxidative stress in disturbing antioxidants function to neutralize ROS ( reactive oxygen species ). OBJECTIVE : To determine the characteristics (age, marital status, duration of menopause and BMI) in postmenopausal paramedics H.Adam Malik Hospital and Satellite Hospital. Recruitment was based on the degree of menopausal complaints. To determine the relationship, the average difference, the interval value (cut-off value) levels of glutathione peroxidase (GPx) the degree of menopausal complaints are assessed by Menopause Rating Scale (MRS), measuring the value of sensitivity and specificity, positive predictive value, negative predictive value and accuracy and area under the curve (AUC) of GPx levels. METHODS : This study is an analytical study using the design of diagnostic tests, carried out in the H.Adam Malik Hospital and Satellite Hospital. Recruitment of samples began in December 2013 until the sample size of 50 people. The study population was postmenopausal patients aged 45-56 years who worked as a paramedic in H.Adam Malik Hospital and Satellite Hospital. RESULTS : Of the 50 study samples obtained each 5 paramedics were no complaints of menopause, 19 minor complaints, 18 moderate complaints and 8 severe complaints. There is a significant difference between the levels of GPx against the severity of menopausal complaints (p = 0.0001). Negative correlation (r = -0.641) was observed in the relationship between the levels of GPx and the severity of menopausal complaints. Value cut point (cut-off value) GPx levels of paramedics menopausal women can be used as a marker of the severity of menopausal complaints are at levels of 533.33 mU / mL . Based on the value of the cut-off value , the degree of severity of moderate to severe menopausal complaints obtained a sensitivity value of 87.5% and specificity 80.8%, positive predictive value 80.8%, negative predictive value 97.5%, and accuracy 84%. It can be concluded that the test glutathione peroxidase (GPx) can be used as a marker of the severity of moderate to severe menopausal complaints due sensitiftas value and specificity >80%.

LATAR BELAKANG : Jumlah wanita menopause diperkirakan akan meningkat setiap tahunnya dan akan menimbulkan masalah tersendiri dengan munculnya keluhan-keluhan pada masa menopause. Walaupun tidak menyebabkan kematian, tetapi dapat menimbulkan rasa tidak nyaman dan menyebabkan gangguan dalam pekerjaaan sehari-hari yang dapat menurunkan kualitas hidup. Skala Penilaian Menopause (MRS) merupakan skala kualitas hidup yang dihubungkan dengan kesehatan selama masa menopause, untuk mengukur tingkat keparahan keluhan menopause, dengan menilai sejumlah gejala tertentu. Stres oksidatif juga terlibat dalam patogenesis keluhan menopause, seperti gangguan vasomotor. Selama menopause, gangguan episode vasomotor berulang menghasilkan peningkatan jangka panjang terhadap masalah metabolisme. Peningkatan ini telah menunjukkan adanya kontribusi pada pembentukan stres oksidatif dengan menempatkan hambatan pada antioksidan dan fungsinya dalam menetralisir ROS ( reactive oxygen species) TUJUAN : Mengetahui karakteristik (usia, status pernikahan, lama menopause dan BMI) paramedis wanita menopause di RSUP.H.Adam Malik Medan dan RS. Jejaring berdasarkan derajat keluhan menopause. Untuk mengetahui hubungan, perbedaan rata-rata, nilai interval (cut off value) kadar Glutathion Peroksidase (GPx) terhadap derajat keluhan menopause yang dinilai berdasarkan Menopause Rating Scale (MRS), Mengetahui nilai sensitivitas dan spesifisitas, nilai prediksi positif, nilai prediksi negatif dan akurasi serta area under curve (AUC) dari kadar GPx. . METODE : Penelitian ini merupakan penelitian analitik dengan menggunakan rancangan uji diagnostic, dilakukan di RSUP. H. Adam Malik Medan dan RS. Jejaring, dimulai bulan Desember tahun 2013 sampai jumlah sampel 50 orang. Populasi penelitian adalah penderita menopause berumur 45-56 tahun yang bekerja sebagai paramedis di RSUP.H.Adam Malik Medan dan RS. Jejaring. HASIL : Dari 50 sampel penelitian didapatkan masing-masing 5 orang paramedis yang tidak ada keluhan menopause, 19 orang keluhan ringan, 18 orang keluhan sedang dan 8 orang keluhan berat. Terdapat perbedaan yang bermakna antara kadar GPx terhadap derajat keparahan keluhan menopause (p=0,0001). Adanya korelasi negatif ( r = -0,641 ) dan hubungan sedang antara kadar GPx terhadap derajat keparahan keluhan menopause. Nilai titik potong (cut off value) kadar GPx dari paramedis wanita menopause dapat dijadikan sebagai penanda derajat keparahan keluhan menopause berada pada kadar 533,33 mU/mL. Berdasarkan nilai cut off value tersebut, untuk derajat keparahan keluhan menopause sedang-berat didapatkan nilai sensitifitas sebesar 87,5 % dan spesifisitas 80,8 %, nilai prediksi positif 80,8 %, nilai prediksi negatif 97,5 %, dan akurasi 84 %. Dapat disimpulkan bahwa uji Glutathion Peroksidase (GPx) bisa digunakan sebagai penanda derajat keparahan keluhan menopause sedang-berat dikarenakan nilai sensitiftas dan spesifisitasnya > 80%.