Hubungan antara Hba1c, Mean Platelet Volume (Mpv) dengan Derajat Retinopati pada Pasien Diabetes Mellitus

Abstract

Background: Mean Platelet Volume (MPV) shows the average size of platelets in the circulation and can be used to assess the activity of platelets. Increased of MPV can be sign of atherotrombosis and can be used to assess the risk of vascular complications in diabetic patients Aim: To assess. the association between HbA1c, MPV and degree of retinopathy in diabetes patients Methods: A cross sectional study had been done . in 77 patients from the outpatient and inpatient at Haji Adam Malik Hospital from June until July 2013 and had been conducted anamneses, vital signs, physical examination, blood routine, fasting blood sugar and 2-hour post prandial, HbA1c, lipid profile and funduscopy. Pearson correlation test was used to assess the association between MPV with HbA1c and Oneway ANOVA was used to assess the association between MPV with other parameters to the degree of retinopathy Results: There is significant difference of mean MPV between normal funduscopy group compared than PDR group (9.57±0.63 vs 10.45±0.51, p=0.044). PDR group are older (p=0.001), longer suffered from diabetes (p=0.0001) and hypertension (p=0.011). There are significant correlation between MPV with duration of diabetes mellitus (r=0.71, p=0.01), platelet count (r=0.52, p=0.0001), hypertension (r=0.284 p=0.012) and degree of retinopathy (r=0.331, p=0.003). There are no significant correlation between MPV with fasting blood glucose levels (p=0.208), 2 hour post-prandial blood glucose (p=0.121) and HbA1c(p=0.538). Conclusion: There are significant correlation between MPV with duration of diabetes, hypertension and degree of retinopathy. There are no correlation between HbA1c with MPV and between HbA1c with degree of retinopathy.

Latar Belakang: Mean Platelet Volume (MPV) merupakan gambaran ukuran rata-rata trombosit di sirkulasi dan dapat digunakan untuk menilai aktivitas trombosit. Peningkatan nilai MPV bisa menggambarkan atherotrombosis dan dapat digunakan untuk menilai risiko komplikasi vaskular pada pasien DM. Tujuan: Untuk menilai hubungan antara HbA1c, MPV dan derajat retinopati pada pasien DM. Metode: Penelitian potong lintang dilakukan terhadap 77 pasien poliklinik dan rawat inap RSUP H.Adam Malik Medan pada bulan Juni - Juli 2013 dan dilakukan anamnesis, pemeriksaan tanda vital dan fisik, darah rutin, KGD puasa dan 2 jam PP, HBA1c, profil lipid dan funduskopi. Uji korelasi Pearson digunakan untuk menilai hubungan antara HbA1c dengan MPV dan uji Oneway ANOVA untuk menilai hubungan antara MPV dan parameter lainnya dengan derajat retinopati. Hasil: Dijumpai perbedaan signifikan nilai mean MPV pada grup funduskopi normal dibandingkan grup PDR (9.57±0.63 vs 10.45±0.51, p=0.044). Grup PDR lebih tua (p=0.001), lebih lama menderita DM (p=0.0001) dan disertai dengan hipertensi (p=0.011). Dijumpai korelasi signifikan antara MPV dengan durasi DM ( r=0.71, p=0.01), nilai trombosit ( r=0.52, p=0.0001), hipertensi ( r=0.284, p=0.012) dan derajat retinopati (r=0.331, p=0.003). Tidak dijumpai korelasi signifikan antara MPV dengan kadar gula darah puasa (p=0.208), 2 jam post prandial (p=0.121) dan HbA1c (p=0.538). Kesimpulan: Dijumpai hubungan yang signifikan antara MPV dengan durasi DM, hipertensi dan derajat retinopati. Tidak dijumpai hubungan signifikan antara HbA1c dengan MPV dan HbA1c dengan derajat retinopati.