Perbandingan Kadar Serum Tissue Inhibitor Metalloproteinase-1 (TIMP-1) pada Wanita Menopause Penderita Prolaps Organ Pelvik dengan tanpa Prolaps Organ Pelvik

Abstract

BACKGROUND: Genital prolapse is the features of protruding genital organs. This disease significantly affects quality of life physically and psychologically. Etiology of pelvic organ prolapse (POP) is multifactorial. Risk factors include age, parity, duration of menopause, and body mass index (BMI) that induce inflammatory process in the levator ani myopathy and neuropathy. It causes disruption of balance between Matrix Metalloproteinase-9 (MMP-9) and Tissue Inhibitors of Matrix Metalloproteinase-1 (TIMP-1). Thus it leads to excessive degradation of extracellular matrix and resulting in POP. OBJECTIVE: To determine the mean serum levels of TIMP-1 between menopause women with and without pelvic organ prolapse. METHODS: This study is an analytical comparative study with cross sectional design to determine difference between TIMP-1 serum level between menopause women with and without pelvic organ prolapse. This study was conducted at H. Adam Malik Hospital from April to July 2015. Data were analyzed with the Mann-Whitney test and t-test. RESULTS: This study is done to 23 menopause women with POP and 23 menopause women without POP. Demographic data showed that, majority of subjects aged 55 years or older (54.3%), parity 3-5 (52.2%), BMI normoweight (60.9%) and have duration of menopause 5-9 years (78.3%). Difference characteristics of the study subjects according with age, parity, BMI, and have duration of menopause with POP group and without POP group with Mann-Whitney test p> 0.05 which shows the characteristics according with age, parity, BMI and have duration of menopause with POP group and without POP group no significant difference. Mean TIMP-1 level in POP grade 4 group is was 189.34 ± 29.98 ng/ml, lower than mean TIMP-1 level in POP grade 3, 205.38 ± 34.43 ng/ml (p>0.05). Mean TIMP-1 level in the group with POP is lower that the group without POP (194.91 ± 31.78 vs 219.32 ± 32.26 ng/mL; p<0,05). CONCLUSION: Mean TIMP-1 serum level between POP grade 3 and 4 is clinically difference but not significant statistically. There is significant difference of TIMP-1 serum level between menopause women with and without POP.