Hubungan indeks massa tubuh dengan rasio neutrofil limfosit pada pasien diabetes melitus tipe 2 di Rumah Sakit Umum Siloam

Onasis, Serena (2020) Hubungan indeks massa tubuh dengan rasio neutrofil limfosit pada pasien diabetes melitus tipe 2 di Rumah Sakit Umum Siloam. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Latar belakang: Diabetes Melitus (DM) tipe 2 merupakan gangguan metabolik dengan karateristik peningkatan kadar glukosa darah (hiperglikemia) yang disebabkan oleh defek sekresi insulin, kelainan kerja insulin, atau kedua-duanya. Salah satu faktor yang berkontribusi terhadap terjadinya peningkatan prevalensi DM tipe 2 yaitu peningkatan indeks massa tubuh (IMT). Berbagai penelitian menunjukkan keterkaitan erat antara IMT dan respons inflamasi jaringan lemak sehingga terjadinya resistensi insulin dan DM tipe 2. Respons inflamasi dapat diukur menggunakan parameter hematologi dengan perhitungan rasio neutrofil-limfosit (RNL). Kemudahan interpretasi, kebutuhan biaya yang murah, dan kemungkinan untuk mendapatkan data hitung leukosit dan limfosit melalui pemeriksaan laboratorium rutin menjadi dukungan untuk dilakukan penelitian ini. Metode Penelitian: Penelitian dilaksanakan dengan desain penelitian cross sectional. Sampel yang digunakan adalah pasien DM tipe 2 di Rumah Sakit Umum (RSU) Siloam yang tidak tumpang tindih dengan faktor eksklusi sehingga diambil secara purposive sampling. Hasil: Terdapat 90 sampel pasien DM tipe 2 di RSU Siloam yang memenuhi kriteria inklusi tanpa tumpang tindih dengan kriteria eksklusi. Dari penelitian ini, ditemukan bahwa sampel memiliki rerata IMT sebesar 23,25 dan RNL sebesar 5,9. Terdapat korelasi yang kuat dan positif antara IMT dan RNL (r = 0,531, p<0,0001). Pasien DM tipe 2 yang disertai komplikasi (hipertensi, neuropati, nefropati, retinopati) memiliki nilai rerata IMT dan RNL yang lebih tinggi dibandingkan tanpa komplikasi (IMT: 23,8 versus 22,2, p<0,05 dan RNL: 6,6 versus 4,4, p<0,05) Kesimpulan: Pada pasien DM tipe 2 ditemukan adanya hubungan yang kuat dan positif antara IMT dan RNL dan nilai IMT dan RNL lebih tinggi ditemukan pada pasien DM tipe 2 dengan komplikasi. Kata kunci: Inflamasi sistemik, indeks massa tubuh, rasio neutrofil-limfosit, diabetes melitus tipe 2/ ABSTRACT Background: Type 2 Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia due to disruption in insulin secretion, insulin action, or both. One of the factors that leads to an increased prevalence of type 2 DM is an increased body mass index (BMI). Various studies have shown a close relationship between an increased BMI towards the body’s inflammatory response of fat tissues thereby increasing insulin resistance and causing type 2 DM. This inflammatory response can be measured through hematological parameters using neutrophil-lymphocyte ratio (NLR). The simple interpretation of the result, the low-cost examination, and the possible access of leukocyte and lymphocyte laboratorial data support the conduction of this research. Method: This research is conducted using a cross sectional research design. The sample was type 2 DM patients in RSU Siloam whom do not overlap with the exclusion factors, and subjects are thus taken using purposive sampling. Results: There were 90 samples of type 2 DM patients in RSU Siloam who met the inclusion criteria without overlapping the exclusion criteria. From this study, it was found that the sample had an average BMI of 23.25 and NLR of 5.9. There was a strong and positive correlation between BMI and NLR (r = 0,531, p<0,0001). The DM type 2 patients with complications (hypertension, neuropathy, nephropathy, retinopathy) showed significantly higher BMI and NLR values compared non-complications patients (BMI: 23,8 versus 22,2, p<0,05 dan NLR: 6,6 versus 4,4, p<0,05) Conclusion: There is a strong and positive correlation between BMI and NLR and DM type 2 patients with complication has greater of BMI and NLR values. Keywords: systemic inflammation, body mass index, neutrophil-lymphocyte ratio, type 2 diabetes mellitus

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