Perbedaan Kadar Tumor Necrosis Factor Alpha (TNF- α) dan Indeks Massa Tubuh (IMT) pada Pasien Diabetes Melitus Tipe 2 dengan Tuberkulosis Paru Sebelum dan Setelah Fase Intensif Pengobatan TB
| Main Author: | Lydia, Wika |
|---|---|
| Other Authors: | Lindarto, Dharma, Syafril, Santi |
| Format: | Masters application/pdf |
| Bahasa: | ind |
| Terbitan: |
Universitas Sumatera Utara
, 2020
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| Subjects: | |
| Online Access: |
http://repositori.usu.ac.id/handle/123456789/28733 |
Daftar Isi:
- 104 Halaman
- Introduction: International Diabetes Federation (IDF) states there is currently an increase in the prevalence of Diabetes Mellitus (DM) worldwide. The prevalence of diabetic patients in North Sumatra, especially Medan city has continued to increase from 2007 to 2013. DM can cause various kinds of complications, one of which is pulmonary tuberculosis (TB). World Health Organization (WHO) states Indonesia is the second country with the highest prevalence of pulmonary TB in 2016. Metabolic disorders in cases of obesity and insulin resistance, are thought to be related to Tumor Necrosis Factor-α (TNF-α) metabolic disorders, an adipocytokines secreted by macrophages, and other cells including adipocytes, which can inhibit insulin transduction. TNF-α is known to play a role through the anti-mycobacterial activity by the process of phagocytic mononuclear, however, it also has negative impact on the pathological process of TB. This study aims to determine differences in TNF-α levels and Body Mass Index (BMI) in Type 2 DM with pulmonary TB before and after 2 months of antituberculosis treatment Method: This is a prospective comparative analytical study with a one-group pretest-posttest design, which was conducted during August 2019-September 2019 in outpatient of Type 2 DM with pulmonary TB at USU General Hospital, Madani Medan Hospital, Teladan Health Center and Clinical Pathology Laboratory of Haji Adam Malik Medan after obtaining approval from the Health Research Ethics Commission. Data were analyzed after normality test, then the mean difference test and correlation test were done by using the SPPS program where p <0.05 was considered significant. Results: This study showed an increase in BMI values, as well as a significant decrease of fasting blood glucose, 2 hour post prandial blood glucose, HbA1C and TNFα levels between before and after 2 months of antituberculosis treatment (p = 0,000; p = 0,000; p = 0,000; p = 0,000). Conclusion: There was a statistically significant increase of BMI and decrease of TNFα level after 2 months of antituberculosis treatment.
- Pendahuluan. International Diabetes Federation (IDF) menyatakan saat ini sedang terjadi peningkatan prevalensi Diabetes Melitus (DM) di seluruh dunia. Prevalensi penderita DM di Sumatera Utara, khususnya kota Medan terus mengalami peningkatan dari tahun 2007 hingga tahun 2013. DM dapat menimbulkan berbagai macam komplikasi, salah satunya TB paru. World Health Organization (WHO) menyatakan Indonesia merupakan negara kedua dengan prevalensi Tuberkulosis (TB) paru terbesar pada tahun 2016. Gangguan metabolik pada kasus obesitas dan resistensi insulin diduga berkaitan dengan gangguan metabolisme Tumor Necrosis Factor-α (TNF-α), adipositokin yang disekresikan makrofag, dan sel lain termasuk adiposit, yang dapat menghambat transduksi insulin. TNF-α diketahui berperan melalui aktivitas anti-mikrobakteri fagosit mononuklear, namun, memiliki dampak negatif dalam proses patologis TB. Penelitian ini bertujuan untuk mengetahui perbedaan kadar TNF-α dan Indeks Massa Tubuh (IMT) pada pasien DM Tipe 2 dengan TB paru sebelum dan setelah fase intensif pengobatan TB. Metode: Penelitian ini bersifat analitik komparatif dengan pendekatan prospektif dengan desain one group pretest-posttest, yang dilaksanakan bulan Agustus 2019-September 2019 pada penderita DM Tipe 2 dengan TB paru di poliklinik rawat jalan RS USU, RS Madani Medan, Puskesmas Teladan serta Laboratorium Patologi Klinik RSUP Haji Adam Malik Medan setelah mendapat persetujuan Komisi Etik Penelitian Bidang Kesehatan. Data dianalisis setelah uji distribusi, kemudian dilakukan uji beda mean dan uji korelasi menggunakan program SPPS di mana p<0,05 dianggap signifikan. Hasil: Penelitian ini menunjukkan adanya peningkatan nilai IMT, serta penurunan kadar GDP, GD2PP, HbA1C dan TNFα yang signifikan antara sebelum dan setelah fase intensif pengobatan TB (p = 0,000; p = 0,000; p = 0,000; p = 0,000). Kesimpulan: Terjadi peningkatan IMT dan penurunan kadar TNFα yang signifikan secara statistik setelah 2 bulan pengobatan dengan OAT.