Korelasi Kadar Asam Urat Serum Dengan Keparahan Neuropati Perifer Diabetik
https://doi.org/10.22146/bns.v18i1.55065 Lia Amalia(1*), Yudiyanta Yudiyanta(2), Indarwati Setyaningsih(3)
(1)
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
Neuropati diabetik adalah komplikasi kronis diabetes yang paling banyak ditemui. Penilaian dan evaluasi keparahan neuropati diabetik diperlukan pada setiap pasien neuropati perifer diabetik. NDS-INA dapat digunakan untuk menilai derajat keparahan neuropati perifer diabetik. Terdapat hubungan antara kadar asam urat serum dengan kejadian neuropati perifer diabetik, namun korelasinya dengan tingkat keparahan neuropati belum diketahui. Penelitianini bertujuan untuk mengukur koefisien korelasi antara kadar asam urat serum dengan keparahan neuropati perifer diabetik yang diukur dengan NDS-INA.
Penelitian ini merupakan penelitian cross sectional, subjek penelitian adalah pasien neuropati perifer diabetik di poliklinik Saraf dan bangsal perawatan Saraf RSUP Dr. Sardjito Yogyakarta yang memenuhi kriteria inklusi dan eksklusi. Subjek dilakukan pemeriksaan kadar asam urat serum dan penilaian NDS-INA. Korelasi antara kadar asam urat serum, variabel demografi dan laboratorium dengan skor NDS-INA dilakukan dengan uji korelasi Spearman dilanjutkan uji regresi linier.
Didapatkan 57 subjek penelitian, rerata kadar asam urat serum 6,27±1,77; rerata skor NDS-INA 6,39±2,12 dan median 6 (4-10). Hasil uji korelasi bivariat yang signifikan adalah korelasi antara kadar asam urat serum dengan skor NDS-INA (r =0,263; p =0,048), kadar HbA1c dengan skor NDS-INA (r =0,322; p =0,015) dan durasi DM dengan skor NDS-INA (r =0,311; p =0,019). Pada uji multivariat, kadar HbA1c dan durasi DM berkorelasi signifikan dengan skor NDS-INA (masing-masing B =0,355; p =0,004 dan B =0,323; p =0,011), sementara kadar asam urat serum tidak menunjukkan korelasi ysng signifikan dengan skor NDS-INA (B =0,090; p =0,481).
Simpulan penelitian ini, tidak terdapat korelasi positif yang bermakna secara statistik antara kadar asam urat serum dengan keparahan neuropati perifer diabetik berdasarkan NDS-INA.
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1.Callaghan BC, Cheng H, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: Clinical manifestations and current treatments. Lancet Neurology. 2012;11(6):521–534.
2.Tesfaye S, Boulton AJM, Dyck PJ, Freeman R, Horowitz M, Kempler P, et al. Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments. Diabetes Care. 2010;33:2285–2293.
3.Zamroni, Asmedi A, Nuradyo D. Uji Reliabilitas dan validitas Neuropathy Symptom Score (NSS) dan Neuropathy Deficit Score (NDS) sebagai Skor Diagnostik Neuropati Diabetik (Tesis). Yogyakarta: Departemen Neurologi Fakultas Kedokteran Universitas Gadjah Mada; 2013.
4.Kiani J, Habibi Z, Tajziehchi A, Moghimbeigi A, Dehghan A, Azizkhani H.Association between serum uric acid level and diabetic peripheral neuropathy (A case control study). Caspian J Intern Med. 2014;5(1):17-21.
5.Lyngdoh T, Marques-Vidal P, Paccaud F, Preiseg M, Waeber G, Bochud M, et al. Elevated Serum Uric Acid Is Associated with High Circulating Inflammatory Cytokines in the Population-Based Colaus Study. PLoS ONE. 2011;6(5):1-8.
6.Borghi C, Rosei EA, Bardin T, Dawsonc J, Dominiczak A, Kielstein JT, et al. Serum uric acid and the risk of cardiovascular and renal disease. Journal of Hypertension. 2015;33:1-15.
7.Papanas N, Katsiki N, Papatheodorou K, Demetriou M, Papazoglou D, Gioka T et al. Peripheral Neuropathy is Associated With Increased Serum Levels of Uric Acid in Type 2 Diabetes Mellitus. Angiology. 2011;62(4):291-295.
8.Darsana IN, Purwata TE, Purna Putra IGN. Korelasi positif kadar asam urat serum tinggi dengan neuropati diabetik perifer pada penderita DM tipe 2 di Rumah Sakit Umum Pusat Sanglah Denpasar. Denpasar: Program Magister, Program Studi Ilmu Biomedik, Program Pascasarjana, Universitas Udayana; 2014.
9.Yu S, Chen Y, Hou X, Xu D, Che K, Li C, et al. Serum Uric Acid Levels and Diabetic Peripheral Neuropathy in Type 2 Diabetes: a Systematic Review and Meta-analysis. Mol Neurobiol. 2014:1-7.
10.Kang D, Ha S. Uric Acid Puzzle: Dual Role as Anti-oxidant and Pro-oxidant. Electrolyte Blood Press. 2014;12:1-6.
11.Desideri G, Castaldo G, Lombardi A, Mussap M, Testa A, Pontremoli R, et al. Is it time to revise the normal range of serum uric acid levels?. European Review for Medical and Pharmacological Sciences. 2014;18:1295-1306.
12.So A, Thorens B. Uric acid transport and disease. J Clin Invest. 2010;120(6):1791–1799.
13.Kanbay M, Segal M, Afsar B, Hee Kang D, Iturbe BR, Johnson RJ. The role of uric acid in the pathogenesis of human cardiovascular disease. Heart. 2014;99:759–766.
14.Miric DJ, KisicBM, DanicSF, GrbicR, DragojevicI, MiricMB, et al. Xanthine Oxidase Activity in Type 2 Diabetes Mellitus Patients with and without Diabetic Peripheral Neuropathy. Journal of Diabetes Research. 2016:1-7.
15.Singh R, Kishore L, Kaur N. Diabetic peripheral neuropathy: Current perspective and future directions. Pharmacological Research. 2013;80:21–35.
16.Yagihashi S, Mizukami H, Sugimoto K. Mechanism of diabetic neuropathy: Where are we now and where to go. Journal of Diabetes Investigation. 2011;2(1): 1-15.
17.Smith AG, Singleton JR. Obesity and Hyperlipidemia are Risk Factors for Early Diabetic Neuropathy. J Diabetes Complications. 2013;27(5):436–442.
18.Albers JW, Pop-Busui R. Diabetic Neuropathy: Mechanisms, Emerging Treatments, and Subtypes. Curr Neurol Neuroscience. 2014;14(8):1-18.
19.Lee JW, Jang S, Hwaa Lee S, Seok Lee H. Correlation Between the Severity of Diabetic Peripheral Polyneuropathy and Glycosylated Hemoglobin Levels: A Quantitative Study. Ann Rehabil Med. 2016;40(2):263-270.
DOI: https://doi.org/10.22146/bns.v18i1.55065
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