PENURUNAN BILIRUBIN MENINGKATKAN OKSIDASI LIPOPROTEIN A PADA NEFROPATI DIABETIK
ABSTRACT: Diabetic nephropathy
is the most common complication of microvascular disease due to diabetes and
the third leading cause of renal failure to the end stage. One of the causes of
diabetic nephrophaty progression is increase oxidants by lipoprotein a.
Bilirubin is a lipophilic endogenous antioxidant that can prevent oxidant
effect. This study aims to determine the correlation between bilirubin levels
and lipoprotein a in patients with diabetic nephropathy. This research is a
case control study with consecutive sampling technique. The subjects were
divided into two groups, 25 subjects in the diabetic nephropathy group and 25
subjects in the type 2 diabetes mellitus group without nephropathy. Spearman
correlation was used to assess the correlation between bilirubin and
lipoprotein a and the mann-whitney test to assess the ratio of bilirubin and
lipoprotein a levels in both groups. Antioxidant effect of bilirubin
significantly negative correlated with lipoprotein a in the diabetic
nephropathy group (r = -0.734; p = 0.000) and also significantly negative
correlated in the group of type 2 DM without nephropathy (r = -0.476; p =
0.016). Bilirubin levels in diabetic nephropathy were lower when compared with
the group of type 2 DM without nephropathy (OR = 1.3, 95%; CI = 0.23-10.3)
whereas lipoprotein a in the diabetic nephropathy group was higher when
compared to the type 2 DM group without nephropathy ( OR = 2.8; 95%; CI =
1.84-12.07). Lipoprotein a is a more important risk factor for diabetic
nephropathy. Low levels of bilirubin can increase oxidant effect of lipoprotein
a and lipoprotein a play a role in progressivity of diabetic nephrophaty.
Kata kunci: Bilirubin, Lipoprotein a, Nefropati Diabetik, Diabetes
Mellitus tipe 2
Penulis: Meutia Atika
Faradilla, Yahwardiah Siregar, Darwin Dalimunthe
Kode Jurnal: jpkedokterandd170540
