THE ENDOTHELIN-1 LEVEL OF FEMALE TYPE 2 DIABETIC PATIENTS WITH AND WITHOUT MICROANGIOPATHY COMPLICATIONS
Siti Mazayyanah(1*)
(1) 
(*) Corresponding Author
Abstract
Background. Chronic complications of diabetes mellitus (DM) include microangiopathy and macroangiopathy. Microangiopathy includes retinopathy, nephropathy and neuropathy, while macroangiopathy includes coronary heart disease, stroke and peripheral arterial disease. When the diagnosis is established in Type 2 Diabetes Mellitus (DM), approximately 25% had suffered non‐proliferative diabetic retinopathy. Within one to three years of non-proliferative retinopathy progresses to proliferative diabetic retinopathy can eventually be leading to retinal detachment, glaucoma and blindness. Diabetic nephropathy occurs in 20‐40% of patients with diabetes mellitus. Diabetic nephropathy is the leading cause of End Stage Renal Disease (ESRD) and is a high risk of Cardiovascular Disease (CVD). Endothelial dysfunction underlies all of this. Markers of endothelial dysfunction endothelin‐1 are assessed in patients with type 2 diabetes with retinopathy or nephropathy and without retinopathy and nephropathy.
Aim of the study. The aim of the study is to show the differences between the level of Endothelin-1 on female patients Type-2 Diabetes Mellitus with retinopathy or nephropathy compared to those without retinopathy and nephropathy.
Method and subjects. This study uses a cross sectional design which was conducted on subjects from outpatient type 2 diabetes mellitus women with retinopathy or nephropathy compared without retinopathy and nephropathy at endocrinology clinic, Dr. Sardjito General Hospital, Yogyakarta. ELISA sandwich’s method was used to measure plasma levels of endothelin‐1 from veins blood. Differences between groups were compared by student’s unpaired t‐test and Mann‐Whitney test (significant when p<0.05). Diabetic retinopathy is enforced through inspection fundoscopy. Diabetic nephropathy is diagnosed by albumin creatinine ratio (ACR) ≥ 30ug/mg.
Result. The results showed that there were 52 female subjects with type 2 DM is composed of them 26 (50%) subjects with retinopathy or nephropathy and 26 (50%) subjects without retinopathy and nephropathy. Median age was 54 (44‐59) years. The mean level(s) of endothelin‐1 obtained (was higher) in women with type‐2 diabetes mellitus with retinopathy or nephropathy (was) 19,47 ± 9,94 ng / ml (and) (compared) with no retinopathy and nephropathy (was) 17,64 ± 11,63 ng / ml (with) (although the difference was not statistically significant) p = 0,944.
Conclusion. (Endothelin‐1 levels were higher in women with type‐2 diabetes mellitus with retinopathy or nephropathy than without retinopathy and nephropathy, but the difference was not statistically significant.) No significant difference in endothelin-1 level between type 2 diabetic female patients with and without microangiopathy complications).
Key words: endothelin‐1, diabetic retinopathy, diabetic nephropathy, type 2 diabetes mellitus.
References
PERKENI, 2006. Konsensus Pengelolaan dan Pencegahan Diabetes Mellitus Tipe 2 di Indonesia. 1-58
McPhee, S.J., Papadakis, M.A., 2010. Current Medical Diagnosis and Treatment. 49th Ed. New York: McGraw-Hill
American Diabetes Association, 2010. Diagnosis dan Klasifikasi Diabetes Mellitus. Diabetes Care , volume 33, Supplement 1: 562-569
Chakrabarti, S., Khan, Z. A., Cukiernik, M., Fukuda, G., Chen, S.,Mukherjee, S., 2002. Alteration of endothelins: A Common pathogenetic mechanism in chronic diabetic complications. Int J ExpDiab. Res., 3, 217-231
LeJemtel, T. H., Frishman, W. H., Sonnenblick, E. H., 2005.Diagnosis Management of heart Failure. In: O’Rourke, R. A.,Fuster, V., Alexander, R.W., Roberts, R., King, S.B., Nash, E.N (eds).Hurst’s The Heart Manual of Cardiology, 11th edition. McGraw-Hills:63-76.
Goldberg, E., Chopra, S., 2010. Diagnostic approach to the patient with cirrhosis. Up-to-date version 19.1.
Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2009.Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. www.goldcopd.com.update
Neviere, R., 2010. Sepsis and the systemic inflammatory response syndrome: Definitions, epidemiology and prognosis. Up-to-date version19. 1.
Grundy, S., Cleeman, J., Daniel, S., Donato, K., Eckel, R., Franklin, B. 2005. Diagnosis and management of the metabolic syndrome, An American Heart Association / National Heart, Lung and Blood Institute Scientific Statement. Circulation. 12: 225-229
Pandelaki, K., 2009. Retinopati Diabetik. Dalam : W.S. Aru, S. Bambang, A. Idrus, S.K. Marcellus, S, Siti (eds). Buku Ajar Ilmu Penyakit Dalam. Edisi ke-5. Fakultas Kedokteran Universitas Indonesia: 1930-1936.
Dahlan, M.S., 2009. Statistik untuk Kedokteran dan Kesehatan, Penerbit Salemba Medika, Jakarta.
Hendromartono, 2009. Nefropati Diabetik. Dalam : W.S. Aru, S. Bambang, A. Idrus, S.K. Marcellus, S, Siti (eds). Buku Ajar Ilmu Penyakit Dalam. Edisi ke-5. FakultasKedokteran Universitas Indonesia: 1942-1946.
Inoue, A., Yanagiswara, M., Kimura, Y., Miyauchi, T., Goto, K.,andMayasaki,Y., 1989. The human endothelin family: predicted by three separate genes. Proc. Natl. Acad. Sci. U. S. A., 86, 2863-2867
Ilyas, S., 2003. Ilmu Penyakit Mata. Edisi ke-2. Fakultas Kedokteran Universitas Indonesia: 224-227
Vismanathan, V., Snehalatha, C., Mamtha, B., Nair and Ramachandran, A., 2004. Markers of endothelial dysfunction in hyperglycaemic Asian Indian subjects. Journal of Diabetes and its Complication, volume 18, Issue 1, 2 : 47-52
Singh, U., Singh, R.G., Singh, S., Shailja, S., 2011. Plasma endothelin level in hypertension and diabetes mellitus. Medical Case Studies. 2 (6):50-53
Ak G., Buyukberber, S., Sevinc, A., Turk H. M., Ates, M., Sari, R.,Savli, H., Cigli, A., 2001. The relation between plasma endothelin-1levels and metabolic control, risk factors, treatment modalities and diabetic microangiopathy in patients with Type 2 diabetes mellitus. J Diabetes Complications., 15(3): 150-7
DOI: https://doi.org/10.22146/acta%20interna.3846
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