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Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 21 / No. 2 / Published : 2015-03

TOC : 3, and page :120 - 124

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Original Article :

High molecular weight adiponectin and vasculer thickness in diabetes type 2 related to fixed dose combination of glimepiride and metformin

Author :

  1. Ari Sutjahjo*1
  1. Bagian Penyakit Dalam RSUD Dr. Soetomo – Universitas Airlangga Surabaya

Abstract :

Diabetic patients have the tendency to develop micro vascular and macro vascular complications due to the hyperglycaemic state. There are various types of oral hypoglycaemic agents available in Indonesia, nevertheless, these agents fail to decrease mortality and morbidity due to the endothelial dysfunction in diabetic patients. It is not yet known whether glimepiride metformin fixed dose combination is able to improve the serum High Molecular Weight (HMW) adiponectin and vascular stiffness which are important parameters of the cardiovascular risk factors. This study was to know the effect of glimepiride metformin fixed dose combination by investigation after 12 weeks of treatment towards HMW adiponectin level and vascular stiffness using ba-PWV in type 2 diabetes. This research was carried out by a Quasi experimental study with pre and post test design. The subjects were type 2 diabetes patients who came to the Endocrinology Outpatient Clinic at the Dr. Soetomo Hospital and 6 health centres in Surabaya during December 2010 to December 2011. In this study, measuring the HMW adiponectin level in plasma was by using ELISA method and the ba-PWV by using the V Serra-1000 before and after treatment with glimepiride metformin fixed dose for 12 weeks. Based on the thirty five type 2 diabetic patients who met the inclusion and exclusion criteria and who were enrolled in this study, after 12 weeks of treatment, the median HMW Adiponectin level was increased from 1736 ng/mL to 1770 ng/mL, which was statistically not significant (p=0.317). After 12 weeks treatment, the median of ba-PWV was decreased from 1580 cm/sec to 1450 cm/sec, which was statistically significant (p=0.028). The level of HMW adiponectin was not signifantly different between before and after treatment. The level of brachial ankle Pulse Wave Velocety (ba-PWV) was significantly different between before and after treatment. Glimepiride metformin fixed dose combination decreases the vascular stiffness, which is one of the parameters of the endothelial dysfunction.   Pasien pengidap penyakit diabetes memiliki kecenderungan untuk terjadi komplikasi mikro dan makrovaskular akibat kondisi hiperglikemia. Ada berbagai jenis obat pencegah diabetes yang tersedia di Indonesia akan tetapi obat-obatan ini gagal untuk mengurangi angka kematian dan kesakitan terkait disfungsi endotel di pasien diabetes. Hingga saat ini masih belum diketahui apakah gabungan glimepiride dan metformin berdosis tetap dapat memperbaiki level serum adiponektin. High Molecular Weight (HMW) dan kekakuan vaskular yang merupakan tolok ukur terpenting dari faktor kebahayaan kardiovaskular. Tujuan penelitian ini adalah untuk mengetahui pengaruh gabungan pengobatan glimepiride metformin setelah diobati selama 12 minggu terhadap kadar HMW adiponektin dan kekakuan vaskular dengan menggunakan alat brachial ankle Pulse Wave Velocety (ba-PWV) di pasien diabetes tipe 2. Kajian yang dilakukan ini adalah kuasi percobaan dengan sebelum dan sesudah rancangan. Sampel adalah pasien diabetes tipe 2 yang datang ke poliklinik rawat jalan endokrin di rumah sakit Dr. Soetomo dan enam (6) pusat kesehatan masyarakat di Surabaya selama bulan Desember 2010 hingga Desember 2011, serta memenuhi patokan kesertaan dan bukan kesertaan. Pasien kemudian mendapatkan pengobatan dengan obat gabungan glimepiride dan metformin selama 12 minggu dan kemudian kadar adiponektin diukur dengan menggunakan metode ELISA serta diukur dengan menggunakan V Serra-1000. Sampel diambil dari 35 orang pasien DM tipe 2 yang memenuhi patokan kesertaan dan bukan kesertaan. Kadar HMW adiponektin meningkat dari 1736 ng/mL menjadi 1770 ng/mL setelah 12 minggu, yang secara statistik tidak berbeda secara bermakna (p=0,317). Rerata dari ba-PWV berkurang dari 1580 cm/sec menjadi 1450 cm/sec setelah 12 minggu pengobatan, yang secara statistik sangat bermakna (p=0,028). Didasari hasil meneliti ini, kadar adiponektin HMW tidak berbeda bermakna sebelum dan setelah pengobatan, sedangkan kadar ba-PWV berbeda bermakna sebelum dan sesudah hal tersebut. Gabungan glimepiride dan metformin terbukti mengurangi kekakuan vaskular, yang merupakan salah satu tolok ukur disfungsi endotel.

Keyword :

Type-2 diabetes mellitus, glimepiride metformin fixed dose, HMW adiponectin, vascular stiffness, ba-PWV,


References :

  1. Kholili U., (2008). Efek glimepiride terhadap kadar adiponektin-high molecular weight (HMW) dan kekakuan vaskuler pada diabetes mellitus tipe-2. 55–61. : Penelitian karya akhir untuk mendapatkan keterangan keahlian Ilmu Penyakit Dalam, Departemen – SMF Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Airlangga, RSU Dr. Soetomo
  2. Nagasaka S, Tanaguchi A, Aiso Y, Yatagai T, Nakamura T, Nakai Y, Fukushima M, Kuroe A, Ishibashi A, (2003). Effect of glimepiride on serum adiponectin level in subjects with type 2 diabetes.. 26: 2215 : Diabetes Care


   


Archive Article

Cover Media Content

Volume : 21 / No. : 2 / Pub. : 2015-03
  1. Pneumatic tube on routine blood test and lactate dehydrogenase
  2. Detection in tetrazolium microplate assay culture methods from pulmonary tuberculosis suspected sputum
  3. High molecular weight adiponectin and vasculer thickness in diabetes type 2 related to fixed dose combination of glimepiride and metformin
  4. Neutrofil/lymphocyte ratio in carcinoma mammae
  5. Platelet aggregation and mean volume with metabolic syndrome in obesity
  6. Diagnosis of pulmonary tuberculosis based on frequency of sputum examination
  7. Genetic variation of hepatitis b virus polymerase gene from chronic hepatitis b infected patient with telbivudine therapy
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  11. Diagnostic value of iga antivca epstein-barr antibody in nasophryngeal carcinoma
  12. Blood glucose test between hexokinase with glucose oxidase and glucose dehydrogenase methods in diabetes mellitus
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  14. Lipoprotein(a) in acute coronary syndrome
  15. D-dimer plasma levels in ishemic stroke
  16. Adrenomedullin’s in breast cancer with metastatic state
  17. Storage temperature for 24 hours of uric acid in urine
  18. Ebola virus disease
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