Anak Agung Gede Budhitresna
Faculty of Medicine and Health Sciences, Warmadewa University, Denpasar

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Korelasi Kadar Angiopoietin-2 Plasma dan Petanda Inflamasi Dengan Resistensi Insulin Pada Penderita Obesitas Abdominal Anak Agung Gede Budhitresna
WMJ (Warmadewa Medical Journal) Vol 1 No 1 (2016): Mei 2016
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.1.1.5.10-16

Abstract

Obesitas abdominal (Ob-Ab) merupakan komponen utama resistensi insulin (RI) yaitu kekutan pendorong utama untuk terjadinya diabetes mellitus (DM)  tipe-2. Kadar angiopoietin-2  (Ang-2) plasma dilaporkan mengalami peningkatan pada  penderita Ob-Ab dan diduga bahwa Ang-2 berpengaruh untuk terjadinya RI. Tujuan penelitian ini adalah untuk mengetahui korelasi kadar Ang-2, Inflamasi dan RI pada penderita Ob-Ab. Dilakukan penelitian secara cross-sectional analitik pada 81 penderita dengan Ob-Ab. Kadar  TNF-α, sTNFR1 dan Ang-2 plasma diukur menggunakan metode ELISA. RI diukur menggunakan HOMA-IR. Analisis varian (ANOVA) dipergunakan untuk mengetahui persamaan variabel kontinyu. Analisis multivariat dipergunakan untuk mengetahui peran kadar TNF-α, s-TNFR-1, Ang-2 terhadap RI. Model analisis jalur (path analysis) dipergunakan untuk mengetahui pengaruh faktor risiko terjadinya RI. Hasil penelitian menunjukkan bahwa kadar TNF-α plasma tidak berkorelasi dengan HOMA-IR, sedangkan sTNFR-1 dan  Ang-2 plasma berkorelasi positif bermakna dengan HOMA-IR (masing-masing r=0,323; p=0,003 dan r=0,641; p=<0,001). Pada analisis multivariat ditemukan Ang-2 merupakan faktor bebas berhubungan dengan HOMA-IR (p=<0,001). Kadar Ang-2 plasma yang tinggi merupakan faktor dominan (64,1%, p=<0,001). Simpulan: pada penderita Ob-Ab kadar Ang-2 berkorelasi dengan terjadinya RI dan inflamasi.Kata kunci: Ang-2, resistensi insulin, inflamasi, obesitas abdominal. [Correlation of Plasma Angiopoietin-2 and Inflammation Marker with Insulin Resistence in Patients with Central Obesity]Abdominal obesity (Ab-Ob) is a central component of insulin resistance (IR) and it is suggested that IR is a driving factor in the development of type 2 diabetes mellitus (T2DM).  Plasma Ang-2 levels have been reported to increase in the Ab-Ob and it has been hypothesized that Ang-2 plays important role in the occurrence of IR. We assessed the relationship between plasma Ang-2 levels, Inflammation and IR in Ab-Ob. A cross-sectional analytic study on 81 abdominally obese subjects was performed. The concentrations of TNF-α, sTNFR1 and Ang-2 plasma were measured using ELISA method. IR was measured using HOMA-IR. Analysis of variance (ANOVA) was used to test the equality of continuous variables. Multivariate analyses were performed to examine the influence of TNF-α, s-TNFR-1, and Ang-2 on IR. Path analysis models were performed to assess the influence of risk factors on occurrence of IR. Plasma of TNF-α was not correlated with HOMA-IR (r=160; p=0.154) whereasTNFR-1 and Ang-2 were significantly positive correlated with HOMA-IR (r=0.323, p=0.003 and r=0.641, p=<0.001, respectively).  The multivariate analysis showed Ang-2 was independently associated with HOMA-IR (p <0.001). It was found that high Ang-2 level was a dominant risk factor (64.1%, p=<0.001) for influencing IR in the abdominally obese subjects. It is concluded that plasma Ang-2 level is correlated with occurrence of IR and inflammation in abdominally obese subjects.Keywords: Ang-2, insulin resistance, inflammation, abdominal-obesity.
Angiography Scores Can Predict Amputation in Diabetic Feet Anak Agung Gede Budhitresna; Anak Agung Gede Agung Budhi Kesuma; Ketut Putu Yasa
WMJ (Warmadewa Medical Journal) Vol 9 No 1 (2024): May 2024
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.9.1.8802.11-17

Abstract

Diabetic foot is a complication of diabetes mellitus, with a risk of amputation. One of the risk factors for amputation is peripheral arterial occlusive disease. Angiography is a diagnostic method used to visualize blood vessels, plan therapeutic actions, and predict prognosis, including the likelihood of amputation. The validity of angiography scores in predicting amputation in diabetic foot patients is assessed. This study is a diagnostic test to determine the validity of angiography scores in predicting amputation in 23 diabetic foot patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Data analysis used the Receiver Operator Curve (ROC) and diagnostic tests to obtain the Area Under the Curve (AUC), cutoff point, sensitivity and specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV), Positive Likelihood Ratio (PLR), and Negative Likelihood Ratio (NLR). The study results showed a cutoff point for angiography scores of 33% with an AUC of 0.9841 (>0.7) for the percent score and a cutoff point of 6 with an AUC of 0.9960 for the total score (>0.7). The sensitivity and specificity of the angiography scores were very good for predicting amputation in diabetic foot, at 92.9% and 88.9% (CI 95%), respectively. With PPV of 92.9% and NPV of 88.9%, the diagnostic value of angiography scores in predicting amputation in diabetic foot patients is supported. This study shows that angiography scores have good validity in predicting amputation in diabetic foot patients.