dharma Lindarto, dharma
Department Of Internal Medicine, Faculty Medicine, Universitas Sumatera Utara, Medan, Indonesia

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Kadar hs-CRP pada Pasien DM tipe-2 Dengan dan Tanpa Hipertensi Efi Ramadhan; Ozar Sanuddin; Dharma Lindarto
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 49, No 2 (2016): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Introduction : More than 50% of patients with type-2 diabetes have hypertension. Hypertension contributes the development of cardiovascular disease. hs-CRP is an inflammation marker which is associated with cardiovascular risk. The aim of this study is to measure hs-CRP in type-2 diabetes with and without hypertension and to assess hs-CRP levels based on cardiovascular risk group.Methods : This study is an analytical observational cross-sectional study. Performed at the Department of Clinical Pathology Adam Malik Hospital, the total of type-2 DM subjects with and without hypertension is 56, with 28 in each group. Laboratory tests: complete blood count, blood sugar levels, HbA1C, SGOT, SGPT, Lipid Profile, hs-CRP.Results : There was significant differences in the average levels of hs-CRP in type-2 diabetic patients with hypertension (4.03±2.49) and without hypertension (1.98 ± 1.93), p = 0.001. In this study seen an increase in the average levels of hs-CRP is based on group risk of cardiovascular disease in patients with type 2 diabetes with and without hypertension (p= 0,001 ). In the group of type-2 diabetes with hypertension, may not find a mild risk of cardio-vascular disease. It shows the type 2 DM patients with hypertension is more at risk of cardio-vascular disease than type 2 DM without hypertension.Discussion : hs-CRP levels were higher in type-2 diabetes with hypertension and associated with the risk of cardiovascular disease. Conclusion : There are significant differences between the levels of hs-CRP type-2 diabetes with and without hypertension.Keywords :  type-2 diabetes, hypertension, hs-CRP 
Hubungan antara Red Blood Cell Count (RBC) dan Retinopati Diabetik pada Pasien Diabetes Melitus tipe 2 Irmayani Irmayani; Santi Syafril; Dharma Lindarto
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 49, No 2 (2016): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Background : Diabetic retinopathy is main complications of diabetes. Some studies suggest a relation between red blood cell count (RBC) and diabetic retinopathy. Diabetic retinopathy is diagnosed with funduscopic examination, while red blood cell count can be seen from the peripheral blood examination, with the result is a relation of a decreased red blood cell count with diabetic retinopathy.Objective : To determine the relation between RBC count and diabetic retinopathy in diabetic type 2 patients. So that these parameters can be used as prospective and reliable indicators to detect complication of diabetes mellitus in the target organs, specially the eyes as early as possible.Methods: This cross sectional study with measurement data from March - June 2015, there were  49 patients with type 2 diabetic examined from the anamnesis, examination of vital signs, physical examination, and examination of routin peripheral blood, HbA1C ,fasting and 2 hours post prandial glucose count, lipid profile and funduscopy, subsequently the patients were classified in to two group, the diabetic retinopathy and without diabetic retinopathy respectively.Results : From 49 subjects were included and observed in this study, from statistical analysis data found that there are relation between age (p=0,001), smoking habbit (p=0,006), hemoglobin (Hb) (p=0.002), duration of diabetic (p=0,0001) and  the RBC count with diabetic retinopathy (p= 0,0001 ). From multivariate analysis we found that RBC range lower than 4,8 billion/mm3 are independent predictor for the incidence of diabetic retinopathy.Conclusion : This study found a significant relation between RBC count and diabetic retinopathy and RBC also can predict the incidence of diabetic retinopathy in patient with diabetes.Keywords : RBC, diabetic retinopathy, diabetes.
Hubungan Fungsi Sel β Pankreas dengan Profil Lipid Individu dengan Toleransi Glukosa Normal Farik Zarmal; Santi Syafril; Dharma Lindarto
Cermin Dunia Kedokteran Vol 43, No 8 (2016): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i8.89

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Latar Belakang: Beberapa studi mendapatkan bahwa disfungsi sel β pankreas akibat dislipidemia merupakan faktor risiko independen timbulnya DM tipe 2. Penelitian ini bertujuan untuk mengetahui hubungan antara fungsi sel β pankreas (HOMA-B) dan profil lipid (kolesterol total, LDL, HDL, trigliserida) pada individu dengan toleransi glukosa normal. Metode: Studi potong lintang terhadap 32 individu bukan penderita DM tipe 2 dengan toleransi glukosa normal. Uji Spearman digunakan untuk menilai korelasi antara HOMA-B dan profil lipid. Hasil: Dari 32 sampel, diperoleh hasil bahwa fungsi sel β pankreas memiliki hubungan signifikan dengan kolesterol total (r= -0,601; p=0,0001) dan LDL (r= -0,555;p=0,001), di mana peningkatan kadar kolesterol total dan LDL diikuti penurunan fungsi sel β pankreas. Tidak terdapat hubungan signifikan antara fungsi sel β pankreas dengan HDL dan trigliserida pada studi ini. Simpulan: Terdapat hubungan signifikan antara HOMA-B dengan kolesterol total dan LDL. Tidak terdapat hubungan signifikan antara HOMA-B dengan HDL dan TG. Kadar kolesterol total dan LDL dapat menjadi prediktor awal disfungsi fungsi sel-β pankreas.
The Differences Level of Resistin between Positive and Negative Helicobacter pylori Gastritis and its Correlation with Nutritional Status Widya Deli Satuti; Gontar Alamsyah Siregar; Dharma Lindarto; Imelda Rey
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 2 (2020): VOLUME 21, NUMBER 2, August 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (241.662 KB) | DOI: 10.24871/2122020114-119

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Background: H. pylori gastritis can be related to people with obesity and metabolic syndrome. The mechanism underlying the relationship between them is suspected to be caused by adipocytokine called resistin. Objective: to analyze the difference level of resistin between positive and negative H. pylori gastritis patients and their relationship with nutritional status.Method: This cross sectional study was done in the Gastroenterology department of General Hospital Adam Malik, Medan, from May to October 2019. Patients with gastritis diagnosed by endoscopy underwent rapid urease test (RUT), resistin, albumin, hemoglobin tests, also body mass index (BMI) and waist circumference (WC) were measured.Results: Sixty gastritis patients found by endoscopic examination, 29 (48.33%) was H. pylori positive and 31 (51.67%) was negative. No significant differences were found between BMI, WC, and albumin against H. pylori gastritis with p values 0.099, 0.055, and 0.528, respectively. Hemoglobin was found significant with a p 0.009. The mean resistin in the positive H. pylori group was 7.62 ng/ml while the negative was 3.23 ng/ml, and statistically significant (p 0.001). There was a strong positive correlation between resistin levels with BMI and WC (BMI p 0.01, r 0.577; WC p 0.001, r 0.592).Conclusion: Resistin levels in gastritis with H. pylori positive are higher than H. pylori negative, body mass index and waist circumference have a strong relationship with resistin levels in patients with positive H. pylori gastritis, hemoglobin is lower in H. pylori positive than negative gastritis.
HUBUNGAN RESISTENSI INSULIN DENGAN DERAJAT KEPARAHAN COVID-19 PADA PASIEN DIABETES MELITUS TIPE 2 Priska Krinanta Ginting; Dharma Lindarto; Santi Syafril
Al-Iqra Medical Journal : Jurnal Berkala Ilmiah Kedokteran Vol 5, No 2 (2022): ILMU KEDOKTERAN
Publisher : Journal Medical Universitas muhammadiyah Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26618/aimj.v5i2.8027

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Resistensi Insulin (IR) mungkin merupakan faktor kunci potensial di balik derajat keparahan COVID-19 namun di Indonesia sendiri, belum ada data mengenai hubungan resistensi insulin terhadap derajat keparahan COVID-19, khususnya yang menggunakan pemeriksaan HOMA IR. Untuk mengetahui hubungan resistensi insulin dengan derajat keparahan COVID-19 pada pasien Diabetes Melitus tipe 2. Penelitian ini dengan rancangan analitik cross sectional dengan pengambilan data secara prospektif dengan sumber rekam medis yang di rawat inap isolasi RSUP Haji Adam Malik Medan dari bulan Juni 2021 – September 2021 pada pasien yang terdiagnosa COVID-19 dengan komorbid diabetes mellitus yang memenuhi kriteria inklusi dan eksklusi. Untuk analisis resistensi insulin berdasarkan skor HOMA-IR dengan derajat keparahan COVID-19 berdasarkan manifestasi klinis yang muncul (ringan, sedang, berat, dan kritis) dilakukan uji chi square dan dinyatakan bermakna apabila nilai p 0.05. Mayoritas subjek penelitian memiliki skor HOMA-IR 3,8 sebanyak 35 orang, 21 orang (60,0%) di antaranya merupakan COVID-19 derajat berat dan 8 orang (22,9%) di antaranya merupakan COVID-19 derajat sedang, 6 orang (17,1%) di antaranya merupakan COVID-19 derajat kritis. Subjek penelitian yang memiliki skor HOMA-IR 2,6 sebanyak 32 orang, 24 orang (75,0%) di antaranya merupakan COVID-19 derajat sedang, 7 orang (21,9%) di antaranya merupakan COVID-19 derajat berat dan 1 orang (3,1%) di antaranya merupakan COVID-19 derajat kritis. Subjek penelitian yang memiliki skor HOMA-IR 2,6-3,8 sebanyak 7 orang, 4 orang (57,1%) diantaranya merupakan COVID-19 derajat sedang, 2 orang (28,6%) di antaranya merupakan COVID-19 derajat berat dan 1 orang (14,3%) di antaranya merupakan COVID-19 derajat kritis. Terdapat perbedaan yang signifikan antara skor HOMA-IR dengan derajat keparahan COVID-19 secara statistik. 
Lipid Profile in Confirmed Covid-19 Patients with Type 2 Diabetes Mellitus At Haji Adam Malik General Hospital Medan from March 2020 to December 2021 Sitepu, Annisa Nidya Rahmatika; Lindarto, Dharma; Nasution, Melati Silvanni
Journal of Society Medicine Vol. 2 No. 3 (2023): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i3.37

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Introduction: Diabetes can cause secondary hyperlipidemia. In COVID-19, dyslipidemia is thought to be the result of biological and pathological processes triggered by SARS-CoV-2. Altered lipid profiles have been reported since the beginning of the COVID-19 pandemic, where the alteration of lipid profile and the severity of SARS-CoV-2 infection were positively correlated. This study aims to analyze the lipid profile in confirmed COVID-19 patients with T2DM at H. Adam Malik General Hospital Medan. Method: This was a descriptive study with a cross-sectional design using a total sampling technique by collecting secondary data on inpatients with confirmed COVID-19 with T2DM  at H. Adam Malik General Hospital from 2020 to 2021 which was then analyzed using the SPSS version 25 application. Results: Of the 372 subjects, the most common sex was male (57.3%), 193 people had a BMI of 18.5 - 24.9kg/m2 (51.9%), the mean overall age was 57.5 ± 10.4 years, and the median length of stay was 8 days. The most common comorbid was hypertension (n=189, 50.8%), 176 people had severe COVID-19 (47.3%), and 225 patients were discharged (60.5%). Based on laboratory data, 327 people had dyslipidemia (87.9%), 31 people had mild acute liver impairments (8.3%), the average of HbA1c was 9.0±2.5%, the average fasting blood glucose was  221.7±122.2 mg/L, the average 2 hours post-prandial blood glucose was 261.7±125.8 mg/L, an average of total cholesterol was 151.2±52.2 mg/L, an average of triglycerides was 147.5±99.1 mg/L, an average of HDL was 33.1±14.6 mg/L, an average of LDL was 97.4±44.5 mg/L, the median of ALT was 25 μ/L, and an average of AST was 30.45±27.42 μ/L. Conclusion: Total cholesterol, triglyceride, and LDL were lower in T2DM patients with a critical illness of COVID-19 and patients who died.
Factors that Influencing Sputum Conversion at the End of Intensive Phase on TB-DM Patients at Medical Health Service in Medan Pertiwi, Vani Gita; Sinaga, Bintang YM; Lindarto, Dharma
Buletin Farmatera Vol 6, No 2 (2021)
Publisher : Universitas Muhammadiyah Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30596/bf.v6i2.4767

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Tuberculosis and type 2 DM are the main problems of health in the world, including Indonesia. Many sputum conversion failures are found in TB-DM patients. This study aims to know about the factors that influence sputum conversion at the end of the intensive phase on TB-DM patients at the Medical Health Service in Medan. This research was carried out in a Specialized Lung Hospital and eight Health Centers in Medan. The Design of this study is observational analytic with a Cross-Sectional approach that took place in October-December 2019. Of 76 patients, there were 65 subjects (85.5%) with sputum conversion and 11 subjects (14.5%) without sputum conversion, the number of male patients was 48 subjects (63.2%), elderly were 51 subjects (67.1%), the normals BMI were 54 subjects (71.0%), patients with smoking were 4 subjects (5.3%), previous alcohol consumptions were 6 subjects (7.9%), current blood sugar levels 200 mg/dl are 23 subjects (30.2%) and the patients which using the anti-diabetes medication regularly were 62 subjects (81.6%). This study found that there was a significant relationship between alcohol, current blood sugar levels, and regularity using anti-diabetes medication with sputum conversion (p=0.036, p=0.001, p=0.001), while the factors that influence sputum conversion are alcohol and regularity using anti-diabetes medication (p=0.032, dan p=0.001).
Effect of Lifestyle Modification with Metformin on Serum Chemerin Concentration of Metabolic Syndrome Subjects Dharma Lindarto; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 1 No. 1 (2019): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (313.702 KB) | DOI: 10.32734/jetromi.v1i1.1110

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Chemerin is adipokine that plays an important role in macrophage infiltration into adipose tissue and may contribute to inflammation development and insulin resistance. This study aimed to determine the effect of lifestyle modification with and without metformin on chemerin in metabolic syndrome. Forty-five metabolic syndrome subjects (IDF-2005) were randomly assigned to one of the two groups: placebo group (n=22) and metformin group (n=23). Both groups underwent a 12-week lifestyle modification (diet and moderate aerobic-exercise). Only 40 participants (placebo group n=20 and metformin group n=20) completed the survey whereas 5 participants dropped out of the study. After their lifestyle was modified, body weight, BMI, WC, and chemerin decreased significantly (p<0.001) in both groups. Moreover, there was a significant difference between both groups in body weight, BMI, and WC (p<0.05) but not for chemerin. Thus, lifestyle modification with metformin improved BW, BMI, WC on metabolic syndrome, and there was no decrease significantly of chemerin between placebo and metformin groups. Further investigations should be done to confirm the effect of lifestyle modification and metformin on chemerin after an extended follow-up period.
The Relationship Between Adma and Anthropometric, Glucose, Lipid, and Inflammatory Parameters in Obese Dharma Lindarto; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 1 No. 1 (2019): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (292.51 KB) | DOI: 10.32734/jetromi.v1i1.1111

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Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxideproduction and involved in various pathological processes, especially processes involvingcardiovascular risk. The purpose of this study was to analyze the correlation betweenADMA and anthropometric, glucose, lipid, and inflammatory parameters. The study wasanalyzed by a cross-sectional study of 45 obese subjects at H. Adam Malik Hospital. Bloodtests were carried out after 8-10 hours of fasting against cardiovascular risk: anthropometry(body weight, BMI, and WC), glucose (FPS, PPS, HbA1C, Fasting Insulin, and HOMA-IR), lipid (LDL-C, HDL-C, TG, and sd-LDL), and inflammation (ApoB and hs-CRP)parameters. The results showed of the 45 subjects, the average age was 41.69 ± 5.69 yearsold, and the average BMI was 33.09 ± 5.05 (Obesity I). ADMA was also found to becorrelated significantly with FPG, HBA1c, and TG parameters [r=-0.506, p=0.001; r=-0.334, p=0.013, dan r = -0.315. p=0.017, respectively]. In obesity, ADMA correlatedsignificantly with cardiovascular risk parameters: FPG, HbA1C, and TG.
Effect of Lifestyle Modification and Metformin on Fetuin-A and Transforming Growth Factor-ß (TGF- ß) in Metabolic Syndrome Melati Silvanni Nasution; Dharma Lindarto
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 1 No. 1 (2019): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (372.858 KB) | DOI: 10.32734/jetromi.v1i1.1266

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Fetuin-A is a liver-synthesized protein that is secreted into serum. Transforming growth factor-β (TGF-β) is a polypeptide member of the TGF-β superfamily of cytokines. The purpose of this study is to evaluate the effects of lifestyle modification and metformin on fetuin-A and Transforming Growth Factor-ß (TGF- ß) in metabolic syndrome (MetS). Forty MetS subjects were randomly assigned to treatment with placebo (n=20) or metformin (n=20) in addition to lifestyle modification for 12 weeks. All 40 participants completed the study. After 12 weeks, both groups had significant reductions in weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (all p<0.001). The placebo group also had significant improvement in fasting plasma glucose (FPG) and C-reactive protein (CRP) (p<0,001 ; p<0.05 respectively). Weight, BMI, WC, FPG, 2-hour postprandial glucose (2h-PPG), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), fetuin-A and TGF- ß in the metformin group decreased significantly compared to the placebo group. Reduction of plasma fetuin-A was significantly associated with TG in the metformin group. Lifestyle modification and treatment with metformin for 12 weeks improved cardio-metabolic risk factors in MetS and reduced fetuin-A levels.