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Serum calcium ions, ratio of calcium/ creatinine urine and bone mass density in perimenopausal and postmenopausal women Riswan Hadi Kusuma; . Windarwati; Harjo Mulyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 02 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Early diagnosis of osteoporosis is important to take early prevention and treatment. Dual energyX-ray absorbtiometry (DEXA) scan is gold standard diagnosis of osteoporosis. However, it ishigh technology and high cost. Biochemical marker using calcium could be developed for diagnosisof osteoporosis. The study was conducted to evaluate the correlation between serum calciumions level as well as urine calcium and urine creatinine (UCa/UCr) ratio and Bone Mineral Density(BMD) in perimenopausal and postmenopausal women. This was an observational study withcross-sectional design involving women aged 45-75 years who fulfilled the inclusion and exclusioncriteria. Bone Mineral Density was measured using DEXA method. Serum and urine calcium ionswere measured using ISE method, while serum and urine creatinine were determined using Jaffemethod. Ratio of UCa/UCr were then calculated. The correlation between serum calcium ions aswell as the ratio UCa/UCr and BMD of subjects were then analyzed. A total 63 subjects wereinvolved in this study consists of 21 normal subjects, 22 subjects with osteopenia and 20subjects with osteoporosis. Negative correlation between BMD and age (r=-0.591; p=0.001)and positive correlation between BMD and body mass index (BMI) (r=0.432; p=0.001) wereobserved. No correlation between serum calcium ions and BMD (r= -0.145; p=0.258), howevernegative correlation between UCa/UCr ratio and BMD (r=-0.310; p=0.013) were reported.Furthermore, no correlation was found between serum calcium ions and lumbar BMD (r=0.036;p=0.778), while negative correlation was found between UCa/UCr ratio and lumbar BMD (r= -0.414; p=0.001). In conclusion, there is no correlation between serum calcium ions levels andBMD, however there is a weak negative correlation between UCa/UCr ratio and BMD

Sensitivity of Total Protein Creatinine Ratio in Urine for Diagnosis Diabetic Nephropathy . Fatrinawati; . Windarwati; Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTDiabetic nephropathy is one of diabetic complication characterized by proteinuria and impaired renal function. Confirmation of diagnosis based either on urine value of albumin excretion rate (AER) 30-300 mg/24 hours or albumin creatinine ratio (ACR) 30-300 mg/g or total protein creatinine ratio (TPCR) 150-500 mg/g. It is reported that TPCR measurement is more acceptable since it is convenient, fast and does not require special preparation. The aim of this study is to investigate the accuracy of TPCR for diagnosis of diabetic nephropathy among type 2 diabetic patients.This was a diagnostic test study which involves 86 type 2 diabetic patients where urine TPCR value equal or more than 150mg/g was independently and blindly compared with AER as a refference standard to diagnose diabetic nephopathy. The inclusion criteria were type 2 diabetic patients that suspected suffer from diabetic nephropathy (long of illness is more than 4 years) and agree to participate in this study. Those whom were suffer from at least on of the following diseases urinary tract infection, congestive heart failure, liver dysfunction, pregnancy, multiple myeloma, microangiopathy hemolytic anemia (MAHA) and incomplete data were excluded from the study. The results of the study were analyzed using 2x2 table in order to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio for positive test result/LR(+),likelihood ratio for negative test result/LR(-),and accuracy. The average of TPCR among diabetic nephropathy patient was 248.07 mg/g. It was significantly higher as compared to those non diabetic nephropathy patient (103.52 mg/g). It was found 75 true positive result, 9 true negative result, and 2 false positive result. The result showed that TPCR had a sensitivity, specificity, positive predictive value, and negative predictive value of 97.4%, 100%, 100%, and 81,8% respectively to diagnose diabetic nephropathy.Total Protein Creatinine Ratio (TPCR) with value equal or more than 150 mg/g in the morning sample urine can be used to diagnose diabetic nephropathy.Keywords: diabetic nephropathy, total protein creatinine ratio, sensitivity, albumin excretion rate, diagnostic test study

Accuracy of albumin creatinine ratio in comparison with albumine excretion rate for diagnosis diabetic nephropathy in type 2 diabetes mellitus . Fatrinawati; . Windarwati; Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Diabetic nephropathy (DN) is one of complications in diabetic patients manifested bymicroalbuminuria with minimal level of 30 mg/24 hour which is measured at least 2 timesin the period of 3 to 6 months. Microalbuminuria can be measured either albumin excretion rate (AER) or albumin creatinine ratio (ACR). Measurement of ACR is an alternative parameter recommended by WHO in 2011 to diagnose diabetic nephropathy since it is more convenient, fast and not requires special preparation. The purpose of this study was to investigate accuracy of ACR to diagnose DN in type 2 diabetes mellitus (T2DM) patients.This was a diagnostic test study involving 80 T2DM patients. In this study ACR value equal or more than 30 mg/g was independently and blindly compared with AER as the gold standard. The data were analyzed using 2x2 tables in order to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Other data were analyzed using statistic descriptive. Eighty T2DM patients consisting of 38males and 42 females participated in this study. They had suffered from T2DM on average9.5 years, and the average of ACR value was 55.5 mg/g. Total result of true positive andtrue negative was 77. Three result were false negative but none of false positive result.The ACR value equal or more than 30 mg/g had sensitivity, specificity, PPV, and NPV of95.9%, 100%, 100%, and 66.7% respectively. In conclusion, the ACR value equal or morethan 30 mg/g derived from morning urine sample can be used to diagnose DN in T2DMpatients.

Correlation between Adiponectin and Triglyceride Levels in Pregnancy with and without Gestational Diabetes Mellitus I Nyoman Gde Sudana; Windarwati Windarwati; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1697

Gestational Diabetes Mellitus (GDM) is glucose intolerance during pregnancy. Adiponectin causes a decrease in glucose transporter 4 translocation, which reduces glucose uptake due to downstream insulin signal delivery and decreases non-esterified fatty acids so that triglyceride synthesis decreases in pregnancy. This study was conducted to determine the relationship between adiponectin and triglyceride levels in pregnancy, especially in a pregnant female with and without gestational diabetes mellitus. This observational cross-sectional study was conducted by measuring the levels of adiponectin and triglycerides in pregnancy, with and without gestational diabetes mellitus. Researchers proved by analyzing 75 subjects, 24-28 weeks pregnant females who were examined at the primary health center and Dr. Sardjito Hospital, Yogyakarta. Adiponectin levels have a moderate negative correlation with triglycerides in pregnant females (r= -0.420 and p=0.002), a strong negative correlation with GDM (r = -0.680 and p=0.001), and moderate negative correlation (r= -0.455, and p=0.022) with those without GDM. Based on this research can be concluded that adiponectin has a moderate negative correlation with triglycerides in pregnancy, a strong negative correlation in pregnant females with gestational diabetes mellitus, and a moderate negative correlation in those without gestational diabetes.

ANALYSIS OF LDL-C MEASUREMENT USING DIRECT AND FRIEDEWALD FORMULA IN TYPE 2 DIABETES MELLITUS PATIENTS Liong Boy Kurniawan; Windarwati Windarwati; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 3 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i3.1339

LDL-C is important to evaluate the risk of cardiovascular disease. LDL-C can be measured directly or by using the Friedewald equation. Type 2 Diabetes Mellitus (DM) patients have tighter LDL-C target compared with normal population. This research is aimed to analyze the difference of LDL-C level measured by direct test and Friedewald equation in DM and non-DM. This research was a cross-sectional study using LDL-C data of 208 patients who were tested in Laboratory of Clinical Pathology, Hasanuddin University Hospital from a period of August 2015 to January 2016. LDL-C and other lipid were measured using ABX Pentra 400 meanwhile Friedewald LDL-C was calculated with equation LDLC= Total Cholesterol-HDL-C-(1/5 Triglycerides). Type 2 DM patients were diagnosed by ADA 2015 criteria or who had previous DM history. Friedewald LDL-C estimates lower than direct method (139.07+50.60 mg/dL vs 155.33+51.74 mg/dL, p=0.000). Delta of direct LDL-C and Friedewald equation measurement is higher in DM than non-DM patients (11.97+11.52% vs 8.49+11.27%, p=0.030) Fridewald LDL-C estimates LDL-C lower than direct method and the difference is wider in DM than non-DM. It is suggested to measure LDL-C directly in DM type 2 to reach the actual LDL-C target.

The Relationship of Neutrophil-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus Patients Nurahmi Nurahmi; Budi Mulyono; Windarwati Windarwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1739

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.

Correlation between Adiponectin and Triglyceride Levels in Pregnancy with and without Gestational Diabetes Mellitus I Nyoman Gde Sudana; Windarwati Windarwati; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1697

Gestational Diabetes Mellitus (GDM) is glucose intolerance during pregnancy. Adiponectin causes a decrease in glucose transporter 4 translocation, which reduces glucose uptake due to downstream insulin signal delivery and decreases non-esterified fatty acids so that triglyceride synthesis decreases in pregnancy. This study was conducted to determine the relationship between adiponectin and triglyceride levels in pregnancy, especially in a pregnant female with and without gestational diabetes mellitus. This observational cross-sectional study was conducted by measuring the levels of adiponectin and triglycerides in pregnancy, with and without gestational diabetes mellitus. Researchers proved by analyzing 75 subjects, 24-28 weeks pregnant females who were examined at the primary health center and Dr. Sardjito Hospital, Yogyakarta. Adiponectin levels have a moderate negative correlation with triglycerides in pregnant females (r= -0.420 and p=0.002), a strong negative correlation with GDM (r = -0.680 and p=0.001), and moderate negative correlation (r= -0.455, and p=0.022) with those without GDM. Based on this research can be concluded that adiponectin has a moderate negative correlation with triglycerides in pregnancy, a strong negative correlation in pregnant females with gestational diabetes mellitus, and a moderate negative correlation in those without gestational diabetes.

The Relationship of Neutrophil-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus Patients Nurahmi Nurahmi; Budi Mulyono; Windarwati Windarwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1739

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.

PREVALENCE OF GESTATIONAL DIABETES MELLITUS IN THE SPECIAL REGION OF YOGYAKARTA Windarwati Windarwati; Rukmono Siswishanto; Wirimena Hurimah; Primalia Sulistiowati; Dian Riski Ariesta; Valentin Widri Enggal; Himawan Sartono; Mutiara Nugraheni
MEDIKORA Vol 22, No 2 (2023): Oktober
Publisher : Faculty of Sports Sciences, Universitas Negeri Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21831/medikora.v22i2.64266

Gestational Diabetes Mellitus (GDM) is glucose intolerance when first detected during pregnancy. The prevalence of DMG in the last 20 years has significantly increased. The high prevalence of GDM has implications for maternal and child health. Mother has gestational hypertension and preeclampsia. Babies born are at risk for macrosomia, shoulder dystocia, and neonatal hypoglycemia. This study aims to see the prevalence of DMG in the Special Region of Yogyakarta. This study is an analytic observational study with a cross-sectional design. The study population was pregnant women with a gestational age of 24-28 weeks who checked themselves at the puskesmas in Yogyakarta. The research time is September 2018 to March 2019. The data analysis used is the Chi Square test. This prevalence study was conducted using the criteria of the World Health Organization (WHO), IADPSG/American Diabetes Association (ADA), NICE and Diabetes in Preganancy in India (DIPSI). The highest prevalence of DMG in the study was found in the NICE diagnostic criteria with a value of 14.9% then the DIPSI criteria 12.6%, IADPSG 12.1% and WHO 11.7%.

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