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All Journal Medula Jurnal Ilmu Kedokteran dan Kesehatan
Intanri Kurniati
Fakultas Kedokteran Universitas Lampung
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : medula

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Peran Growth Differentiation Factor-15 (GDF-15) sebagai Biomarker Prognostik Gagal Jantung: Literature Review Brian; Iswandi Darwis; Eka Putri Rahmadhani; Intanri Kurniati
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1770

Abstract

Heart failure is a complex clinical syndrome with high morbidity and mortality, contributing to a substantial global health burden, including in Indonesia. Although conventional biomarkers such as BNP and NT-proBNP are well established for diagnosis and risk stratification, they have limitations in capturing the heterogeneous pathophysiology of heart failure. Growth Differentiation Factor-15 (GDF-15), a member of the TGF-β superfamily that increases in response to oxidative stress, inflammation, and myocardial ischemia, has emerged as a more comprehensive prognostic biomarker. This literature review examines clinical studies, prospective and retrospective cohorts, observational research, and meta-analyses evaluating the prognostic value of GDF-15 in acute and chronic heart failure. The synthesized evidence demonstrates that elevated GDF-15 levels consistently correlate with increased risks of mortality, rehospitalization, and disease progression. In addition, serial measurements of GDF-15 reflect therapeutic response, as failure of GDF-15 levels to decline is associated with poorer outcomes. Combining GDF-15 with other biomarkers, such as NT-proBNP, further enhances risk stratification accuracy compared with single-biomarker assessment. Based on current evidence, GDF-15 holds substantial potential as an independent and dynamic prognostic biomarker, supporting more precise risk assessment, disease monitoring, and clinical decision-making in patients with heart failure.
Korelasi Kadar Feritin dan ALT pada Pasien Talasemia Beta Mayor: Tinjauan Pustaka Mutiara Maharani; Intanri Kurniati; Muhammad Maulana; Susianti
Medula Vol 15 No 4 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i4.1696

Abstract

Beta thalassemia major is an autosomal recessive genetic blood disorder caused by mutations in the globin gene, resulting in impaired globin chain synthesis. It represents the most severe form of thalassemia and is characterized by chronic anemia, regular blood transfusions, and a high risk of iron overload. The global prevalence of beta thalassemia major continues to increase, including in Indonesia and the Lampung region. Excess iron is primarily stored as ferritin, which becomes toxic to hepatic tissue at high levels and is reflected by increased alanine transaminase (ALT) levels. This study aimed to analyze the relationship between ferritin and ALT levels in patients with beta thalassemia major through a literature review approach. Relevant scientific publications from reputable databases and accredited national journals were reviewed, focusing on studies that evaluated the association between these two parameters. The results demonstrated a statistically significant positive correlation (p < 0.05), in which elevated ferritin levels were consistently associated with increased ALT levels. These findings indicate a close relationship between iron overload and hepatocellular damage. However, the interpretation of ferritin and ALT levels should consider confounding factors such as inflammation, infection, and other clinical conditions that may influence laboratory results. Pathophysiologically, repeated blood transfusions lead to excessive iron accumulation that exceeds storage capacity, triggering oxidative stress, hepatocyte injury, and subsequent ALT release into circulation. Therefore, regular monitoring of ferritin and ALT levels is essential for early detection and prevention of hepatic complications in patients with beta thalassemia major.
Hubungan IMT Terhadap Kadar Gula Darah Pada Pasien Diabetes Mellitus Tipe 2: Tinjauan Pustaka Ighra Afifah; Intanri Kurniati; Selvi Marcellia; Muhammad Ricky Ramadhian
Medula Vol 15 No 4 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i4.1704

Abstract

Type 2 diabetes mellitus is a chronic metabolic disease with a steadily increasing prevalence globally, including in Indonesia. One of the main risk factors contributing to the development and severity of type 2 diabetes is obesity, clinically measured by Body Mass Index (BMI). Increased BMI is closely associated with impaired glucose metabolism and insulin resistance, which play a key role in the pathogenesis of type 2 diabetes. This study used a literature review approach by examining various studies analyzing the relationship between BMI and blood glucose levels. The results showed that increased BMI is positively correlated with fasting blood glucose, random blood glucose, and HbA1c levels. Individuals with a higher BMI tend to experience more severe glycemic control disorders. Pathophysiologically, increased adipose tissue, especially visceral fat, produces various inflammatory mediators such as TNF-α and IL-6, which disrupt the insulin signaling pathway, reduce glucose uptake by muscle tissue, and trigger hyperglycemia. Furthermore, dysfunction of adipokine hormones such as decreased adiponectin and resistance to leptin contribute to worsening insulin sensitivity
Co-Authors Brian Cahaya Carla Bangsawan Eka Putri Rahmadhani Ighra Afifah Iswandi Darwis Muhammad Maulana Muhammad Ricky Ramadhian Mutiara Maharani Selvi Marcellia Susianti Susianti