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All Journal Media Ilmu Keolahragaan Indonesia Biomedical Journal of Indonesia Majalah Kedokteran Nusantara The Journal Of Medical School Indonesian Journal of Medicine Sumatera Medical Journal Jurnal Keperawatan Priority Journal of Telenursing (JOTING) Indonesian Journal of Global Health research Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Journal of Society Medicine (JSOCMED) Jurnal Penyakit Dalam Indonesia
Santi Syafril, Santi
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Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health

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Correlation between HbA1c Levels and Red Distribution Cell Width in Type 2 Diabetes Mellitus Patients Rahma, Hadiyatur; Siregar, Jelita; Syafril, Santi; Ganie, Ratna Akbari; Siregar, Dewi Indah Sari; Ginting, Almaycano
Indonesian Journal of Medicine Vol. 9 No. 1 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.1.684

Abstract

Background: HbA1c is used as a parameter for diagnosis and monitoring of diabetes mellitus (DM). Apart from that, HbA1c, red blood cells also experience changes which result in changes in erythrocyte structure and hemodynamic characteristics. The parameter that changes in this case is red cell distribution width (RDW). This study aimed to analyze correlation between HbA1c levels and RDW in type 2 DM patients. Subjects and Method: This a cross sectional study conducted at H. Adam Malik General Central Hospital, Medan, North Sumatera, Indonesia, from December 2022-April 2023. Total sample of 75 type 2 DM patients was selected consecutively. The dependent variable was RDW. The independent variable was HbA1c. Data of RDW and HbA1c were collected from complete blood count test. Data were analyzed using the Spearman correlation. Results: HbA1c was negatively associated with RDW, but it was statistically non-significant (r= -0.08; p= 0.508). Conclusion: HbA1c is negatively associated with RDW, but it is statistically non-significant.   Keywords: diabetes melitus, HbA1c, red cell distribution width
Relationship of Neutrophil Lymphocyte Ratio and Glomerulus Filtration Rate in Diabetic Nephropathy Patients at H. Adam Malik Hospital, Medan, Indonesia Merlin, Asri; Siregar, Jelita; Syafril, Santi
Indonesian Journal of Medicine Vol. 9 No. 1 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.1.720

Abstract

Background: Diabetic nephropathy is a serious complication of diabetes mellitus (DM). The neutrophil-lymphocyte ratio is the result of the relative count of neutrophils divided by the relative number of lymphocytes in diabetic nephropathy patients in % units obtained from routine hematology results using EDTA blood samples and measured by flow cytometry with Sysmex XN-1000, glomerular filtration rate was measured according to the Cockroft-Gault formula. This study aimed to determine the relationship between neutrophil lymphocyte ratio (NLR) and glomerular filtration rate in diabetic nephropathy patients. Subjects and Method:  This was a cross sectional study conducted at H. Adam Malik Hospital, Medan, North Sumatera, Indonesia, from November 2022 – January 2023. 30 diabetic nephropathy patients were selected for this study consecutively. The dependent variable was the glomerular filtration rate. The independent variable was the NLR. Blood sample was taken for a complete blood count and creatinine examination. Data were analyzed using the Spearman test. Results: NLR was negatively associated with eGFR in patients with diabetic nephropathy, but it was statistically non significant (r= -0.25; p= 0.186). Conclusion: NLR is negatively associated with eGFR in patients with diabetic nephropathy, but it is statistically non significant.  Keywords: neutrophil lymphocyte ratio, glomerular filtration rate, diabetic nephropathy
Corelation Between Uric Acid and Neutrophil Lymphocyte Ratio (NLR) in Controlled and Uncontrolled Type 2 Diabetes Mellitus Situmorang, Immanuel; Siregar, Jelita; Syafril, Santi
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6986

Abstract

Type 2 diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia, often linked to metabolic complications and inflammatory conditions. Uric acid and Neutrophil-Lymphocyte Ratio (NLR) are biomarkers of inflammation and oxidative stress in this condition. This study aims to examine the relationship between uric acid and NLR in controlled and uncontrolled type 2 DM patients. Using an analytical observational design with a cross-sectional approach and consecutive sampling, 112 subjects were divided into controlled (HbA1c < 7%) and uncontrolled (HbA1c ≥ 7%) groups. Data were collected from RSUP H. Adam Malik Medan through laboratory tests for whole blood, uric acid, and HbA1c levels. Pearson or Spearman correlation tests were used to assess relationships between variables with a significance level of p < 0.05. Significant demographic differences were found between groups, with higher uric acid and HbA1c levels in the uncontrolled DM group. Positive correlations were observed between uric acid and NLR, as well as uric acid and HbA1c, in both groups. Additionally, a strong positive association between HbA1c and NLR was found in both groups. Uric acid, NLR, and HbA1c are correlated in both controlled and uncontrolled type 2 diabetes mellitus.
Hubungan Visceral Adiposity Index dengan Neuropati Diabetik Perifer pada Pasien Diabetes Melitus Tipe 2 Sanusi, Muhammad Arif; Lubis, Dian Anindita; Syafril, Santi
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. Type 2 diabetes mellitus (T2DM) is the leading metabolic disease in Indonesia. Diabetic peripheral neuropathy (DPN), a major complication of T2DM, was associated with insulin resistance and adipose dysfunction. Visceral adiposity index (VAI) is a tool to measure visceral fat as the indicator of adipose dysfunction and insulin sensitivity. The association between VAI and DPN has not been widely researched, especially in Indonesia. This study aims to assess the association between them. Methods. This was a cross-sectional study conducted on adult patients (aged ≥18 years) with T2DM at H. Adam Malik General Hospital, Medan, from December 2024 to March 2025. DPN was assessed using the Michigan Neuropathy Screening Instrument (MNSI), consisting of a questionnaire (MNSI A) and physical examination (MNSI B). VAI was calculated using waist circumference, body mass index (BMI), triglyceride level, and high-density lipoprotein (HDL) cholesterol level. A bivariate analysis was conducted to compare mean VAI values between patients with and without DPN and to assess correlations between VAI and MNSI scores. Results. From a total of 80 subjects, the average age was 56 years (SD 9), and the majority were female (56.3%). The median VAI value in the DPN group was 2.863 (0.401–11.665), slightly higher than in the non-DPN group, which was 2.549 (0.781–17.414), but the difference was not statistically significant (p=0.34). No statistically significant correlation was found between VAI and MNSI A score (r=0.092; p=0.42) or MNSI B score (r=0.12; p=0.31). Conclusion. There was no significant association between VAI and DPN in patients with T2DM.
RASIO MONOSIT LIMFOSIT SEBAGAI PREDIKTOR KEPARAHAN NEFROPATI DIABETIK PADA PASIEN DIABETES MELITUS TIPE 2 Bernando, Andri; Siregar, Jelita; Syafril, Santi
Jurnal Keperawatan Priority Vol. 6 No. 2 (2023)
Publisher : Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jukep.v6i2.4073

Abstract

Diabetic nephropathy is a complication that often occurs in diabetics. In this disease, there is damage to the kidney filter, known as the glomerulus. Due to glomerular damage, diabetic nephropathy is closely related to the mechanism of inflammation. The Monocyte-Lymphocyte Ratio is a relatively new marker of inflammation. This study aims to explore the significance of the prediction of the Monocyte-Lymphocyte Ratio as a predictor of the severity of diabetic nephropathy in Type 2 Diabetes Mellitus (DMT2) patients at H. Adam Malik Hospital, Medan. The research was conducted using the cross-section method. This study took blood samples from 44 patients with type 2 diabetes mellitus with diabetic nephropathy, 22 patients with macroalbuminuria, and 22 patients with microalbuminuria. Then blood was drawn from the vein, and the Monocyte-Lymphocyte Ratio was assessed in all patients. In this study, the average MLR for all patients was 0.41±0.037. There was a significant difference between MLR values ​​in diabetic nephropathy patients with macroalbuminuria compared to diabetic nephropathy patients with microalbuminuria (p<0.001). The optimal cut-off value of MLR in predicting diabetic nephropathy with macroalbuminuria and microalbuminuria was 0.37 with a specificity of 81.8% and a sensitivity of 81.8%. The MLR value in type 2 diabetic patients with diabetic nephropathy can be used as a prognostic factor for the incidence of microalbuminuria and macroalbuminuria.
Inflammatory Markers and Diabetic Foot: Their Role in Type 2 Diabetes Patients at H. Adam Malik Hospital Siregar, Syahrozad Fuadah; Zubir, Zuhrial; Syafril, Santi
Biomedical Journal of Indonesia Vol. 12 No. 1 (2026): Vol 12, No 1, 2026
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v12i1.292

Abstract

Introduction. Diabetic foot is a severe complication of type 2 diabetes mellitus, resulting from chronic hyperglycemia, vascular disorders, neuropathy, and infection. Inflammatory markers such as C-Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), fibrinogen, and D-dimer reflect inflammation and coagulation that worsen diabetic foot conditions. However, data from the local population in Medan remain limited. Methods. This cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, from May to June 2025. Participants were hospitalized patients with type 2 diabetes mellitus, both with and without diabetic foot, recruited by consecutive sampling. Inclusion criteria were patients ≥18 years with type 2 diabetes, with or without diabetic foot (grade II–V). Exclusion criteria included chronic diseases (HIV, malignancy, autoimmune), concurrent infections, use of anticoagulants, NSAIDs, steroids, hormones, immunomodulators, pregnancy, or incomplete records. Data on demographics, HbA1c, CRP, ESR, fibrinogen, and D-dimer were analyzed with significance set at p<0.05. Results. A total of 63 patients were included. BMI showed a significant association with diabetic foot (p<0.05), while age, sex, and HbA1c did not. Levels of CRP, ESR, fibrinogen, and D-dimer were significantly higher in patients with diabetic foot than those without (p=0.001). CRP was also significantly associated with ulcer severity based on Wagner classification. Conclusion. CRP, ESR, fibrinogen, and D-dimer were elevated in diabetic foot patients, with CRP as the strongest predictor of ulcer severity. Monitoring these markers is essential for risk assessment and management of diabetic foot in type 2 diabetes.
Association Between Mean Platelet Volume to Lymphocyte Ratio (MPVLR) and Diabetic Nephropathy Incidence in Type 2 Diabetes Mellitus Maisharah; Siregar, Jelita; Syafril, Santi
Biomedical Journal of Indonesia Vol. 12 No. 1 (2026): Vol 12, No 1, 2026
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v12i1.295

Abstract

Introduction. Diabetic nephropathy is a microvascular complication of uncontrolled diabetes mellitus (DM), with inflammation among its underlying pathogenesis. Inflammation causes fibrosis, increased vascular permeability, and podocytopathy, which lead to albuminuria. Mean Platelet Volume (MPV) measures thrombocyte size, which may mark increased metabolic and enzymatic activity of thrombocytes. An absolute decrease in lymphocytes occurs due to inflammation-induced decrease in apoptosis. MPVLR value can be used to assess low-grade inflammation in diabetic nephropathy in type 2 DM patients. This study aimed to determine the association between MPVLR values and diabetic nephropathy incidence in type 2 DM. Methods. This study was a cross-sectional study on type 2 DM patients at the Endocrinology outpatient clinic of Adam Malik Hospital aged ≥ 18 years. Sixty patients met the inclusion criteria. Complete blood count, creatinine, and albumin creatinine ratio (ACR) were performed to determine the incidence of diabetic nephropathy. Results. There was a significant difference in age between the diabetic nephropathy and non-nephropathy groups. There were significant differences in absolute lymphocyte count, Hb, HbA1c, and renal parameters such as estimated Glomerular Filtration Rate (eGFR) and creatinine between diabetic nephropathy and non-nephropathy groups. MPVLR showed a significant negative correlation with eGFR and Hb (r = -0.325, p = 0.011), showing that MPVLR increased in line with eGFR and Hb decrease. MPVLR was not significantly associated with diabetic nephropathy incidence based on semiquantitative ACR (p = 0.139). Conclusion. MPVLR was not associated with diabetic nephropathy in type 2 DM patients.
Co-Authors Awaluddin Saragih Aznan Lelo Bernando, Andri Dairion Gatot, Dairion dharma Lindarto, dharma ELMAN BOY Ginting, Almaycano Handayani, Savina Harahap, Juliandi Ihsan, Brama Imelda Rey Irawaty, Noni Kembaren, Tambar Lubis, Dian Anindita Maisharah Mardia, Andri Iskandar Merlin, Asri Pangaribuan, Jessica Patricia Prianwari, Catur Rahma, Hadiyatur Rahmad Isnanta, Rahmad Ratna Akbari Ganie, Ratna Akbari Ricke Loesnihari Sanusi, Muhammad Arif Sembiring, Rosita Juwita Sholat, Alfi Dewi Siregar, Dewi Indah Sari Siregar, Jelita Siregar, Syahrozad Fuadah Situmorang, Immanuel Sri Sumartiningsih Sugeng Santoso Tarigan, Amira Permatasari Theresia, Lydia Yetty Machrina Yulindaa, Wina Yusni Yusni Zubir, Zuhrial