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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

Show Abstract | Download Original | Original Source | Check in Google Scholar

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.
Low Serum Nerve Growth Factor Levels Are Associated with Insulin Resistance, Beta Cell Dysfunction, and Neuropathy Screening Scores in Subjects with Type 2 Diabetes Mellitus Sylvana, Dhini; Lindarto, Dharma; Syafril, Santi
The Indonesian Biomedical Journal Vol 17, No 5 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i5.3750

Abstract

BACKGROUND: Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM), associated with chronic hyperglycemia, insulin resistance, and neuroinflammation. Despite the widespread use of Michigan Neuropathy Screening Instrument (MNSI) for early identification in neuropathy screening, studies assessing its relationship between NGF, insulin resistance, and neuropathy in T2DM patients, particularly in Indonesia, remain limited. Therefore, this study was conducted to evaluate associations between serum NGF, insulin resistance, β-cell function, and MNSI scores in T2DM.METHODS: Seventy-seven T2DM subjects were classified into DPN and non-DPN groups using MNSI. Subjects were excluded if they have comorbidities and conditions potentially affecting metabolic, immune, or organ function. Enzyme-linked immunosorbent assay (ELISA) was used for the measurement of serum NGF, enzymatic hexokinase method for fasting plasma glucose (FPG) and 2-hour postprandial glucose (2HPP), high-performance liquid chromatography (HPLC) for glycated hemoglobin (HbA1c), and chemiluminescent immunoassay for fasting insulin. Homeostatic model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β) were then calculated.RESULTS: Most of the study subjects had NGF level of <11 pg/mL. NGF concentrations showed inverse correlations with HOMA-IR (r=–0.263, p=0.021) and HOMA-β (r=–0.316, p=0.005). In the DPN subgroup, NGF demonstrated a stronger negative correlation with HOMA-β (r=–0.425, p=0.009), whereas no significant correlation was found in non-DPN. HbA1c was higher in DPN (p=0.014). No significant associations were observed between NGF and HbA1c, FPG, or 2HPP. NGF was significantly associated with MNSI Part B scores (p=0.032), reflecting objective neuropathic findings, but not with MNSI Part A or total scores.CONCLUSION: Lower NGF levels were significantly associated with insulin resistance and β-cell dysfunction in T2DM. The association with MNSI part B suggests that physical examination findings may reflect NGF-related neuropathic alterations better than symptom-based assessments.KEYWORDS: diabetic peripheral neuropathy, HOMA-IR, HOMA-β, Michigan Neuropathy Screening Instrument, nerve growth factor, 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.