Korelasi Kadar Angiopoietin-2 Plasma dan Petanda Inflamasi Dengan Resistensi Insulin Pada Penderita Obesitas Abdominal

Anak Agung Gede Budhitresna (Faculty of Medicine and Health Sciences, Warmadewa University, Denpasar)

WMJ (Warmadewa Medical Journal)
Vol 1 No 1 (2016): Mei 2016

Obesitas abdominal (Ob-Ab) merupakan komponen utama resistensi insulin (RI) yaitu kekutan pendorong utama untuk terjadinya diabetes mellitus (DM)  tipe-2. Kadar angiopoietin-2  (Ang-2) plasma dilaporkan mengalami peningkatan pada  penderita Ob-Ab dan diduga bahwa Ang-2 berpengaruh untuk terjadinya RI. Tujuan penelitian ini adalah untuk mengetahui korelasi kadar Ang-2, Inflamasi dan RI pada penderita Ob-Ab. Dilakukan penelitian secara cross-sectional analitik pada 81 penderita dengan Ob-Ab. Kadar  TNF-α, sTNFR1 dan Ang-2 plasma diukur menggunakan metode ELISA. RI diukur menggunakan HOMA-IR. Analisis varian (ANOVA) dipergunakan untuk mengetahui persamaan variabel kontinyu. Analisis multivariat dipergunakan untuk mengetahui peran kadar TNF-α, s-TNFR-1, Ang-2 terhadap RI. Model analisis jalur (path analysis) dipergunakan untuk mengetahui pengaruh faktor risiko terjadinya RI. Hasil penelitian menunjukkan bahwa kadar TNF-α plasma tidak berkorelasi dengan HOMA-IR, sedangkan sTNFR-1 dan  Ang-2 plasma berkorelasi positif bermakna dengan HOMA-IR (masing-masing r=0,323; p=0,003 dan r=0,641; p=<0,001). Pada analisis multivariat ditemukan Ang-2 merupakan faktor bebas berhubungan dengan HOMA-IR (p=<0,001). Kadar Ang-2 plasma yang tinggi merupakan faktor dominan (64,1%, p=<0,001). Simpulan: pada penderita Ob-Ab kadar Ang-2 berkorelasi dengan terjadinya RI dan inflamasi.Kata kunci: Ang-2, resistensi insulin, inflamasi, obesitas abdominal. [Correlation of Plasma Angiopoietin-2 and Inflammation Marker with Insulin Resistence in Patients with Central Obesity]Abdominal obesity (Ab-Ob) is a central component of insulin resistance (IR) and it is suggested that IR is a driving factor in the development of type 2 diabetes mellitus (T2DM).  Plasma Ang-2 levels have been reported to increase in the Ab-Ob and it has been hypothesized that Ang-2 plays important role in the occurrence of IR. We assessed the relationship between plasma Ang-2 levels, Inflammation and IR in Ab-Ob. A cross-sectional analytic study on 81 abdominally obese subjects was performed. The concentrations of TNF-α, sTNFR1 and Ang-2 plasma were measured using ELISA method. IR was measured using HOMA-IR. Analysis of variance (ANOVA) was used to test the equality of continuous variables. Multivariate analyses were performed to examine the influence of TNF-α, s-TNFR-1, and Ang-2 on IR. Path analysis models were performed to assess the influence of risk factors on occurrence of IR. Plasma of TNF-α was not correlated with HOMA-IR (r=160; p=0.154) whereasTNFR-1 and Ang-2 were significantly positive correlated with HOMA-IR (r=0.323, p=0.003 and r=0.641, p=<0.001, respectively).  The multivariate analysis showed Ang-2 was independently associated with HOMA-IR (p <0.001). It was found that high Ang-2 level was a dominant risk factor (64.1%, p=<0.001) for influencing IR in the abdominally obese subjects. It is concluded that plasma Ang-2 level is correlated with occurrence of IR and inflammation in abdominally obese subjects.Keywords: Ang-2, insulin resistance, inflammation, abdominal-obesity.