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"ABSTRAKStres oksidatif berperan dalam kerusakan fungsi ginjal pada pasien diabetes melitus tipe 2. Hingga saat ini belum ada penanda yang dapat mendeteksi kerusakan ginjal sejak awal. Penelitian ini bertujuan menganalisis kadar hidrogen peroksida pada urin sebagai penanda stres oksidatif dan mengungkap hubungan dengan estimasi laju filtrasi glomerulus sebagai parameter fungsi ginjal. Kadar hidrogen peroksida urin dan nilai eLFG juga dibandingkan antara dua kelompok pengobatan untuk mengetahui efektivitas pengobatan pada pasien diabetes melitus tipe 2. Desain penelitian yang digunakan adalah cross sectional dengan jumlah sampel keseluruhan sebanyak 84 orang. Pengambilan sampel dilakukan di puskesmas kecamatan Pasar Minggu. Nilai hidrogen peroksida urin diperoleh dengan pengukuran menggunakan metode Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) dan dinormalisasi dengan nilai kreatinin urin. Pengukuran kreatinin urin dilakukan dengan metode kinetik Jaffe. Perhitungan nilai eLFG diperoleh dengan 3 tiga rumus yaitu Cockroft-gault, MDRD, dan CKD-EPI. Kadar hidrogen peroksida urinpada dua kelompok pengobatan tidak berbeda bermakna (p = 0,545. Hasil uji beda nilai eLFG pada dua kelompok juga tidak berbeda bermakna (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Hasil analisis hubungan kadar hidrogen peroksida urin dengan ketiga nilai eLFG tidak menunjukkan hubungan yang bermakna (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703).

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ABSTRACTOxidative stress plays a major role in renal dysfunction caused by type 2 diabetesmelitus. Up to now, there is no biomarker can be used in early detection of renal dysfunction. This study aims to analyze of urinary hydrogen peroxide concentration as biomarker of oxidative stress and correlated it with estimated Glomerular Filtration Rate as parameters of renal function. Urinary hydrogen peroxide and value of eGFR were also compared between the two groups of treatment to find out the effectiveness of treatment in type 2 diabetic patients. Design of this study was cross sectional with 84 sample that was taken in Puskesmas Pasar Minggu. Concentration of urinary hydrogen peroxide were measured with Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) method and normalize with urine creatinine that measured with kinetic Jaffe method. Three formulations used to measure value of eGFR were Cockroft-gault, MDRD, dan CKD-EPI. Concentration of urinary hydrogen peroxide in two groups of treatment have no significant difference (p = 0,545), while value of eGFR also didn?t have significant different (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Results of correlation analysis urinary hydrogen peroxide with eGFR showedno significant correlation (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703)."

"[ABSTRAKGangguan fungsi ginjal yang sering terjadi pada pasien diabetes melitus tipe 2 diperankan oleh stres oksidatif. Belum diketahui efektivitas pengobatan diabetes melitus tipe 2 terhadap gangguan fungsi ginjal. Penelitian ini membandingkan dan menganalisis hubungan hidrogen peroksida urin yang merupakan produk stress oksidatif dan estimasi Laju Filtrasi Glomerulus (eLFG) pada kelompok pengobatan sulfonilurea dan kombinasi biguanid-sulfonilurea. Penelitian ini menggunakan desain penelitian kohort retrospektif dengan jumlah sampel 50 orang yang diambil di RSK Dr. Sitanala Tangerang dengan teknik total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang diukur menggunakan metode kinetik Jaffe, sedangkan hidrogen peroksida urin menggunakan metode FOX (Ferrous ion Oxidation Xylenol Orange) 1. Nilai hidrogen peroksida urin pada dua kelompok pengobatan tidak memiliki perbedaan yang bermakna (p = 0,69). Sedangkan nilai eLFG pada dua kelompok juga tidak memiliki memiliki perbedaan yang bermakna dengan Cockroft Gault adalah p = 0,884; MDRD p = 0,886; dan CKDEP p= 0,490. Analisis hubungan hidrogen peroksida urin dengan eLFG berdasarkan persamaan MDRD dan CKDEPI menghasilkan hubungan positif bermakna (r = 0,326; p = 0,021) dan (r = 0,282; p = 0,047).

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ABSTRACT

, Renal dysfunction which frequently occurs in type 2 diabetes mellitus patients caused by oxidative stress. The effectiveness of the type 2 diabetes mellitus treatment to renal dysfunction is unknown. This study compare and analyze the correlation between urinary hydrogen peroxide which is a product of oxidative stress and estimated glomerular filtration rate (eGFR) in the treatment groups of sulfonylurea and combination biguanide-sulfonylurea. This study used a retrospective cohort study design with 50 sampels that was taken in Dr. Sitanala Tangerang hospital with total sampling technique. Estimated GFR value obtained based on serum creatinine values were measured using a kinetic Jaffe method, while the urinary hydrogen peroxide using FOX (Ferrous ion Oxidation Xylenol Orange) 1. Value of urinary hydrogen peroxide in the two treatment groups did not have significant difference (p = 0.69) , While the value eGFR the two groups did not have significant differences with the Cockroft Gault is p = 0.884; MDRD p = 0.886; and CKDEP p = 0.490. Analysis of urinary hydrogen peroxide and eGFR based on the MDRD equation and CKDEPI generate significant positive correlation (r = 0.326; p = 0.021) and (r = 0.282; p = 0.047).

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"ABSTRAKGangguan fungsi ginjal merupakan komplikasi yang sering terjadi pada pasien diabetes melitus tipe 2 yang dapat ditandai oleh senyawa 8-iso-Prostaglandin F2a. Pada penelitian ini, dilakukan analisis hubungan antara kadar 8-iso-Prostaglandin F2a dengan estimasi Laju Filtrasi Glomerulus (eLFG). Sampel yang dianalisis adalah 50 pasien diabetes melitus tipe 2 di RSK Dr. Sitanala Tangerang yang terbagi menjadi dua yaitu kelompok sulfonilurea dan kombinasi biguanid-sulfonilurea dengan teknik total sampling. Penelitian ini merupakan penelitian observasional dengan metode kohort retrospektif. Nilai eLFG diperoleh berdasarkan kadar kreatinin serum, sedangkan kadar 8-iso-Prostaglandin F2a diukur dengan metode Enzyme Linked Immunosorbent Assay (ELISA). Uji beda dilakukan terhadap nilai eLFG antara kedua kelompok, yaitu Cockroft Gault (p = 0,961), MDRD (p = 0,567), CKD-EPI (p = 0,443), serta pada kadar 8-iso-Prostaglandin F2a (p = 0,070). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dianalisis pada seluruh sampel (n=48), yaitu Cockroft-Gault (r = 0,329; p = 0,023), MDRD (r = 0,231; p = 0,115) dan CKD-EPI (r = 0,256; p = 0,079). Sehingga, tidak terdapat perbedaan nilai eLFG dan kadar 8-iso-Prostaglandin F2a di antara kedua kelompok. Terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2a dengan nilai eLFG berdasarkan Cockroft-Gault, namun tidak terdapat hubungan pada nilai eLFG MDRD dan CKD-EPI.

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ABSTRACTRenal dysfunction is a common complication in type 2 diabetes mellitus patient that can be characterized by 8-iso-prostaglandin F2a compound. The aim of this study was to analyze the correlation between the level of 8-iso-prostaglandin F2a and estimated Glomerular Filtration Rate (eGFR). Samples analyzed were 50 patients with type 2 diabetes mellitus in Dr. Sitanala Tangerang Hospital were divided into two groups of sulfonylurea and combination of biguanide-sulfonylurea using total sampling technique. This study was an observasional study using cohort retrospective method. The value of eGFR obtained by serum creatinine levels, while the level of 8-iso-Prostaglandin F2a measured by the method of Enzyme Linked Immunosorbent Assay (ELISA). Different test carried out on eGFR values ​​between the two groups, those were Cockroft-Gault (p = 0,961), MDRD (p = 0,567), CKD-EPI (p = 0,443), as well as on the level of 8-iso-prostaglandin F2a (p = 0.070). The correlation between the levels of 8-iso-prostaglandin F2a with eGFR was analyzed on all samples (n=48), those are Cockroft-Gault (r = 0,329; p = 0,023), MDRD (r = 0,231; p = 0,115) and CKD-EPI (r = 0,256; p = 0,079). Thus, there was no difference in eGFR values ​​and levels of 8-iso-Prostaglandin F2a between the two groups. There was significant correlation between the levels of 8-iso-Prostaglandin F2a and eGFR values were calculated by Cockroft-Gault equation, meanwhile there was no correlation in eGFR values were calculated by MDRD and CKD-EPI equation."

"ABSTRAKSalah satu komplikasi kronis pada pasien dengan diabetes mellitus tipe 2 adalah disfungsi ginjal yang dikenal sebagai nefropati diabetik. Stres oksidatif yang disebabkan oleh kondisi hiperglikemia berperan dalam kerusakan fungsi ginjal pada pasien diabetes mellitus. Hidrogen peroksida urin adalah salah satu penanda stres oksidatif yang sedang diselidiki karena perannya sebagai penanda kerusakan ginjal. Selain itu, salah satu penanda yang telah distandarisasi sebagai pendeteksi kerusakan ginjal adalah estimasi laju filtrasi glomerulus (eGFR). Penelitian ini bertujuan untuk mencari penanda awal nefropati diabetik dengan membandingkan kadar hidrogen peroksida urin pada kelompok pasien dengan diabetes mellitus dengan eGFR ≥90 dan 60-89 ml / min / 1,73 m2 dan untuk melihat perbandingan kemih. kadar hidrogen peroksida pada kedua kelompok dengan status albuminuria. Penelitian ini dilakukan dengan menggunakan studi cross sectional dan teknik purposive sampling dengan sampel 196 subjek yang diambil dari Dr. Sitanala Tangerang dan Puskesmas Pasar Minggu. Nilai eGFR diperoleh dari persamaan CKD-EPI dan tingkat hidrogen peroksida diperoleh dari pengukuran menggunakan metode Ferrous ion Oxidation Xylenol Orange (FOX-1) yang dinormalisasi dengan kreatinin urin. Tingkat rata-rata hidrogen peroksida urin dalam eGFR ≥90 ml / min / 1,73 m2 adalah 25,40 ± 1,81 μmol / mg kreatinin dan dalam eGFR 60-89 ml / min / 1,73 m2 adalah 16,27 μmol / mg kreatinin. Hasil tingkat hidrogen peroksida yang berbeda pada kedua kelompok tidak menunjukkan perbedaan yang signifikan (p = 0,946). Hasil hidrogen peroksida yang berbeda pada kedua kelompok dengan status albuminuria menunjukkan perbedaan yang signifikan (p = 0,002). Hasil penelitian menunjukkan bahwa hidrogen peroksida urin tidak dapat digunakan sebagai penanda nefropati diabetik awal.

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ABSTRACTOne chronic complication in patients with type 2 diabetes mellitus is kidney dysfunction known as diabetic nephropathy. Oxidative stress caused by the condition of hyperglycemia plays a role in impairing kidney function in patients with diabetes mellitus. Urine hydrogen peroxide is a marker of oxidative stress that is being investigated for its role as a marker of kidney damage. In addition, one of the markers that has been standardized to detect kidney damage is the estimated glomerular filtration rate (eGFR). This study aims to look for early markers of diabetic nephropathy by comparing urine hydrogen peroxide levels in a group of patients with diabetes mellitus with eGFR ≥90 and 60-89 ml / min / 1.73 m2 and to look at urinary comparisons. hydrogen peroxide levels in both groups with albuminuria status. This research was conducted using a cross sectional study and purposive sampling technique with a sample of 196 subjects taken from Dr. Sitanala Tangerang and Pasar Minggu Health Center. The eGFR value was obtained from the CKD-EPI equation and the hydrogen peroxide level was obtained from measurements using the Ferrous ion Oxidation Xylenol Orange (FOX-1) method which was normalized with urine creatinine. The average level of urine hydrogen peroxide in eGFR ≥90 ml / min / 1.73 m2 was 25.40 ± 1.81 μmol / mg creatinine and in eGFR 60-89 ml / min / 1.73 m2 was 16.27 μmol / mg creatinine. The results of the different levels of hydrogen peroxide in the two groups did not show a significant difference (p = 0.946). Different hydrogen peroxide results in the two groups with albuminuria status showed a significant difference (p = 0.002). The results showed that urine hydrogen peroxide could not be used as a marker of early diabetic nephropathy."

"ABSTRAKNefropati diabetika dapat dideteksi melalui nilai UACR. Di sisi lain, 8-iso-Prostaglandin F2α sedang diteliti perannya sebagai penanda awal disfungsi ginjal.Penelitian ini bertujuan untuk menganalisis kadar 8-iso-Prostaglandin F2α, UACRserta hubungan 8-iso-Prostaglandin F2α dan UACR pada 72 orang pasien diabetesmelitus tipe 2 (usia 33-75 tahun) di Puskesmas Kecamatan Pasar Minggu. Sampelpenelitian dibagi menjadi 2 kelompok, yaitu kelompok biguanid (n = 36) dankelompok biguanid-sulfonilurea (n = 36). Kadar 8-iso-Prostaglandin F2α urin diukurmenggunakan ELISA dan albumin urin diukur menggunakan kit BCG Albumin.Hasil uji beda rata-rata menunjukkan tidak terdapat perbedaan kadar 8-iso-Prostaglandin F2α (p = 0,083) dan UACR (p = 0,509) pada kedua kelompok sampel.Hasil uji beda rata-rata pada kelompok sampel dengan albuminuria (n = 33) jugamenunjukkan tidak terdapat perbedaan kadar 8-iso-Prostaglandin F2α (p = 0,532)dan UACR (p = 0,067). Hubungan antara kadar 8-iso-Prostaglandin F2α denganUACR pada seluruh sampel (r = 0,120; p = 0,315), sedangkan antara 8-iso-Prostaglandin F2α dengan UACR pada kelompok albuminuria (r = 0,534; p = 0,001).Jadi, tidak terdapat hubungan yang signifikan antara kadar 8-iso-Prostaglandin F2αdengan UACR pada seluruh sampel, tetapi terdapat hubungan yang cukup kuat dansignifikan antara kadar 8-iso-Prostaglandin F2α dengan UACR pada sampel denganalbuminuria.

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ABSTRACTDiabetic nephropathy can be detected by UACR value. Meanwhile, 8-iso-Prostaglandin F2α is being studied for its role as early marker for renal dysfunction.This study were to analize 8-iso-Prostaglandin F2α, UACR, and the correlationbetween 8-iso-Prostaglandin F2α and UACR on 72 type 2 diabetes mellitus patient(from ages: 33-75 years) at Pasar Minggu Community Health Center. Samples weredivided into two groups, which was biguanid group (n = 36) and biguanidsulfonylureagroup (n = 36). Urinary 8-iso-Prostaglandin F2α was measured byELISA and urinary albumin by BCG Albumin kit. The results of mean different testshowed there were no difference for 8-iso-Prostaglandin F2α (p=0,083) and UACR(p=0,509) in two group samples. The results of mean different test showed therewere also no difference for 8-iso-Prostaglandin F2α (p=0,532) and UACR (p=0,067)in group samples with albuminuria (n=33). The correlation between 8-iso-Prostaglandin F2α and UACR on total samples (r = 0,120; p = 0,315), meanwhilethe correlation between 8-iso-Prostaglandin F2α with UACR on samples withalbuminuria (r = 0,534; p = 0,001). So, there was no significant correlation between8-iso-Prostaglandin F2α and UACR on total samples, meanwhile there was strongenough and significant correlation between 8-iso-Prostaglandin F2α and UACR onsamples with albuminuria."

"Renal dysfunction which frequently occurs in type 2 diabetes mellitus patients caused by oxidative stress. The effectiveness of the type 2 diabetes mellitus treatment to renal dysfunction is unknown. This study compare and analyze the correlation between urinary hydrogen peroxide which is a product of oxidative stress and estimated glomerular filtration rate (eGFR) in the treatment groups of sulfonylurea and combination biguanide-sulfonylurea. This study used a retrospective cohort study design with 50 sampels that was taken in Dr. Sitanala Tangerang hospital with total sampling technique. Estimated GFR value obtained based on serum creatinine values were measured using a kinetic Jaffe method, while the urinary hydrogen peroxide using FOX 1 (Ferrous ion Oxidation Xylenol Orange1). Value of urinary hydrogen peroxide in the two treatment groups did not have significant difference (p = 0.69), while the eGFR value of two groups did not have significant differences with the Cockroft Gault is p = 0.884; MDRD p = 0.886; and CKDEPI p = 0.490. Correlation analysis of urinary hydrogen peroxide and eGFR based on the MDRD equation and CKDEPI generate significant positive correlation (r = 0.326; p = 0.021) and (r = 0.282; p = 0.047). There is no antioxidant activity in the treatment groups. Urinary hydrogen peroxide may play a role in the pathophysiologic significance of diabetic nephropathy."

"Penyakit ginjal kronik (PGK) merupakan salah satu komplikasi serius yang sering terjadi pada pasien diabetes melitus tipe 2. Dibutuhkan sebuah penanda yang dapat mendeteksi PGK sejak awal untuk mencegah progresifitasnya. Penelitian ini bertujuan untuk menganalisis hubungan antara kadar malondialdehida (MDA) serum dengan estimasi laju filtrasi glomerulus (eLFG). MDA merupakan penanda stres oksidatif yang diprediksi berperan dalam tahap awal kerusakan ginjal. Desain penelitian ini adalah potong lintang. Populasi yang digunakan adalah pasien DM tipe 2 rawat jalan di Puskesmas Pasar Minggu. Sampel yang dianalisis sejumlah 50 orang (14 laki-laki, dan 36 perempuan, rentang usia 39-74 tahun), diambil dengan tenik total sampling. Kadar MDA diukur secara spektrofotometri berdasarkan reaksi antara MDA dengan asam tiobarbiturat, dengan nilai koefisien korelasi (r) dari metode tersebut 0,9996 dan koefisien variasi (%KV) intra dan antar pengukuran berkisar 2,75-13,33%. Nilai eLFG diukur berdasarkan metode kinetik Jaffe, dengan koefisien korelasi (r) 0,9994 dan %KV intra dan antar pengukuran berkisar 2,91 – 9,52%. Kadar MDA pasien DM tipe 2 diperoleh 0,82 ± 0,26 nmol/ml, dan nilai eLFG diperoleh 78,30 ± 26,77 (Cockroft-Gault); 76,08 ± 24,17 (MDRD study); dan 79,25 ± 21,04 (CKD-EPI). Terdapat hubungan yang bermakna antara kadar MDA dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (p =0,039, r = -0,293), tetapi tidak terlihat hubungan yang bermakna dengan nilai eLFG berdasarkan persamaan MDRD study dan CKD-EPI (p = 0,051 dan p = 0,053; r = -0,277 dan r = -0,275).

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Chronic kidney disease (CKD) is one of serious complication that most common in type 2 diabetes mellitus patients. It is important to find a marker that can detect it earlier to prevent its progression. The aim of this study was to analyze the correlation between malondialdehyde (MDA) concentration and estimated glomerular filtration rate (eGFR). MDA is an oxidative stress marker which was predicted allies in early stage of kidney damage.

The design of this study is cross sectional. The population was type 2 DM outpatients at Pasar Minggu Local Government Clinic. Total sampling method was used in sample selection. Samples being analyzed were as much as 50 patients (14 males, 36 females, age ranges : 39-74 years). MDA was measured by spectrophotometric based on its reaction with thiobarbituric acid. The coefficient correlation (r) of this method was 0.9996 and the coefficient of variation (%CV) within and between run were 2.75 - 13.33%.

eGFR was measured based on kinetic Jaffe method. Its coefficient correlation (r) was 0.9994 and %CV within and between run were 2.91-9.52%. MDA concentration in type 2 DM patients in this research was 0.82 ± 0.26 nmol/mL and the eGFR values were 78.30 ± 26.77 (Cockroft-Gault); 76.08 ± 24.17 (MDRD study); and 79.25 ± 21.04 (CKD-EPI). There was a significant correlation between MDA concentration and eGFR based on Cockroft-Gault formula (p =0.039, r = -0.293), but there were no significant correlation between MDA concentration and eGFR based on MDRD study and CKD-EPI (p = 0.051 and p = 0.053; r = -0.277 and r = -0.275)."

"Stres oksidatif yang diinduksi hiperglikemia memainkan peran utama dalam patogenesis komplikasi ginjal di antara pasien diabetes mellitus tipe 2, yang dikenal sebagai nefropati diabetik. Peroksidasi asam arakidonat, salah satu komponen membran fosfolipid yang dapat ditemukan sebagian besar di sel mesangial glomerulus, membentuk kelompok zat mirip prostaglandin yang disebut isoprostanes. Salah satu metabolit, 8-iso-Prostaglandin F2α, diketahui memiliki aktivitas vasokonstriktif yang kuat, yang diduga terkait dengan patofisiologi hiperfiltrasi glomerulus pada tahap awal nefropati diabetik. Oleh karena itu, penelitian multisenter cross-sectional ini dilakukan untuk mengevaluasi apakah 8-iso-Prostaglandin F2α dikaitkan dengan hiperfiltrasi glomerulus, yang tercermin oleh perkiraan laju filtrasi glomerulus (eGFR) yang tinggi. Pengambilan sampel dilakukan pada tahun 2019 di Puskesmas Pasar Minggu (n = 57). Sampel yang diperoleh peneliti sebelumnya pada tahun 2015 di Rumah Sakit Sitanala, dan pada tahun 2016 dan 2017 di Puskesmas Pasar Minggu juga digunakan dalam penelitian ini (n = 154). Semua spesimen serum dan urine partisipan dianalisis untuk mengukur kreatinin serum dan konsentrasi 8-iso-Prostaglandin F2α urin mereka masing-masing. Kreatinin serum digunakan untuk menghitung eGFR berdasarkan persamaan CKD-EPI. 8-iso-Prostaglandin F2α urine diukur menggunakan metode ELISA kompetitif. Sampel (n = 211) dibagi menjadi dua kelompok berdasarkan nilai eGFR ≥90 dan 60-89 mL/menit/1,73 m2. Hasil analisis statistik menunjukkan bahwa tidak ada perbedaan karakteristik dasar antara kedua kelompok, kecuali usia peserta (p <0,001). Rerata 8-iso-Prostaglandin F2α urin ditemukan lebih tinggi pada kelompok eGFR ≥90. Namun, perbedaannya tidak signifikan secara statistik (p = 0,214), menunjukkan bahwa 8-iso-Prostaglandin F2α mungkin terkait dengan hiperfiltrasi glomerulus tetapi masih belum cukup spesifik untuk digunakan sebagai penanda tahap awal nefropati diabetik.

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Oxidative stress induced by hyperglycemia plays a major role in the pathogenesis of kidney complications among patients with type 2 diabetes mellitus, known as diabetic nephropathy. Arachidonic acid peroxidation, one of the components of the phospholipid membrane that can be found mostly in mesomer cells glomerulus, forming a group of prostaglandin-like substances called isoprostanes. One of the metabolites, 8-iso-Prostaglandin F2α, is known to have strong vasoconstrictive activity, which is thought to be related to the pathophysiology of glomerular hyperfiltration in the early stages of diabetic nephropathy. Therefore, this cross-sectional multicenter study was conducted to evaluate whether 8-iso-Prostaglandin F2α was associated with glomerular hyperfiltration, which was reflected by the high estimated glomerular filtration rate (eGFR). Sampling was carried out in 2019 at the Pasar Minggu Health Center (n = 57). Samples obtained by previous researchers in 2015 at Sitanala Hospital, and in 2016 and 2017 at Pasar Minggu Health Center were also used in this study (n = 154). All participants' serum and urine specimens were analyzed to measure serum creatinine and their respective urine 8-iso-Prostaglandin F2α concentrations. Serum creatinine is used to calculate eGFR based on the CKD-EPI equation. 8-iso-Prostaglandin F2α urine is measured using the competitive ELISA method. The sample (n = 211) was divided into two groups based on eGFR values ​​of ≥90 and 60-89 mL/min/1.73 m2. Statistical analysis showed that there were no differences in baseline characteristics between the two groups, except the age of the participants (p <0.001). The mean 8-iso-Prostaglandin F2α urine was found to be higher in the eGFR group ≥90. However, the difference was not statistically significant (p = 0.214), suggesting that 8-iso-Prostaglandin F2α might be associated with glomerular hyperfiltration but still not specific enough to be used as a marker for the early stages of diabetic nephropathy."

"[ABSTRAK Penelitian mengenai efektivitas pengobatan diabetes melitus dan kaitannyadengan pencegahan komplikasi masih menujukkan hasil yang beragam. Penelitianini bertujuan untuk membandingkan efektivitas hipoglikemik dan fungsi ginjaldari sulfonilurea, kombinasi sulfonilurea dan biguanid serta injeksi insulin. Disainpenelitian adalah kohort retrospektif pada pasien diabetes melitus tipe 2 rawatjalan yang mengkonsumsi obat yang sama selama empat bulan terakhir di RSKDr. Sitanala Tangerang. Penelitian ini dilaksanakan pada kurun waktu April-Juni2015, dan sudah mendapatkan lulus kaji etik dari Komite Etik rumah sakit ini.Subyek penelitian dibagi kedalam tiga kelompok yaitu yang menggunakan injeksiinsulin (n = 30), yang menggunakan obat sulfonilurea tunggal (n = 30), dankombinasi sulfonilurea dan biguanid (n = 45). Efektivitas hipoglikemik dilihatdari nilai HbA1C pasien dan komplikasi nefropati diabetik dilihat dari nilai eLFGyang dihitung dari angka serum kreatinin. Rerata usia keseluruhan pasien adalah54,98±7,47, sebagian besar adalah wanita (72%) dan cenderung overweight(rerata IMT 25,47±4,77). Ada perbedaan yang bermakna (p = 0,042 ) pada nilaiHbA1C pasien kelompok kombinasi sulfonilurea-biguanid (rerata HbA1C7,28±0,09) dibandingkan dengan kelompok insulin (rerata HbA1C 8,10±0,09),sementara dengan kelompok sulfonilurea tunggal tidak ada perbedaan yangbermakna. Sedangkan nilai eLFG untuk setiap kelompok obat tidak ditemukanperbedaan yang bermakna. Subyek yang memiliki riwayat diabetes melitus dalamkeluarga mempunyai peluang 4,512 kali (interval kepercayaan 95%, p = 0,010)lebih besar dibandingkan dengan yang tidak memiliki riwayat diabetes dalamkeluarga untuk memiliki nilai HbA1C lebih dari 7%. Pasien dengan IMT >30kg/m2 mempunyai peluang sebesar 21,631 (p = 0,012) dibandingkan pasiendengan IMT < 18,5 kg/m2 untuk memiliki nilai HbA1C yang tidak terkontrol ataudiatas 7%. Pengobatan dengan kombinasi antidiabetik oral sulfonilurea danbiguanid lebih efektif dalam menurunkan nilai HbA1C pasien DM tipe 2dibandingkan dengan insulin atau sulfonilurea tunggal, dan tidak ada perubahanbermakna dalam penurunan fungsi ginjal ABSTRACT Research on effectiveness of therapy on diabetes mellitus associated with

prevention of its complication still remain varied in results. The hypoglycemic

effectiveness and the kidney function were compared between sulfonylurea,

sulfonylurea and biguanide combination and insulin, with the retrospective cohort

study design, on patients that use those agents in last four months and came to

out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical

Clearance from the Ethical Committee of this hospital. Subjects were classify into

three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and

sulfonylurea and biguanide combination group (n = 45). Hypoglycemic

effectiveness is measured with the HbA1C level and diabetic nephrophaty with

the eGFR which calculated from the measured serum creatinin. Mean age of all

subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend

to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the

sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)

with those from the insulin group (8,10±0,09), and there was no significant

difference with the sulfonylurea group. There was no significant difference in

diabetic nephropathy between groups. Subject with diabetic family history has

4,512 times chance to have the HbA1C level > 7% compare to those without

diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance

to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea

and biguanide combination was more effective compare to insulin or sulfonylurea

monotherapy on decreasing HbA1C level of type 2 DM patients, without

significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with

prevention of its complication still remain varied in results. The hypoglycemic

effectiveness and the kidney function were compared between sulfonylurea,

sulfonylurea and biguanide combination and insulin, with the retrospective cohort

study design, on patients that use those agents in last four months and came to

out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical

Clearance from the Ethical Committee of this hospital. Subjects were classify into

three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and

sulfonylurea and biguanide combination group (n = 45). Hypoglycemic

effectiveness is measured with the HbA1C level and diabetic nephrophaty with

the eGFR which calculated from the measured serum creatinin. Mean age of all

subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend

to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the

sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)

with those from the insulin group (8,10±0,09), and there was no significant

difference with the sulfonylurea group. There was no significant difference in

diabetic nephropathy between groups. Subject with diabetic family history has

4,512 times chance to have the HbA1C level > 7% compare to those without

diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance

to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea

and biguanide combination was more effective compare to insulin or sulfonylurea

monotherapy on decreasing HbA1C level of type 2 DM patients, without

significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with

prevention of its complication still remain varied in results. The hypoglycemic

effectiveness and the kidney function were compared between sulfonylurea,

sulfonylurea and biguanide combination and insulin, with the retrospective cohort

study design, on patients that use those agents in last four months and came to

out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical

Clearance from the Ethical Committee of this hospital. Subjects were classify into

three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and

sulfonylurea and biguanide combination group (n = 45). Hypoglycemic

effectiveness is measured with the HbA1C level and diabetic nephrophaty with

the eGFR which calculated from the measured serum creatinin. Mean age of all

subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend

to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the

sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)

with those from the insulin group (8,10±0,09), and there was no significant

difference with the sulfonylurea group. There was no significant difference in

diabetic nephropathy between groups. Subject with diabetic family history has

4,512 times chance to have the HbA1C level > 7% compare to those without

diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance

to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea

and biguanide combination was more effective compare to insulin or sulfonylurea

monotherapy on decreasing HbA1C level of type 2 DM patients, without

significant difference in effect of lowering kidney functionH;Research on effectiveness of therapy on diabetes mellitus associated with

prevention of its complication still remain varied in results. The hypoglycemic

effectiveness and the kidney function were compared between sulfonylurea,

sulfonylurea and biguanide combination and insulin, with the retrospective cohort

study design, on patients that use those agents in last four months and came to

out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical

Clearance from the Ethical Committee of this hospital. Subjects were classify into

three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and

sulfonylurea and biguanide combination group (n = 45). Hypoglycemic

effectiveness is measured with the HbA1C level and diabetic nephrophaty with

the eGFR which calculated from the measured serum creatinin. Mean age of all

subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend

to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the

sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)

with those from the insulin group (8,10±0,09), and there was no significant

difference with the sulfonylurea group. There was no significant difference in

diabetic nephropathy between groups. Subject with diabetic family history has

4,512 times chance to have the HbA1C level > 7% compare to those without

diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance

to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea

and biguanide combination was more effective compare to insulin or sulfonylurea

monotherapy on decreasing HbA1C level of type 2 DM patients, without

significant difference in effect of lowering kidney functionH, Research on effectiveness of therapy on diabetes mellitus associated with

prevention of its complication still remain varied in results. The hypoglycemic

effectiveness and the kidney function were compared between sulfonylurea,

sulfonylurea and biguanide combination and insulin, with the retrospective cohort

study design, on patients that use those agents in last four months and came to

out-patient clinic of RSK Dr. Sitanala Tangerang. This research had the Ethical

Clearance from the Ethical Committee of this hospital. Subjects were classify into

three groups, i.e insulin group (n = 30), sulfonylurea group (n = 30) and

sulfonylurea and biguanide combination group (n = 45). Hypoglycemic

effectiveness is measured with the HbA1C level and diabetic nephrophaty with

the eGFR which calculated from the measured serum creatinin. Mean age of all

subjects was 54,98±7,47 (p=0,157), most were women (72%, p=0,235), and tend

to overweight (mean BMI is 25,49±4,84; p = 0,59). Mean HbA1C level from the

sulfonylurea-biguanide (7,28±0,09) group were significantly different (p = 0,042)

with those from the insulin group (8,10±0,09), and there was no significant

difference with the sulfonylurea group. There was no significant difference in

diabetic nephropathy between groups. Subject with diabetic family history has

4,512 times chance to have the HbA1C level > 7% compare to those without

diabetic family history. Subjects with BMI >30 kg/m2 have 21,631 times chance

to get the HbA1C >7% compare to subjects with BMI <18,5 kg/m2. Sulfonylurea

and biguanide combination was more effective compare to insulin or sulfonylurea

monotherapy on decreasing HbA1C level of type 2 DM patients, without

significant difference in effect of lowering kidney functionH]"