Skip to main content Skip to main navigation menu Skip to site footer

Derajat keparahan psoriasis vulgaris berkorelasi positif terhadap kadar HBA1C

Abstract

 

Psoriasis vulgaris (PV) adalah  kelainan kulit inflamasi kronis diperantarai sistem imun. Peranan mediator inflamasi (Th-1, TNF-α, IL-6,IL-7, IL-8, IL-17, dan IL-23) pada PV menyebabkan penghambatan reseptor insulin dan uptake glukosa sehingga terjadi resistensi insulin, mengakibatkan peningkatan kadar glukosa, dimana rerata kadar glukosa selama 3 bulan dinyatakan kadar HbA1c (Hemoglobin glikosilasi), yaitu  ikatan glukosa darah pada hemoglobin.

Metode penelitian ini adalah cross sectional. Tujuan penelitian untuk mengetahui hubungan derajat keparahan PV terhadap  kadar HbA1c. Pemeriksaan kadar HbA1c dengan pengambilan darah vena, menggunakan metode kromatografi. Pengambilan sampel secara consecutive sampling sesuai kriteria inklusi dan eksklusi. Dari  total subyek 51 orang, subyek bukan PV 18 orang, subyek PV 22 lelaki, 11 perempuan, usia 15- 65 tahun.   Derajat keparahan PV menggunakan skor Psoriasis Area Severity Index (PASI),  dikategorikan ringan (skor PASI <7), sedang (skor PASI  7 – 12), dan berat (skor PASI > 12). Sebagian besar (19 subyek) termasuk kelompok ringan. Nilai minimum kadar HbA1c subyek penelitian  4.6%, maksimum 12.1 %, dan nilai tengah 5.4%.  Berdasarkan konsensus Perkeni, nilai HbA1c normal <5,7%, prediabetes 5,7-6,4%, diabetes >6,5%. Kadar HbA1c subyek PV lebih tinggi dibanding bukan PV (p=0,019). PV menyebabkan peningkatan kadar HbA1c, dengan Prevalence Ratio (PR) 6,55; berarti subyek PV berisiko lebih tinggi 6,5 kali lipat untuk mengalami peningkatan kadar HbA1c dibanding bukan PV. Korelasi derajat keparahan dan kadar HbA1c berarah positif signifikan, kekuatan korelasi sedang (Korelasi Spearman; r = 0.490, p=0,004). Simpulan penelitian ini kadar HbA1c darah subyek PV lebih tinggi dibanding bukan PV, dan derajat keparahan PV berkorelasi positif terhadap peningkatan kadar HbA1c.

References

  1. Griffiths, CEM, Barker JNWN. Psoriasis. Rook’s Textbook of Dermatology. 8th ed. Oxford: Wiley-Blackwell; 2012. p.20.1-20.21.
  2. Gudjonsson JE, Elder JT. Psoriasis. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw-Hill; 2012. p.197-231.
  3. Anonim. Register Poliklinik Kulit dan Kelamin bagian Imunologi RSUP Sanglah Denpasar tahun 2014-2016.
  4. Soelistijo, SA., Novida H, Rudijanto A, Soewondo P, Suastika K, Manaf A, Sanusi H, Lindarto D, Shahab A, Pramono B, Langi YA, Purnamasari D, Soetedjo NN, Saraswati MR, Dwipayana MP, Yuwono A, Sasiarini L, Sugiarto,. Sucipto KW, Zufry H. Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. Konsensus Perkeni; 2015.
  5. Elgendy, A., Alshawadfy E, Altaweel A, dan Elsaidi A. Cardiovascular and Metabolic Comorbidities of Psoriasis.Dermatol Case Rep. 2016; 1(1):1-9.
  6. Armstrong, AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus : a systematic review and meta analysis. JAMA Dermatol. 2013;149(1):84-91.
  7. Fitzgerald, R, Sadlier M, Connolly M, Tobin AM. Psoriasis and Insulin Resistance: A Review. J of Diabetes Res Clin Metabolism. 2014; 3(3):1-5.
  8. Gyldenlove, M, Storgaard H, Hoist JJ, Vilsboll T, Knop FK, Skov L. Patients with Psoriasis are Insulin Resistant. J Am Acad Dermatol. 2015; 1(4):1-7.
  9. Azfar, R.S. and Gelfand J.M. Psoriasis and Metabolic Disease: Epidemiology and Pathophysiology. Curr Opin Rheumatol. 2008; 20(4): 416-422.
  10. Boehncke WH, Boehncke S. More than Skin-Deep: The Many Dimensions of The Psoriatic Disease. In: Swiss Med Wkly. 2014;144:1-8.
  11. Setyorini, M., Triestianawati, W., Wiryadi, B.E., Jacoeb, T.N. Proporsi sindrom metabolik pada pasien PV berdasarkan kriteria national cholesterol education program adult treatment panel III di Rumah Sakit Dr Cipto Mangunkusumo dan sebuah klinik swasta di Jakarta. MDVI. 2012; 39(1): 2-9.
  12. Huerta, C., Rivero, E., Rodriguez, G. Incidence and risk factor for psoriasis in general population. Arch Dermatol. 2007; 143: 1559-65.
  13. Takahashi H, Takahashi I, Honma M, Ishida YA, Iizuka H. Prevalence of metabolic syndrome in Japanese psoriasis patients. J Dermatol Sci. 2010; 57: 143-4.
  14. Salunke, AS., Nagargoje MV, Belgaumkar VA, Tolat SN, Chavan RB. Association of metabolic syndrome in chronic plaque psoriasis patients and their correlation with disease severity, duration and age: a case control study from western Maharashtra. J of Clin Diagnostic Res. 2017; 11(8):WC06-10.
  15. Aruna, C, Rao V, Ramanamurthy P, Rambabu P. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case control study from a tertiary care center in Andhra Pradesh. JNTR Univ Health Sci. 2016; 5:13-6.
  16. Naito R, Imafuku S. Distinguishing features of body mass index and psoriasis in men and women in Japan: A hospital based case-control study. J Dermatol. 2016 ;43(12):1406-11.
  17. Gui XY, Yu XL, Jin HZ, Zuo YG, Wu C.. Prevalence of metabolic syndrome in Chinese psoriasis patients: a hospital based cross-sectional study. J of Diabetes Invest. 2018; 9(1): 39-43.
  18. Hercogova J, Ricceri F, Lara T, Lotti T, Prignano F. Psoriasis and body mass index. Dermatol Therapy. 2010;23: 152-4.
  19. Milcic D, Jancovic S, Vesic S, Milinkovic M, Marinkovic J, Circovic A, Jancovic J. Prevalence of metabolic syndrome in patients with psoriasis: a hospital based cross sectional study. An Bras Dermatol. 2017; 92(1):46-51.
  20. Madanagobalane, Shraddha, Sandhya, Venkatswami. Anandan, Sankarasubramanian., Seshadiri, Khrisna.. Circulating Adiponectin Levels in Indian Patients with Psoriasis and Its Relation to Metabolic Syndrome. Indian J of Endocrinol and Metabol. 2014; 18: 191-6.
  21. Ali, NM, Kuruvila M, Unnikrishnan B., 2014. Psoriasis and metabolic syndrome: A case control study. Indian J Dermatol Venereol Leprol. 2014;80:255-7.
  22. Singh S, Dogra S, Malhotra S. Prevalence of metabolic syndrome in psoriasis and levels of interleukin-6 and tumor necrosis factor-α in psoriasis patients with metabolic syndrome: Indian tertiary care hospital study. Int J of Appl Basic Med Res. 2017; v.7(3).
  23. Davidovici, B.B, , Sattar, N., Jo, P.C., Puig, L., Emery, P., Barker, J.N., Kerkhof, P., Stahle, M., 8, Nestle, F., Girolomoni, G. dan Krueger, J.G. Psoriasis and Systemic Inflammatory Diseases: Potential Mechanistic Links between Skin Disease and Co-Morbid Conditions. J of Invest Dermatol. 2010; 130: 1785–1796.

How to Cite

Rahardjo, F. N., Adiguna, M. S., & Wardhana, M. (2019). Derajat keparahan psoriasis vulgaris berkorelasi positif terhadap kadar HBA1C. Medicina, 50(1). https://doi.org/10.15562/medicina.v50i1.306

HTML
38

Total
43

Share

Search Panel