Hubungan Kadar HbA1c Dan Rasio TG/HDL Dengan Cystatin-C Serum Pada Pasien Diabetes Melitus Tipe 2

Latar belakang: Diabetes melitus (DM)  tipe 2 dapat menyebabkan komplikasi salah satunya nefropati. Kontrol glikemik yang dinilai dengan HbA1c dan dislipidemia yang dinilai dengan rasio trigliserida/high density lipoprotein (TG/HDL) diduga berhubungan dengan komplikasi nefropati. Cystatin C merupakan petanda yang dapat menilai kerusakan fungsi ginjal dini. Hubungan kadar HbA1c dan rasio TG/HDL dengan Cystatin C pada pasien DM tipe 2 belum diketahui dengan jelas. Tujuan: Mengetahui hubungan antara kadar HbA1c dan rasio TG/HDL dengan Cystatin C pada pasien diabetes melitus tipe 2. Metode: Penelitian observasional analitik dengan pendekatan belah lintang dilakukan pada bulan April - Juni 2019 melibatkan 34 pasien DM tipe 2 di Puskesmas Karang Ayu yang memenuhi kriteria inklusi dan ekslusi. Pemeriksaan kadar HbA1c menggunakan metode HPLC, rasio TG/HDL dihitung dengan perbandingan TG dengan HDL yang diperiksa menggunakan alat kimia klinik otomatis, kadar Cystatin C menggunakan metode ELISA. Uji statistik menggunakan korelasi Spearman. p < 0,05 dianggap signifikan.  Hasil: Rerata±SD kadar HbA1c adalah 8,21±1,65. Median (minimum-maksimum) rasio TG/HDL dan Cystatin C berturut-turut adalah 3,65(1,3–9,7), 0,72(0,46 – 1,22) mg/L. Korelasi HbA1c dengan Cystatin C dan rasio TG/HDL dengan Cystatin C berturut-turut adalah (r = 0,505; p = 0,002) dan (r = 0,471; p = 0,005). Simpulan: Terdapat hubungan positif sedang bermakna antara kadar HbA1c dengan Cystatin C  dan rasio TG/HDL dengan Cystatin C pada pasien diabetes melitus tipe 2. Kata kunci: HbA1c, rasio TG/HDL, Cystatin C, DM.   The correlation of HbA1c and TG/HDL ratio with serum cystatin C in type 2 diabetes patients   Background: Type 2 diabetes mellitus (DM) can cause chronic complications such as nephropathy. Glycemic control assessed with HbA1c and dyslipidemia assessed by the tryglyceride/high density lipoprotein (TG / HDL) ratio is thought to be associated with complications of nephropathy. Cystatin C is a marker that can assess early kidney function damage. Relationship between HbA1c levels and TG / HDL ratio with Cystatin C in type 2 DM patients is not clearly known. Objective: to investigate the correlation of HbA1c and TG/HDL ratio with Cystatin C  in acute type 2 diabetes mellitus patients. Methods: Analytic observational study with cross sectional approach was conducted in April-June 2019 involving 34 type 2 diabetes mellitus patients at the Karang Ayu Puskesmas who were screened according to the inclusion and exclusion criteria. The level of HbA1c were measured by the HPLC method, TG/HDL ratio was measured by automatic chemistry analyzer and Cystatin C was measured by ELISA method. Statistical analysis used Spearman Correlation Test. p <0.05 was considered significant. Results: The mean ± SD HbA1c level was 8.21 ± 1.65. The median (minimum-maximum) ratio of TG / HDL and Cystatin C were 3.65 (1.3–9.7), 0.72 (0.46 - 1.22) mg / L, respectively. Correlation of HbA1c with Cystatin C and the ratio of TG / HDL with Cystatin C respectively (r = 0.505; p = 0.002) and (r = 0.471; p = 0.005). Conclusions: There are significant moderate positive correlation between HbA1c with  Cystatin C and TG/HDL ratio with Cystatin C in type 2 diabetes mellitus patients. Keywords : HbA1c, TG/HDL ratio, Cystatin C, Type 2 Diabetes mellitus.