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Nur Irawati
"Diabetes melitus banyak dikaitkan dengan risiko tinggi aterosklerosis dan komplikasinya. Makrofag merupakan kunci dalam semua tahap aterosklerosis dan sudah diketahui berperan penting dalam patomekanisme penyakit metabolik dan kardiovaskuler. Makrofag menginternalisasi LDL teroksidasi melalui scavenger receptor seperti CD36. Makrofag juga mempunyai sistem transpor aktif seperti ABCA1 untuk eliminasi kolesterol dari makrofag ke akseptor ekstraseluler. Keterlibatan protein CD36 dan ABCA1 dalam mekanisme masuk dan keluarnya kolesterol pada makrofag diduga berhubungan dengan risiko pembentukan sel busa  sehingga diperlukan penelitian pola ekspresi CD36 dan ABCA1 serta ekspresi sitokin pro-inflamasi  IL-1b dan anti inflamasi IL-10 makrofag pada subyek non T2DM dan T2DM. Pengamatan dilakukan pada 11 subyek non T2DM dan 13 subyek T2DM. Disain penelitian menggunakan studi obervasional dan intervensi invitro. Monosit distimulasi menjadi makrofag menggunakan M-CSF. Tahap selanjutnya, makrofag dibagi dalam tiga perlakuan yaitu tanpa stimulasi, stimulasi LPS dan stimulasi ox-LDL. Ekspresi makrofag CD36 dan ABCA1 diukur  secara flowcytometri menggunakan alat BD FACSCanto II Flow Cytometer sedangkan ekspresi IL-1b dan IL-10 makrofag diukur  dengan multiplex immunoassay pada alat LuminexTM 200. Pada penelitian ini ditemukan adanya hubungan negatif rasio Trigliserida/HDL dengan ekspresi makrofag CD36-ABCA1+. Makrofag yang distimulasi ox-LDL menunjukkan perbedaan ekspresi CD36+ABCA1- pada subyek non T2DM dan T2DM yang tidak signifikan (p=0,12) sedangkan  ekspresi CD36-ABCA1+ menunjukkan perbedaan yang signifikan (p=0,04). Subyek non T2DM menunjukkan ekspresi CD36-ABCA1+ dominan tinggi (72.7%) sedangkan pada subyek T2DM dominan ekspresi rendah (59.2%). Makrofag yang distimulasi LPS dan ox-LDL menunjukkan perbedaan rasio IL-1b/IL-10  pada subyek non T2DM dan T2DM (p=0.05; p=0.02). Subyek T2DM menunjukkan rasio IL-1b/IL-10 lebih tinggi dibandingkan non T2DM. Analisa hubungan rasio IL-1b/IL-10 dengan ekspresi makrofag CD36-ABCA1+ menunjukkan kecenderungan subyek dengan rasio IL-1b/IL-10 tinggi mempunyai ekspresi makrofag CD36-ABCA1+ rendah. Analisis juga menunjukkan 62% subyek T2DM menunjukkan eskpresi makrofag CD36- & ABCA1+ rendah disertai rasio IL-1b/IL-10 tinggi  dan hsCRP diatas nilai median sedangkan subyek non T2DM 91% menunjukkan ekspresi CD36-ABCA1+ tinggi dengan rasio IL-1b/IL-10 rendah dan hsCRP rendah.  Pada penelitian ini ditemukan adanya hubungan ekspresi makrofag CD36-ABCA1+ dan  rasio IL-1b/IL-10 terhadap hs-CRP yang merupakan penanda risiko penyakit kardiovaskuler.

Diabetes mellitus is associated with a high risk of atherosclerosis and its complications. Macrophages are key in all stages of atherosclerosis and are known to play an important role in the pathomechanism of metabolic and cardiovascular disease. Macrophages internalize oxidized LDL via scavenger receptors such as CD36. Macrophages also have active transport systems such as ABCA1 for elimination of cholesterol from macrophages to extracellular acceptors. The involvement of CD36 and ABCA1 proteins in the mechanism of entry and exit of cholesterol in macrophages is thought to be associated with the risk of foam cell formation, so it is necessary to study the expression patterns of CD36 and ABCA1 as well as the expression of the pro-inflammatory cytokine IL-1b and anti-inflammatory IL-10 in macrophages in non-T2DM subjects and T2DM. Observations were made on 11 non-T2DM subjects and 13 T2DM subjects. The research design used observational studies and in vitro interventions. Monocytes were stimulated to become macrophages using M-CSF. In the next stage, macrophages were divided into three treatments: no stimulation, LPS stimulation and ox-LDL stimulation. The expression of CD36 and ABCA1 macrophages was measured by flowcytometry using the BD FACSCanto II Flow Cytometer while the expression of IL-1b and IL-10 macrophages was measured by multiplex immunoassay on the LuminexTM 200. This study found a negative relationship between triglyceride/HDL ratio and expression of CD36-ABCA1+ macrophages. Ox-LDL stimulated macrophages showed insignificant differences in CD36+ABCA1- expression in non-T2DM and T2DM subjects (p=0.12) while CD36-ABCA1+ expression showed significant differences (p=0.04). Non-T2DM subjects showed high dominant CD36-ABCA1+ expression (72.7%) while T2DM subjects had low dominant expression (59.2%). The LPS and ox-LDL-stimulated macrophages showed different ratios of IL-1b/IL-10 in non-T2DM and T2DM subjects (p=0.05; p=0.02). T2DM subjects showed a higher IL-1b/IL-10 ratio than non-T2DM subjects. Analysis of the relationship between the IL-1b/IL-10 ratio and CD36-ABCA1+ macrophage expression showed a tendency for subjects with a high IL-1b/IL-10 ratio to have low CD36-ABCA1+ macrophage expression. The analysis also showed that 62% of T2DM subjects showed low expression of CD36- ABCA1+ macrophages with high IL-1b/IL-10 ratio and hsCRP above the median value, while 91% of non-T2DM subjects showed high CD36-ABCA1+ expression with IL-1b/IL-10  low and low hsCRP. In this study, it was found that there was a relationship between the expression of CD36-ABCA1+ macrophages and the ratio of IL-1b/IL-10 to hs-CRP which is a marker of cardiovascular disease risk."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Rona Kartika
"Diabetes melitus (DM) tipe 2 adalah penyakit yang berhubungan dengan kondisi inflamasi ringan kronis. Selain terjadi peningkatan kadar sitokin proinflamasi, diduga terjadi gangguan pada mediator antiinflamasi, yaitu enzim indoleamine 2,3-dioxygenase (IDO). Tujuan dari penelitian ini adalah menganalisis produksi IDO dari kultur peripheral blood mononuclear cells (PBMC) pada penderita DM tipe 2 dan meneliti hubungan IDO dengan kadar sitokin proinflamasi seperti TNF-α, IL-6, dan IFN-γ; serta sitokin antiinflamasi, IL-10. Sampel PBMC diambil dari 21 pasien DM tipe 2 dan 17 subjek kontrol sehat kemudian dilakukan kultur dengan stimulasi phytohemagglutinin (PHA). Setelah kultur selama 3 hari, produksi TNF-α, IL-6, IFN-γ, dan IL-10 diukur menggunakan multiplex immunoassay, sedangkan kadar IDO diukur menggunakan ELISA. Kadar IDO dari kultur PBMC tanpa stimulasi dan dengan stimulasi PHA secara signifikan lebih tinggi pada pasien DM tipe 2 dengan p<0,001 dan p=0,012. Sebanyak 52,8% pasien DM tipe 2 mengalami penurunan produksi IDO setelah distimulasi PHA dan hal tersebut berhubungan dengan kadar IFN-γ yang rendah dengan p=0,005. Di lain pihak, 42,8% pasien DM tipe 2 mengalami peningkatan produksi IDO setelah stimulasi PHA dan hal ini berhubungan dengan rasio TNF-α/IL-10 (r=0,513 p=0,079), IL-6/IL-10 (r=0,446 p=0,114) dan IFN-γ/IL-10 (r=0,422 p=0,129). Pada DM tipe 2, terjadi perubahan produksi IDO. IFN-γ yang rendah berkontribusi pada penurunan produksi IDO. Sementara itu, respon proinflamasi berhubungan dengan peningkatan produksi IDO.

Type 2 diabetes mellitus (T2DM) is associated with chronic low-grade inflammatory condition. Besides the increased of proinflammatory cytokines level, it was found that anti-inflammatory mediators were disturbed. So, we would analyse the production of indoleamine 2,3-dioxygenase (IDO) in PHA-stimulated PBMC from type 2 DM patients and investigate its association to pro and anti-inflammatory cytokines. PBMC samples were collected from 21 patients with T2DM and 17 healthy subjects, then followed by 3-day PHA stimulation. In vitro production of TNF-α, IL-6, IFN-γ and IL-10 were measured using multiplex immunoassay; meanwhile, IDO level was assessed using ELISA. IDO concentration from unstimulated and PHA-stimulated PBMC were significantly higher in T2DM patients with p<0,001 and p=0.012 respectively. Reduced IDO production occurred in 52,8% of T2DM and it was associated with low interferon γ with p=0.005; whereas 42,8% of T2DM had higher IDO production and had moderate positive correlations with ratio of TNF-α/IL-10 (r=0,513 p=0,079), IL-6/IL-10 (r=0,446 p=0,114) and IFN-γ/IL-10 (r=0,422 p=0,129). We could conclude that there is an alteration of IDO production after PHA stimulation in T2DM. Low interferon γ level seems to contribute in reducing IDO production. In T2DM with higher IDO production, proinflammatory responses are more influential in increasing IDO production."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tesis Membership  Universitas Indonesia Library
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Ujang Saeful Hikmat
"Aspek metabolik komplikasi DM tipe 2, khususnya penyakit kardiovaskular, telah banyak dibahas, namun aspek imunometabolik masih terbatas, sehingga sangat penting untuk memahami peran sistem imun dalam perkembangan komplikasi. Tujuan penelitian ini adalah untuk memahami peran subset monosit (CD14,CD16) dan mediator inflamasinya (IL-1β, IL-10) terhadap risiko penyakit kardiovaskular pada Pasien DM tipe 2. Subset monosit CD14, CD16 diperiksa menggunakan sampel kultur PBMC dan dianalisis menggunakan flow cytometry. Metode Multiplex Immunoassays digunakan untuk mengukur IL-1β, dan IL-10. Hasil penelitian ini, menunjukkan terdapat pola peningkatan subset monosit CD14+, CD16+ pada DM tipe 2, namun tidak berbeda secara signifikan. Peningkatan monosit CD14+,CD16+ lebih dari 6.8% berhubungan dengan peningkatan risiko penyakit kardiovaskular. Rasio mediator inflamasi IL-1β, sebelum dan sesudah stimulasi LPS secara signifikan lebih tinggi pada DM tipe 2 dibandingkan kontrol. Pada kondisi inflamasi, peningkatan IL-10 berespon terhadap stimulasi LPS, namun tidak mampu mengkompensasi peningkatan IL-1β, sehingga kecenderungan menjadi lebih hiperinflamasi pada DM tipe 2. Glukosa puasa merupakan penanda metabolik yang berhubungan dengan peningkatan monosit CD14+,CD16+.

The metabolic aspects of Type 2 Diabetes (T2D) complications, particularly cardiovascular disease, have been widely discussed, but the immunometabolic aspects are still limited, so it is critical to understand the role of the immune system in the development of complications. The objective of this study is to understand about the role of the monocyte subset (CD14,CD16) and its inflammatory mediators (IL-1β, IL-10) in the risk of CVD in T2D. CD14, CD16 monocyte subset was examined using PBMC culture samples and analyzed using flow cytometry. The Multiplex Immunoassays method was used to measure IL-1β and IL-10. This study shows there is an increase in the CD14+, CD16+ monocyte subset in type 2 diabetes, but it is not significantly related. An increase in CD14+,CD16+ monocytes of more than 6.8% is associated with an increased risk of CVD. The ratio of the inflammatory mediator IL-1β to basal conditions and LPS stimulation was significantly higher in T2D than in controls. In inflammatory conditions, the increase in IL-10 responds to LPS stimulation, but it is unable to compensate for the increase in IL-1β in T2D, so the tendency becomes more hyperinflammatory in type 2 DM. Fasting glucose is a metabolic marker associated with an increase in CD14+,CD16+ monocytes"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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"Periodontal status is a periodontum condition evaluated by using plaque index, calculus index, gingival index and pocket index. The main mediator of periodontum inflammation is IL-113 examined by ELISA method. There is an evaluation of PMN s in periodontum inflammation, but the leucotoxin as well as the protease in turn lowers the PMN phagocytotic function. Phagocytotic function was measured by flowcytometry. The aim of the study was to evaluate the high risk factors of being type 2 DM. A diagnostic study was conducted by using cross-sectional design on 45 controlled DM (CDM) subjects, 45 uncontrolled DM (UCDM) subjects in the Metabolic Endocrinology Clinic Cipto Mangunkusumo Hospital Jakarta, as compared to 45 non-DM control subjects. The result of multivariate analysis showed that patients of older age (>54 years old), low periodontum status (periodontal index >1.80), high IL-113 level (>23.70 pg/mL), and low PMN phagocytotic function <<53.47%), were significantly at high risk of having DM compared to non-DM (p<0.05). Lower periodontum status showed an increase in IL-113 level, decrease PMN phagocytotic function, and consequently, an increase in the risk of being type 2 DM."
[Fakultas Kedokteran Gigi, Journal of Dentistry Indonesia], 2007
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Artikel Jurnal  Universitas Indonesia Library
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Rizki Andriani
"Penerapan pedoman gizi kedalam menu sehari-hari merupakan tantangan bagi mayoritas pasien diabetes karena memerlukan penyesuaian dan kesukarelaan dari pasien untuk mengubah pola makan yang sudah lama terbentuk dan sering menimbulkan kejenuhan dan stress disebabkan pasien diabetes harus mengikuti program diet seumur hidupnya. Aktivitas self management serta respon psikologis memiliki pengaruh yang besar pada pasien diabetes melitus dalam melakukan usaha pengontrolan diet. Penelitian ini menggunakan desain cross sectional yang dilakukan di RSPAD Gatot Soebroto, RS Fatmawati dan RSUPN Dr. Cipto Mangunkusomo Jakarta dengan jumlah responden 260 orang pasien diabetes melitus tipe 2. Pengukuran respon psikologis menggunakan Problem Areas In Diabetes PAID, aktivitas self management diukur menggunakan Diabetes Self Management Questionare DMSQ yang telah dilakukan uji validitas dan reliabilitas serta pengukuran asupan makanan melalui kuesioner food recall 1x24 jam dan status nutrisi dinilai dengan indeks massa tubuh IMT. Hasil analisis menunjukkan terdapat hubungan bermakna antara respon psikologis dan status nutrisi p = 0,000, OR =4,944 , terdapat hubungan bermakna antara diabetes self management dengan status nutrisi p = 0,002, OR = 2,217 yang tidak dipengaruhi variabel perancu jenis OAD, asupan makanan, dan usia. Diperlukan penambahan materi konseling untuk memenuhi kebutuhan psikologis terkait diabetes serta penguatan edukasi secara berulang-ulang kepada pasien.

The application of nutritional guidelines into the daily menu is a challenge for the majority of diabetic patients because it requires adjustment and volunteering of patients to change the long established diet and often leads to saturation and stress because diabetic patients should follow a diet plan for the rest of their lives. Self management activities as well as psychological responses have a great influence on diabetes mellitus patients in doing diet control efforts. This research use cross sectional design which done in Gatot Soebroto army hospital, Fatmawati Hospital and Dr. Cipto Mangunkusomo hospital Jakarta with the number of respondents 260 people with type 2 diabetes mellitus. Measurement of psychological response using Problem Areas In Diabetes PAID, self management activity is measured using Diabetes Self Management Questionare DMSQ which has tested the validity and reliability and measurement of food intake through food recall questionnaire 1x24 hours and nutritional status assessed with body mass index BMI. The result showed that there was a significant correlation between psychological response and nutritional status p 0,000, OR 4,944 , there was a significant correlation between diabetes self management with nutritional status p 0,002, OR 2,217 unaffected by confounder type OAD, intake food, and age. Required addition of counseling material to meet the psychological needs related to diabetes as well as the strengthening of education repeatedly to the patient.
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Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2018
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UI - Tesis Membership  Universitas Indonesia Library
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Rahma Ayu Larasati
"ABSTRAK
Diabetes Melitus Tipe 2 (DMT2) adalah masalah global yang sangat serius. Penyakit ini menyerang pada usia yang paling produktif sehingga dapat menurunkan derajat ekonomi dan mengurangi usia harapan hidup. Patogenesis DM sangat erat kaitannya dengan inflamasi, ditandai dengan peningkatan kadar sitokin proinflamasi seperti IL-6, IL-8 dan TNF. Namun, belum ada agen antiinflamasi yang terbukti berperan dalam tatalaksana DMT2. Butirat merupakan asam lemak rantai pendek yang diproduksi dari fermentasi pati resisten di lumen usus. Dalam kondisi normal butirat diserap dan digunakan sebagai sumber energi bagi sel kolonosit, hati dan otot. Butirat mampu berikatan dengan reseptor GPR41 dan GPR43 pada monosit sehingga mampu mengubah pola ekspresi sitokin, aktivasi, migrasi dan diferensiasi sel. Sehingga menarik untuk meneliti pengaruh butirat terhadap migrasi dan sitokin yang diekspresikan oleh monosit pada pasien DMT2. Kadar sitokin dihitung dari supernatan yang diambil dari kultur monosit . Sebanyak 37 subJek dibagi menjadi dua perlakuan yaitu kontrol dan dengan penambahan butirat. Monosit hari pertama diisolasi dalam gel kolagen tipe 1 untuk dilakukan uji migrasi menggunakan μ-slide chemotaxis IBIDI. Analisis gambar menggunakan software ImageJ dan Chemotaxis tool. Terdapat adanya perbedaan yang bermakna pada rasio TNF/IL 10 antara kelompok sehat dan DMT2. Butirat juga terlihat menekan produksi sitokin TNF dan meningkatkan produksi IL10. Indikator migrasi monosit seperti jarak akumulasi dan kecepatan migrasi memiliki perbedaan bermakna antara kelompok sehat dan DMT2. Butirat dapat menekan laju migrasi monosit diikuti dengan penurunan jarak dan kecepatan migrasi monosit

ABSTRACT
Type 2 Diabetes Mellitus (DMT2) is a very serious global problem. This disease attacks at the most productive age so that it can reduce economic status and reduce life expectancy. The pathogenesis of DM is very closely related to inflammation. characterized by increased levels of proinflammatory cytokines such as IL-6, IL-8 and TNF. However, no anti-inflammatory agent has been proven to play a role in the management of T2DM. Butyrate is a short chain fatty acid produced from resistant starch fermentation in the intestinal lumen. In normal conditions the butyrate is absorbed and used as an energy source for colonocytes, liver and muscle cells. Butirate is able to bind to GPR41 and GPR43 receptors on monocytes so that it can change the pattern of cytokine expression, activation, migration and cell differentiation. So it is interesting to examine the effect of butyrate on migration and cytokines expressed by monocytes in T2DM patients. Cytokine levels were calculated from supernatants taken from monocyte cultures. A total of 37 subjects were divided into two treatments, namely control and with addition of butyrate. The first day monocytes were isolated in type 1 collagen gel for migration testing using the slide chemotaxis IBIDI. Image analysis using ImageJ and Chemotaxis tool software. There was a significant difference in the TNFα / IL 10 ratio between healthy groups and T2DM. Butyrate also appears to suppress TNF cytokine production and increase IL10 production. Monocyte migration indicators such as accumulation distance and migration speed have significant differences between healthy groups and T2DM. Butirat can reduce inflammation responds and the distance and speed of monocyte migration"
2019
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UI - Tesis Membership  Universitas Indonesia Library
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Risty Yasmin Bonita
"Diabetes mellitus tipe 2 (DMT2) adalah penyakit metabolik kronis, yang melibatkan berbagai macam proses patogenik. Secara keseluruhan pada seluruh proses tersebut menghasilkan hilangnya massa dan/atau fungsi dari sel - β pankreas yang dimanifestasikan sebagai hiperglikemia. Pengaruh faktor keluarga tampaknya terlibat dalam inisiasi dan perkembangan DMT2 melalui faktor genetik dan nongenetik. Lingkungan keluarga yang sama dengan pasien dengan diabetes, kerabat tingkat pertama pasien dengan diabetes menunjukkan peningkatan risiko 30-70% terkena diabetes. Resistensi insulin dan disfungsi sel telah diidentifikasi pada individu dengan riwayat keluarga diabetes, bahkan sebelum adanya muncul gejala DMT2.
Monocyte chemoattractant protein-1 (MCP-1) adalah kemokin-CC dengan kemampuan efek atraktan untuk monosit, sel T memori dan basofil. Ekspresi dari MCP-1 jaringan adiposa dan kadar yang bersirkulasi berkorelasi positif dengan adipositas. Adiposit yang lebih besar dikaitkan dengan resistensi insulin. Penelitian ini bertujuan untuk mengetahui perubahan ekspresi MCP-1 terhadap monosit sebelum dan setelah perlakuan diet tinggi lemak selama lima hari. Hasilnya didapatkan adanya perubahan aktifitas inflamasi yang ditandai dengan rasio TNF-α/IL - 10 yang tinggi pada kelompok FDR sehingga dapat meningkatkan aktifitas MCP-1. Namun, idak ditemukan hubungan kadar MCP-1 serum dengan presentase monosit CD14+CD16+ baik pada kedua kelompok.

Type 2 diabetes mellitus is a chronic metabolic disease, which involves a variety of pathogenic processes. Overall these processes result in loss of mass and/or function of pancreatic -cells which is manifested as hyperglycemia. The influence of familial factors appears to be involved in the initiation and development of T2DM through both genetic and nongenetic factors. In the same family environment as patients with diabetes, first-degree relatives of patients with diabetes show a 30-70% increased risk of developing diabetes. Insulin resistance and cell dysfunction have been identified in individuals with a family history of diabetes, even before the onset of T2DM symptoms.
Monocyte chemoattractant protein-1 (MCP-1) is a CC-chemokine with an attractant effect on monocytes, memory T cells and basophils. Expression of adipose tissue MCP-1 and circulating levels were positively correlated with adiposity. Larger adipocytes are associated with insulin resistance. This study aims to determine the changes in MCP-1 expression on monocytes before and after treatment with a high-fat diet for five days. The results showed that there was a change in inflammatory activity which was indicated by a high ratio of TNF-α/IL - 10 in the FDR group so that it could increase MCP-1 activity. However, there was no relationship between serum MCP-1 levels and the percentage of CD14+CD16+ monocytes in both groups.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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Rifka Putri Salma
"Hingga tahun 2021 IDF melaporkan sekitar 537 juta orang dewasa hidup dengan diabetes dan diproyeksikan akan terus meningkat, serta 90% diantaranya adalah tipe 2. Salah satu faktor utama yang dapat menyebabkan risiko Diabetes melitus tipe 2 adalah polusi udara termasuk polutan PM2.5. Namun, penelitian dengan topik ini belum banyak diteliti terutama di Indonesia sehingga untuk menelaah lebih jauh penelitian ini dilakukan untuk mengetahui gambaran faktor-faktor terkait pajanan PM2.5 serta faktor individu dalam meningkatkan risiko kejadian Diabetes melitus tipe 2 berdasarkan kajian sistematis terhadap literatur. Sebanyak 12 literatur berupa artikel jurnal ilmiah dari berbagai negara yang dipublikasikan pada tahun 2013-2021 disintesis dalam penelitian ini. Berdasarkan kajian sistematis, diketahui bahwa faktor risiko pajanan PM2.5 jangka panjang, konsentrasi PM2.5 yang tinggi, dan tinggal pada daerah padat penduduk, dekat dengan jalan raya, serta pada daerah dengan aktivitas industri dapat meningkatkan risiko Diabetes melitus tipe 2. Kejadian ini kemudian dapat lebih berisiko pada populasi dengan usia lebih tua (>40 tahun) dan IMT kelebihan berat badan (25 kg/m3 -30 kg/m3) dan obesitas (≥30 kg/m3). Namun untuk faktor risiko jenis kelamin lebih banyak pada laki-laki dan pada yang sudah berhenti atau tidak pernah merokok, yang mana hasil ini merupakan penemuan baru yang berbeda dari teori dan penelitian sebelumnya sehingga perlu dilakukan penelitian lebih lanjut beserta faktor risiko lainnya.

Until 2021, the IDF reports that around 537 million adults live with diabetes and that number is projected to continue to increase, and 90% of them are type 2. One of the main factors that can increase the risk of type 2 Diabetes mellitus is air pollution, including PM2.5 pollutants. However, research on this topic has not been widely studied, especially in Indonesia, so to examine further, this study was conducted to determine the description of factors related to PM2.5 exposure and individual factors in increasing the risk of type 2 diabetes mellitus based on a systematic review of the literature. A total of 12 literatures in the form of scientific journal articles from various countries published in 2013-2021 were synthesized in this study. Based on a systematic study, it is known that the risk factors for long-term PM2.5 exposure, high PM2.5 concentrations, and living in densely populated areas, close to roads, and in areas with industrial activity can increase the risk of type 2 Diabetes mellitus. They may be more vulnerable in the population with an older age (> 40 years) and a BMI of overweight (25 kg/m3-30 kg/m3) or obese (30 kg/m3). However, the risk factors for sex are higher in men and in those who have stopped or have never smoked, which is a new finding that is different from previous theories and research, so further research needs to be done along with other risk factors."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2022
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UI - Skripsi Membership  Universitas Indonesia Library
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Laurentius A. Pramono
"ABSTRAK
Latar Belakang. Prevalensi disfungsi tiroid lebih tinggi pada pasien diabetes dibandingkan populasi
umum. Hipotiroidisme memperburuk komplikasi, morbiditas, mortalitas, dan kualitas hidup pasien
diabetes melitus tipe 2 (DM tipe 2). Faktor risiko hipotiroidisme pada pasien DM tipe 2 selama ini masih
kontradiktif dan belum dikaji secara lengkap. Keberadaan sistem skor hipotiroidisme pada pasien DM
tipe 2 diperlukan untuk membantu diagnosis dan menapis pasien DM tipe 2 yang memerlukan
pemeriksaan laboratorium fungsi tiroid sebagai baku emas diagnosis hipotiroidisme.
Tujuan. Mengetahui prevalensi dan determinan hipotiroidisme pada pasien DM tipe 2.
Metode. Penelitian dengan desain potong lintang dilakukan di Poliklinik Divisi Metabolik Endokrin
(Poliklinik Diabetes) RSCM pada Juli sampai September 2015 dengan metode sampling konsekutif.
Subjek menjalani anamnesis, pemeriksaan fisis, dan pemeriksaan laboratorium (TSH dan fT4). Analisis
data dilakukan dengan program statistik SPSS Statistics 17.0 untuk analisis univariat, bivariat,
multivariat, dan Receiving Characteristics Operator (ROC) dan SPSS Statistics 20.0 untuk analisis
bootstrapping pada Kalibrasi Hosmer-Lemeshow.
Hasil. Sebanyak 303 subjek dianalisis untuk mendapatkan proporsi disfungsi tiroid dan 299 subjek
dianalisis untuk mendapatkan determinan hipotiroidisme. Sebanyak 23 subjek (7,59%) terdiagnosis
hipotiroidisme, terdiri dari 43,5% subjek hipotiroid klinis dan 56,5% subjek hipotiroid subklinis
berdasarkan Indeks Zulewski dan/atau Indeks Billewicz, dengan 16,7% hipotiroid klinis dan 83,3%
hipotiroid subklinis berdasarkan hasil pemeriksaan fT4. Determinan hipotiroidisme pada pasien DM
tipe 2 adalah riwayat penyakit tiroid di keluarga dengan OR sebesar 4,719 (95% Interval
Kepercayaan/IK 1,07-20,8, p = 0,04), keberadaan goiter dengan OR sebesar 20,679 (95% IK 3,49122,66, p = 0,001),
kontrol glikemik yang buruk dengan OR sebesar 3,460 (95%
IK 1,075-11,14, p = 0,037), dan adanya sindrom metabolik
OR sebesar 25,718 (95% IK 2,21-299,99, p = 0,01). Simpulan. Proporsi hipotiroidisme pada pasien DM tipe 2 adalah 7,59%. Determinan diagnosis dan komponen sistem skor hipotiroidisme pada pasien DM tipe 2 adalah riwayat penyakit tiroid di keluarga, keberadaan goiter, kontrol glikemik yang buruk, dan adanya sindrom metabolik. Sistem skor yang diberi nama Skor Hipotiroid RSCM ini diharapkan menjadi alat bantu diagnosis hipotiroidisme pada pasien
DM tipe 2.
ABSTRACT
Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to general
population. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type
2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are still
contradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism in
T2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergo
thyroid function test as a gold standard diagnostic for hypothyroidism.
Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.
Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient Clinic
Cipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. All
subjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysis
was done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (Receiving
Operator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshow
Calibration. Results. 303 subjects included for proportion study of thyroid dysfunction and 299
subjects included for analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as having
hypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidism
based on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinical
hypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.
Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719
(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%
CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and
metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01). Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and components
of scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,
having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which is
called RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism in
T2DM patients.;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to general
population. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type
2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are still
contradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism in
T2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergo
thyroid function test as a gold standard diagnostic for hypothyroidism.
Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.
Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient Clinic
Cipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. All
subjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysis
was done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (Receiving
Operator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshow
Calibration.
Results.
303
subjects
included
for
proportion
study
of
thyroid
dysfunction
and
299
subjects
included
for
analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as having
hypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidism
based on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinical
hypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.
Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719
(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%
CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and
metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01).
Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and components
of scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,
having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which is
called RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism in
T2DM patients.
;Background. Prevalence of thyroid dysfunction is greater in diabetes patients compared to general
population. Hypothyroidism is worsening complications, morbidity, mortality, and quality of life in type
2 diabetes mellitus (T2DM) patients. Risk factors of hypothyroidism in T2DM patients are still
contradictive and not assessed completely. Presence of scoring system to estimate hypothyroidism in
T2DM patients are needed to help diagnosing and screening of T2DM patients who need to undergo
thyroid function test as a gold standard diagnostic for hypothyroidism.
Aim. To identify prevalence and estimators of hypothyroidism in T2DM patients.
Methods. A cross-sectional study was conducted in Metabolic Endocrine (Diabetes) Outpatient Clinic
Cipto Mangunkusumo Hospital from July-September 2015 with consecutive sampling method. All
subjects underwent interview, physical examination, and laboratory testing (TSH and fT4). Analysis
was done by using SPSS Statistics 17.0 for univariate, bivariate, multivariate, and ROC (Receiving
Operator Characteristics) analysis and SPSS Statistics 20.0 for bootstrapping analysis in HosmerLemeshow
Calibration.
Results.
303
subjects
included
for
proportion
study
of
thyroid
dysfunction
and
299
subjects
included
for
analysis of hypothyroidism determinants. 23 subjects (7,59%) are diagnosed as having
hypothyroidism, consisted of 43,5% clinical hypothyroidism and 56,5% subclinical hypothyroidism
based on clinical scoring index by Zulewski and Billewicz, and 16,7% subjects as having clinical
hypothyroidism and 83,3% subjects as having subclinical hypothyroidism based on fT4 examination.
Determinants for hypothyroidism in T2DM patients are family history of thyroid disease with OR 4,719
(95% Confident Interval/CI 1,07-20,8, p = 0,04), having goiter or difus struma with OR 20,679 (95%
CI 3,49-122,66, p = 0,001), poor glycemic control with OR 3,460 (95% CI 1,075-11,14, p = 0,037), and
metabolic syndrome with OR 25,718 (95% CI 2,21-299,99, p = 0,01).
Conclusion. Proportion of hypothyroidism in T2DM patients is 7,59%. Determinants and components
of scoring system of hypothyroidism in T2DM patients consist of family history of thyroid disease,
having goiter or difus struma, poor glycemic control, and metabolic syndrome. Scoring system which is
called RSCM Hypothyroid Score is expected to be a tool for helping diagnosis of hypothyroidism in
T2DM patients.
"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Johan Adiyasa
"Latar belakang: Penderita diabetes melitus tipe 2 memiliki risiko yang lebih tinggi untuk mengalami karies gigi. Fosfat memegang peranan utama dalam kapasitas buffer unstimulated saliva sehingga kadar fosfat berhubungan dengan faktor risiko karies individu. Kondisi ketosis dan hiperparatiroidisme yang menyertai diabetes melitus tipe 2 dapat menyebabkan penurunan buffer fosfat tubuh yang kemudian menurunkan kadar fosfat dalam unstimulated saliva.
Tujuan: Menganalisis kadar fosfat dalam unstimulated saliva pada pasien diabetes melitus tipe 2.
Metode: Unstimulated saliva 15 subjek diabetes melitus tipe 2 dan 15 subjek non diabetes melitus dikumpulkan untuk kemudian diukur kadar fosfatnya dengan metode phosphomolydate pada alat UV-Vis Spectrophotometer.
Hasil: Terdapat perbedaan kadar fosfat yang bermakna (p < 0,05) antara subjek uji dan subjek kontrol.
Kesimpulan: Kadar fosfat dalam unstimulated saliva pada pasien diabetes melitus tipe 2 (0,27 ± 0,05 mmol/L) lebih rendah jika dibandingkan dengan individu non diabetes melitus (2,16 ± 0,22 mmol/L) yang mana berdasarkan analisis statistik, hal tersebut berbeda bermakna secara signifikan.

Background: Type 2 diabetes mellitus patients have a higher risk to suffer from dental caries. Phosphate plays a primary role in buffer capacity of unstimulated saliva so that phosphate concentration is associated with individual caries risk factors. Ketosis and Hyperparathyroidism conditions that come within type 2 Diabetes Mellitus could decrease the phosphate buffer in the body which then will decrease the phosphate concentration in unstimulated saliva.
Objective: To analyze the phosphate concentration in unstimulated saliva of type 2 diabetes mellitus patients.
Method: Unstimulated saliva of 15 type 2 diabetes mellitus subjects and 15 non-diabetic subjects were collected and then the concentration of phosphate was measured by the phosphomolydate method on UV-Vis Spectrophotometer instrument.
Result: There were significant differences in the phosphate concentration (p <0.05) between test subjects and control subjects.
Conclusion: The phosphate concentration in unstimulated saliva of type 2 diabetes mellitus patients (0.27 ± 0.05 mmol / L) is lower than individuals without diabetes mellitus (2.16 ± 0.22 mmol / L), which is significantly different by statistical analysis.
"
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2016
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UI - Skripsi Membership  Universitas Indonesia Library
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