Study of Risk Factors Diabetic Peripheral Neuropathy at One Single Center in Indonesia

Ahmad Mahdi Rezkiansyah (1) , Feda Anisah Makkiyah (2) , Maria Selvester Thadeus (3) , Marlina Dewi Astuti (4)
(1) Undergraduate Program, Faculty of Medicine, UPN “Veteran” Jakarta, Jakarta , Indonesia
(2) Department of Neurosurgery, Faculty of Medicine,UPN “Veteran” Jakarta , Indonesia
(3) Department of Pathology Anatomy, Faculty of Medicine,UPN “Veteran” Jakarta , Indonesia
(4) Department of Internal Medicine, Faculty of Medicine,UPN “Veteran” Jakarta , Indonesia

Abstract

Background: Diabetes Mellitus (DM) is a disease that can lead to diabetic peripheral neuropathy (DPN). DPN is caused by various risk factors such as age, body mass index (BMI), glycated hemoglobin variability including mean HbA1c (M-HbA1c), hypertension status, triglyceride levels, total cholesterol levels, low-density lipoprotein (LDL) levels, and high-density lipoprotein (HDL) levels. This study aims to investigate the factors influencing DPN.
Methods: A retrospective cross-sectional study of diabetic patients with and without DPN was undertaken at Jakarta referral hospitals from January 2021 to December 2022. Age, BMI, mean HbA1c variability, hypertension status, triglycerides, total cholesterol, LDL, and HDL values were compared between DPN and non-DPN groups. Chi-square analysis and logistic regression were performed to identify factors influencing DPN.
Results: There were 62 patients diagnosed with DPN and 51 patients without DPN. Chi-square analysis showed a correlation between the variability of M-HbA1c (p = 0.003), triglycerides (p = 0.002), total cholesterol (p = 0.001), and LDL (p = 0.016) and the incidence of DPN in patients. Variability of M-HbA1c (p = 0.032, PR: 0.340, 0.127 – 0.914 95% CI), (p = 0.008, OR : 0.430, 0.205 – 0.793 95% CI), and HDL levels (p = 0.024, OR : 0.325, 0.122 – 0.865 95% CI) was revealed by logistic regression analysis.
Conclusion: DPN correlates with a high degree of variability in M-HbA1c, triglyceride levels, total cholesterol, and LDL. Consequently, diabetics must monitor their respective health conditions in order to prevent DPN.


Abstrak
Latar belakang: Diabetes Mellitus (DM) merupakan penyakit yang dapat menyebabkan neuropati diabetik perifer (NDP). Neuropati diabetik perifer disebabkan oleh berbagai faktor risiko seperti usia, indeks massa tubuh (IMT), variabilitas HbA1c salah satunya rata-rata HbA1c (M-HbA1c), status hipertensi, kadar trigliserida, kadar kolesterol total, kadar low-density lipoprotein (LDL), dan kadar high-density lipoprotein (HDL). Penelitian ini untuk mengetahui faktor-faktor yang memengaruhi NDP.
Metode: Penelitian potong-lintang retrospektif dengan melibatkan pasien DM dengan komplikasi neuropati diabetik perifer dan tidak di rumah sakit rujukan nasional di Jakarta, Indonesia pada Januari 2021 - Desember 2022. Perbandingan antara grup NDP dan tidak berdasarkan umur, IMT, Variabilitas rata-rata HbA1c, status hipertensi, trigliserida, kolesterol total, LDL, dan HDL. Analisis chi-square dan regresi logistik dilakukan untuk mengidentifikasi faktor-faktor mempengaruhi NDP.
Hasil: 62 pasien datang dengan diagnosis NDP dan 51 pasien tanpa NDP. Analisis chi-square menyatakan terdapat hubungan signifikan antara variabilitas rata-rata HbA1c (p = 0,003), trigliserida (p = 0,002), kolesterol total (p = 0,001), dan LDL (p = 0,016) dengan kejadian NDP pasien. Analisis regresi logistik menunjukkan variabilitas rata-rata M-HbA1c (p = 0,032, OR: 0,340, 0,127 – 0,914 95% CI), kadar trigliserida (p = 0,008, OR : 0,430, 0,205 – 0,793 95% CI), dan kadar HDL (p = 0,024, OR : 0,325, 0,122 – 0,865 95% CI).
Kesimpulan: Variabilitas M-HbA1c, kadar trigliserida, kolesterol total, LDL yang tinggi berkorelasi dengan NDP. dengan demikian, para penderita DM ini perlu selalu memantau kondisi kesehatan masing-masing agar tidak menimbulkan NDP.

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References

Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia. Buku Ajar Ilmu Penyakit Dalam. 6th ed. Setiati S, Alwi I, Sudoyo AW, K MS, Setiyohadi B, Syam AF, editors. Vol. 1. Jakarta: InternaPublishing; 2014. 1–4164 p.

Bodman MA, Varacallo M. Peripheral Diabetic Neuropathy. StatPearls [Internet]. 2022 Sep 29 [cited 2023 Jan 30]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK442009/

Kementerian Kesehatan RI. Laporan Riskesdas 2018 Nasional [Internet]. Badan Penelitian dan Pengembangan Kesehatan Kementerian RI; 2018 [cited 2023 Jan 9]. 1–220 p. Available from: https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf

Li Z, Lei X, Xu B, Wang S, Gao T, Lv H. Analysis of risk factors of diabetes peripheral neuropathy in type 2 diabetes mellitus and nursing intervention. Exp Ther Med. 2020 Oct 1;20(6):1–1.

Bansal D, Gudala K, Muthyala H, Esam HP, Nayakallu R, Bhansali A. Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting. J Diabetes Investig. 2014 Nov 1;5(6):714–21.

Rosyida K. Gambaran Neuropati Perifer pada Diabetisi di Wilayah Kerja Puskesmas Kedungmundu Semarang [Internet]. [Semarang]: Universitas Diponegoro; 2016 [cited 2023 Jun 13]. Available from: http://eprints.undip.ac.id/49953/2/SKRIPSI_KHANA_ROSYIDA.pdf

Hasyim H. Faktor Risiko Kejadian Neuropati Diabetik pada Penderita Diabetes Melitus Tipe 2 yang Dirawat [Internet]. [Makassar]: Universitas Bosowa; 2023 [cited 2023 Jun 7]. Available from: https://repository.unibos.ac.id/xmlui/bitstream/handle/123456789/5740/2023 HAMZAH HASYIM 4519111046.pdf?sequence=1&isAllowed=y

Mildawati, Diani N, Wahid A. Hubungan Usia, Jenis Kelamin Dan Lama Menderita Diabbetes Dengan Kejadian Neuropati Perifer Diabetik. Caring Nurs J [Internet]. 2019 [cited 2023 Jun 9];3(2):31–7. Available from: https://journal.umbjm.ac.id/index.php/caring-nursing/article/view/238

Irawan D, Wuysang AD, Goysal Y. Hubungan Kadar Lipid Darah dengan Derajat Keparahan Neuropati Diabetik Perifer di Rumah Sakit Wahidin Sudirohusodo. Neurona [Internet]. 2019 Dec [cited 2023 Jul 1];37(1):37–41. Available from: https://ejournal.neurona.web.id/index.php/neurona/article/view/99

Siregar E. Faktor-Faktor Penyebab Kejadian Neuropathy Perifer pada Penderita Diabetes Melitus Tipe 2 di Wilayah Kerja Puskesmas Padang Matinggi di Kota Padangsidimpuan Tahun 2021 [Internet]. [Padangsidimpuan]: Universitas Aufa Royhan; 2021 [cited 2023 Jun 30]. Available from: https://repository.unar.ac.id/jspui/bitstream/123456789/211/1/skripsi Erlina.pdf

Wicaturatmashudi S, Bakri I, Putri ER. Hubungan Status Gizi Dan Kadar Gula DArah Dengan Kejadian Komplikasi Pada Pasien Diabetes Mellitus Di Ruang Poliklinik Penyakit Dalam RSUP DR. Mohammad Hoesin Palembang. J Kesehat [Internet]. 2013 [cited 2023 Jun 30];1(12):8–14. Available from: https://jurnal.poltekkespalembang.ac.id/index.php/JPP/article/view/275/290

Kadri H, Nurfitriani N. Hubungan Lama Menderita dan Indeks Massa Tubuh terhadap Gejala Neuropati pada Penderita Diabetes Melitus di Wilayah Kerja Puskesmas Kenali Besar. J Akad Baiturrahim Jambi. 2021 Sep 18;10(2):446.

Nozawa K, Ikeda M, Kikuchi S. Association Between HbA1c Levels and Diabetic Peripheral Neuropathy: A Case–Control Study of Patients with Type 2 Diabetes Using Claims Data. Drugs - Real World Outcomes. 2022 Sep 1;9(3):403–14.

Su J bin, Zhao L hua, Zhang X lin, Cai H li, Huang H yan, Xu F, et al. HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovasc Diabetol. 2018 Mar 29;17(1).

Rachman SK, Hendryanny E, Bhatara T. Hubungan Antara Kontrol Glikemik (HBA1C), Durasi Penyakit, dan Profil Lipid Pada Pasien Diabetes Melitus Tipe II Dengan Kejadian Neuropati Diabetik: Scoping Review. J Integr Kesehat Sains. 2021 Jul 31;3(2).

Ozaki K, Matsuura T. Superimposition of hypertension on diabetic peripheral neuropathy affects small unmyelinated sensory nerves in the skin and myelinated tibial and sural nerves in rats with alloxan-induced type 1 diabetes. J Toxicol Pathol. 2020;33(3):161–9.

Andamari AI, Ardiansyah M. Hubungan Antara Hipertensi Dengan Neuropati Diabetik [Internet]. [Yogyakarta]: Universitas Muhammadiyah Yogyakarta; 2016 [cited 2023 Jun 30]. Available from: http://repository.umy.ac.id/handle/123456789/9068?show=full

Komang Arimbawa I, Ayu I, Indrayani S. Hipertensi Sebagai Faktor Risiko Nyeri Neuropati Diabetik pada Pasien Diabetes Mellitus Tipe II di RSUP Sanglah Denpasar Made Dyah Vismita Indramila Duarsa [Internet]. Vol. 8, MEDIKA UDAYANA. 2019. Available from: https://ojs.unud.ac.id/index.php/eum

Jende JME, Groener JB, Rother C, Kender Z, Hahn A, Hilgenfeld T, et al. Association of serum cholesterol levels with peripheral nerve damage in patients with type 2 diabetes. JAMA Netw Open. 2019 May 1;2(5).

Andersen ST, Witte DR, Andersen H, Bjerg L, Bruun NH, Jørgensen ME, et al. Risk-factor trajectories preceding diabetic polyneuropathy: ADDITION-Denmark. In: Diabetes Care. American Diabetes Association Inc.; 2018. p. 1955–62.

Authors

Ahmad Mahdi Rezkiansyah
Feda Anisah Makkiyah
fedamakkiyah@yahoo.com (Primary Contact)
Maria Selvester Thadeus
Marlina Dewi Astuti
Rezkiansyah, A. M., Makkiyah, F. A., Thadeus, M. S., & Astuti, M. D. (2023). Study of Risk Factors Diabetic Peripheral Neuropathy at One Single Center in Indonesia. Health Science Journal of Indonesia, 14(2). https://doi.org/10.22435/hsji.v14i2.6615

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