Pengaruh Status Metabolik dan Imunitas Seluler terhadap Status Periiodontal Rendah Penyandang DM tipe 2: kajian pada Kadar IL -1β dan fungsi Fagositosis

Tahun 2005 Volume 40 Nomor 2
Oleh : Oedijani Santoso, Prayitno Sw, Sarwono W, Kresno SB, Sutrisna B

Latar belakang: DM type 2 dengan status metabolik buruk (kadar HbA1c, kadar glucose puasa dan 2 jam PP tinggi )
merupakan kondisi sistemik yang mendukung terjadinyapenurunan status periodontal karena hyperglikemia mempengaruhi immunitas seluler
Tujuan penelitian ini adalah unuk mengetahui pengaruh status metabolik dan immunitas seluler terhadap status periodontal rendah pada penyandang DM type 2 dengan kajian kadar IL-1β  dan fungsi fagositosis

Metoda:
Studi belah lintang pada 45 subject DM Terkandali (DMT) , umur 40-60 tahun , di poliklnik Metabolik – Endokrinolog RSUPN Cipto Mangunkusumo Jakarta , April sampai Augustus 2003 dan 45 subjek Non –DM sebagai kontrol . Subject DM tetap mendapatkan pengobatan baku DM, diet dan OHO (Obat Hipoglikemik Oral) selama penelitian berlangsung. Status periodontal deitentukan dengan index plak, indek kalkulus, index gingiva cytometry. Analisis statistik menggunakan program Strata 7, uji komparabilitas dengan Fisher’s exact tes, dan untuk mengetahui pengaruh status metabolik (kadar HbA1c,  dan kadar glucose darah) menggunakan perhitungan rasio resiko relaif dan analisis regresi logistik multinomial , dengan memakai batas kebermaknaan p<0,05)

Hasil:
Pengaruh kadar HbA1c tinggi (>6%) , Kadar glucose puasa tinggi (>103 mg/dl) dan fungsi fogositosi rendah (<53.47%) terhadap status periodontal tidak bermakna secara statistic (p>0.05) , namun pengaruh kadar glukose darah 2 jam PP tinggi (>144 mg/dl) dan kadar IL-1 β  Tinggi (>23,70%) terhadap periodontal status bermakna secara statistic (p<0.05)


Simpulan:
kadar Hb1Ac tinggi , kadar il-1 β tinggi serta fungsi fagositosis rendah berpengaruh terhadap penurunan status periodontal

The Influenceof metabolc status and selular immunity to low periodontal status of type 2 diabetic patients : the role of IL- 1β level and phagocytoticn Function

Background :Uncontrolled metabolic status in type 2 diabetic (high HbA1c and blood glucose level) is a systemic condition to induce cellular immunity defect and causing decrease periodontal status. The aim of this study was to evaluated the influence of metabholic status and cellular immunity to low periodontal status of type 2 diabetic patients throught the role of IL-1β level and phagocytotic function

Methods:
 Uncontrolled metabolic status in type 2 diabetic (high HbAc and blood glucose level) is a systemc condition to induce celular immunity defect and causing decrease perodontal status . The aim of this status was to evaluate the influence of metabolic status and cellular immunity to low perodontal status  of type 2 diabetic patients throught the role of IL -1β level and phagocytotic function. metode Cross – sectional study was conducted in 45 controlled – DM (CDM) subjects, 40-60 years old attending at outpatients Metabolic – Endocrinology clinic of Cipto Mangunkusumo Hospital , Jakarta between April to August 2003 and  45 non-DM subjects as a control group. The diabeetic subject were on standart diet and OHA (Oral Hypoglicemic Agent) treatmen . along the study . Perodontal status were determined by plague index, calculus index, gingival index and pocket index. Interleukin  – 1 β level was examined by ELISA methods and phagocytotic function was measured by flowcytometri . Statistical analysis was performed using comparability test, relative risk ratio calculation and multinomial logistic regresion analysis with strata 7.0 software.

Result:
The Influence of high and blood glucose level (>6%) , high fasting blood glucose level( >103 mg/dl ) . Low phagocytotic function (<53.47%) on perodontal status were no statisticaly significan (p>0.05) , however th influence of high 2 hours postprandial blood glucse level (>144 mg/dl) and high 1 β level (>23,70 pg/mL) on perodontal status were statisfically significant (p<0.05)

Conclusion:
high HbA1C and blood glucose level ,high 1L-1β level and llow phagocytotic function had the influence toward low peridontol status