Uji Diabetes Secara Non-Invasif Berbasis Kadar Asam Sialat Saliva

  • Muhammad Fauzan Harlan Fakultas Kedokteran Universitas Mataram
  • Ni Nyoman Geriputri Fakultas Kedokteran Universitas Mataram
  • I Gede Yasa Asmara Fakultas Kedokteran Universitas Mataram

Abstract

Latar Belakang: Diabetes mellitus (DM) merupakan kelainan metabolisme karbohidrat yang mempengaruhi banyak sistem, ditandai dengan hiperglikemia dan glukosauria akibat insufisiensi sekresi insulin absolut atau relatif, atau resistensi insulin pada target jaringan. Diabetes menyebabkan mortalitas dan morbiditas terutama karena komplikasinya. Self-Monitoring of Blood Glucose (SMBG) merupakan suatu terobosan besar dalam penanganan diabetes karena pasien dapat menentukan kadar glukosa mereka selama kehidupan sehari-hari.

Tujuan: Penelitian ini dilakukan untuk mengkaji kemungkinan penggunaan kadar asam sialat saliva sebagai bahan uji non-invasif pada penderita diabetes melitus.

Metode: Penelitian ini merupakan penelitian komparatif. Sampel yang digunakan adalah saliva yang berasal dari 20 orang dan terbagi menjadi 2 kelompok, yaitu kelompok orang dengan diabetes (D), dan kelompok orang normal/non-DM (N). Saliva yang terkumpul disentrifugasi dengan 8000 rpm. Hasil sentrifugasi berupa supernatan diambil sebanyak 50 μl dan ditambahkan 100 μl reagen Ninhydrin. Hasil campuran dipanaskan pada suhu 60°C dan dibaca dengan spektrofotometer pada 570 nm. Uji statistik dilakukan dengan menggunakan Independent Sample T-test

Hasil: Rerata kadar asam sialat saliva pada kelompok D dan N masing-masing  4.579 ± 1.113 dan 1.204 ± 0.549. Berdasarkan data tersebut, secara statistik terlihat perbedan kadar asam sialat saliva yang bermakna ( p<0,05).

Kesimpulan: Terjadi peningkatan kadar asam sialat saliva yang bermakna pada penderita diabetes melitus bila dibandingkan dengan kadar asam sialat saliva pada orang tanpa diabetes, hal ini menunjukan konsentrasi DNA saliva dapat digunakan sebagai bahan uji non-invasif pada penderita diabetes melitus.

References

1. Shaw JE, Sicree RA, Zimmed PZ. Global Estimates of Prevalence of Diabetes for 2010 and 2030. Diabetes research and clinical practice 87 (2010) 4 – 14.
2. World Health Organization. Diabetes, Death per 100.000 Data by Country. Global Health Observatory Data Repository, 2012.
3. World Health Organization. The Top 10 Causes of Death, 2014.
4. Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011.
5. Kolb H, Schneider B, Heinemann L, Heise T, Lodwig V, Tshiananga JK dkk. Type 2 Diabetes Phenotype and Progression in Significantly Different if Diagnosed before versus after 65 Years of Age. J Diabetes Sci Technol. 2008 Jan; 2(1): 82–90.
6. Kolb H, Kempf K, Martin S, Stumvoll M, Landgraf L. On what Evidence-Base do we Recommend Self-Monitoring of Blood Glucose? Diabetes Res Clin Pract. 2010 Feb;87(2):150-6.
7. Martin S, Kolb H, Schneider B, Heinemann L, Lodwig V, Weber C dkk. Natural Course of Type 2 Diabetes Before Macrovaskular Event: Impact of SMBG. Diabetes;Jun2007 Supplement 1, Vol. 56, pA118.
8. Martin S, Schneider B, Heinemann L, Lodwig V, Kurth HJ, Kolb H dkk. Self-Monitoring of Blood Glucose in Type 2 Diabetesand Long-Term Outcome: an Epidemiological Cohort Study. Diabetologia. 2006 Feb;49(2):271-8. Epub 2005 Dec 17.
9. Martin S, Kolb H, Schneider B, Heinemann L, Weber C, Kocher S dkk. Myocardial Infartcion and Stroke in Early Years after Diagnosis of Type 2 Diabetes : Risk Factor and Relation to Self-Monitoring of Blood Glucose. Diabetes Technol Ther. 2009, Apr;11(4):234-41.
10. Kolb H, Schneider B, Heinemann L, Lodwig V, Scherbaum WA, Martin S. Altered Disease Course after Initiation of Self-Monitoring of Blood Glucose in Noninsulin-Treated Type 2 Diabetes (ROSSO 3). J Diabetes Sci Technol. 2007 Jul; 1(4): 487–495.
11. Vincze G, Barner JC, Lopez D. Factor Associated with Adherence to Self Monitoring of Blood Glucose Among Persons with Diabetes. Diabetes Educ. 2004 Jan-Feb;30(1):112-25.
12. Ong WM, Chua SS, Ng CJ. Barriers and Facilitators to Self-Monitoring of Blood Glucose in People with Type 2 Diabetes Using Insulin: A Qualitative Study. Patient Preference and Adherence 2014:8 237–246.
13. Carley SD, Libetta C, Flavin B, Butler J, Tong N, Sammy I. An Open Prospective Randomised Trial to Reduce the Pain of Blood Glucose Testing: Ear Versus Thumb. BMJ VOLUME 321 1 JULY 2000.
14. Fineberg SE, Bergenstal RM, Bernstein RM, Laffel LM, Schwartz SL. Use of an Automated Device for Alternative Site of Blood Glucose Monitoring. Diabetes Care 24:1217–1220, 2001.
15. Knapp PE, Showers KM, Phipps JC, Speckman JL, Sternthal E, Freund KM dkk. Self-Monitoring of Blood Glucose with Finger Tip Versus Alternative Site Sampling: Effect on Glycemic Control in Insulin-Using Patients with Type 2 Diabetes. DIABETES TECHNOLOGY & THERAPEUTICS Volume 11, Number 4, 2009.
16. Wagner J, Malchoff C, Abbott G. Invasiveness as a Barrier to Self-Monitoring Blood Glucose in Diabetes. Diabetes Technol Ther. 2005 Aug;7(4):612-9.
17. Satish BN, Srikala P, Maharudrappa B, Awanti SM, Kumar P, Hugar D. Saliva : A Tool Assessing Glucose Level in Diabetes Mellitus. Journal of International Oral Health 2014; 6(2):114-117.
18. Malamud D, Rodriguez-Chavez IR. Saliva as Diagnostic Fluid. Dent Clin North Am. 2011 January ; 55(1): 159–178. doi:10.1016/j.cden.2010.08.004, 2010.
19. Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Petterson CM dkk. Test of Glycemia in Diabetes. Diabetes Care July 2004 vol. 27 no. 7 1761 – 1773.
20. Pfaffe T, Cooper-White J, Beyerlein P, Kostner K, Punyadeera C. Clinical Chemistry 57:5 675–687, 2011.
21. Panchbhai AS, Degwekar SS, Bhowte RR. Estimation of Salivary Glucose, Salivary Amylase, Salivary Total Protein, and Salivary Flow Rate in Diabetic in India. Journal of Oral Science, Vol. 52, No. 3, 359-368, 2010.
22. Belce A, Ulsu E, Kucur M, Umut M, Ipbuker A, Seymen HO. Evaluation of Salivary Sialic Acid Level and Cu-Zn Superoxide Dismutase Activity in Type 1 Diabetes Mellitus. Tohoku J. Exp. Med., 2000, 192, 219-225.
23.Romero AC, Ibuki FK, Nogueira FN. Sialic Acid Reduction in the Saliva of Streptozotocin Induced Diabetic Rats. Archives of Oral Biology 57 (2012) 1189 – 1193.
24.Kumar J. Saliva – a Marker for the Diabetic: A Comparative Study of Healthy and the Diabetic Individuals. Indian J. Innovations Dev., Vol. 1, No. 2 (Feb 2012).
25.Crook MA, Pickup JC, Lumb PJ, Georgino F, Webb DJ, & Fuller JH. Relationship Between Plasma Sialic Acid Concentration and Microvascular and Macrovascular Complications in Type 1 Diabetes The EURODIAB Complications Study. Diabetes care, 24(2), 316-322, 2001.
26.MacFadyen DA, Fowler N. ON THE MECHANISM OF THE REACTION OF NINHYDRIN WITH α-AMINO ACIDS II. A SPECTROPHOTOMETRIC STUDY OF HYDRINDANTIN REACTIONS. Journal of Biological Chemistry. 1950 Sep 1;186(1):13-22.
27.Lindberg G, Eklund GA, Gullberg B, & RÃ¥stam L. Serum sialic acid concentration and cardiovascular mortality. Bmj, 302(6769), 143-146, 1991.
28.Edgar WM. Saliva: its secretion, composition and functions. British dental journal, 172(8), pp.305-312, 1992.
29.Komabayashi T, Nakano K, Nakamura T, Tsuboi M. Stimulation of amylase and sialic acid releases from dog submandibular gland slices by pilocarpine or high K+ medium: A possible role of calmodulin for their releases. The Japanese journal of physiology, 33(6), 921-930, 1983.
30.Nicolau J, de Souza, DN, Carrilho M. Increased glycated calmodulin in the submandibular salivary glands of streptozotocin‐induced diabetic rats. Cell biochemistry and function, 27(4), 193-198, 2009.
Published
2017-08-30
Section
Research

Most read articles by the same author(s)