Hubungan Kadar Kolesterol LDL, Kolesterol HDL, Rasio LDL/HDL dan Kadar ADMA dengan Kejadian Preeklamsia Di RSUD Dr. H. Slamet Martodirdjo Kabupaten Pamekasan.

Nurhani, Mazdalina Rahmawandari (2019) Hubungan Kadar Kolesterol LDL, Kolesterol HDL, Rasio LDL/HDL dan Kadar ADMA dengan Kejadian Preeklamsia Di RSUD Dr. H. Slamet Martodirdjo Kabupaten Pamekasan. Magister thesis, Universitas Brawijaya.

Abstract

Preeklamsia di definisikan sebagai suatu kondisi khusus pada kehamilan lebih dari 20 minggu yang di tandai dengan peningkatan tekanan darah lebih dari 140/90 mmHg dan proteinuria lebih dari 300 mg/hari atau nilai ≥ 1+ pada dipstick protein urin. Penyebab preeklamsia masih belum di ketahui dengan pasti. Salah satu teori yang berkembang adalah teori stres oksidatif. Stres oksidatif dapat di picu oleh tingginya kadar kolesterol LDL, rendahnya kadar kolesterol HDL, tingginya rasio kolesterol LDL/HDL dan tingginya kadar ADMA yang mengakibatkan L-arginin menurun dan eNOS uncoupling meningkat sehingga menyebabkan preeklamsia akibat dari terjadinya disfungsi endotel. Penelitian ini adalah penelitian observasional analitik dengan pendekatan Case Control Studi. Penelitian melibatkan 64 sampel yang di bagi dalam 2 kelompok, kelompok pertama adalah kelompok ibu hamil preeklamsia dan kelompok kedua adalah kelompok ibu hamil tanpa preeklamsia. Setiap sampel di periksa kadar kolesterol LDL, kadar kolesterol HDL, rasio kolesterol LDL/HDL dan kadar ADMA nya, kemudian di lakukan analisa data untuk mencari hubungan antara kadar kolesterol LDL, HDL, rasio kolesterol LDL/HDL dan kadar ADMA dengan kejadian preeklamsia. Hasil penelitian menunjukkan bahwa kadar kolesterol LDL, rasio kolesterol LDL/HDL dan kadar ADMA lebih tinggi pada ibu hamil preeklamsia di bandingkan dengan ibu hamil tanpa preeklamsia, sedangkan kadar kolesterol HDL pada ibu hamil preeklamsia lebih rendah di bandingkan dengan ibu hamil tanpa preeklamsia. Kadar kolesterol LDL, rasio kolesterol LDL/HDL dan kadar ADMA memiliki korelasi positif kuat dengan kejadian preeklamsia, sedangkan kadar kolesterol HDL memiliki korelasi negatif kuat dengan kejadian preeklamsia. Hasil penelitian juga menunjukkan bahwa ibu hamil dengan kadar kolesterol LDL yang tinggi (>190 mg/dl), kadar kolesterol HDL yang rendah (<40 mg/dl), rasio kolesterol LDL/HDL yang tinggi (>3) dan kadar ADMA yang tinggi (>160 ng/ml) memiliki resiko lebih besar untuk menderita preeklamsia di bandingkan dengan ibu hamil dengan kadar kolesterol LDL, kadar kolesterol HDL, rasio kolesterol LDL/HDL dan kadar ADMA yang normal. Besarnya resiko untuk masing-masing variabel secara berurutan adalah sebesar 4.413, 4.564, 5.894, dan 8.930 kali lipat untuk untuk terjadi preeklamsia. Semakin tinggi kadar kolesterol LDL, rasio kolesterol LDL/HDL dan kadar ADMA, maka semakin tinggi resiko untuk terjadi preeklamsia, sedangkan semakin tinggi kadar kolesterol HDL, maka resiko untuk terjadi preeklamsia semakin turun. Hal ini di sebabkan karena kadar kolesterol LDL yang tinggi, kadar kolesterol HDL yang rendah dan rasio LDL/HDL yang tinggi akan mengakibatkan peningkatan oksidasi LDL yang mengakibatkan LDLox meningkat. Peningkatan LDLox dapat menurunkan produksi enzim DDAH dan mengakibatkan kadar ADMA meningkat. Kondisi tersebut akan mengakibatkan disfungsi endotel yang menjadi patofisiologi awal terjadinya preeklamsia

English Abstract

Preeclampsia is defined as a particular condition occuring after 20 weeks of gestation which is marked by increased blood pressure of more than 140/90 MmHg and proteinuria of more than 300 mg/day or equal to a value of ≥ 1+ on urine protein dipstick. The exact causes of preeclampsia are not yet known although oxidative stress is one of the developing theories. Oxidative stress may be triggered by high LDL cholesterol level, low HDL cholesterol level, high LDL/HDL-c ratio, and high ADMA level. These lead to a decrease in L-arginine and an increase in eNOS uncoupling which result in endothelial dysfunction which causes preeclampsia. The study was an analytical observational research using case control design. There were 64 subjects who were divided into two groups, preeclamptic and non preeclamptic. LDL cholesterol level, HDLcholesterol level, LDL-c/HDL-c ratio, and ADMA level of each subject were measured and the result was subjected to data analysis to find the correlation among LDL cholesterol level, HDLcholesterol level, LDL-c/HDL-c ratio, ADMA level, and preeclampsia. The result showed that LDL cholesterol level, LDL-c/HDL-c ratio, and ADMA level were higher in preeclamptic pregnant women than those in non-preeclamptic women, while HDL cholesterol level in preeclamptic pregnant women was lower than that in non- preeclamptic pregnant women. LDL cholesterol level, LDL-c/HDL-c ratio, and ADMA level had significant positive correlation with preeclampsia, while HDL cholesterol level had significant negative correlation with preeclampsia. The result of the study also indicated that pregnant women with high LDL cholesterol level (>190 mg/dl), low HDL cholesterol level (<40 mg/dl), high LDL-c/HDL-c ratio (>3), and high ADMA level (>160 ng/ml) were at higher risk of developing preeclampsia than pregnant women with normal LDL cholesterol level, HDL cholesterol level, LDL-c/HDL-c ratio, and ADMA level. The risk of developing preeclampsia for LDL cholesterol level, HDL cholesterol level, LDL-c/HDL-c ratio, and ADMA level was 4.413-fold, 4.564-fold, 5.894-fold, and 8.930-fold respectively. The higher the LDL cholesterol level, the LDL-c/HDL-c ratio, and ADMA level, the higher the risk of preeclampsia. In contrast, the higher the HLD cholesterol level, the lower the risk of developing preeclampsia. This is because high LDL cholesterol level, low HDL cholesterol level, high LDL-c/HDL-c ratio, and high ADMA level lead to an increase in the oxidation of LDL which results in an increase in oxidized LDL. The increase may lower DDAH enzyme production and increase ADMA level . These conditions will result in endothelial dysfunction which is the first step in the pathophysiology of preeclampsia

Other obstract

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Item Type: Thesis (Magister)
Identification Number: TES/618.361 32/NUR/h/2019/041905122
Uncontrolled Keywords: Kadar KolesteroL, Kolesterol HD, Preeklamsia
Subjects: 600 Technology (Applied sciences) > 618 Gynecology, obstetrics, pediatrics, geriatrics > 618.3 Diseases and complications of pregnancy > 618.36 Pregnancy complications due to co-occurrence of pregnancy and disease in the mother > 618.361 Diseases of cardiovascular system > 618.361 3 Diseases of blood vessels > 618.361 32 Hypertension
Divisions: S2/S3 > Magister Kebidanan, Fakultas Kedokteran
Depositing User: Endang Susworini
Date Deposited: 11 Aug 2022 02:56
Last Modified: 11 Aug 2022 02:59
URI: http://repository.ub.ac.id/id/eprint/193135
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