Tesis

Gambaran elektrokardiogram, ekspresi protein Peroxysome Proliferator Gamma Coactivator (PGC-1α) dan Brain Natriuretik Peptide pada jantung tikus yang diberi diet defisiensi vitamin B12 = Electrocardiogram patterns, expression of Peroxysome Proliferator Gamma Coactivator (PGC-1α) and Brain Natriuretic Peptide (BNP) in heart of cobalamin deficient rats.

Defisiensi kobalamin dapat menyebabkan berkurangnya donor metil yang berpotensi menggangu metabolisme jantung. Defisiensi kobalamin dapat terjadi pada pasien dengan malnutrisi, ulkus peptikum, diabetes melitus, dan alkoholisme. Berbagai studi pada defisiensi vitamin B12 masih berfokus pada aterogenesis dan stress oksidatif. Penelitian ini bertujuan mengetahui korelasi defisiensi vitamin B12 dengan penurunan fungsi jantung melalui gambaran EKG, ekspresi protein PGC1α dan protein BNP. Empat belas tikus Sprague-Dawley jantan usia 24-28 minggu dibagi dalam 2 kelompok (kontrol dan perlakuan). Kelompok kontrol diberikan pakan standar dengan nutrisi lengkap, sementara kelompok perlakuan diberikan pakan AIN-93M termodifikasi defisien vitamin B12. Kedua kelompok diberikan pakan dalam periode yang sama yakni selama 16 minggu. Pada akhir minggu ke16 dilakukan pemeriksaan EKG, pemeriksaan ELISA vitamin B12 plasma, Hcy plasma, ekspresi PGC-1α dan kadar BNP-45 plasma. Hasil penelitian pada kelompok perlakuan menunjukkan terdapat penurunan kadar vitamin B12 plasma, peningkatan kadar Hcy plasma diikuti dengan aritmia pada rekam EKG 2 tikus di kelompok tersebut disertai dengan penurunan ekspresi protein PGC-1α dan peningkatan kadar BNP-45 plasma. Terdapat korelasi cukup kuat antara penurunan ekspresi PGC-1α dengan peningkatan BNP-45 plasma. Defisiensi kobalamin terbukti menyebabkan gangguan metabolisme energi kardiomiosit yang berujung pada aritmia dan pembesaran ventrikel kiri.
Kata Kunci: Defisiensi kobalamin, EKG, PGC-1α, BNP


Cobalamin deficiency may cause lack of dietary methyl donors which alter heart metabolism. Cobalamin deficiency are common in patients with malnutrition, gastrics ulcers, diabetes mellitus, and alcoholism. Most studies on cobalamin deficiencies are focused on its relationship with oxidative stress and atherogenesis. Therefore, this study aims to find the corelation between cobalamin deficiency and heart function deterioration through analysis of ECG pattern, expression of PGC1α protein, and plasma BNP-45 level. Fourteen male Sprague-Dawley rats (age 2428 weeks) were divided into 2 groups: control group and treatment group. The control group was given standard diet while the treatment group received a modified diet type AIN-93M. Both groups are fed with the same 16-weeks period. ECG and ELISA was performed to evaluate plasma vitamin B12, Hcy levels, expression of PGC-1α protein and plasma BNP-45 levels in each group at the end of the treatment period. At the end of study period, higher Hcy level was observed in the treatment group with lower plasma cobalamin followed by two rats has developed arrythmias and decreased expression of PGC-1α protein and also increased in plasma BNP-45 levels. There is a relatively strong correlation between deterioration of PGC-1α protein with the increased in plasma BNP-45 levels. Cobalamin deficiency has proven to alter cardiomyocites energy metabolism which resulted in arrythmia and tendency to developed left ventricular hypertrophy.
Keywords: Cobalamin deficiency, ECG, PGC-1α, BNP