Tesis

Hubungan Kadar Vitamin D dengan Kejadian Depresi pada Pasien dengan Diabetes Melitus Tipe 2 = Relationship between Vitamin D Levels and Depression in Patients with Type 2 Diabetes Mellitus.

Latar Belakang. Populasi penderita DM tipe 2 semakin meningkat, dimana seringkali disertai dengan komorbid, salah satunya yaitu depresi dengan prevalensi yang bervariasi. Adanya depresi dapat mempengaruhi keluaran penyakit DM tipe 2. Beberapa obat antidepresan diketahui dapat mengganggu kontrol gula darah. Kadar vitamin D, yang telah lama diketahui berkaitan dengan berbagai penyakit kronik, berpotensi memperbaiki gejala depresi, walaupun belum diketahui hubungannya. Tujuan. Mengetahui adanya hubungan antara kadar vitamin D pada pasien DM tipe dengan kejadian depresi pada pasien dengan DM tipe 2. Metode. Penelitian ini merupakan studi dengan desain potong lintang yang dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM). Pasien dengan DM tipe 2 yang memenuhi kriteria inklusi pada rawat jalan, dilakukan penapisan depresi menggunakan kuesioner BDI-II, kemudian dibagi menjadi dua kelompok, depresi (BDI-II ≥ 14) dan tanpa depresi (BDI-II < 14). Kemudian kedua kelompok dilakukan pemeriksaan kadar vitamin D dengan metode ELISA, dan dilakukan analisis perbedaan rerata pada kedua kelompok tersebut. Kemudian dilakukan analisis multivariat regresi logistik terhadap variabel perancu. Hasil. Dari 60 subjek dengan DM tipe 2 yang yang memenuhi kriteria, didapatkan 23 subjek (38,3%) yang depresi, dan 37 subjek (61,7%) yang tidak depresi. Didapatkan median kadar vitamin D 21,8 ng/mL (RIK 14,9-26,6) pada kelompok depresi, sementara median kadar vitamin D 26,5 ng/mL (RIK 23,96-34,08) pada kelompok tanpa depresi. Terdapat perbedaan bermakna antara keduanya (p = 0,001). Setelah dilakukan analisis multivariat dengan variabel perancu jenis kelamin, paparan sinar matahari, dan IMT, didapatkan adjusted odds ratio (adjusted OR) 1,123 (IK 95%: 1,003-1,259) dengan nilai p=0,045. Kesimpulan. Kadar vitamin D yang lebih rendah meningkatkan kejadian depresi pada pasien DM tipe 2.
Kata Kunci. DM tipe 2, Depresi, kadar vitamin D



Background. The population of people with type 2 diabetes is increasing, which is often accompanied by comorbid, one of them is depression with varying prevalence. The presence of depression can affect the outcome of type 2 diabetes mellitus. Some of antidepressants are known to interfere with blood sugar control. Vitamin D levels have long been known to be associated with a variety of chronic diseases, have the potential to improve symptoms of depression, although the relationship is not yet known. Aim. Understanding the relationship between vitamin D levels in patients with type 2 DM and the incidence of depression in patients with type 2 DM. Methods. This research is a cross sectional study conducted at Cipto Mangunkusumo Hospital. Patients with type 2 DM who met the inclusion criteria on an outpatient basis were screened for depression using BDI-II questionnaire, then divided into two groups, depressed (BDI-II ≥ 14), and without depression (BDI-II < 14). Then both groups were examined for vitamin D levels using the ELISA method, and an analysis of the mean difference between the two groups was performed. Then a multivariate logistic regression analysis was performed on the confounding variables. Results. From the 60 subjects with type 2 DM who met the criteria, 23 subjects (38.3%) were depressed, and 37 subjects (61.7%) were not depressed. The median of vitamin D level was 21.8 ng/mL (IQR 14.9-26.6) in the depressed group, while the median vitamin D level was 26.5 ng/mL (IQR 23.96-34.08) in the non-depressed group. There was a significant difference between the two (p = 0.001). After doing multivariate analysis with confounding variables of gender, sun exposure, and BMI, the adjusted odds ratio was 1.123 (95% CI: 1.003-1.259) with p value=0.045. Conclusion. Lower levels of vitamin D increase the incidence of depression in type 2 DM patients.
Keywords. Type 2 DM, depression, vitamin D level