Tesis

Hubungan antara Micro RNA-21 dengan Albuminuria pada Penyandang Diabetes Melitus Tipe 2 = The Association Between Micro RNA-21 and Albuminuria in Patients with Type 2 Diabetes Mellitus.

Latar Belakang: Micro RNA-21 (miRNA-21) semakin dikenal sebagai biomarker molekuler yang terlibat dalam patogenesis penyakit ginjal diabetik (PGD), terutama melalui perannya dalam cedera podosit dan fibrosis glomerulus. Namun, hubunga MicroRNA-21 dengan albuminuria sebagai penanda awal kerusakan ginjal, masih belum sepenuhnya dipahami, khususnya pada populasi diabetes melitus tipe 2 (DMT2) di Indonesia. Tujuan: Mengevaluasi hubungan antara kadar ekspresi relatif serum miRNA-21 dengan keberadaan albuminuria pada pasien DMT2. Metode: Penelitian ini merupakan studi analitik potong lintang menggunakan data sekunder dari follow-up ke-30 kohort penyakit tidak menular (PTM) oleh Badan Penelitian dan Pengembangan Kesehatan (Balitbangkes), melibatkan 100 subjek DMT2 di Bogor. Kadar miRNA-21 serum diukur menggunakan qRT-PCR, dan status albuminuria ditentukan berdasarkan rasio albumin-kreatinin urin (RAKU). Analisis data dilakukan dengan uji Mann–Whitney U, korelasi Spearman, dan regresi logistik multivariat. Hasil: Median ekspresi relatif miRNA-21 secara signifikan lebih tinggi pada kelompok albuminuria [6,79 (RIK 4,41 –12,05)] dibandingkan kelompok normoalbuminuria [3,00 (RIK 1,98–4,53); p < 0,0001]. miRNA-21 juga menunjukkan korelasi positif sedang dengan RAKU pada kelompok normoalbuminuria (r = 0,545; p < 0,0001) dan albuminuria (r = 0,470; p = 0,001). Pada analisis multivariat, miRNA-21 tetap berhubungan signifikan dengan albuminuria (PR = 3,383; IK 95%: 1,931 –5,928) setelah dikontrol terhadap variabel perancu. Simpulan: Ekspresi miRNA-21 secara signifikan lebih tinggi pada pasien DMT2 dengan albuminuria. Ekspresi ini berkorelasi positif dengan RAKU pada kelompok normoalbuminuria maupun albuminuria, yang menunjukkan potensi miRNA-21 sebagai biomarker awal cedera ginjal diabetik.
Kata kunci: diabetes mellitus, miRNA-21, albuminuria


Background: Micro RNA-21 (miRNA-21) is increasingly recognized as a molecular biomarker involved in the pathogenesis of diabetic kidney disease (DKD), particularly through its role in podocyte injury and glomerular fibrosis. However, its association with albuminuria, an early marker of kidney damage, remains to be fully elucidated, especially in the Indonesian population with type 2 diabetes mellitus (T2DM). Objective: To evaluate the association between serum relative expression levels of miRNA-21 and the presence of albuminuria among T2DM patients. Methods: This was a cross-sectional analytical study utilizing secondary data from the 30th follow-up of the non-communicable disease (NCD) cohort by the National Institute of Health Research and Development (Balitbangkes), involving 100 T2DM subjects in Bogor. Serum miRNA-21 levels were measured using qRT-PCR, and albuminuria status was determined by urinary albumin-to-creatinine ratio (UACR). Data were analyzed using the Mann–Whitney U test, Spearman’s correlation, and multivariate logistic regression. Results: The median relative expression of miRNA-21 was significantly higher in the albuminuria group [6.79 (IQR 4.41 –12.05)] compared to the normoalbuminuria group [3.00 (IQR 1.98–4.53); p < 0.0001]. miRNA-21 also showed a moderate positive correlation with UACR in both normoalbuminuria (r = 0.545; p < 0.0001) and albuminuria (r = 0.470; p = 0.001 ) groups. In multivariate analysis, miRNA-21 remained significantly associated with albuminuria (PR = 3.383; 95% CI: 1.931 – 5.928) after adjusting for potential confounders. Conclusions: miRNA-21 expression was significantly higher in T2DM patients with albuminuria. Its expression correlated positively with UACR in both normoalbuminuria and albuminuria groups, suggesting a potential role as an early biomarker of diabetic kidney injury.
Key words: diabetes mellitus, miRNA-21, albuminuria