Hubungan Kadar Proprotein Convertase Kexin/Type 9 (PCSK9) dengan Aterosklerosis pada Penyandang Diabetes Melitus Tipe 2: Sebuah Telaah Sistematis
Bibliographic record
Abstract
Pendahuluan. Diabetes melitus (DM) tipe 2 merupakan salah satu faktor risiko penyakit kardiovaskular dengan peningkatan low density lipoprotein sebagai mekanisme utama terjadinya aterosklerosis. PCSK9 adalah regulator reseptor LDL utama sehingga kaitannya dengan aterosklerosis saat ini sedang banyak diteliti. Beberapa studi mengenai hubungan kadar PCSK9 dengan aterosklerosis pada penyandang DM tipe 2 telah tersedia namun bersifat inkonsisten. Untuk itu, telaah penelitian ini dilakukan untuk menelaah lebih lanjut mengenai hubungan kadar PCSK9 dengan aterosklerosis pada pasien DM tipe 2 secara sistematis. Metode. Penelitian ini berbentuk telaah sistematis yang telah didaftarkan di PROSPERO. Penelusuran pustaka sesuai panduan PRISMA dilakukan pada tanggal 18 Juli – 02 September 2020. Setelah dilakukan penilaian risiko bias dengan Newcastle Ottawa scale, kemudian dilakukan telaah naratif pada pustaka yang didapatkan oleh dua penilai independen. Hasil. Didapatkan empat studi yang relevan dengan total subjek 430. Tiga studi memiliki kategori kualitas tinggi sementara satu studi dengan kualitas sedang. Hubungan antara kadar PCSK9 dengan aterosklerosis pada penyandang DM tipe 2 didapatkan pada studi oleh Guo, dkk. dengan nilai OR: 1,12 (IK 95% 1,041 – 1,204), p: 0,002 dan studi oleh Ma, dkk. dengan p<0,05. Sementara dua studi lainnya melaporkan tidak ada hubungan antara kadar PCSK9 dengan aterosklerosis pada penyandang DM tipe 2. Cheng, dkk. melaporkan nilai β: 1,08 (IK 95% -0,59 -2,75) dan Xie, dkk. melaporkan nilai p=0,334 (IK 95% -18 – 10). Simpulan. Belum ada bukti yang cukup untuk menjelaskan hubungan antara PCSK9 dengan aterosklerosis pada pasien DM tipe 2 sehingga dibutuhkan penelitian primer yang bersifat longitudinal. Kata Kunci: Aterosklerosis, DM tipe 2, PCSK9 Association of Proprotein Convertase Kexin/Type 9 with Atherosclerosis in People with Type 2 Diabetes Mellitus: a Systematic Review Introduction. Type 2 diabetes melitus is the leading cause of cardiovascular event with high level of low-density lipoprotein as the main predictor marker of atherosclerosis. PCSK9 plays a role in LDL-receptor regulation, its association with atherosclerosis had been investigated but the result is inconsistent. This study aimed to examine the association between PCSK9 level and atherosclerosis in people with type 2 diabetes. Methods. A systematic review was done in July 18 – September 02, 2020 and registered in PROSPERO. Risk of bias of each study was analyzed with Newcastle Ottawa scale tools. Studies involved in this systematic review then narratively analyzed by two independent reviewers. Results. There are 430 subjects involved from 4 studies. Guo, et al. reported that there was a significant association between PCSK9 level with atherosclerosis in type 2 diabetes melitus (OR: 1.12 (CI 95% 1.041 – 1.204), p: 0.002), those association was also reported by Ma, et al. with p value <0.05. While a different result came from Xie, et al. (p: 0.334 (CI 95% -18 – 10) and Cheng, et al. (: 1.08 (IK 95% -0.59 -2.75). Conclusions. There is still insufficient evidence that show the association between PCSK9 level and atherosclerosis in type 2 DM. Therefore, longitudinal primary research is needed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".