Farmakoterapi

Dislipidemia
 Definisi
• Suatu kondisi dimana adanya gangguan terhadap kadar lemak dalam darah (Marry Anne and
Alledredge, 2013)
Prevalence

• According to the World Health Organization (WHO) estimates in 2008, the prevalence of
dyslipidemia (defined as blood levels of TC > 5 mmol/L [190 mg/dL]) in the Southeast Asia (30.3%)
and the Western Pacific (36.7%) were much lower than that in the Europe (53.7%) and the
Americas (47.7%). However, the prevalence of dyslipidemia across Asia Pacific region varies.
Dyslipidemia

• Dyslipidemia, including high levels of total cholesterol, low-density lipoprotein cholesterol (also
called bad cholesterol), and triglyceride (also called bad carrier), and low levels of high-density
lipoprotein cholesterol (also called good cholesterol), is a major risk factor of atherosclerosis that
leads to various cardiovascular diseases.
Cholesterol inside blood vessel
Aterosklerosis

1. LDL masuk ke endotel 5. Foam cell

2. Oksidasi LDL 6. proliferasi SMC
3. Pengeluaran sitokin 7,8. Pembentukan plak aterosklerosis
4. Penarikan monosit ke endotel
6
Sieacuse, 2012
HDL and LDL
Lab Value of cholesterol product
Sources of Cholesterol
Penatalaksanaan diabetes dyslipidemia
§ Terapi awal : modifikasi lifestyle
(tidak merokok, TD yang
terkontrol, penurunan BB,
peningkatan aktivitas fisik).
§ Penurunan LDL-C, Peningkatan
HDL, Penurunan TG

ADA, 2017 14
Efek Pleiotropik

18
Zhao el al, 2014
TNF-α

Melalui NF-kB, menginduksi pembentukan CAM,

TNF-α MCP-1, Selektin aktivasi monosit dan limfosit
migrasi ke rongga sub endotel
terbentuknya foam cell, fatty streak
aterosklerosis.
§ TNF-α diproduksi oleh à makrofag, monosit, sel T, sel
otot polos, adiposa, dan fibroblas.
§ Sitokin pusat à metabolisme intermediet.
§ 2 reseptor TNF-a :
1. tipe I : tumor necrosis factor receptor type I (TNF-RI)
2. tipe II : TNF-RII, terdapat pada semua jenis
membran sel kecuali eritrosit.

Popa et al, 2007 19