Background. Genetic studies of end-stage renal disease (ESRD), including those of human leukocyte antigen (HLA) genes, have been reported in several populations but have not yet been evaluated in Indonesia. Some studies have reported that these genes had a substantial role in ESRD. This study aims to analyze the association between HLA genes and ESRD within the Indonesian community. Method. A retrospective study to investigate HLA class I and II alleles to find out the distribution of HLA-A, -B, -C, -DPB1, -DQB1, and -DRB1 in renal transplant recipients and to ascertain their role in susceptibility to ESRD was performed on totally 149 subjects, consisting of 69 ESRD patients and 80 healthy controls. HLA typing was determined using Luminex techniques. The allele and haplotype frequencies were compared between ESRD patients and controls. Result. High-frequency alleles were HLA-A ∗ 24 (43.6%), B ∗ 15 (38.2%), C ∗ 08 (30.8%), DRB1 ∗ 12 (47.3%), DQB1 ∗ 03 (50.6%), and DPB1 ∗ 13 (22.5%). HLA-A ∗ 24 p = 0.01 and HLA-B ∗ 35 p = 0.02 were associated with a protective effect, with OR 0.537 (95%CI 0.34–0.86) and 0.316 (95%CI 0.11–0.88), respectively. There were some two-locus haplotypes associated with susceptibility to ESRD, such as B ∗ 15-DRB1 ∗ 12, B ∗ 13-DRB1 ∗ 15, A ∗ 02-B ∗ 15, A ∗ 02-C ∗ 08, and B ∗ 13-DQB1 ∗ 05. HLA-A ∗ 02-B ∗ 15-DRB1 ∗ 12 and A ∗ 24-B ∗ 13-DRB1 ∗ 15 appear to be associated with susceptibility to ESRD. Conclusion. The allele groups of HLA-A ∗ 24 and HLA-B ∗ 35 are associated with protection from ESRD. Meanwhile, HLA-B ∗ 13-DRB1 ∗ 15 and A ∗ 24-B ∗ 13-DRB1 ∗ 15 are the most frequent HLAs associated with ESRD in two-locus and three-locus haplotype, respectively.

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Objectives: This study aims to investigate the relationship between the molecular heterogeneity of prolactin (PRL) and anti-doublestranded deoxyribonucleic acid (anti-dsDNA), anti-C1q, and complement 3 (C3) levels in patients with systemic lupus erythematosus (SLE). Patients and methods:This study included 30 premenopausal females with SLE from the Rheumatology Clinic of Doctor Saiful Anwar General Hospital in Malang, Indonesia and 30 healthy females as the control group. Prolactin heterogeneity (small and large) was determined using the ultra filtration method and electrochemiluminescence immunoassay, while the total PRL, anti-dsDNA, anti-C1q, and C3 serum levels were measured by enzyme-linked immunosorbent assay. Results:The mean total PRL and small PRL serum levels for the SLE patients were 13.83±8.78 ng/mL and 4.45±1.88 ng/mL, respectively, whereas they were 9.14±3.85 ng/mL and 2.49±0.29 ng/mL, respectively for the healthy controls, indicating a significant difference between the groups (p=0.01 and p=0.00, respectively). Significant correlations were found between the small PRL serum levels and the anti-dsDNA (r=0.978; p=0.00) and C3 (r= -0.970; p=0.00) levels. Conclusion:The activity disease of SLE patients was correlated with the level of small PRL but not with total PRL.

Hariogie Putradi1, Catur Suci Sutrisnani21Resident of Clinical Pathology Department, Faculty of Medicine Brawijaya University Malang/ dr. Saiful Anwar General Hospital, Malang2Clinical Pathology Department, Faculty of Medicine Brawijaya University Malang/                    dr. Saiful Anwar General Hospital, MalangABSTRACTBackgroundHyperglycemia crisis can occur in Diabetes Mellitus (DM). The uncontrolled complications of DM are Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS). Inflammatory response is potentially occur in these condition. Platelet-to-Lymphocyte Ratio (PLR) is a new marker of inflammation in which platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis. AimDescribe PLR on acute complication of DM and to know the difference of PLR between DKA and non-DKA (HHS and Mixed).MethodRetrospective study in patients with acute complication of DM in dr. Saiful Anwar General Hospital Malang in January 2017-May 2018. The platelet and lymphocyte count were obtained from the Laboratory Information System (LIS). The PLR was calculated by dividing the platelet count by the lymphocyte count.ResultA total of 71 patients were involved in the study, consisting of 21 DKA patients and 50 non-DKA patients. There was significant difference of platelet count between DKA and non-DKA patients (p=0,001). However, there were no significant differences of lymphocyte count (p=0,087) and PLR (p=0,762) between DKA and non-DKA patients.DiscussionIn DKA, there is a chronic inflammatory process that can affect PLR. As a result, platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis.  Conclusion and SuggestionThe study showed significant difference of platelet count between DKA and non-DKA groups, and no significant difference of PLR between DKA and non-DKA groups. It is recommended to conduct further research with larger sample size.

Endothelial dysfunction is a key mechanism in the pathogenesis of complications of cardiovascular disease in Diabetes Mellitus (DM) patients. One of the new biomarkers for inflammatory conditions and endothelial dysfunction is endocan. This study aimed to determine the correlation between endocan levels and HbA1c in type 1 DM patients. This study was an analytical observational study with a cross-sectional approach performed at the Dr. Saiful Anwar Hospital, Malang from May to August 2019. The research subjects were children aged 10-18 years with a diagnosis of type 1 DM who met the inclusion criteria. Students who underwent routine health checks participated as the control group. In both groups, serum endocan levels were measured using the ELISA method and HbA1c levels were measured by the HPLC method. Independent T-test analysis was used to determine the differences between both groups and the Pearson test was used to determine the correlation between serum endocan and HbA1c with SPSS version 23. In this study, there were 40 type 1 DM patients and 40 healthy controls with a mean age of 14.5 (3.16) years in the type 1 DM group and 14.7 (0.99) years in the healthy control group. There was a higher number of female subjects in both the type 1 DM group (57.5%) and the healthy control group (65%). The mean endocan level in the type 1 DM group was higher than the control group and was statistically significant with 1090.61 (150.84) pg/mL vs. 775.56 (8.91) pg/mL, p=0.000). The mean value for HbA1c levels in the type 1 DM group was also significantly higher compared to the control group 9.63 (2.22%) vs. 4.69 (0.251%), p <0.001), respectively. There was a significant positive correlation between endocan levels and HbA1c in DM patients (p=0.025, r=0.354). This study showed a correlation between serum endocan levels and HbA1c in patients with type 1 DM.