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Guntur Darmawan
Association between serum uric acid and non-alcoholic fatty liver disease: a meta-analysis / Guntur Darmawan, Laniyati Hamijoyo, Irsan Hasan
"ABSTRACT
Background: non alcoholic fatty liver disease (NAFLD) is known to be associated with some metabolic disorders. Recent studies suggested the role of uric acid in NAFLD through oxidative stress and inflammatory process. This study is aimed to evaluate the association between serum uric acid and NAFLD. Methods: a systematic literature review was conducted using Pubmed and Cochrane library. The quality of all studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). All data were analyzed using REVIEW MANAGER 5.3. Results: eleven studies from America and Asia involving 100,275 subjects were included. The pooled adjusted OR for NAFLD was 1.92 (95% CI: 1.66-2.23; p<0.00001). Subgroup analyses were done based on study design, gender, non-diabetic subjects, non-obese subjects. All subgroup analyses showed statistically significant adjusted OR and most of which having low to moderate heterogeneity. Two studies revealed relationship between increased serum uric acid levels and severity of NAFLD. No publication bias was observed. Conclusion: our study demonstrated association between serum uric acid level and NAFLD. This finding brings a new insight of uric acid in clinical practice. Increased in serum uric acid levels might serve as a trigger for physician to screen for NAFLD."
Jakarta: University of Indonesia. Faculty of Medicine, 2017
616 UI-IJIM 49:2 (2017)
Artikel Jurnal  Universitas Indonesia Library
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Ignatius B. Prasetya
Prevalence and profile of fibrosis in diabetic patients with non-alcoholic fatty liver disease and the associated factors
"Background: the risk of Non Alcoholic Fatty Liver Disease (NAFLD) is increasing in patients with type 2 diabetes. Prevalence and factors related to the increased risk of NAFLD in diabetic patients in Indonesia has never been studied before. Data regarding the profile of fibrosis in the population has also been unknown. This study aimed to identify the difference on the profile of diabetic patients with and without NAFLD as well as the degree of fibrosis.
Methods: the study was conducted using a cross sectional method in type 2 diabetic patients who were treated at the outpatient clinic of endocrinology and metabolic division in Cipto Mangunkusumo Hospital. Sampling was done consecutively. Collected data comprised of age, duration of diabetes, body mass index (BMI), waist circumference, HDL, triglyceride, and HbA1C levels. Abdominal ultrasonography was conducted for all patients to determine the presence of NAFLD. Patients with NAFLD were subsequently underwent transient elastography in order to assess their degree of liver fibrosis. Chi-square or Fishers Exact tests were used for bivariate analysis and logistic regression was used for multivariate analysis.
Results: as many as 186 patients were analyzed in the study and 84 patients (45.2%) were demonstrated to have NAFLD. Transient elastography examinations were carried out in 68 patients and 17 patients (25.0%) were found with severe fibrosis. Univariate analysis showed significant differences on BMI (PR=1.878; 95%CI= 1.296 2.721; p<0.001) and waist circumference (PR=2.368; 95%CI= 1.117 5.017; p=0.018) between patients with and without NAFLD. However, the multivariate test showed that BMI was the only factor that had a significance difference between both groups (OR=2.989; 95%CI=1.625-5.499; p<0.001).
Conclusion: prevalence of NAFLD among type 2 diabetic patients in Cipto Mangunkusumo Hospital has reached 45.2% and 25.0% among them had severe fibrosis. BMI is the only factor found to be associated with the occurrence of NAFLD."
Jakarta: University of Indonesia. Faculty of Medicine, 2017
616 UI-IJIM 49:2 (2017)
Artikel Jurnal  Universitas Indonesia Library
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Sepreka Mirly
Hubungan antara Metabolic associated Fatty Liver Disease (MAFLD) dengan Kelelahan Kerja pada Pelaut Kapal Tugboat = The Relationship Between Metabolic associated Fatty Liver Disease (MAFLD) and Work Fatigue in Tugboat Seafarers
"Latar belakang: Indonesia merupakan negara maritim yang berhubungan erat dengan industri pengiriman dan kekayaan laut yang berdampak pada sosio-ekonomik negara. Kesehatan pelaut berperan penting dalam mempertahankan manajemen ini dan perlu mendapat perhatian khusus. Pelaut memiliki risiko mengalami MAFLD, kelelahan saat bertugas, atau kombinasi keduanya. Penelitian ini bertujuan untuk mengetahui hubungan antara MAFLD dengan kelelahan kerja pada Pelaut tugboat.

Metode: Penelitian ini menggunakan metode potong lintang dengan data sekunder hasil MCU karyawan Perusahaan X. MAFLD didefinisikan sebagai fatty liver berdasarkan hasil USG ditambah dengan adanya obesitas atau overweight. Kelelahan diukur menggunakan kuesioner SOFI yang telah divalidasi dalam bahasa Indonesia. Hubungan antara MAFLD dengan kelelahan dianalisis menggunakan uji regresi logistik untuk mendapatkan nilai signifikansi (P), odds ratio (OR) dan interval kepercayaan (IK) 95%.

Hasil: Prevalensi pekerja yang mengalami kelelahan sedang sebanyak 64 orang (23,5%). Kelelahan kerja secara statistik berhubungan signifikan dengan MAFLD (aOR 5,05; IK 95% 2,65-9,60; p <0,001) dan kurangnya aktivitas fisik/olahraga (aOR 2,79; IK 95% 1,17-6,68; p 0,021).

Kesimpulan: Hampir seperempat dari total jumlah pelaut tugboat mengalami kekelahan sedang saat bekerja. Kelelahan tersebut berhubungan signifikan dengan MAFLD dan kurangnya aktivitas fisik/olahraga

Background: Indonesia is a maritime nation closely associated with shipping industry and oceanic wealth that impacts the country's socio-economic status. The health of sailors plays a crucial role in maintaining this management and requires specific attention. Sailors are at risk of experiencing MAFLD, on-duty fatigue, or a combination of both. This research aims to investigate the relationship between MAFLD and work-related fatigue among tugboat sailors.

Methods: This study used a cross-sectional method with secondary data from the Medical Check-Up (MCU) results of Company X's employees. MAFLD was defined as fatty liver based on ultrasound results combined with the presence of obesity or overweight. Fatigue was measured using the validated SOFI questionnaire in the Indonesian language. The association between MAFLD and fatigue was analyzed using logistic regression to obtain significance values (P), odds ratios (OR), and a 95% confidence interval (CI).

Results: The prevalence of workers experiencing moderate fatigue was 64 individuals (23.5%). Statistically, work-related fatigue was significantly associated with MAFLD (aOR 5.05; 95% CI 2.65-9.60; p <0.001) and insufficient physical activity/exercise (aOR 2.79; 95% CI 1.17-6.68; p 0.021).

Conclusion: Nearly a quarter of the total number of tugboat sailors experience moderate fatigue while working. This fatigue is significantly associated with MAFLD and insufficient physical activity/exercise."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Yoppi Kencana
Titik Potong Rasio Hitung Neutrofil dan Limfosit untuk Memprediksi Derajat Steatosis dan Fibrosis Penyakit Perlemakan Hati Non Alkoholik = Diagnostic Value of Neutrophil to Lymphocyte Ratio in Non-Alcoholic Fatty Liver Disease evaluated using Transient Elastography (TE) with Controlled Attenuated Parameter (CAP)
"ABSTRAK
Non-alcoholic fatty liver disease (NAFLD) adalah penyakit hati kronik yang ditandai dengan akumulasi lemak berlebihan di hati. Elastografi Transien (ET) dan metode Controlled Attenuation Parameter (CAP) merupakan metode pemeriksaan non-invasif untuk menilai derajat fibrosis dan steatosis, namun tidak tersedia di seluruh rumah sakit di Indonesia. Rasio Neutrofil Limfosit (RNL) merupakan penanda peradangan sederhana yang berpotensi memprediksi luaran penyakit. Tujuan : Mengetahui nilai diagnostik RNL sebagai indikator derajat keparahan steatosis dan fibrosis NAFLD. Metode : Penelitian ini adalah studi potong lintang menggunakan data sekunder dari data rekam medis tahun 2016-2018. Analisis statistik deskriptif dan analitik berupa uji korelasi, Receiver Operating Curve (ROC) dan Area Under The Curve (AUC) dipakai untuk mengetahui luaran studi. Hasil : Dari 106 subjek penelitian, kebanyakan pasien adalah perempuan (62,3%) berusia rata-rata 57,29 tahun dan menderita sindrom metabolik (77,4%). Sebagian besar pasien memiliki derajat steatosis sedang-berat (66%) dengan rerata ET 6,14 (2,8-18,2). Terdapat korelasi antara nilai CAP (r=0,648; p<0,001) dan ET (r=0,621; p<0,001) dengan RNL. Penggunaan RNL untuk menilai derajat steatosis sedang-berat memiliki titik potong 1,775 dengan sensitivitas, spesifisitas, NDP dan NDN sebesar 81,5%, 80,6%, 89,1%, dan 69,1%; titik potong 2,150 untuk menilai fibrosis signifikan dengan sensitivitas, spesifisitas, NDP dan NDN berurutan sebesar 92,3 %; 87,5%; 70,6%; dan 97,2%. Simpulan : RNL memiliki korelasi positif dan signifikan terhadap derajat steatosis (CAP) dan fibrosis (ET) dengan sensitivitas dan spesifisitas yang cukup tinggi.
ABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) is a device and method to examine the degree of fibrosis and steatosis. However, this device is not widely available across Indonesia. Neutrophil and Lymphocyte Ratio (NLR) is a simple marker for inflammation which has a potency to predict disease outcome. This study aims to know the diagnostic value of NLR as the indicator of steatosis and fibrosis severity. Methods: This was a cross-sectional study with consecutive sample collection. We used secondary data from medical record, starting from 2016-2018. A descriptive and analytic statistic, including correlation test, multivariate linear regression, t test, Receiver Operating Curve (ROC) and Area Under the Curve (AUC) were done to know the outcome of the study. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) Version 20.0 (SPSS Inc, Chicago, Illinois). A P value <0.05 was considered as statistically significant. Results: Out of 106 subjects, 62.3% patients were women with the mean of age 57.29 years old and 77.4% had metabolic syndrome. Most patients had moderate to severe steatosis degree (66%) with the mean of ET mean 6.14 (2.8-18.2). There was a positive correlation between CAP and TE compared with NLR with r=0.647 (p<0.001) and r=0.621 (p<0.001) respectively. The use of RNL to assess moderate-severe steatosis has a cutoff point of 1.775 with sensitivity,  specificity, PPV and NPV respectively at 81,5%, 80,6%, 89,1%, and 69,1%; cutoff point 2,150 to assess significant fibrosis with sensitivity, specificity, PPV and NPV of 92.3 %, 87.5%, 70.6%, and 97.2% respectively. Conclusion: NLR has a positive and significant correlation with the degree of steatosis and fibrosis with high sensitivity and specificity in comparison with TE/CAP."
2019
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UI - Tesis Membership  Universitas Indonesia Library
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Anggilia Stephanie
Korelasi kadar trigliserida dengan derajat steatosis menggunakan controlled attenuation parameter pada pasien nonalcoholic fatty liver disease = The correlation between triglyceride levels and steatosis degree using controlled attenuation parameter on nonalcoholic fatty liver disease patients
"ABSTRAK
Sebagai salah satu penyebab terbanyak peningkatan enzim hati, dan sirosis, NAFLD perlu dinilai derajat steatosisnya. Trigliserida sebagai salah satu komponen sindrom metabolik diketahui mempunyai pengaruh terhadap terjadinya nonalcoholic fatty liver disease NAFLD , namun korelasinya dengan derajat steatosis pada pasien NAFLD belum diketahui. Studi ini bertujuan untuk mendapatkan korelasi antara kadar trigliserida dengan nilai Controlled attenuation parameter CAP pada pasien NAFLD, serta mendapatkan nilai titik potong trigliserida yang optimal untuk memprediksi derajat steatosis sedang-berat pada pasien NAFLD. Studi potong lintang dilakukan pada pasien NAFLD dewasa di poliklinik Penyakit Dalam RSCM, yang direkrut secara konsekutif. Pasien dengan sirosis hepatis dieksklusi dari penelitian. Diagnosis NAFLD dilakukan dengan menggunakan USG, sementara derajat steatosis ditentukan dengan metode CAP menggunakan alat Fibroscan. Sampel darah puasa diambil untuk pemeriksaan trigliserida. Korelasi antara kadar trigliserida dengan nilai CAP dianalisis dengan uji Pearson. Sebanyak enam puluh dua subyek, dengan median usia 55 rentang 21 ndash; 78 tahun. Median nilai IMT 26,1 rentang 19-38 kg/m2, lingkar pinggang 96,6 SB: 8,49 cm, kadar trigliserida 160,3 SB: 65,5 mg/dL, kolesterol LDL 147,8 SB: 38,2 mg/dL, kolesterol HDL 48,5 SB:11,1 mg/dL dan nilai CAP 268,5 SB: 46,8 dB/m. Obesitas sentral didapatkan sebanyak 94,8 . Komorbid didapatkan berupa hipertensi 46,8 , DM tipe 2 54,8 , dan sindrom metabolik pada 72,6 . Didapatkan adanya korelasi yang lemah antara TG dengan derajat steatosis r=0,272; p= 0,033 . Dari kurva ROC didapatkan kemampuan TG dalam memprediksi derajat steatosis kurang baik AUC 0,66 IK 95 0,48 ndash; 0,83 , sehingga tidak dilanjutkan untuk mencari titik potong. Didapatkan adanya korelasi lemah antara kadar trigliserida dengan derajat steatosis pada pasien NAFLD. Saat ini kadar trigliserida tunggal tidak dapat digunakan untuk mendeteksi derajat steatosis sedang-berat.ABSTRACT As one of the most common cause of elevated liver enzymes and cirrhosis nowadays, steatosis degree need to be evaluated in NAFLD cases. Triglyceride, one of metabolic syndrome components, is known to be associated with NAFLD. However, correlation between the triglyceride levels and steatosis degree, has not yet understood. This study aim to find correlation between triglyceride level with Controlled Attenuation Parameter CAP value in NAFLD patients, and also gain optimal cut off point of triglyceride for predicting moderate to severe NAFLD. A cross sectional study on adult NAFLD patient in RSCM Internal Medicine Clinic, recruited consecutively in four months. Patients with liver cirrhosis was excluded. Diagnosis of NAFLD using Ultrasound, meanwhile steatosis degree was assessed using CAP in Fibroscan. Blood samples were taken for Triglycerides examination. The correlation between triglyceride levels with CAP values were analyzed by Pearson test. Sixty two NAFLD subjects, with a median age of 55 range 21 78 years. Median value of BMI was 26.1 range 19 38 kg m2, mean for waist circumference, levels of LDL and HDL cholesterol was 96.6 SD 8.49 cm, 147.8 SD 38.2 mg dL, 48.5 SD 11.1 mg dL , respectively. Mean for triglyceride was 160.3 SD 65.5 mg dL, and CAP value 268.5 SD 46.8 dB m. Central obesity found in as many as 94.8 of subject. Comorbidities such as hypertension and type 2 diabetes was found at 46.8 and 54.8 respectively, and metabolic syndrome 72.6 . In this study, we found a weak correlation between triglyceride values and CAP r 0.272 p 0.033 . From the ROC we find the TG capability of predicting steatosis degree was not good enough AUC 0.66, 95 CI 0.48 to 0.83 . Therefore cut off point of TG was not assessed. As a conclusion, there is a weak correlation between triglyceride levels and degree of steatosis in patients with NAFLD. Triglyceride level cannot be used solely for assessment of steatosis degree. "
Fakultas Kedokteran Universitas Indonesia, 2017
T55689
UI - Tugas Akhir  Universitas Indonesia Library
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Sharon Sandra
Korelasi kadar asam urat dengan nilai elastografi transien dan controlled attenuation parameter penyakit perlemakan hati non alkoholik = The correlation between serum uric acid level and the steatosis and fibrosis degree of non alcoholic fatty liver disease evaluated using controlled attenuation parameter - transient elastography
"Latar belakang. Hiperurisemia merupakan salah satu parameter metabolik yang diperkirakan mempunyai peranan dalam perjalanan non-alcoholic liver disease NAFLD . Studi mengenai peranan asam urat dalam progresivitas penyakit hati masih terbatas.Tujuan. Mengetahui korelasi antara kadar asam urat dengan nilai Elastografi Transien ET dan Controlled Attenuation Parameter CAP pasien NAFLD.Metode. Penelitian ini merupakan studi potong lintang dengan menggunakan data sekunder yang melibatkan 113 pasien NAFLD dewasa. Dilakukan uji korelasi antara kadar asam urat dengan nilai ET dan nilai CAP. Lalu dilakukan analisis tambahan dengan membagi pasien menjadi 2 kelompok berdasarkan nilai ET dan CAP. Nilai titik potong ET untuk fibrosis signifikan sebesar ge; 7 kPa dan nilai CAP ge; 285 dB/m digunakan untuk membedakan steatosis ringan dan steatosis sedangberat. Faktor metabolik yang mempengaruhi derajat steatosis dan fibrosis dianalisis dengan menggunakan uji chi-square dan dilakukan analisis regresi logistik.Hasil. Terdapat 45 pasien dengan steatosis sedang-berat dan 34 pasien yang mengalami fibrosis signifikan. Tidak terdapat korelasi antara kadar asam urat dengan nilai CAP koefisien korelasi r = 0,2 dan p=0,026 maupun nilai ET r = 0,151 dan p = 0,110 . Terdapat perbedaan rerata kadar asam urat antara kelompok steatosis ringan dibandingkan steatosis sedang-berat 6,31 1,44 mg/dL vs 6,94 1,62 mg/dL, p = 0,03 . Tidak terdapat hubungan independen antara hiperurisemia dan derajat steatosis. Sedangkan faktor yang berhubungan secara independen dengan derajat fibrosis signifikan adalah hiperurisemia OR 2,450; 95 IK 1,054- 5,697 dan kenaikan kadar glukosa puasa OR 3,988 1,105-14,389 . Kelompok fibrosis signifikan mempunyai nilai rerata kadar asam urat yang lebih tinggi 6,89 1,60 mg/dL vs 6,42 1,50 mg/dL walau tidak bermakna secara statistik nilai p = 0,145 .Kesimpulan. Tidak terdapat korelasi antara kadar asam urat dengan nilai ET dan CAP
Background. Hyperuricemia is one of metabolic parameter which has been considered to play an important role in NAFLD. There is still lack of studies or evidence about correlation between serum uric acid level with liver disease progression.Aim of the study. To know the correlation between serum uric acid level and the steatosis and fibrosis degree of non alcoholic fatty liver disease evaluated using Controlled Attenuation Parameter CAP Transient Elastography TE examination.Methods. This study is a cross sectional study using secondary data of 113 NAFLD. Correlation between uric acid level and the degree of steatosis and fibrosis were also evaluated. Cutoff value for significant liver fibrosis ge 7 kPa. Mild and moderate severe steatosis diagnosed with a cutoff value of ge 285 dB m. Each metabolic factors were analyzed using chi square test. Univariate and multivariate analysis were performed using logistic regression test.Results. Of 113 NAFLD patients, there were 45 patients with moderate severe steatosis and 34 patients with significant fibrosis. There was no correlation between uric acid level and CAP correlation coefficient 0.2, P 0.026 and ET correlation coefficient 0.151, P 1,110 value were found. The difference of uric acid level mean value was found between mild steatosis and moderate severe steatosis 6.31 1.44 mg dL vs. 6.94 162 mg dL, P 0,03 . Hyperuricemia was not independent risk factor of moderate severe steatosis. High level of fasting blood glucose OR 3.98, 95 CI 1.105 14.389 and hyperuricemia OR 2.501, 95 CI 1.095 5.714 were found to be independent risk factors for significant liver fibrosis. Significant liver fibrosis group tends to have a higher mean value of uric acid level 6.89 1.60 mg dL vs. 6.42 1,50 mg dL with a p value 0,145.Conclusion. There was no correlation between uric acid an CAP TE value"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tesis Membership  Universitas Indonesia Library
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Barry Anggara Putra
Korelasi skor model for end-stage liver disease meld dengan critical flicker frequency off pada pasien sirosis hati = The correlation between model for end stage liver disease meld score with critical flicker frequency cff in patient with liver cirrhosis
"ABSTRAK
Latar Belakang: Ensefalopati hepatikum minimal (EHM) adalah spektrum teringan dari abnormalitas neuropsikologis yang merupakan komplikasi dari sirosis hati yang berimplikasi pada kualitas hidup pasien. Namun, saat ini modalitas untuk mendiagnosis EHM masih terbatas. Salah satu modalitas pemeriksaan EHM adalah Critical Flicker Frequency (CFF), namun tidak semua fasilitas kesehatan memiliki alat ini. Model for End-Stage Liver Disease (MELD) adalah suatu sistem skoring yang dikembangkan untuk mengetahui prognosis pasien yang akan menerima transplantasi hati dan berdasarkan beberapa studi, berkorelasi dengan EHM. Penelitian ini bertujuan untuk mengetahui korelasi antara MELD dengan CFF pada pasien sirosis hati.
Metode: Penelitian dilakukan secara potong lintang. Pengambilan data dilakukan sejak Maret hingga Mei 2016 di poliklinik Hepatologi RSUPN Cipto Mangunkusumo. Kriteria inklusi meliputi pasien sirosis hati dengan nilai Glasgow
Coma Scale (GCS) 15. Kriteria eksklusi meliputi pasien dengan ensefalopati hepatikum, hematemesis melena, stroke, gangguan penglihatan dan sirosis alkoholik, Subjek penelitian kemudian dilakukan pemeriksaan dengan alat CFF dan dihitung skor MELD masing masing.
Hasil: Sebanyak 60 pasien memenuhi kriteria inklusi dan eksklusi. Didapatkan 28 pasien tanpa EHM dan 32 pasien dengan EHM. Rata rata usia pasien 54,8 tahun. Jumlah hepatitis terbanyak adalah hepatitis B sejumlah 34 pasien dan skor Child Pugh terbanyak adalah Child Pugh A sebanyak 39 pasien. Nilai rerata CFF 36,9 ± 8,57 Hz dan skor MELD 10,3 ± 3,6. Didapatkan nilai r -0,097.
Simpulan: Tidak terdapat korelasi antara skor MELD dan skor CFF.
ABSTRACT
Background: Minimal hepatic encephalopathy (MHE) is the mildest spectrum of neuropsychological abnormality as a complication of liver cirrhosis which has implication in quality of life. Meanwhile, there are only few modalities to diagnose MHE. One of them is Critical Flicker Frequency(CFF), but this modality is not available in every health center. Model for End-Stage Liver Disease (MELD)-a scoring system developed to determine the prognosis of patients who receive liver transplant-is correlated with EHM according to several studies. This study aimed to determine the correlation between MELD with CFF in cirrhotic patients.
Method:
This was a cross sectional study. Data were collected from March until May 2016 in Hepatological outclinic RSUPN Cipto Mangunkusumo. Inclusion criteria consist of cirrhosis pasien with Glasgow Coma Scale (GCS) 15. Exclution criteria consist of patient with hepatic encephalopathy, hematemesis melena, stroke, visual impairment, and alcoholic cirrhosis. All subjects were examined using CFF and MELD scores.
Results:
A total of 60 patients met the inclusion and exclusion criteria for the study. There are 28 patients with EHM and 32 patients without EHM. r value of -0,097. The mean age were 54.8 years old. Most subjects were diagnosed with hepatitis B (34 patients) and most subjects were scored A based on Child Pugh scoring(39 patients). Mean value of CFF and MELD are 36,9 ±8,57 Hz and 10,3 ±3,6 consecutively. The correlation score between two modalities were r -0,097.
Conclusion:
There was no correlation between MELD score and CFF score."
2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Cornelia Yasmin Gunawan
Fibrosis and Ductular Proliferation Comparison between CCl4-induced and 2AAF/CCl4-induced Liver Injury in Mouse Model = Perbandingan Fibrosis dan Proliferasi Duktular antara Kerusakan Hati Akibat Induksi CCl4 dan 2AAF/CCl4 pada Model Tikus
"mengalami kerusakan dan sirosis hati. Walaupun tidak ada data terbaru mengenai insiden kerusakan hati di Indonesia, Riskesdas 2013 menyampaikan adanya prevalensi yang tinggi dari persentase HBsAg, anti-HBs, dan anti-HBc. Selain itu, dalam kurun waktu 30 tahun (1980—2010), terdapat peningkatan tingkat kematian sirosis hati sebanyak 25,1%. Model hewan yang sesuai sangatlah penting dalam meneliti kerusakan hati. Karbon tetraklorida (CCl4) sudah lama digunakan untuk menginduksi fibrosis hati pada model tikus. Walaupun dapat menginduksi pengendapan jaringan ikat, regenerasi hepatoseluler, proliferase sel stelata, dan infiltrasi sel-sel inflamasi, kerusakan pada model tikus yang diinduksi CCl4 hanya merepresentasikan kerusakan hati sampai batas tertentu, mirip dengan kerusakan hati akibat obat. Dengan tujuan meniru kerusakan hati yang lebih parah, penelitian ini mengkombinasikan penggunaan CCl4 dengan asetilaminofluorena-2 (2AAF) karena 2AAF terbukti dapat menekan proliferasi hepatosit sehingga terjadi proliferasi sel oval yang berakibat pada proliferasi duktular. Metode: Desain penelitian ini adalah penelitian observasional terhadap penelitian analitik eksperimental dengan bahan biologis tersimpan yang diambil dari Departemen Patologi Anatomi Fakultas Kedokteran Universitas Indonesia. Penelitian ini menggunakan data primer eksperimental dengan 15 sampel yang dikategorikan dalam 3 kelompok: kontrol sehat, diinduksi CCl4, dan diinduksi 2AAF/CCl4, dan dianalis di bawah mikroskop dalam hal tingkat fibrosis, daerah cakupan fibrosis, dan jumlah proliferasi duktus. Analisis statistik yang digunakan meliputi uji Fisher, Shapiro-Wilk, Kruskal Wallis, dan Mann Whitney menggunakan program SPSS. Hasil: Kelompok 2AAF/CCl4 dan CCl4 memiliki perbedaan derajat fibrosis yang signifikan dengan kontrol sehat (p=0,024 dan p=0,048 secara berurutan), tanpa perbedaan signifikan di antara kedua kelompok tersebut (p=0,286). Perbedaan cakupan area fibrosis antara kedua kelompok juga tidak signifikan (p=0,055), walau kelompok 2AAF/CCl4 dan CCl4 berbeda signifikan dengan kontrol sehat (p=0,007 dan p=0,008 secara berurutan). Dalam hal proliferasi duktular, kelompok CCl4 tidak menunjukkan perbedaan signifikan dengan kontrol sehat (p=0,101), namun berbeda signifikan dengan kelompok 2AAF/CCl4 (p=0,000). Kesimpulan: Tidak terdapat perbedaan derajat dan cakupan area fibrosis yang signifikan antara kelompok 2AAF/CCl4 dan CCl4. Namun demikian, terjadi proliferasi duktular yang secara signifikan lebih tinggi pada kelompok 2AAF/CCl4 dibandingkan kelompok CCl4 saja.
Background: In 2017, approximately 1.8% of adult in United States suffer from chronic liver disease and cirrhosis. Although there is not any recent data, Riskesdas 2013 showed a high percentage of HBsAg, anti-HBs, and anti-HBc prevalence in Indonesia. On top of that, in Indonesia, in the course of 30 years (1980—2010), liver cirrhosis mortality rate increased by 25,1%. In order to study liver disease, having an appropriate animal model is crucial. Carbon tetrachloride (CCl4) has been used to induce liver fibrosis in mouse model. Although able to induce connective tissue deposition, hepatocellular regeneration, stellate cells proliferation, and inflammatory infiltration, CCl4-induced rat models only represent liver injury to some extent, similar to drug-induced liver injury. In order to mimic a more severe liver injury, this study combined the use of CCl4 with 2- acetylaminofluorene (2AAF), as 2AAF has proven to be able to suppress hepatocyte proliferation and allow oval cells proliferation that leads to ductular proliferation. Method: This research design is an observational research on an analytic experimental study with stored biological material taken from the Department of Anatomy Faculty of Medicine University of Indonesia. This research uses experimental primary data, with 15 samples categorized into three groups: healthy control, CCl4-induced, and 2AAF/CCl4- induced, and analysed for the degree of fibrosis, fibrosis-affected area, and number of proliferating ductules under the microscope. A statistical analysis is then conducted using Shapiro-Wilk, Kruskal Wallis, and Mann Whitney by using SPSS programme. Result: There is a significant difference in the degree of fibrosis between both 2AAF/CCl4 and CCl4 groups with the healthy control (p=0,024 dan p=0,048 respectively), without any significant difference in between the two groups (p=0,286). The affected fibrosis area difference between the two groups is also insignificant (p=0,055), though the 2AAF/ CCl4 and CCl4 groups are significantly different to the healthy control (p=0,007 and p=0,008 respectively). For ductular proliferation, CCl4 group did not show any significant difference compared to the healthy group (p=0,101), but was significantly different to the 2AAF/CCl4 group (p=0,000). Conclusion: There is not any significant difference regarding the degree of fibrosis and its affected area between the 2AAF/CCl4 and CCl4 groups. However, there is a significant difference between the two groups in terms of ductular proliferation, in which the 2AAF/CCl4 group’s ductular proliferation was higher."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
TA-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Diseases of the liver / editor by William T. Foulk
New York: Blakiston Division, McGraw-Hill , 1968
616.362 DIS
Buku Teks  Universitas Indonesia Library
cover
Jimmy Kurniawan
Hubungan antara pajanan kromium dengan status fungsi hati pekerja di perusahaan alat berat PT X Cakung Cilincing = Correlation between chromium exposure and liver function to worker in heavy equipment manufacturer PT X Cakung Cilincing
"ABSTRAK
Latar belakang: Pekerja di perusahaan alat berat terutama bagian pengelasan dapat terpajan berbagai macam logam berbahaya yang terdapat pada plat yang digunakan. Salah satu logam yang dapat menyebabkan kerusakan sel bahkan dapat menyebabkan kanker adalah kromium. Hati merupakan salah satu target organ dan sering mengalami kerusakan akibat logam ini. Tujuan penelitian ini adalah mencari hubungan kadar kromium di dalam eritrosit dengan status fungsi hati pekerja.
Metode: Penelitian potong lintang komparasi dilakukan terhadap pekerja yang terpajan dengan pekerja yang tidak terpajan. Data yang digunakan berdasarkan hasil pengukuran fisik, hasil pengukuran kromium eritrosit dan Serum Glutamic Pyruvic Transaminase (SGPT), serta hasil kuisioner.
Hasil: Dari 50 pekerja yang terbagi menjadi 25 orang terpajan dan 25 orang tidak terpajan, terdapat hubungan bermakna secara statistik antara kadar kromium eritrosit dengan masa kerja (p=0,044). Tidak terdapat hubungan bermakna secara statistik antara kadar kromium di dalam eritrosit dengan SGPT (p=0,814).
Kesimpulan: tidak terdapat hubungan bermakna secara statistik mengenai hubungan kadar kromium dengan kadar SGPT. Namun hasil rerata kadar kromium pekerja tidak terpajan lebih tinggi daripada populasi normal lainnya.
ABSTRACT
Background: worker in heavy equipment manufacturer especially can be exposed to a various kinds of harmful metals contained in the plate. One of metal that can cause cell damage or even cancer which are often used in workplace is chromium. Liver is one of targeted organ could be damaged due to this metal. The purpose of this study is to correlate between chromium level in erythrocytes and welder?s liver function status.
Methods: A Cross Sectional Comparative study was conducted to workers who were exposed and unexposed. The data used is based on worker?s physical measurement result, chromium level erythrocytes and Serum Glutamic Pyruvic Transaminase (SGPT) results, and also questionnaire.
Results: From 50 workers which are consisted of 25 exposed workers and 25 unexposed workers, there is statistically significant correlation between chromium erythrocytes level and duration of employment (p=0,044). There is no statistically significant correlation between chromium level in erythrocytes and SGPT (p=0.814).
Conclusion: There is no statistically significant correlation between erythrocytes chromium level and SGPT level. But the average result of erythrocytes chromium level of the unexposed workers were higher compare to other normally unexposed workers."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tesis Membership  Universitas Indonesia Library
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