scholarly journals Pengaruh Pemberian N-Acetylcysteine Oral terhadap High Sensitivity C Reactive Protein (Hs-CRP) pada Pasien Hemodialisis Kronis

2017 ◽  
Vol 2 (4) ◽  
pp. 228
Author(s):  
Ratih Tri Kusuma Dewi ◽  
Parlindungan Siregar ◽  
Idrus Alwi ◽  
Cleopas Martin Rumende

Pendahuluan. Inflamasi dan stres oksidatif merupakan faktor risiko penyakit kardiovaskuler pada pasien penyakit ginjal kronis yang menjalani hemodialisis. Pasien hemodialisis kronis akan mengalami peningkatan kadar Hs-CRP. Hs-CRP merupakan marker inflamasi yang telah terbukti pada beberapa penelitian bermanfaat dalam memprediksi cardiovascular event. Pemberian N-Acetylcysteine (NAC) oral dapat digunakan sebagai strategi untuk menurunkan proses inflamasi yaitu disfungsi endotel dan stress oksidatif yang berperan pada atherosclerosis pada pasien hemodialsis. Pemberian NAC ini diharapkan dapat menurunkan angka morbiditas dan mortalitas karena penyakit kardiovaskuler.Metode. Penelitian eksperimen dengan Randomized Double Blind Controlled Trial pada 65 pasien hemodialisis kronis yang memenuhi kriteria inklusi di unit hemodialisis RS.Cipto Mangunkusumo Jakarta. Penelitian dilakukan pada Agustus sampai Oktober 2013Hasil. Perlakuan dengan NAC oral selama 60 hari tidak memberikan perbedaan dibandingkan dengan plasebo. Analisis statistik dengan Mann Whitney menunjukkan bahwa tidak ada penurunan kadar Hs-CRP yang signifikan diantara kedua kelompok dengan p value Δ post1-baseline, Δ post2-baseline, and Δ post2-post1 kelompok NAC dibanding kelompok plasebo secara berurutan yaitu 0.796, 0.379 dan 0.712. Sementara itu, hasil uji Wilcoxon Signed Ranks untuk membandingkan penurunan kadar Hs-CRP pada tiap kelompok dalam tiga interval pengukuran Hs-CRP menunjukkan p value dari perbandingan kadar Hs-CRP untuk masing-masing kelompok baseline:Post1, baseline:Post2 dan Post1:Post2 (kelompok NAC Vs kelompok plasebo) secara berurutan 0.821vs0.651; 0.845vs0.358 dan 0.905vs0.789.Simpulan. Pemberian N-Acetylcysteine oral belum terbukti dapat menurunkan kadar Hs-CRP pada pasien hemodialisis kronis.

2016 ◽  
Vol 10 ◽  
pp. CMC.S32804 ◽  
Author(s):  
Shokoufeh Hajsadeghi ◽  
Mandana Chitsazan ◽  
Mitra Chitsazan ◽  
Negar Salehi ◽  
Ahmad Amin ◽  
...  

Objectives A growing body of clinical and laboratory evidence indicates that inflammation plays a crucial role in atherosclerosis. In the present study, we compared the effects of clopidogrel and prasugrel on high-sensitivity C-reactive protein (hs-CRP) in patients undergoing percutaneous coronary intervention (PCI). Methods The present randomized, double-blind clinical trial included 120 patients who underwent PCI. Eligible patients were randomly assigned 2:1 to one of the two groups: 80 patients in the first group received clopidogrel (Plavix®; loading dose and maintenance dose of 300 and 75 mg daily, respectively) and 40 patients in the second group received prasugrel (Effient®; loading dose and maintenance dose of 60 and 10 mg, respectively) for 12 weeks. The hs-CRP levels between baseline and 12th week were compared. Results Of the 120 patients, 69 patients (57.5%) were male. Pretreatment hs-CRP level was statistically comparable in clopidogrel (median, 15.10 mg/dL; interquartile range [IQR], 9.62-23.75 mg/dL) and prasugrel groups (median, 18 mg/dL; IQR, 14.25-22 mg/dL; P = 0.06). Patients taking clopidogrel showed a significant reduction in hs-CRP level compared with the baseline values ( P < 0.001). Prasugrel administration also resulted in a significant reduction in hs-CRP level ( P < 0.001). A significant 73% overall reduction in the hs-CRP level was seen with prasugrel compared with 39% overall reduction in hs-CRP level with clopidogrel ( P 0.002). Conclusion Prasugrel seems to be superior to clopidogrel in the reduction of hs-CRP in patients undergoing PCI.


2012 ◽  
Vol 97 (8) ◽  
pp. 2898-2906 ◽  
Author(s):  
L. Carcaillon ◽  
F. J. García-García ◽  
J. A. F. Tresguerres ◽  
G. Gutiérrez Avila ◽  
R. Kireev ◽  
...  

Abstract Background: Adverse effects of higher endogenous estradiol (E2) levels on various clinical outcomes and on determinants of the frailty syndrome have recently been reported. However, there are no data about the potential relationship between E2 and frailty. We aimed to study the association between E2 levels and frailty among older postmenopausal women not taking hormonal therapy. Methods: We used data from the Toledo Study for Healthy Aging, a Spanish population-based cohort study. Frailty was defined according to Fried's approach. Multivariate odds ratios (OR) and 95% confidence intervals (CI) associated with E2 levels were estimated using polytomous logistic regression. Results: E2 levels decreased significantly with age and educational level, whereas they increased with body mass index, high-sensitivity C-reactive protein (hs-CRP), and impairment in Katz activities of daily living. Higher E2 levels were associated with the prevalence of frailty among women younger than 79 yr, but not in the oldest group (p interaction = 0.047). After adjustment, OR of frailty associated with a 1 sd increase of E2 was 1.51 (95% CI, 1.04–2.20; P = 0.03). We identified an interaction between E2 and hs-CRP on the prevalence of frailty (P value = 0.042). Women with both higher E2 and hs-CRP (defined as values into the upper tertile) had an age-adjusted OR of 4.2 (95% CI, 1.7–10.5; P = 0.002), compared with women with low levels of both E2 and hs-CRP. Conclusion: Higher E2 levels were associated with frailty in postmenopausal women. The synergism between higher E2 and hs-CRP levels suggests the existence of physiopathological mechanisms connecting inflammation and estrogen to frailty.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 399
Author(s):  
Cécile Vors ◽  
Maryka Rancourt-Bouchard ◽  
Charles Couillard ◽  
Iris Gigleux ◽  
Patrick Couture ◽  
...  

Increased blood pressure (BP), vascular dysfunction and inflammation are involved in the etiology of cardiovascular disease (CVD). Although several dietary components such as polyphenols and L-citrulline may help to control BP, their combined impact on ambulatory BP in individuals at risk of CVD remains unknown. The objective of this research was to investigate the short-term impact of supplementation with a combination of polyphenol extract and L-citrulline on ambulatory BP, endothelial function and inflammation. In a randomized double-blind parallel trial, 73 men and women with prehypertension were supplemented with a placebo (cellulose, n = 34, Plac) or 548 mg/day of polyphenols and 2 g/day of L-citrulline (n = 35, Suppl) for 6 weeks. The primary outcome of this study was the difference between groups in 24-h ambulatory diastolic BP (DBP) at week six. Secondary outcomes were a difference between groups at week six in ambulatory systolic BP (SBP), casual BP, serum lipids and high-sensitivity C-reactive protein (hs-CRP) concentrations and skin advanced glycation end products (AGEs). Potential interaction of treatment with sex was examined. Suppl had no impact on mean ambulatory SBP and DBP (p > 0.10 vs. placebo). Daytime and 24-h SBP were reduced with Suppl in women (p ≤ 0.01), but not in men (p ≥ 0.27). A non-significant reduction in AGEs was observed after Suppl compared to Plac among all participants (p = 0.07) and there was no difference in the concentrations of blood lipids (p > 0.20) or CRP (p = 0.36) between treatments at week six. Therefore, supplementation with polyphenol extract and L-citrulline for 6 weeks has no impact on ambulatory BP, blood lipids and CRP in adults with prehypertension. However, the polyphenol extract/L-citrulline supplement may reduce ambulatory SBP in women, but not in men. These preliminary results need further research efforts towards further documenting this sex-dependent BP response to supplementation with polyphenols and L-citrulline.


Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 721
Author(s):  
Tannaz Jamialahmadi ◽  
Mohsen Nematy ◽  
Simona Bo ◽  
Valentina Ponzo ◽  
Ali Jangjoo ◽  
...  

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.


2013 ◽  
Vol 5 (3) ◽  
pp. 527-533
Author(s):  
Y. Rasmi ◽  
M. H. Seyed-Mohammadzad ◽  
S. Raeisi

Cytotoxin-associated gene A (CagA) may induce a persistent systemic inflammatory response in cardiac syndrome X (CSX). We aimed to evaluate relationship of CagA status and high sensitivity C-reactive protein (hs-CRP) in CSX patients. Sixty CSX patients and 60 gender matched controls were enrolled. Plasma samples were tested in terms of the presence of IgG antibody to Helicobacterpylori (anti-H. pylori) and CagA (anti-CagA) using ELISA method. Also, plasma level of hs-CRP was measured by ELISA method. CSX patients were detected to have significantly higher plasma hs-CRP level in comparison with the control ones (3.64 ± 3.07 vs. 0.54 ± 0.49, µg/ml, P = 0.0001). Plasma levels of hs-CRP in CSX patients with anti-CagA+ were significantly higher than those in anti-CagA(-) (CSX: 4.66±3.63 vs. 2.58±1.95 µg/ml, P = 0.011). Also, plasma levels of hs-CRP in the controls with anti-CagA+ were significantly higher than those in anti-CagA- (1.05±0.68 vs. 0.32±0.31 µg/ml, respectively, P = 0.004). The present data suggested that CagA status was probably associated with susceptibility to severe CSX by causing inflammation. The evidence for this hypothesis indicated that levels of hs-CRP increased in anti-CagA+ patients compared to the anti-CagA- ones. Keywords: Cardiac syndrome X; Helicobacter pylori; Inflammation ; hs-CRP, Cytotoxin-associated gene A. © 2013 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v5i3.14171 J. Sci. Res. 5 (3), 527-533 (2013)


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