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"Kelainan kardiovaskular merupakan komplikasi dan penyebab kematian terbanyak pada anak penyakit ginjal kronik (PGK). Hepsidin adalah protein berperan dalam homeostasis besi yang berkontribusi dalam patogenesis anemia penyakit kronik. Penelitian sebelumnya menunjukkan hubungan hepsidin dan kelainan kardiovaskular pada pasien PGK dewasa, tetapi belum ada pada anak PGK. Penelitian ini bertujuan untuk menilai korelasi hepsidin dan kelainan kardiovaskular pada anak PGK. Penelitian dengan metode potong lintang dilakukan pada anak PGK stadium 3–5 yang berusia 2–18 tahun di rumah sakit Cipto Mangunkusumo (RSCM). Ekokardiografi menilai left ventricular mass index (LVMI), relative wall thickness (RWT), fungsi sistolik, diastolik, dan peningkatan carotid intima media thickness (cIMT). Kadar hepsidin diperiksa dengan menggunakan ELISA (enzyme-linked immunosorbent assay). Penelitian ini melibatkan 78 anak dengan PGK stadium 3–5. Penelitian ini menunjukkan korelasi hepsidin Q2 dan LVMI bermakna [adjusted b 0,37 (95% IK 0,08–0,65); p = 0,011] dan hepsidin Q4 terhadap LVMI [adjusted b 0,31 (95% IK 0,02–0,60); p = 0,036] pada analisis multivariat regresi linear. Korelasi bermakna antara hepsidin dan MV E/A yaitu kadar hepsidin Q2 [Crude b -0,16 (95% IK -0,29 – -0,02); p = 0,024] juga ditemukan. Tidak ada korelasi hepsidin dan fungsi sistolik serta peningkatan cIMT. Penelitian ini merupakan penelitian awal dan membutuhkan penelitian prospektif selanjutnya untuk dapat memastikan hubungan hepsidin dan kelainan kardiovaskular.

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Cardiovascular disease (CVD) is a common complication and an important cause of mortality in children with chronic kidney disease (CKD). Hepcidin is a protein that regulates iron metabolism and has been closely linked with the pathogenesis of anemia in chronic disease. Recent studies have shown a substantial association of hepcidin and CVD in adults with CKD, however this association has not been studied in children. This study aimed to investigate the correlation of hepcidin and CVD in children with chronic kidney disease. This was a cross sectional study that involved children aged 2–18 years with CKD in Cipto Mangunkusumo Hospital. Echocardiography was performed to describe LVMI, RWT, systolic and diastolic function as well as increase cIMT. Plasma hepcidin was obtained and analysed using ELISA (enzyme-linked immunosorbent assay). This study involved 78 patients with CKD stage 3–5. The study showed a positive correlation of hepcidin Q2 and LVMI [adjusted b 0,37 (95% IK 0,08–0,65); p=0,011] as well as hepsidin Q4 and LVMI [adjusted b 0,31 (95% IK 0,02–0,60); p = 0,036] in the multivariate linear regression analysis. A correlation of hepcidin Q2 and MV E/A [Crude b -0.16 (95% IK -0.29 – -0.02); p = 0.024] was also observed. We did not find any correlation of hepcidin and systolic function as well as increased cIMT. Our study needs further prospective cohort studies to confirm our results."

"ABSTRAKThalassemia patients who undergo life-long recurrent blood transfusion will experience iron overload in various organs including the liver and possibly suffer from chronic hepatitis C infection which may lead to liver impairment. The liver produces hepcidin, a hormone which plays role in the regulation of iron level in the blood. Various factors may influence hepcidin level in the blood. Chronic hepatitis C causes iron overload and liver impairment. Liver impairment and haemolytic anaemia due to haemoglobinopathy will suppress hepcidin production. Anaemia stimulates growth differentiation factor 15 (GDF-15) to increase erythropoiesis and suppress hepcidin production. Iron overload causes increase in hepcidin level. Presence of factors which decrease or increase hepcidin production will express various levels of hepcidin. This study aimed to identify the expression of hepcidin and GDF-15 levels in thalassemia patients with iron overload and positive anti-HCV. Information on hepcidin and GDF-15 levels are beneficial in the management of iron overload in thalassemia with positive anti-HCV.Method: This study was a descriptive analytic study in thalassemia patients who had received recurrent blood transfusion ≥ 12 times, suffered from iron overload (transferrin saturation > 55% and ferritin > 1,000 ng/mL), which consisted of 31 individuals with positive anti-HCV and 27 individuals with negative anti-HCV. This study was performed in Thalassemia Centre Department of Child Health and Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, in October 2011–January 2012. Serum hepcidin and GDF-15 examinations were performed using enzyme-linked immunosorbent assay (ELISA) method. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) examinations were performed using colorimetry method. Data on ferritin and transferrin saturation were obtained from medical records in the last 3 months. Data was analysed using SPSS Windows version 17 software.Results: Characteristics of subjects in this study included ferritin level, transferrin saturation, AST, and ALT were 5,289 (SD 2,492) ng/mL, 96.7 (SD 9.2)%, 41.8 (SD 26.7) U/L, and 50.6 (24.9) U/L, respectively. It was obtained that the hepcidin levels were within the normal limits with median of 51.5 (19-166) pg/mL, while GDF-15 levels were higher than the normal range with median of 1,936 (643-2,475) pg/mL. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV groups, with p value of 0.842 and 0.115, respectively.Conclusion: We obtained that the hepcidin levels were within normal limits and GDF-15 levels were higher than the normal range. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV group."