Value of Inflammation Marker in Patients with Intercritical Gout Arthritis

Writer : Endy Adnan
(supervised by Edu S Tehupeiory)

Background. Intercritical gout arthritis is an acute gout in intermittent period, caused by inflammation process neither with tofus. Inflammation is a complex mechanism among pathogenic agents, parenchymal cell, tissue and blood vessels either with plasma or blood cellular. Inflammation induced by uric crystal in the joint is a patomechanismin gout arthritis and than activated and release celluler, humoral or complement mediators. The aim of this study to investigatigate the value of leucocyte, ESR, CRP, C3 components and C4 components in intercritical gout arthritis.
Subject and Method. This is an observational study with case control approach conducted in 20 subjects with intercritical gout arthritis (case) and 20 with asymptomatic hyperuricemia (control). Eclusioc criteria were rheumatoid arthritis, septic arthritis, psoriatic arthritis, osteoarthritis, chronic infection disease, and history of trauma, diagnosed as anemia, chronic kidney disease, malignancies, during consumption diuretics or AINS.
Result. We found mean age 54,93 year old, uric acid 9,445 mg/dl, 5 with positif CRP. Mean value of leucocyte both case and control were 9988,25 +- 2819,936 / mm3 vs 9540,5 +- 2333,656 / mm3 (p=0,153). No correlation between intercritial gout arthritis and the higher value of leucocyte (p=0,11), (OR 1.625; Cl 0.869-3.038). Mean value of ESR were 58,70 +- 12,650 vs 36,75 +- 7,587212 (p=0.343) and the statistical correlation between value of C4 and intercrtitical gout arthritis was uncalculated because of invariant data.
Conclusion. The higher value of ESR and CRP were correlated in intercritical gout arthritis comparing with asymtomatic hyperuricemia, while leucocyte, C3 and C4 were not correlated.

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Association Between C-Reactive Protein Level and Components of the Metabolic Syndrome

Writer : Daniel Josten
(supervised by John M.F. Adam)

Association between C-reactive protein, a sensitive marker for inlammation, and the development of atherosclerosis disease had been observed in experimental and epidemological studies. Interest in CRP was increased along with problem of metabolic syndrome because basically all components of metabolic syndrome were inflammation process. In Indonesia, the same study was so limited, eventhough according to WHO prevelance of obesity was increased in developing countries so do in developed countries wich will increase the metabolic syndrome population. The aim of this study is to know association between CRP level and components of metabolic syndrome. We studied 138 apparently health subjects aged 35-65 years old whoparticipated in the East Indonesia Diabetes Epidemiology Group (EIDEG) in November 2005 until January 2007. Method in this study was observational study with cross sectional approach. Anamnesis and complete physical examintaion was performed to all subjects included blood pressure and waist circumference. After 12-h fasting, blood was taken for fasting plasma glucose (FPG), HDL-cholesterol, triglyseride and C-reactive protein (CRP). For the diagnosis of Mets we used criteria defined by the International Diabetes Federation (IDF) 2005. The result of this study showed there were a statistically significant positive correlation between CRP and waist circumference (r=0.1), TG (r=0.3), FPG (r=0.2), blood pressure (r=0.3) (all p<0.05). A negative correlation was found between CRP and HDL cholesterol (r=0.3) (p=0.02). Mean CRP levelth 0 components of the metabolic syndrome were 1.04, 1.52, 3.15, 4.21, 4.65, and 6.33 mg/l respectively (r=0.54, p <0.0001). From this study we concluded that CRP leel were associated with components of metabolic syndrome.

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The Relation Between Components of Metabolic Syndrome with Plasminogen Activator Inhibitor-1

Writer :Himawan Dharmayani Sanusi

(supervised by John MF Adam, A. Fachruddin Benyamin)

Plasminogen activator inhibitor-1 is an acute phase protein that regulate fibrinolysis from hemostatic process and plays an important role in the pathogenesis of atherothrombosis. Subject with metabolic syndrome are high risk of cardiovascular complication. The aim of this study is to find out of relation between PAI-1 and the component of metabolic syondrome. In this study, we enrolled subject of age varied from 30 – 65 years. Those with diabetes mellitus, and clinical cardiovascular complications were excluded. History taking and complete physical examinations were performed to all subject. After 12 hour fasting,blood was taken for the examinations of fasting HDL –cholestrol ,triglyceride fasting flasma glucose and PAI -1.PAI -1 was measured by sensitive enzyme immunoassay technique for the diagnosis of metabolic syndrome, the AHA/NHLBI guideline was used with the modification of waist circumeference fro Asian population.Statistical analysis using SPSS 12 for windows.

During the study,183 subjects can be covered , 41% males and 59 % females. PAI – 1 levels was statistical significant higner among patients with metabolic syndrome compared to normal subjects,18.01 ± 9.33 mlU/ml and 4.33± 4.83 mlU/ml subsequently [ P= 0.000 ] . there was significant positive correlation between fasting hyperglycemia , triglycerides,waist circumference,blood pressure with increased of PAI – 1 and significant negatife correlation between HDL – chosterol with increased levels of PAI – 1 [p<> 7 IU /ml as a high level,statistical analysis showed that subjects with high trigly cerydes had the higner risk for hig PAI – 1 activity compared to correlation between the componenst of metabolic syndrome with the increasing of PAI – 1 levels, being the highest among those with five components .[r =0.828 and p=0.000]

In conclusion , there was a corelation between the components of metabolic syndrome and levels of plasminogen activator inhibitor – 1 those with hypetriglycerides had the highest risk to have high levels of plasminogen activator inhibitor – 1.

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