Korelasi Kadar Vitamin D, dengan TNF-α dan Manifestasi Klinis pada Pasien Artritis Rematoid
DOI:
https://doi.org/10.21776/ub.jkb.2014.028.01.7Abstract
Artritis rematoid (AR) adalah penyakit autoimun yang ditandai dengan sinovitis erosif simetrik, diawali dengan  aktivasi sel T dependent antigen yang akan mencetuskan respon imun, terutama tipe Th1. Tumor necrosis factor (TNF-α) adalah sitokin sentral pada patogenesis AR.  Diketahui bahwa defisiensi vitamin D berkaitan dengan eksaserbasi respon imun Th1. Penelitian ini bertujuan untuk mengetahui korelasi kadar vitamin D dengan kadar TNF- α, beratnya aktivitas penyakit pada pasien rematoid artritis. Penelitian cross sectional dilakukan pada pasien rawat jalan yang memenuhi kriteria inklusi sebanyak 24 pasien, kriteria diagnosis ditegakkan menurutkriteria ACR/EULAR 2010. Vitamin D dalam darah  dan TNF-α  diukur dengan metode ELISA, beratnya manifestasi klinis penyakit AR dinilai dengan score DAS28, VAS, dan skala fungsional. Sebesar 45,8% pasien mengalami defisiensi  vitamin D (36,13 ng/ml). Gangguan fungsional terbanyak adalah kelas I (66,6%). Terdapat korelasi yang bermakna antara vitamin D dengan usia pasien (p=0,005, r=-0,553), dengan lama sakit (p=0,009, r=-0,522), dengan DAS 28 (p=0,001, r=-0,615), banyaknya sendi yang sakit (p=<0,001, r=-0,733), dan sendi yang bengkak (p=0,045, r=-0,413), VAS pasien (p=0,006, r=-0,541) serta dengan kadar TNF  (p=0,048, r=-0,408) dan status fungsional pasien (p=0,039, r=-0,424). Hasil membuktikan bahwa kadar vitamin D dalam darah mempunyai hubungan dengan manifestasi klinis AR dan kadar TNF
Kata Kunci: Artritis rematoid, DAS 28, CRP, TNF VAS, vitamin D
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