Pengaruh Kadar Interleukin-10 Serum Dengan Penyakit Perlemakan Hati Non Alkoholik

Abstract

Background. In NAFLD there is an inflammatory process due to lipotoxicity resulting in macrophage balance imbalance in the liver. Impaired balance of liver macrophages causes IL-10 production is decline, whereas the function of IL-10 is to repair hepatocellular damage. Through this research, we will study the role of cytokines, especially IL-10 as anti-inflammatory cytokines and laboratory abnormalities, especially liver enzymes and lipid profiles in relation to the pathogenesis and development of NAFLD so that it can be a non-invasive parameter to assess NAFLD severity. Aim. To determine association of serum Interleukin 10 level with Non-alcoholic Fatty Liver Disease. Methods. Cross-sectional study of 30 consecutive NAFLD patients who came to Adam Malik General Hospital Medan,, from May to July 2018. NAFLD was diagnosed by abdominal ultrasound. Blood glucose, total cholesterol, triglycerides, high- and low-density lipoproteins, parameters of liver function, and IL-10 were measured in each subject. Univariate analysis, Bivariate analysis (Mann-Whitney test and Spearman test) with SPSS version 20. Results. In comparison with control group, patients with NAFLD showed increased fasting blood sugar levels (160 vs 99 mg / dl), AST levels (27.1 vs 20.2 U/L), ALT levels (31.5 vs 19.3 U / L), Total Cholesterol (259 vs 174 mg / dL), Triglycerides (175 vs 122 mg / dL), LDL (180 vs 88 mg / dL) while HDL levels were lower in NAFLD than controls (40 vs 61 mg / dL). Serum IL-10 levels were lower in the NAFLD group than controls (0.71 vs 1.45 pg / ml, p <0.001). There is a negative correlation between IL-10 and AST (r = -0.57, p <0.001), ALT (r = -0.52, p = 0.002), Triglycerides (r = -0.62, p <0.001) and LDL (r = -0.66, p <0.001)) and there is a positive correlation between IL-10 levels and HDL (r = 0.48, p = 0.004) Conclusion. There was a significant difference between serum IL-10 levels in NAFLD patients compared to controls

Latar Belakang: Pada NAFLD terjadi proses inflamasi akibat lipotoksisitas sehingga terjadi gangguan keseimbangan makrofag hati. Gangguan keseimbangan makrofag hati menyebabkan produksi IL-10 menurun, padahal fungsi IL-10 adalah untuk memperbaiki kerusakan hepatoseluler. Melalui penelitian ini diharapkan dapat memberi gambaran peran sitokin terutama IL-10 sebagai sitokin anti-inflamasi dan kelainan laboratorium terutama enzim hati dan profil lipid dalam hubungannya dengan patogenesis dan perkembangan NAFLD sehingga dapat menjadi parameter non invasif untuk menilai tingkat keparahan NAFLD. Tujuan: Mengetahui perbedaan kadar IL-10 serum pada pasien NAFLD dibandingkan kontrol. Metode: Penelitian cross-sectional ini dilakukan di RSUP H. Adam Malik Medan pada bulan Mei hingga Juli tahun 2018 terhadap 30 pasien NAFLD dan 30 kontrol. Dilakukan pemeriksaan USG abdomen, pemeriksaan IL-10 serum, AST , ALT, Kadar Gula darah dan Profil lipid. Analisa univariat, bivariate (Mann-Whitney test dan uji Spearman) menggunakan SPSS versi 20. Hasil Penelitian: Jika dibandingkan dengan kelompok kontrol, pada pasien NAFLD ditemukan kadar gula darah puasa yang lebih tinggi (160 vs 99 mg/dl), kadar AST ( 27,1 vs 20,2 U/L), kadar ALT ( 31,5 vs 19,3 U/L), Kolesterol Total (259 vs 174 mg/dL), Trigliserida (175 vs 122 mg/dL), LDL (180 vs 88 mg/dL) sedangkan kadar HDL lebih rendah pada NAFLD dibanding kontrol (40 vs 61 mg/dL). Kadar IL-10 serum lebih rendah pada kelompok NAFLD dibanding kontrol ( 0,71 vs 1,45 pg/ml, p < 0,001). Terdapat korelasi negatif antara IL-10 dengan AST (r= -0,57, p<0,001), ALT (r= -0,52, p=0,002), Trigliserida (r= -0,62, p<0,001) dan LDL (r= -0,66, p <0,001)) dan terdapat korelasi positif antara kadar IL-10 dengan HDL (r= 0,48, p=0,004) Kesimpulan: Terdapat perbedaan yang signifikan antara kadar IL-10 serum pada pasien NAFLD dibandingkan kontrol.