Keefektifan ekstra putih telur terhadap peningkatan albumin dan penurunan IL-1β pada pasien tuberkulosis dengan hipoalbuminemia

Agus Prastowo; Wiryatun Lestariana; Siti Nurdjanah; Retno Sutomo

doi:10.22146/ijcn.18857

Keefektifan ekstra putih telur terhadap peningkatan albumin dan penurunan IL-1β pada pasien tuberkulosis dengan hipoalbuminemia

https://doi.org/10.22146/ijcn.18857

Agus Prastowo^(1*), Wiryatun Lestariana⁽²⁾, Siti Nurdjanah⁽³⁾, Retno Sutomo⁽⁴⁾

(1) Fakultas Kedokteran, Universitas Jenderal Soedirman Purwokerto
(2) Bagian Biokimia, Fakultas Kedokteran Universitas Gadjah Mada
(3) Bagian Penyakit Dalam, Fakultas Kedokteran Universitas Gadjah Mada
(4) Bagian Anak, Fakultas Kedokteran Universitas Gadjah Mada
(*) Corresponding Author

Abstract

Background: Tuberculosis (TB) is world health problem which still needs attention. Recently, Indonesia ranks the third in TB prevalence after India and China. Research revealed that albumin decreases significantly in TB patients, due to lack of nutritious intakes such as low-calorie intake, anorexia, increased catabolism, enteropathy and acute protein reaction. Low albumin was associated with increased IL-1β and cytokines inflammation in TB patient. Albumin had a very important role in the body and white egg known as a good quality source of protein.

Objective: To assess the effect of white egg supplementation in TB patient towards the level of albumin and the level of IL-1β.

Method: A single-blind randomized controlled trial was conducted with 75 patient selected for the study and divided to 37 patient as the study group and 38 as a control group. Both groups received high energy high protein diet, while the study group received, additionally, an oral egg white-based on formula calculation Baxter for 14 days. Control group received, additionally, an extra soybean curd and mungbean powder. Albumin and IL-1β were checked before and after the intervention. Data is analyzed by using Mann-Whitney.

Results: Research results show that average albumin pre-intervention in the study group was 2.82 g/dL and control group was 2.85 g/dL. Average albumin difference in the study group was 3.47 g/dL and control group was 2.81 g/dL. Bivariate analysis results show significant of increasing albumin between study group and control group (p<0.05). Research results show average IL-1β pre-intervention difference in study group (0.9 pg/mL) and control group (0.67 pg/mL). The average IL-1β difference in the study group was -0.39 pg/mL and control group was 0.76 pg/mL. Bivariate analysis results show a significant difference of IL-1β depletion between study group and control group (p<0.05).

Conclusion: Egg white increase albumin level and IL-1β depletion in tuberculosis patients effectively.

Keywords

egg white; albumin; IL-1β; tuberculosis patients

Full Text:

PDF

References

PDPI. Tuberkulosis: pedoman diagnosis dan penatalaksanaan di Indonesia. Jakarta: Penerbit FKUI; 2002.

Adedapo KS, Arinola OG, Adedapo ADA, Ige OM, Salimonu LS. Combination of reduced leves of serum albumin and alpha-2-macroglobulin differentiates newly diagnosed pulmonary tuberkulosis patients from patients on chemotherapy. African Journal of Biomedical Research 2006;9(3):169-72.

Moses AO, Emmanuel OO, Ganiyu AO, Fidelis AA, Dickson AO. Assessment of antioxidants and nutritional status of pulmonary tuberculosis patients in Nigeria. Eur J Gen Med 2008;5(4):208-11.

Ramakrishnan K, Shenbagarathai R, Kavitha K, Uma A, Balasubramaniam R, Thirumalaikolundusubramanian P. Serum zinc and albumin levels in pulmonary tuberkulosis patients with and without HIV. Jpn J Infect Dis 2008;61(3):202-4.

Ascenzi P, Bolli A, Masi A, Tundo GR, Fanali G, Coletta M, Fasano M. Isoniazid and rifampicin inhibit allosterically heme binding to albumin and peroxynitrite isomerization by heme-albumin. J Biol Inorg Chem 2010;16(1):97-108.

Lovering, Mcgowan. A comparative study of the rifampicin binding and elution characteristics for collagen and albumin sealed vascular grafts. UK: Department of Medical; 1998.

Brenner DA, Buck M, Feitelberg SP, Chojkier M. Tumor necrosis factor alpha inhibits albumin gene expression in murine model of cachexia. J Clin Invest 1990;85(1):248-55.

Karyadi E, Dolmans WM, West CE, Van Crevel R, Nelwan RH, Amin Z, Gross R, Van der Ven-Jongekrijg J, Van der Meer JW. Cytokines related to nutritional status in patients with untreated pulmonary tuberkulosis in Indonesia. Asia Pac J Clin Nutr 2007;16(2):218-26.

PERSAGI. Tabel komposisi pangan Indonesia. Jakarta: Elex Media Komputindo; 2008.

González-Espinoza L, Gutiérrez-Chávez J, del Campo FM, Martínez-Ramírez HR, Cortés-Sanabria L, Rojas-Campos E, Cueto-Manzano AM. Randomized, open label, controlled clinical trial of oral administration of an egg albumin-based protein suplement to patients on continous ambulatory peritoneal dialysis. Perit Dial Int 2005;25(2):173-80.

Sjamsuhidajat R, Jong W. Buku ajar ilmu bedah. Jakarta: EGC; 2004.

Lameshow. Adequacy of sample size in sample size in health studies. New York: Jhon wiley and Sons, Inc; 1990.

Saryono, Prastowo A, Mekar D. Perbedaan kadar albumin plasma pada pasien sebelum dan sesudah menjalani rawat inap di RSUD Margono Soekardjo. The Soedirman Journal of Nursing 2006;1:1-5.

Lassen KO, Olsen J, Grinderslev E, Kruse F, Bjerrum M. Nutritional care of medical in patients: a health technology assessment. BMC Health Serv Res 2006;6:7.

Pichard C, Kyle UG, Morabia A, Perrier A, Vermeulen B, Unger P. Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay. Am J Clin Nutr 2004;79(4):613-8.

Thalacker-Mercer AE, Johnson CA, Yarasheski KE, Carnell NS, Campbell WW. Nutrient ingestion, protein intake, and sex, but not age, affect the albumin synthesis rate in humans. J Nutr 2007;137(7):1734-40.

Krause 3rd. Mahan LK, Escott-Stump S. editors. Food nutrition and diet therapy. 11nd ed. USA: Elsevier; 2004.

Kennedy N, Ramsay A, Uiso L, Gutmann J, Ngowi FI, Gillespie SH. Nutritonal status and weight gain in patients with pulmonary tuberkulosis in Tanzania. Trans R Soc Trop Med Hyg 1996;90(2):162-6.

Boirie Y, Gachon P, Cordat N, Ritz P, Beaufrère B. Differential insulin sensitivities of glucose, amino acid, and albumin metabolism in elderly men and women. J Clin Endocrinol Metab 2001;86(2):638-44.

Garay SM. In: Rom W, Garay SM, editors. Pulmonary tuberculosis, tuberculosis. Ed 2. Philadelpia USA: Lippincot Williams & Wilkins; 2004.

Depkes. Daftar komposisi bahan makanan: putih telur ditinjau dari kandungan proteinnya. Jakarta: PT Rineka Cipta; 2005.

Kemenkes & Kementan. Tanya jawab seputar telur sumber makanan bergizi. Jakarta: Kemenkes RI; 2010.

Rumanoff AL. The avian egg. 2nd. New York: Jhon Wiley and Sons Inc; 1963.

Guyton AC, Hall JE. Buku ajar fisiologi kedokteran. Jakarta: EGC; 2004.

Moses AO, Emmanuel OO, Ganiyu AO, Fidelis AA, Dickson AO. Assessment of antioxidants and nutritional status of pulmonary tuberculosis patients in Nigeria. Eur J Gen Med 2008;5(4):208-11.

Wu TW, Wu J, Li RK, Mickle D, Carey D. Albumin bound bilirubin protects human ventricular miocytes against oxyradical damage. Biochem Cell Biol 1991;69(10-11):683-8.

Peters JT. All about albumin. biochemstry, genetics, and medical application. New York: Academic Press; 1996

DOI: https://doi.org/10.22146/ijcn.18857