Tesis

Efek Zink terhadap Aktivitas Penyakit Inflammatory Bowel Disease : Kajian Sistematis = Zink Effect on Inflammatory Bowel Disease Activity : Systematic Review.

Latar Belakang/Tujuan: Pasien IBD berisiko terjadi defisiensi Zink. Sedangkan Zink memiliki peran dalam menstimulasi sistem imun, regenerasi sel, dan berperan sebagai koenzim yang berperan sebagai antioksidan. Pemberian suplementasi Zink diharapkan dapat menurunkan aktivitas penyakit dan meningkatkan aktivitsas antioksidan. Metode: Penelitian ini merupakan kajian sistematis dan meta-analisis. Pencarian literatur dilakukan sampai desember 2020 dengan mencari pada tiga database yaitu Cochrane central, Pubmed, dan Embase. Berdasarkan kriterian eligibilats didapatkan 9 artikel yang menilai efek Zink terhadap aktivitas penyakit IBD. Aktivitas penyakit dinilai berdasarkan skor CDAI dan skor Mayo, serta aktivitas enzim SOD. Hasil: Sebanyak 9 studi didapat dari pencarian, dilakukan analisis kualitatif dan kuantitatif. Meta-analisis dilakukan dengan membagi menjadi 3 subgrup, yaitu Zink terhadap aktivitas penyakit IBD, Zink terhadap aktivitas enzim SOD, serta aktivitas penyakit sebelum dan sesudah pemberian. Empat studi menilai efek Zink terhadap aktivitas penyakit menunjukkan tidak terdapat penutunan aktivitas penyakit IBD, dua studi menilai efek Zink terhadap aktivitas SOD menunjukkan tidak terdapat peningkatan aktivitas SOD, dua studi menilai efek Zink terhadap ekspresi metalotinonin datu studi menunjukkan peningkatan dan satu studi tidak menunjukkan peningkatan. Tiga studi pre dan post dari dua studi menunjukkan tidak terdapat penurunan aktivitas penyakit dan 1 studi menunjukkan penurunan aktivitas jika diberikan jangka panjang. Simpulan: Tidak didapatkan perbedaan aktivitas penyakit, aktivitas SOD, aktivitas metalotionin dengan suplementasi Zink jangka pendek, suplementasi jangka panjang dapat menurunkan aktivitas penyakit IBD
Kata Kunci: Zink, IBD, disease activity, SOD, metalotionin


Background/Aim: IBD patients are at risk of Zinc deficiency. Zinc has a role in stimulating the immune system, cell regeneration, and as a coenzyme acts as an antioxidant. Zinc supplementation will decrease disease activity and increase antioxidant activity. Method: This research is a systematic review and meta-analysis. Literature searches are conducted until December 2020, we searched in three databases Cochrane central, Pubmed, and Embase. Based on eligibility criteria, there are 9 articles evaluate effect of Zinc on disease activity of IBD. Disease activity is assessed based on CDAI score and Mayo score, as well as SOD enzyme activity. Result: We identified 9 studies, Of all the potentially relevant papers, 9 studies were identified. All of the studies were assessed for risk of bias along with qualitative analysis. Pre-specified outcomes were Zinc and disease activity, Zinc and SOD activity, metallothionine expression as well as disease activity before and after administration. Four studies evaluated effect of Zinc on disease activity showed no improvement in IBD disease activity, two studies evaluated effect of Zinc on SOD activity showed no increase in SOD activity, two studies evaluated effect of Zinc on metalotinonin expression, one study showed increase of expression and the other had no increase. There are 3 pre and post studies from two studies showed no decrease in disease activity and 1 study showed a decrease in activity if supplemented for long term. Conclusion: The results of the systematic review revealed there were no difference in disease activity, SOD and methalotionen activity with short term Zinc supplementation, long term supplementation decrease disease activity of IBD
Keywords: Zink, IBD, disease activity, SOD, MT