Ability of curcuminoid compared to diclofenac sodium in reducing the secretion of cycloxygenase-2 enzyme by synovial fluid's monocytes of patients with osteoarthritis.

AIM: to assess the ability of curcuminoid from Curcuma domestica Val in reducing the cycloxygenase-2 secretion by synovial fluid's monocytes compared to diclofenac sodium in patients with osteoarthritis. METHODS: this was a prospective randomized open end blinded evaluation (PROBE) study. The subjects were patients with knee osteoarthritis who were divided randomly into two groups, the first group received 30 mg 3 times daily of curcuminoid and the second group received 25 mg 3 times daily of diclofenac sodium. The joints aspiration was done and the secretion of cycloxygenase-2 enzyme by synovial fluid's monocytes was evaluated by scoring method before and after 4 weeks of treatments. RESULTS: a total of 80 patients with knee osteoarthritis were enrolled. In curcuminoid group the average scores were 1.84±0.37 and 1.15±0.28 respectively (p<0.001). In diclofenac group the average scores were 1.79±0.38 and 1.12±0.27 respectively (p<0.001). In curcuminoid group the decreasing score of cycloxygenase-2 secretion was 0.70±0.51 while in diclofenac group was 0.67±0.45. There was no significant difference in decreasing the score of cycloxygenase enzyme secretion between both treatment groups (p=0.89). CONCLUSION: the ability of curcuminoid from Curcuma domestica Val. rhizome extract was not significantly different compared to diclofenac sodium in suppressing the secretion of cycloxygenase-2 enzyme by synovial fluid's monocytes.

The difference between mean plasma levels of von Willebrand factor and platelet aggregation in type 2 diabetes mellitus with and without peripheral vascular disease at Sardjito General Hospital, Yogyakarta.

AIM: To determine the differences in mean plasma values of von Willebrand factor and platelet aggregation in type 2 DM patient with or without peripheral arterial disease. METHODS: This is a cross-sectional study, conducted from August to December 2006, in Dr. Sardjito General Hospital Yogyakarta, on type 2 DM patients, aged 50 years and above, and signed the informed consent. The exclusion criteria are cardiac failure, renal insufficiency (creatinine clearance <30 ml/minute), malignancy, acute disease, decrease hepatic function, having ulcer or DM gangrene, amputation, taking multivitamine and/or antiplatelet, and smoking. All samples that matched inclusion criteria were divided into 2 groups: with peripheral arterial disease and without peripheral arterial disease. The data of subjects are presented as mean and standard deviation and proportion. Variables with numeric data are analized with the student t-test for normal distribution and with Mann-Whitney U-test for abnormal distribution. Significancy limit was set at p value of <0,05. Statistical analysis was done by using SPSS 11.5 software. RESULTS: There were 17 subjects having PVD. There were no significantly differences of mean vWF plasma levels (140.544 + 76,137% vs. 133.325 + 53,246%) and platelet aggregation (87.741 + 19.886% vs. 93.981 + 10.138%) between type 2 DM with and without PVD (p >0.05). CONCLUSION: There were no statistically difference in mean vWF plasma levels and platelet aggregation between type 2 diabetes mellitus with and without PVD.

Hypoadiponectinemia: a risk factor for metabolic syndrome.

AIM: To find out correlation between plasma adiponectin levels, insulin resistance and IDF criteria of Mets Patients. METHODS: A case-control study was conducted on Native Javanese people from June 2006 to January 2007 in Outpatients Clinic of Dr Sardjito Hospital. The case group involved patients aged between 20 to 55 years old. The diagnosis of metabolic syndrome was confirmed according to IDF criteria. Patients without metabolic syndrome with matching age and sex,were taken as control group. RESULTS: there were significant differences between case and control group for BMI (body mass index) (30.2 +/- 4.1 vs 26.9 +/- 4.7 kg/m2), waist circumference (93.5 +/- 7.9 vs 84.4 +/- 11.5 cm), triglyceride (207.4 +/- 101.8 vs. 119.3 +/- 71.5 mg/dL) , HDL cholesterol (48.6 +/- 9.4 vs. 59.9 +/- 11.8m g/dL), systolic blood pressure (132.8 +/- 17.9 mmHg vs 120.6 +/- 13.5 mmHg) and diastolic blood pressure (83.8 +/- 8.5 mmHg vs. 79.4 +/- 10.7), fasting blood glucose (128.3 +/- 40.8 mg/dL vs. 100.7 +/- 29.4 mg/dL), HOMA index (6.7 +/- 17.4 vs. 2.0 +/- 2.0) and adiponectin levels (3.8 +/- 1.4 vs. 5.9 +/- 2.5), respectively. For metabolic syndrome, hypoadiponectinemia showed the OR value of 6.0 (95% CI 2.13 to 16.98); insulin resistance showed the OR value of 5.7 (95% CI 1.3 to 25.02), after adjustment for waist circumference, TG, HLD, blood pressure, fasting blood glucose. CONCLUSION: Hypoadiponectinemia and insulin resistance represent independent risk factors for metabolic syndrome development.

Fibrinogen and plasminogen activator inhibitor-1 level in peripheral arterial disease of type 2 diabetes patients.

AIM: To determine association of fibrinogen and plasminogen activator inhibitor-1 with peripheral arterial disease (PAD) in type 2 diabetes patients. METHODS: This is a cross-sectional study with 52 type 2 diabetes patients of 41-74 years old. The subjects were divided into two groups, those who were diagnosed with PAD (16) and without PAD (36). Diagnosis of PAD was based on the ankle brachial index (ABI) measurement. Fibrinogen and plasminogen activator inhibitor-1 (PAI-1) level were evaluated as hemostatic factors. The two groups were compared for age, sex, smoking, plasma fasting glucose, total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride concentrations, diabetes duration, systolic blood pressure and diastolic blood pressure level. Statistical analyse were conducted to check the significance of differences between variables in the two groups as well as interrelationship between hemostatic factors and other parameters. RESULTS: Fibrinogen was similar in both group (402.42 +/- 74.44 mg/dl in PAD group and 322.45 +/- 101.05 mg/dl in non-PAD group) (p= 0.259). PAI-1 was also similar in both group (8.93 +/- 11.02 IU/ml in PAD group and 7.06 +/- 7.32 IU/ml in non-PAD group) (p=0.721). Hyperfibrinogenemia was more prevalent in PAD group (68.8%) than in non-PAD group (25%) (p= 0.005). CONCLUSION: Our data showed that fibrinogen and PAI-1 level were similar in both groups. As a risk factor hyperfibrinogenemia was more prevalent in PAD group.

Microalbuminuria prevalence study in hypertensive patients with type 2 diabetes in Indonesia.

AIM: To assess the prevalence of macroalbuminuria and microalbuminuria in hypertensive patients with type 2 diabetes in 10 Asian countries. METHODS: This cross-sectional clinic-based epidemiological study is a subanalysis of data collected from patients attending three medical centres in Indonesia from May 2002 to October 2002. A total of 207 patients were enrolled, of which 177 patients constituted the per protocol population (patients with bacteriuria and haematuria were excluded). RESULTS: Overall, the prevalence of diabetic kidney disease was high, with macroalbuminuria comprising 44.7% (41.2-48.1;95% confidence interval) and microalbuminuria comprising 33.0% (29.7-36.3; 95% confidence interval). While the majority (91.53%) of patients were receiving treatment for hypertension, only 6.21% of the patients had systolic/diastolic blood pressures below the 130/85 mmHg target. CONCLUSION: The prevalence of microalbuminuria and macroalbuminuria was high in hypertensive patients with type 2 diabetes in Indonesia, which is indicative of an impending pandemic of diabetic cardiovascular and renal diseases in the region.