Triyanta Yuli Pramana
Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

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Correlation Between TNF-α Levels and APRI Score with Ejection in Hepatic Cirrhosis Muslim Thaher; Triyanta Yuli Pramana; Heru Sulastomo; Dhani Redhono; Eti Poncorini Pamungkasari
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.454

Abstract

Cirrhotic cardiomyopathy is a condition of heart dysfunction characterized by impaired myocardial contractility, left ventricular hypertrophy, diastolic dysfunction, chronotropic dysfunction, and electrophysiological disturbances of the heart. One of the complications in patients with hepatic cirrhosis is influenced by several factors, particularly TNF-α levels and the APRI score. This study aimed to analyze the effect of TNF-α and APRI score on ejection fraction in Child-Pugh C hepatic cirrhosis. Methods: This study employed an analytical observational design with a cross-sectional approach. The sample consisted of 40 inpatients with Child-Pugh C hepatic cirrhosis at the dr. Moewardi Surakarta Regional General Hospital. Samples were selected using consecutive sampling. Data analysis was performed using Spearman’s correlation test and linear regression. Results: The correlation between TNF-α levels and ejection fraction in Child-Pugh C hepatic cirrhosis is r = -0.559, p<0.001 (moderate correlation). The correlation between APRI score and ejection fraction in Child-Pugh C hepatic cirrhosis is r = -0.445, p<0.001 (moderate correlation). There is a significant correlation between TNF-α levels and APRI score with ejection fraction in Child-Pugh C hepatic cirrhosis. The implication is that clinicians may incorporate TNF-α levels and the APRI score into clinical algorithms to monitor cirrhotic patients who are at high risk of developing cardiovascular complications.
The Hepatoprotective Role of Ethanolic Mangosteen Peel Extract (Garcinia mangostana L.) on MDA, TNF-α, E-Selectin, and SGPT Levels in Isoniazid-Induced Liver Fibrosis Wistar Rats Triyanta Yuli Pramana; Rodi Nur Fajri; Brian Wasita; Eti Poncorini Pamungkasari
Gema Lingkungan Kesehatan Vol. 24 No. 2 (2026): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i2.525

Abstract

Isoniazid is a first-line anti-tuberculosis drug known to cause drug-induced liver injury (DILI) through oxidative stress and inflammatory mechanisms that contribute to the development of liver fibrosis. Mangosteen peel (Garcinia mangostana L.) contains xanthone compounds with antioxidant and anti-inflammatory properties, making it a potential hepatoprotective agent. This study aimed to determine the role of ethanol extract of mangosteen peel on malondialdehyde (MDA) levels, tumor necrosis factor-α (TNF-α) expression, E-selectin expression, and SGPT levels in the liver of isoniazid-induced fibrosis Wistar rats. This experimental study used a post-test only control group design. Twenty-eight male Wistar rats were randomly divided into four groups: negative control group, positive control group (isoniazid 50 mg/kgBW/day), treatment group 1 (isoniazid + mangosteen peel ethanol extract 250 mg/kgBW/day), and treatment group 2 (isoniazid + mangosteen peel ethanol extract 500 mg/kgBW/day) for 30 days. MDA and SGPT levels were measured using spectrophotometry, while TNF-α and E-selectin expression were assessed using immunohistochemistry. Administration of mangosteen peel ethanol extract significantly reduced MDA and SGPT levels and decreased TNF-α and E-selectin expression compared to the positive control group. The most significant reduction was observed in the group receiving the extract dose of 500 mg/kgBW. Mangosteen peel ethanol extract reduces MDA, TNF-α, E-selectin, and SGPT levels in isoniazid-induced Wistar rats. These findings demonstrate its hepatoprotective potential in a preclinical setting, further translational and clinical studies are warranted to evaluate its efficacy and safety in humans as potential hepatoprotective agent.