Supplementation of omega-3 fatty acids can reduce tumor necrosis alpha ( TNF-α) levels and pain intensity in osteoarthritis patients
Authors: Adengganan Yogi , Muis Siti Fatimah , Muniroh Muflihatul 
Published: January 2025

<p dir="ltr"><strong>ABSTRAK </strong></p><p dir="ltr"><em><strong>Latar Belakang: </strong></em><span>Osteoarthritis (OA) merupakan penyakit sendi yang paling umum di seluruh dunia, dengan dampak yang kuat pada kesehatan individu dan populasi. Secara global prevalensi OA meningkat sebesar 113,2% dari 247,5 juta pada tahun 1990 menjadi 527,8 juta pada tahun 2019. Prevalensi OA di Indonesia meningkat seiring bertambahnya usia yaitu sebesar 5% pada individu berusia kurang dari 40 tahun, 30% pada usia 40-60 tahun, dan 65% pada usia di atas 60 tahun. Angka kejadian OA lutut relatif tinggi, yaitu 15,5% pada pria dan 12,7% pada wanita. Penyakit ini dapat menyebabkan nyeri kronis, kecacatan, dan menurunkan kualitas hidup penderita. </span><span>Tingginya kadar sitokin pro inflamasi seperti TNF-α pada penderita OA dapat berperan sebagai faktor utama yang menginduksi kematian krondosit dan menghambat diferensiasi serta proliferasi kondrosit. Penelitian sebelumnya mengatakan bahwa suplementasi omega 3 dapat menurunkan kadar sitokin proinflamasi, memperbaiki nyeri, dan kekakuan fungsi fisik pada individu dengan OA lutut, namun belum ada yang meneliti pengaruh suplementasi omega 3 ini dengan penurunan kadar Tumor Necrosis Factor α (TNF-α).</span></p><p dir="ltr"><strong>Tujuan: </strong><span>Menganalisis pengaruh suplementasi asam lemak omega 3 terhadap kadar </span><span>TNF-α</span><span> dan intensitas nyeri pada penderita osteoarthritis. </span></p><p dir="ltr"><strong>Metode: </strong><span>Studi</span><span> ini merupakan </span><span>quasi-experimental</span><span> desain kelompok tunggal dengan rancangan penelitian </span><span>one group pre-post test without control group design</span><span> pada 31 pasien. Pengumpulan data dilakukan dengan pengukuran antropometri, pengambilan sampel darah dan pengukuran skor nyeri dilakukan sebanyak dua kali, yaitu sebelum dan sesudah dilakukannya intervensi. analisa </span><span>TNF-α</span><span> menggunakan </span><span>Enzym Linked Immunosorbent Assay </span><span>(</span><span>Elisa</span><span>)</span><span>, intensitas nyeri menggunakan </span><span>numeric rating scale</span><span> (NRS). Analisis uji statistik pengaruh suplementasi asam lemak omega 3 terhadap kadar </span><span>TNF-α</span><span> dan intensitas nyeri menggunakan uji </span><span>Wilcoxon</span><span>.</span></p><p dir="ltr"><em><strong>Hasil: </strong></em><span>Hasil yang diperoleh pada </span><span>TNF-α </span><span>dengan nilai </span><span>P</span><span>=0,007</span><span> dan intensitas nyeri dengan nilai </span><span>P</span><span>=</span><span>0,001 yang menunjukkan hasil yang signifikan.</span></p><p dir="ltr"><em><strong>Kesimpulan: </strong></em><span>Suplementasi asam lemak omega 3 pada penderita OA dapat mengasilkan beberapa mediator anti inflamasi yang mampu menurunkan kadar sitokin pro inflamasi </span><span>TNF-α </span><span>dan intensitas nyeri</span><span>secara siginifikan.</span></p><p dir="ltr"><span><br /></span></p><p dir="ltr"><strong>KATA KUNCI: </strong><em>asam lemak omega 3 ; tumor necrosis alpha (TNF-α); intensitas nyeri; inflamasi; osteoarthritis </em></p><div><span><br /></span></div><div><span><br /></span></div><div><p dir="ltr"><strong>ABSTRACT</strong></p><p dir="ltr"><em><strong>Background</strong>: </em><span>Osteoarthritis (OA) is the most common joint disease worldwide, strongly impacting individual and population health. Globally, the prevalence of OA increased by 113.2% from 247.5 million in 1990 to 527.8 million in 2019. The prevalence of OA in Indonesia increases with age, namely by 5% in individuals under 40 years, 30% in those aged 40-60 years, and 65% in those over 60 years. The incidence of knee OA is relatively high, namely 15.5% in men and 12.7% in women. This disease can cause chronic pain and disability and reduce the quality of life of sufferers. High levels of pro-inflammatory cytokines such as TNF-α in OA sufferers can act as a major factor in inducing chondrocyte death and inhibiting chondrocyte differentiation and proliferation. Previous studies have shown that omega-3 supplementation can reduce proinflammatory cytokine levels and improve pain and stiffness of physical function in individuals with knee OA. Still, no one has studied the effect of omega-3 supplementation on reducing TNF-α levels.</span></p><p dir="ltr"><em><strong>Objectives: </strong></em><span>To analyze the effect of omega-3 fatty acid supplementation on TNF-α levels and pain intensity in patients with osteoarthritis.</span></p><p dir="ltr"><em><strong>Methods: </strong></em><span>This study is a quasi-experimental single-group design with a one-group pre-post test without a control group design in 31 patients. Data collection was carried out by anthropometric measurements, blood sampling, and pain score measurements twice, namely before and after the intervention. TNF-α analysis using Enzyme-Linked Immunosorbent Assay (Elisa), pain intensity using a numeric rating scale (NRS). Statistical analysis of the effect of omega 3 fatty acid supplementation on TNF-α levels and pain intensity using the Wilcoxon test.</span></p><p dir="ltr"><em><strong>Results: </strong></em><span>The results obtained on TNF-α with a P value = 0.007 and pain intensity with a P value = 0.001 showed significant results.</span></p><p dir="ltr"><span><em><strong>Conclusion:</strong></em> Supplementation of omega-3 fatty acids in OA patients can produce several anti-inflammatory mediators that significantly reduce the levels of pro-inflammatory cytokines TNF-α and pain intensity.</span></p></div><div><span><span id="docs-internal-guid-03235b08-7fff-5ce2-8205-78d9a8098f2a"><br /><strong>KEYWORDS: </strong><em>omega 3 fatty acids; tumor necrosis alpha (TNF-α); pain intensity; inflammation; osteoarthritis</em></span></span></div><div><span><br /></span></div><div><span><br /></span></div><div><span><em>Received: August 14, 2024; Revised: Nov 18 2024; Accepted: Nov 20, 2024; Available online: Nov 30, 2024; Published: Nov 30, 2024.</em></span></div>