Oleh Admin Kalbe Medical pada September 13, 2017 07:30

Vitamin C Bermanfaat dalam Terapi Gout

Gout merupakan artritis inflamasi yang paling sering pada pria dewasa. Di antara faktor protektif yang bermanfaat melawan hiperurisemia dan gout adalah vitamin C. Kaitan antara gout dan vitamin C sebenarnya telah diteliti dalam sejumlah studi selama lebih dari 30 tahun. Hasil suatu studi telah menunjukkan bahwa suplementasi vitamin C dapat menurunkan asam urat serum melalui efek urikosurik, meskipun studinya kecil, atau durasinya singkat, serta menggunakan dosis yang sangat tinggi (3-12 gram sekali konsumsi, selama beberapa hari). Efek urikosurik vitamin C dapat disebabkan karena kompetisi reabsorpsi ginjal melalui sistem transpor pertukaran anion pada tubulus proksimalis.

Suatu studi pada 184 non-perokok, yang dipublikasikan pada 2005 yang meneliti gout dan vitamin C menyimpulkan bahwa jumlah vitamin C diperlukan untuk mencapai penurunan kadar asam urat serum adalah 500 mg/hari. Suplementasi vitamin C 500 mg/hari selama 2 bulan dapat menurunkan kadar asam urat serum sebesar 10% (0,5 mg/dL). Penurunan asam urat lebih besar pada subjek dengan kadar asam urat yang lebih tinggi saat mulai studi. Subjek yang mendapat plasebo menunjukkan sedikit peningkatan kadar asam urat. Hasil studi cohort selama periode 20 tahun pada 46.994 pria tanpa risiko gout menunjukkan kaitan antara asupan vitamin C dan risiko kejadian gout, yaitu bahwa asupan vitamin C yang lebih tinggi terkait secara independen dengan risiko gout yang lebih rendah, sehingga asupan vitamin C suplemental dapat bermanfaat dalam mencegah gout.

Suatu studi meta-analisis juga telah dilakukan untuk menilai efek suplementasi vitamin C pada asam urat serum dengan mengumpulkan penemuan dari studi-studi acak dengan kontrol yang telah dipublikasikan. Total 2082 publikasi telah diidentifikasi dengan kriteria inklusi, yaitu RCT pada subjek manusia, studi yang melaporkan rata-rata dan perubahan kadar asam urat serum pada akhir studi, studi yang didesain dengan suplementasi vitamin C oral dan dengan kelompok kontrol, serta durasi studi minimal 1 minggu, dan studi yang mengeksklusi pasien anak atau pasien dialisis.

Tiga belas RCT diidentifikasi dari database Medline, EMBase, dan Cochrane Central Register of Controlled Trials, dengan total subjek 556, dosis median vitamin C 500 mg/hari, jumlah subjek 8-184 pasien, dan median durasi studi 30 hari. Kadar asam urat serum praterapi berkisar dari 2,9-7,0 mg/dL (172,5-416,4 µmol/L). Hasil analisis menunjukkan bahwa terdapat penurunan kadar asam urat serum sebesar -0,35 mg/dL atau -20,8  µmol/L (95% CI -0,66 s/d -0,03; p=0,032).

Dari hasil analisis tersebut disimpulkan bahwa suplementasi vitamin C secara bermakna menurunkan kadar asam urat serum. Namun, hati-hati bahwa perubahan kadar asam urat yang cepat dapat memicu serangan gout. (EKM)

Image : Ilustrasi
Referensi:
1.Choi HK, Gao X, Curhan G. Vitamin C intake and the risk of gout in men – a prospective study. Arch Intern Med. 2009; 169(5):502–7. doi:  10.1001/archinternmed.2008. 606
2.Juraschek SP, Miller ER 3rd, Gelber AC. Effect of oral vitamin C supplementation on serum uric acid: A meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken). 2011;63(9):1295-306. doi: 10.1002/acr. 20519.
3.Gout and Vitamin C? Yes vitamin C is good for gout, but there's a small caution [Internet]. 2017 [cited 2017 Aug 28]. Available from: http://www.best-gout-remedies.com/gout-and-vitamin-c.html

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