ORIGINAL ARTICLE

Correlation between the stress scale with cortisol levels in leprosy patients

Putri Astrid Novianti Nazli , Syahril Rahmat Lubis, Khairina Khairina

Putri Astrid Novianti Nazli
Postgraduate Master of Clinical Medicine, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia. Email: [email protected]

Syahril Rahmat Lubis
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia

Khairina Khairina
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia
Online First: April 30, 2021 | Cite this Article
Nazli, P., Lubis, S., Khairina, K. 2021. Correlation between the stress scale with cortisol levels in leprosy patients. Bali Medical Journal 10(1): 500-504. DOI:10.15562/bmj.v10i1.2213


Introduction: Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae) that causes a complex problem. Stress can trigger several physiological responses, including the endocrine, nervous, and immune systems. In leprosy patients, stimulation in the form of infection and cytokine secretion lasts a long time, causing adrenal exhaustion, resulting in decreased serum cortisol production. This study aims to determine the correlation between the stress scale and cortisol levels in leprosy patients.

Methods: This was a cross-sectional analytic correlation study with a consecutive sampling method. The research subjects were obtained from the Dermatology and Venereology Polyclinic of Universitas Sumatera Utara Hospital and the Dermatology and Venereology Polyclinic of Dr. Pirngadi Hospital Medan from March until November 2020. The research variables consisted of a stress scale and cortisol levels. Data analysis using the Spearman test. P-value <0.05 was significant. The study was conducted after approval from the Ethics Committee Faculty of Medicine, Universitas Sumatra Utara.

Result: A total of 35 patients enrolled in the study, the majority had characteristics of the male gender, multibacillary type of leprosy, duration of leprosy in the group > 12 months, with a median age of 36 (19 - 79) years. The mean stress scale was 15.17 ± 6.3, with the mild stress scale was the most common. The median cortisol levels were 9.5 (4 – 20,8) g/dl, which was still in the low category. The lowest median cortisol levels were found in the multibacillary type of leprosy, duration of leprosy in the group > 12 months, and severe stress scale. There was a significant moderate negative correlation between the stress scale and cortisol levels in leprosy patients (p = 0.017; r = -0.402).

Conclusion: The heavier the stress scale, the lower the cortisol levels in leprosy patients.

References

Infodatin. Kusta. Pusat Data dan Informasi Kementrian Kesehatan RI. 2015. Available from: https://www.depkes.go.id/resources/download/pusdatin/infodatin/infodatin_kusta.pdf

Departemen Kesehatan RI. Buku Pedoman Nasional Pemberantasan Penyakit Kusta. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. 2014. 1-169 p.

Aagaard-Hansen J, Chaignat CL. Neglected tropical diseases: equity and social determinants. In: Equity, social determinants and public health programs. Geneva: World Health Organization. 2010:135-58. Available from: http://www.who.int/social_determinants/en/

Gopal PK. Psychosocial Aspects in Leprosy. In: Kar KH, Kumar B, editor. IAL Textbook of Leprosy. 2nd ed. London: Churchill Livingstone. 2017: 641-5.

Infodatin. Hapuskan stigma dan diskriminasi terhadap kusta. Pusat Data dan Informasi Kementrian Kesehatan RI. 2018. Available from: http://www.pusdatin.kemkes.go.id/article/view/18053000001/infodatin-kusta-2018.html

Roifah I. Peningkatan Kualitas Hidup Penderita Kusta dengan Menggunakan Metode Self Help Group (SHG). Jurnal Ilmu Kesehatan. 2017;6(1):82-89.

Santos VS, Oliveira LS, Castro FD, Gois-Santos VT, Lemos LM, Ribeiro MD, Cuevas LE, Gurgel RQ. Functional activity limitation and quality of life of leprosy cases in an endemic area in Northeastern Brazil. PLoS neglected tropical diseases. 2015;9(7):e0003900.

Zachariae R, Zacharie H, Blomqvist K, Davidsson S, Molin L, Sigurgeirsson B, et al. Self-reported stress reactivity and psoriasis-related stress of Nordic psoriasis sufferers. J Eur Acad Dermatol Venereol. 2004;18:27-36.

Hane LO, Arsin AA, Stang. Faktor yang mempengaruhi kualitas hidup penderita kusta di Kabupaten Maluku Tengah tahun 2017 [Thesis]. Makassar: FKM Universitas Hasanuddin; 2017.

Coimbra S, Oliveira H, Figueiredo A, Rocha-Pereira P, Santos-Silva A. Psoriasis: epidemiology, clinical and histological features, triggering factors, assessment of severity and psychosocial aspects. In: O'Daly J, editor. Psoriasis – a systemic disease. Croatia: InTech. 2012:69-82.

Arck PC, Slominski A, Theoharis TC, Peters EM, Paus R. Neuroimmunology of stress: skin takes center stage. J Invest Dermatol. 2006;126:1697-704.

Cooper MS, Stewart PL. Corticosteroid insufficiency in acutely ill patients. N En J Med. 2003;348:727-34.

Rook GA, Baker R. Cortisol metabolism, cortisol sensitivity, and the pathogenesis of leprosy reactions. Trop Med Int Health. 1999;4(7):494-8.

Sinambela DWI, Lubis SR, Dalimunthe DA. Hubungan Perceived Stigma Dengan Kualitas Hidup Pasien Kusta [Thesis]. Medan: Universitas Sumatera Utara; 2020.

Thorat DM, Sharma P. Epidemiology. In: Kar KH, Kumar B, editor. IAL Textbook of Leprosy. 2nd ed. London: Churchill Livingstone. 2017:57-76.

Pane RS, Lubis SR, Darmi M. Analysis of Malondialdehyde Level in Leprosy Patients. International Journal of Innovative Research in Medical Science. 2018;3(10).

Darus NIM, Jusuf NK, Lubis RD. Analysis of serum vitamin D level in leprosy patients. Bali Medical Journal. 2019:8(2).

Ayudianti P, Suyoso S, Indramaya DM. Kadar Kortisol Serum Pasien Eritema Nodusum Leprosum (ENL) Baru. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2014;26(2):90-96.

Tami M. Hubungan Antara Kusta Tipe Pausi Basiler Dengan Angka Keberhasilan Pengobatan Kusta Di Jawa Timur. Jurnal Berkala Epidemiologi. 2019; 7(1): 17-24.

Saraswati PA, Rusyati LMM, Karmila ID. Karakteristik Penderita Kusta Multi Basiler (MB) dengan Reaksi Erythema Nodosum Leprosum (ENL) di Poliklinik Kulit dan Kelamin RSUP Sanglah selama Tahun 2016-2018. Intisari Sains Medis. 2019; 10(3): 655-658.

Prawoto. Faktor - Faktor Risiko Yang Berpengaruh Terhadap Terjadinya Reaksi Kusta [Thesis]. Semarang: Universitas Diponegoro; 2008.

Kementrian Kesehatan Republik Indonesia. Kusta masih ada di Indonesia. 2018. Available from: http://www.depkes.go.id/article/print/18013100003/kusta-masih-ada-di-indonesia.html

Swarth J. Stres dan Nutrisi. Jakarta: Bumi Aksara; 2001. 16-22 p.

Citrashanty I, Suyoso S, Rahmadewi. Insufisiensi Adrenal Sekunder pada Eritema Nodosum Leprosum: Studi Profil TNF-? dan Kortisol Serum. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2014;26(2):84-89.

Hary ZE. Hubungan antara Kelekatan Terhadap Ibu dengan Tingkat Stres pada Mahasiswa Perantau [Thesis]. Yogyakarta: Fakultas Psikologi Universitas Sanata Dharma; 2017.

Marik PE, Zaloga GP. Adrenal insufficiency in the critically ill. Chest 2002; 122: 1784-96.

Bambang G. Stres dan Sistem Imun Tubuh: Suatu Pendekatan Psikoneuroimunologi. Cermin Dunia Kedokteran. 2007;54:1-4.

Carroll TB, Aron DC, Findling JW, Tyrell B. Glucocorticoids, and adrenal androgens. In: Greenspan FS, Gardner DG, Shoback DM, editors. Greenspan's Basic and Clinical Endocrinology. 9th ed. New York: McGraw-Hill Education LLC. 2011:307-46.

Lupien SJ. How to measure stress in humans. Fernand-Seguin Research Centre of Louis-H. Lafontaine Hospital. 2007:1-39.

Hill EE, Zack E, Battaglini C, Viru M, Viru A, Hackney AC. Exercise and circulating cortisol levels: the intensity threshold effect. J Endocrinol Invest. 2008;31(7):587-91.


Article Views      : 0
PDF Downloads : 0