{"paper_id":"48c4ed23-7a2d-4a5a-9c78-29770073867a","body_text":"Revista de Chimie                                                                                                                                                                \nhttps://revistadechimie.ro   \nhttps://doi.org/10.37358/Rev.Chim.1949 \n \nRev. Chim., 73 (3), 2022, 82-86                                                                    82                                https://doi.org/10.37358/RC.22.3.8537 \n \nThe Correlation Between the Degree of Pain with Estradiol \nHormone Levels, Interleukin 1β (il-1β) Levels and Nitrite Oxide \nin Blood Serum of Endometriosis Patients \n \nLIDYA METRI*, AFRIWARDI AFRIWARDI \nBiomedical Doctoral Study Program, Faculty of Medicine, Andalas University, Limau Manis Str - Pauh, 25163, Padang City, \nIndonesia \n \nAbstract: Endometriosis is the c hronic disease, in which the glandular and stromal -like endometrium \ngrows outside the uterine cavity, Endometriosis is inflammatory and estrogen-dependent that affects 6-\n10% of women during their reproduc tive years and up to 50% of women receiving fertility treatment. \nThe purpose of this study was to determine the correlation between the degree of pain with estradiol \nhormone levels, interleukin-1β (IL-1β) levels and Nitrite Oxide (NO) in the blood serum of patients with \nendometriosis. This type of research is an observational analytic with a cross sectional comparative \nstudy design in which the dependent and independent var iables are obtained simultaneously. The \nresearch was conducted in type B and C hospitals. To take blood serum samples for endometriosis \npatients and the Biomedical Laboratory of FK Unand to check levels of estradiol hormone, levels of \nInterleukin-1β (IL-1β) and NO. The study was conducted in January - November 2020. The population \nwas all patients who doing examination at the obstetrics gynecology department of the hospital. Samples \nwere taken consecutively that met the inclusion and exclusion criteria with a total sample of 40 people. \nData analysis using analyzed by univariate, bivariate and multivariate with chi -square test.  The \nresearch results were obtained The mean age of endometriosis patients was 38.85 years, the mean pain \ndegree of patients and the distribution of levels of estradiol, interleukin, 1β (IL-1β) and Nitric oxide. The \nresults of the bivariate analysis showed that there were differences  degree of pain with each Estradiol \nlevel, interleukin, 1β (IL-1β) as well as nitric oxide. The results of the multivariate analysis showed that \nthere was a difference in the degree of pain with the three Estradiol levels.  interleukin, 1β (IL-1β) and \nnitric oxide in the blood serum of people with endometriosis (P = 0,000 then p <α (0.05).  From the \nresearch results it can be concluded that there are  the relationship between degree of pain and level  \nEstradiol, interleukin, 1β (IL-1β) and nitric oxide in the blood serum of people with endometriosis. \n \nKeywords: Pain degree, endometriosis, Estradiol levels, interleukin, 1β (IL-1β), Nitrite oxide \n \n1.Introduction \nEndometriosis is a chronic  and painful disease which the endometrium such as glandular cells and \nstroma grows outside the uterine cavity [1,2]. Endometriosis is an inflammation and estrogen-dependent \ndisease that affects 6-10% of women during their reproductive years and up to 50% of women receiving \nfertility treatment. When the endometrial tissue is present in the myometrium, it is called adenomyosis. \nThe site of endometriosis is often found in the pelvic peritoneum but it can be found in other places such \nas the ovaries and utero -sacral ligaments [3,4]. Endometriosis represents a very significant problem in \ngynecology, affecting 10% -20% of women who are still menstruating.  Found in 30% -45% of infertile \nwomen. In the world, 10% of women are estimated to have endometriosis. Endometriosis cases cause \n20% of all gynecological operations and is the only cause of non -obstetric hospitalization (> 5%) in \nwomen aged 15-44 years [5-7]. For this reason, it is necessary to investigate the correlation between the \ndegree of pain and Estradiol hormones levels, interleukin,1β (IL-1β) levels and nitric oxide in the blood \nserum of people with endometriosi s. This study aims to analyze the correlation between the degree of \npain and Estradiol hormones levels, interleukin,1β (IL-1β) levels and nitric oxide in the blood serum of \npeople with endometriosis. \n \n \n*email:metrilidya1@gmail.com \n\nRevista de Chimie                                                                                                                                                                \nhttps://revistadechimie.ro   \nhttps://doi.org/10.37358/Rev.Chim.1949 \n \nRev. Chim., 73 (3), 2022, 82-86                                                                    83                                https://doi.org/10.37358/RC.22.3.8537 \n \n2.Materials and methods  \nThis study was an observational analytic study with a cross sectional comparative study design which \nthe dependent and independent variables were obtained at the same time. The sample in this study was \n40 patients with endometriosis diagnosed by a specialist in Gynecological Obstetrics in accordance with \nthe ASRM criteria and transvaginal ultrasound examination in Hospital. This study was started from  \nJanuary  to November 2020  in the City of Padang.  Retrieving data by measuring the d egree of pain in \npatients with endometriosis using a Visual analog scale / VAS (mm) and Estradiol levels,  interleukin, \n1β (IL-1β) and nitric oxide in blood serum in Andalas University Laboratory. This study explores the differences in the degree of pain in endometriosis sufferers with Estradiol \nlevels. interleukin, 1β (IL-1β) and nitric oxide in blood serum. Then analyze the relationship between \nthe dependent and independent variables. The dependent variables of this study were levels of the \nhormone estradiol; IL-1β levels; and NO, while the independent variable is the degree of endometriosis \npain. \n \n3.Results and discussions \nBased on the results of research conducted on the Relationship between Pain Degree and Estradiol \nHormone Levels, Interleukin -1β (IL-1β) Levels and Nitrite Oxide in Blood Serum for Endometriosis \nPatients in 2020. with a sample size of 40 endometriosis sufferers. the following research results were \nobtained: \n \nTable 1. Distribution of clinical frequency of \nMenstrual pain in patients with endometriosis \nVariable Percentage n \nLow 12.5 5 \nModerate 35.0 14 \nWeight 52.5 21 \n \nBased on Table 1, it shows that of the 40 respondents, 21 people with endometriosis experienced \nsevere pain (52.5%), while for moderate pain there were 14 people (35%) and 5 people with low pain \ndegrees (12.5). Most endometriosis sufferers experienced severe pain degrees of 52.5%. \nThe results of the research that has been done, it is known that from 40 respondents It was found that \nthe mean degree of pain in endometriosis patients was 5.98 with a standard deviation of 1.942. The \nlowest pain degree score was 2 and the highest was 9 in 2020. From the results of the research obtained \nafter measuring the degree of pain using the Vas scale in endometriosis sufferers, it was found that 52.5% \nof respondents had a high pain scale above the average. \nThis is consistent with the research that endometriosis patients show a higher VAS value compared \nto normal women on the same pain stimulus. This suggests the possibility of  sensitization in endo -\nmetriosis patients [8-10]. \n \nTable 2. The Correlation between the variable degree of pain \nand Estradiol levels in blood serum of endometriosis patients \nEstradiol Pain scale Total P value Low Moderate weight \nnormal 0 2 2 4 \n0.024 \n, 0% 50.0% 50.0% 100.0% \nabnormal 5 12 19 36 \n13.9% 33.3% 52.8% 100.0% \nTotal 5 14 21 40 \n12.5% 35.0% 52.5% 100.0% \n\nRevista de Chimie                                                                                                                                                                \nhttps://revistadechimie.ro   \nhttps://doi.org/10.37358/Rev.Chim.1949 \n \nRev. Chim., 73 (3), 2022, 82-86                                                                    84                                https://doi.org/10.37358/RC.22.3.8537 \n \nBased on Table 2. It shows 4 people with endometriosis with normal estradiol levels with 2 people \nwith moderate pain degrees (50%) and 2 people with severe pain degrees (50%). While there were 36 \npatients with endometriosis with abnormal estradiol levels with 5 people (13.9%) with low pain degrees, \n12 people with moderate pain degrees (33.3%) and 19 severe pain degrees (52.8%). Most endometriosis \nsufferers experience severe pain with abnormal estradiol levels. \nThe statistical test results obtained by the value of P = 0.024, then p <α (0.05), it can be concluded \nthat there is a correlation between the degree of pain and the level of the hormone estradiol in the blood \nserum of patients with endometriosis.  \n \nTable 3. The correlation between the variable degree of pain and levels \n of IL1β in blood serum of endometriosis patients \nIL1β Pain scale Total P value Low Moderate Weight \nnormal 0 1 0 1 \n0,000 \n, 0% 100.0% , 0% 100.0% \nabnormal 5 13 21 39 \n12.8% 33.3% 53.8% 100.0% \nTotal 5 14 21 40 \n12.5% 35.0% 52.5% 100.0% \nBased on Table 3, it shows that 1 person with endometriosis with normal blood serum IL1β levels \nwith moderate pain degrees. Meanwhile, there were 39 patients with endometriosis with abnormal \nestradiol levels with 5 people (12.8%) with low pain degrees, 13 people with moderate pain degrees \n(33.3%) and 21 people with severe pain degrees (53 .8%). Endometriosis sufferers experience the most \nseverity of pain with abnormal IL1β levels. The statistical test results showed that the value of P = 0.000, \nthen p <α (0.05), it can be concluded that there is a correlation between the degree of pain and the IL1β \nlevel in the blood serum of patients with endometriosis [11-16]. \n \nTable 4. The Correlation between the variable degree of \npain and levels of Nitric Oxide (NO) in blood serum  \nof endometriosis patients \nNO Pain scale Total P value low moderate Weight \nabnormal 5 14 21 40 \n0,000 12.5% 35.0% 52.5% 100.0% \nTotal 5 14 21 40 \n12.5% 35.0% 52.5% 100.0% \n \nBased on Table 4, it was found that all (100%) endometriosis sufferers had abnormal blood serum \nNO levels. Endometriosis sufferers experience the most severe degrees of pain having abnormal NO \nlevels. The statistical test results showed that the value of P = 0.000, then p <α (0.05), it can be concluded \nthat there is a correlation between the degree of pain and the NO level in the blood serum of \nendometriosis sufferers.  This is in accordance with  the increase in the number and  activity of \nmacrophages in endometriosis patients is accompanied by excessive release of cytokines and immune \nmediators such as NO (a type of ROS). Previous studies have also shown that increased NO and NOS \nare found in endometriosis patients [17-24]. \n \nTable 5. Results of Multivariate Analysis of a sample \nof patients with endometriosis \nNo. Independent Variable P value R Square \n1 Estradiol 0.03 \n0.19 2 IL-1β 0.02 \n3 NO 0.01 \n\nRevista de Chimie                                                                                                                                                                \nhttps://revistadechimie.ro   \nhttps://doi.org/10.37358/Rev.Chim.1949 \n \nRev. Chim., 73 (3), 2022, 82-86                                                                    85                                https://doi.org/10.37358/RC.22.3.8537 \n \nBased on Table 5 is the final result of the multivariate analysis of multiple logistic regression tests. \nBecause the levels of estradiol, IL-1β and NO have p <0.05, these variables were not excluded from the \nmodel and all three are factors that influence the degree of pain in endometriosis sufferers. In addition, \nthe R square value is 0.19, this means that the variable levels of estradiol, IL -1β and NO have a \ncontribution of 19% to the degree of pain in endometriosis patients.  \n4. Conclusions  \nBased on the results of the research conducted the results showed that the levels were increased from \nnormal, so there was a close correlation between the degree of pain and blood serum levels of estradiol, \nIL-1β and NO and the threshold of menstrual pain. The higher the blood s erum levels of estradiol, IL -\n1β and NO accompanied by the heavier a person's menstrual pain, it helps prove the existence of an \nendometriosis.the year 2020. \n \nAcknowledgments: Thanks to all the people who took part in guiding and helping this research so that \nit can be completed properly.  \n \nReferences \n1.ADAMSON, G. D., KENNEDY, S., HUMMELSHOJ, L., Creating solutions in endometriosis : global \ncollaboration through the World Endometriosis Research Foundation, (January), 2010 \n2.HIFERI, POGI, Konsensus tata laksana nyeri endometriosis, Revisi Pertama, 2017 \n3.***ASRM. The Practice Committee of the American Society for Reproductive Medicine. Fertil Steril, \n2014;10(4):927-35. \n4.DUNSELMAN G., et. al., ESHRE guideline, management of women with endometriosis. 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Chim., 73 (3), 2022, 82-86                                                                    86                                https://doi.org/10.37358/RC.22.3.8537 \n \n16.HOFFMAN B ., et. al., polimorfisme gen endothelial nitric oxide synthase (nNOS) dan kadar \ninterleukin 1 Beta (1L-1beta), Nitric oxide (NO) dan 8 -Hydroxy -2 deoxyguanosine (8-OH-dG) cairan \nfolikuler pada pasien endometriosis, 2015,1-9. \n17.MACMICKING, J., XIE, Q. W. , NATHAN, C., Nitric oxide and macrophage function . Annu Rev \nImmunol, 1997.15323-50. \n18.NAMBA, T. , et. al.,  Angiogenesis Induced by Endothelial Nitric Oxide Synthase Gene Through \nVascular Endothelial Growth Physiology, C. Effect of Mst1 on Endometriosis Apoptosis and Migration : \nRole of Drp1 -Related Mitochondrial Fission and Parkin -Required Mitophagy, 2015 , 1172–1190. \nhttps://doi.org/10.1159/000487450 \n19.OTA, H., IGARASHI, S., HATAZAWA, J., TANAKA, T., Endometriosis and free radicals. 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