Hubungan asupan yodium dengan status gondok dan tingkat intelegensi anak SD daerah endemik gaky di Kabupaten Dharasraya Provinsi Sumatera Barat
YANTI, Fitri, Prof. dr. Hamam Hadi, MS,Sc.D
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: Yodium merupakan zat gizi mikro yang penting untuk pembentukan hormon tiroid. Defisiensi yodium menyebabkan pembesaran kelenjar gondok yang akan menyebabkan gangguan pematangan otak. Asupan yodium berasal dari makanan, garam beryodium, air minum dan kapsul beryodium. Suatu metaanalisis menyatakan bahwa rata-rata skor IQ anak di daerah kekurangan yodium 13,5 poin lebih rendah dari anak di daerah cukup yodium. Kabupaten Dharmasraya (dahulu bagian dari Kabupaten Sawahlunto Sijunjung) merupakan salah satu kabupaten endemik terberat di Provinsi Sumatera Barat dengan TGR 30,3% (Pemetaan 2003). Sementara itu hasil ujian nasional tahun 2008 menempatkan Kabupaten Dharmasraya pada peringkat ke 19 dari 19 kabupaten/kota. Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui hubungan asupan yodium dengan status gondok dan tingkat inteligensi anak SD daerah endemik GAKY di Kabupaten Dharmasraya Provinsi Sumatera Barat. Metode Penelitian: Jenis penelitian adalah observasional dengan rancangan cross-sectional. Populasi adalah murid SD kelas 3-5 di daerah endemik GAKY berat dan endemik GAKY ringan di Kabupaten Dharmasraya. Pengambilan sampel menggunakan metoda systematic random sampling. Pengumpulan data menggunakan instrumen semi kuantitatif FFQ, metode WISC. Hasil: Hasil analisis menunjukkan terdapat perbedaan rerata total asupan yodium antara daerah endemik berat dan ringan (113,27±36,44 μg/hr dan 141,20±36,08 μg/hr). Rerata skor IQ performance dan full scale berbeda antara daerah endemik berat dan ringan (74,63±10,24 dan 88,58±9,46; 79,93±10,69 dan 89,28±8,41). Terdapat perbedaan skor IQ verbal. performance dan full scale antara penderita gondok dan tidak gondok (83,10±8,48 dan 93,45±9,73; 73,10±8,69 dan 86,43±11,02; 76,17±7,96 dan 89,39±8,89). Status gondok merupakan faktor yang paling berhubungan dengan skor IQ. Kesimpulan: Terdapat perbedaan total asupan yodium yang signifikan antara daerah endemik berat dan endemik ringan, baik asupan yodium makanan, asupan yodium air maupun asupan yodium garam. Terdapat perbedaan IQ full scale dan IQ performance yang signifikan antara daerah endemik ringan dan endemik berat. Tidak ada hubungan asupan yodium dengan kejadian gondok di daerah endemik GAKY. Ada hubungan status gondok dengan inteligensi di daerah endemik GAKY. Penderita gondok mempunyai skor IQ full scale 13,121 poin lebih rendah dibandingkan dengan penderita tidak gondok.
Background: Iodine is an important micronutrient for producing thyroid hormone. Iodine deficiency can cause goiter which then adversely affecting brain growth and development. Iodine intake comes from food, iodinated salt, drinking water and iodized capsule. A meta analysis showed that IQ mean score of children lived in the endemic area of IDD was 13,5 points lower than those who lived in the non endemic area of IDD. Dharmasraya District (previously part of Sawahlunto Sijunjung District) is one of the most severe area of IDD endemic in West Sumatra Province with 30,3% TGR (2003 survey). At the same time, 2008 national examination result placed Dharmasraya District at the 19th rank from 19 districts in West Sumatra. Objective: The aim of this research was to determine the relationship between iodine intake with goiter status and intelligent in elementary school children at endemic area of IDD Dharmasraya District, West Sumatra Province. Method: This was an observational research with cross-sectional design. Population of this research were 3rd-5th grade elementary school students in the mild and severe area of IDD Dharmasraya. District. Samples were taken by systematic random sampling method. Instruments used in this research were semi quantitative FFQ,and WISC. Result: Statistical analysis showed that there was difference of total iodine intake between severe and mild endemic IDD area (113,27±36,44 μg/hr and 141,20±36,08 μg/hr). There were difference on full scale IQ and performance IQ between severe and mild IDD endemic area (74,63±10,24 and 88,58±9,46; 79,93±10,69 dan 89,28±8,41). There were difference on verbal IQ, performance IQ and full scale IQ between children with goiter and without goiter (83,10±8,48 and 93,45±9,73; 73,10±8,69 and 86,43±11,02; 76,17±7,96 and 89,39±8,89). Goiter status was the most significant factor related to IQ score. Conclusion: There was statistically significant difference of iodine intake between severe and mild endemic IDD area. There were a significant difference on iodine intake in food, water, and salt. There were a significant difference on full scale IQ and performance IQ between severe and mild IDD endemic area. There was no significant relationship between iodine intake and goiter enlargement in the endemic area of IDD. There was a significant relation between goiter enlargement and intelligent in the endemic area of IDD. Children with goiter had full scale IQ score 13,121 points lower than children without goiter.
Kata Kunci : Gaky,Asupan yodium,Gondok,Inteligensi,IDD, iodine intake, goitre, intelligent
