Pengaruh pemberian suplemen seng sulfat terhadap kadar seng serum dan jumlah CD4+ pada wanita usia lanjut sehat

SARI, Yang Rusfinda, dr. M. Jufrie, SpAK.,PhD

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Gizi dan Kesehatan)

Latar Belakang : Menua merupakan proses alamiah yang dialami oleh semua mahluk hidup. Menua diikuti dengan kemunduran fungsi fisiologis tubuh. Usia lanjut merupakan faktor risiko defisiensi mikronutrien termasuk Seng yang berperan penting dalam sistem imun. Kondisi ini mengakibatkan penurunan fungsi imunitas seluler yang ditandai dengan penurunan jumlah CD4+. Tuiuan Penelitian : Mengetahui pengaruh pemberian suplemen Seng sulfat terhadap kadar Seng serum dan jumlah CD4+ sebagai indikator sistem imun seluler pada usia lanjut. Metode dan Subjek Penelitian : Penelitian ini menggunakan rancangan penelitian uji klinis, one group pre-post test design (before and after trial). Subjek penelitian ini adalah individu usia lanjut “sehat” berusia lebih dari 60 tahun bersedia mengikuti penelitian. Dilakukan penilaian status gizi dan pemeriksaan fisik dan pemeriksaan kadar seng dan jumlah CD4+ diberikan suplemen seng 15 mg sekali sehari selama 28 hari kemudian dilakukan pemeriksaan ulang kadar seng dan jumlah CD4+. Analisis statistik dengan uji paired t. Hasil : Tiga puluh usia lanjut mengikuti penelitian dengan rerata usia 64,43±3,10 tahun. Rerata kadar Seng awal 5,85±1,95 μmol/L, 26 (86%) subyek mempunyai kadar Seng dibawah normal, 4 (14%) mempunyai kadar Seng normal dan tidak didapatkan subyek yang mempunyai kadar Seng diatas normal.. Kadar Seng pada akhir penelitian meningkat pada 27(90%) subyek dengan rerata peningkatan sebesar 4,54±3,84 μmol/L (p < 0,001). Jumlah CD4+ meningkat pada 11(36%) dengan rerata peningkatan sebesar 26,83±137,46 (/mm3) (p = 0,29). Faktor-faktor yang berpengaruh terhadap peningkatan jumlah CD4+ adalah umur, berat badan, skor MNA, LLA, dan kadar seng awal. Simpulan : Pemberian suplemen Seng 15 mg selama 28 hari pada usia lanjut dapat meningkatkan kadar Seng serum secara bermakna dan dapat meningkatkan jumlah CD4+ hanya pada 11(36%) subyek.

Background: Aging is a natural process which happens to all living creatures. Aging followed by declining physiological function. Elderly is a risk factor of micronutrient deficiency including zinc which has an important role in the immune system. This condition causes declining cellular immunity functions as indicated by declining immune response through reduced amount of CD4+ lymphocyte. Objective: To identify the effect of sulphate zinc supply to serum zinc level and amount of CD4+ lymphocyte as an indicator of cellular immune system among the elderly. Method: The study used clinical test research design, one group pre-post test design (before and after trial). Subject of the study were “healthy” elderly individuals of more than 60 years old, willing to be studied. Assessment on nutrition status, physical examination and examination of zinc level were made to the subjects. Next, the subject are supplied with 15 mg of zinc supplement once a day for 28 days. Then, re-examination was made to identify zinc level and the amount of CD4+ lymphocyte. Statistical analysis used paired t-test. Result: Average age of the elderly observed (n=30) was 64.43 + 3.10 years. Average zinc level before the study was 5.85 + 1.95 umol/L, as many as 26 subjects (86%) had zinc under normal level, 4 subjects (14%) had normal zinc level and no subject had zinc above normal level. Zinc level at the end of the study increased in as many as 27 subjects (90%) with average increase as much as 4.54 + 3.84umol/L (p<0.001). The amount of CD4+ lymphocyte increased in 11 subject (36%) with average increase 26.83 + 137.46(/mm3) (p=0.29). Factors affecting increase of CD4+ lymphocyte were age, weight, score of mini nutritional assessment and upper arm circle, and preliminary zinc level. Conclusion: The supply of 15 mg zinc for 28 days among the elderly could elevate serum zinc level significantly and could increase the amount of CD4+ lymphocyte only in 11 subjects (36%).

Kata Kunci : Gizi Manula,Sistem Imun,Suplemen Seng Sulfat,CD4