Hubungan asupan vitamin, mineral dan rasio asupan kalsium dan fosfor dengan kepadatan mineral tulang kalkaneus wanita muda

RAMAYULIS, Rita, dr. I Dewa Putu Pramantara, SpPD

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat (Gizi dan Kesehatan)

Latar belakang: Angka kejadian osteoporosis yang didefinisikan sebagai kepadatan mineral tulang > -2,5 di bawah rata-rata wanita muda di Indonesia belum diketahui secara pasti, namun risiko terjadinya osteoporosis cukup tinggi. Zat gizi khususnya mikronutrien berperan penting dalam memelihara kepadatan mineral tulang. Namun saat ini, jutaan penduduk mengalami defisiensi zat gizi mikronutrien tidak hanya 1 tetapi beberapa dari vitamin dan mineral seperti kalsium, seng dan beta karoten. Tujuan penelitian : untuk mengetahui hubungan asupan vitamin A, C dan mineral Ca, P, Zn serta rasio asupan Ca dan P dengan Kepadatan Mineral Tulang atau Bone Mineral Density (BMD). Metode penelitian: Jenis penelitian adalah observasional dengan rancangan cross sectional. Subyek penelitian adalah wanita muda usia 35 sampai 40 di pusat kebugaran Health Fitness Depkes RI Jakarta tahun 2007. Pemilihan subyek tanpa probabilitas secara purposive sampling. Variabel terikat dalam penelitian ini adalah kepadatan mineral tulang. Variabel bebas adalah asupan vitamin A, C dan mineral Ca, P, Zn serta rasio asupan Ca dan P. Variabel penganggu yang sudah disamakan untuk semua subyek penelitian adalah status gizi, exercise, konsumsi rokok, konsumsi alkohol, konsumsi kafein, faktor genetik, faktor penyakit, faktor pengobatan. Data asupan dikumpulkan dengan menggunakan metode food record dan food frequency. Data dianalisis dengan menggunakan uji chi square, Fisher exact test, korelasi pearson dan spearman serta independent t- test. Hasil Penelitian: Subyek yang memiliki kriteria inklusi dan ekslusi adalah 102 orang dengan proporsi kepadatan mineral tulang 6,9% osteoporosis, 31,3% osteopeni dan 61,8% normal. Wanita muda dengan Asupan vitamin A, C dan kalsium, fosfor,seng baik memiliki rata-rata skor BMD berurutan 0,35 poin, 0,36 poin dan 0,97 poin, 1,02 poin, 1,26 poin lebih tinggi dibanding wanita muda dengan asupan kurang. Wanita muda dengan rasio asupan kalsium dan fosfor baik memiliki skor BMD 1,13 poin lebih rendah dibanding wanita muda dengan rasio asupan kalsium dan fosfor tidak baik. Namun hubungan vitamin A, C dan kalsium, fosfor, seng serta rasio asupan kalsium dan fosfor dengan kepadatan mineral tulang tidak bermakna secara statistik (p>0,05). Kesimpulan : Hubungan asupan vitamin A, C dan mineral Ca, P, Zn serta rasio asupan Ca dan P dengan BMD tidak bermakna secara statistik. Wanita muda dengan asupan vitamin A, C dan kalsium, fosfor, seng baik cenderung untuk memiliki skor BMD lebih tinggi dibanding wanita muda dengan asupan kurang.

Background: The prevalence of osteoporosis as defined by bone mineral density (BMD) > - 2.5 below the average of young women in Indonesia is not yet known; however the risk for the prevalence of osteoporosis is relatively high. Nutrients especially micronutrients have an important role in maintaining bone status. Yet, until today millions of people have micronutrient deficiency in vitamin and mineral such as calcium, zinc and beta-carotene. Objective: To identity the relationship between intake of vitamin A, C and mineral calcium, phosphor, zinc and ratio of intake of calcium and phosphor and BMD. Method: The study was observational with cross sectional design. Subject of the study were young women of 35 – 40 years old at health fitness centre of the Ministry of Health in 2007. There were as many as 102 subjects purposively taken. The dependent variable of the study was BMD and the independent variables were intake of vitamin A, C, and mineral calcium, phosphor, zinc and ratio of calcium and phosphor intake. The confounding variables were nutrition status, exercise, smoking, alcohol consumption, caffeine consumption, genetic, disease and medication factors. Intake data were obtained through blood record and food frequency methods. Data analysis used chi square, Fisher exact test and independent t-test. Result: The proportion of BMD of young women was 6.9 % osteoporosis, 32.4 % osteopenia and 60.8 % normal. Young women with good intake of vitamin A and C, calcium, phosphor, zinc had average score of BMD as much as 0.35 point, 0.36 point and 0.97 point, 1.02 point, 1.26 point subsequently higher than those with less intake. Young women with ratio of good calcium and phosphor intake had BMD score as much as 1.13 point lower than those with ratio of poor calcium and phosphor intake. However, the relationship between intake of vitamin A, C, calcium, phosphor, zinc and ratio of calcium and phosphor intake and BMD was statistically insignificant (p>0.05) Conclusion: The relationship between intake of vitamin A, C, calcium, phosphor, zinc and ratio of calcium and phosphor intake and BMD was statistically insignificant. Young women with good intake of vitamin A, C and calcium, phosphor, zinc tended to have higher score of BMD than those with poor intake.

Kata Kunci : Osteoporosis,Kepadatan Mineral Tulang,Vitamin A, C dan Kalsium,vitamin A, vitamin C, calcium, phosphor, zinc, bone mineral density