Defisiensi vitamin dan zink sebagai faktor resiko terjadinya stunting pada balita di Provinsi Nusa Tenggara Barat

TAUFIQURRAHMAN, Prof. dr. Hamam Hadi, MS, Sc.D

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Pada umur 1-5 tahun sering terjadi masalah gizi seperti gizi kurang, defisiensi vitamin A, defisiensi zinc, anemia, stunting, dan Mental Development Index (MDI) yang rendah. Defisiensi vitamin A menyebabkan kegagalan pertumbuhan dan menurunnya transport dan mobilisasi zinc di hati dan sebaliknya zinc diperlukan dalam sintesis Retinol Binding Protein (RBP). Jika defisiensi berlangsung lama akan menyebabkan gangguan pertumbuhan yang dimanifestasikan dengan kejadian stunting Tujuan : Untuk mempelajari defisiensi vitamin A dan zinc sebagai faktor risiko terjadinya stunting pada balita di Nusa Tenggara Barat. Metode : Penelitian observasional analitik, dengan rancangan cros sectional. Subjek penelitian adalah balita usia 6 – 59 bulan di Provinsi NTB terdiri dari 327 balita. Penilaian status gizi secara antropometri, pengukuran kadar serum retinol metode HPLC, kadar serum zinc metode AAS dan Hb metode HemoCue. Wawancara untuk melihat karakteristik dan pola asuh, serta recall 2 kali 24 jam untuk mengukur asupan zat gizi balita. Analisis bivariat pada variabel yang berhubungan dengan stunting digunakan chi-square test untuk data kategori, independent t-test untuk data rasio dan untuk mengukur risiko beberapa variabel secara bersamaan dengan kejadian stunting digunakan regresi logistik test. Hasil : Secara bivariat umur anak dan status menyusu menunjukkan hubungan yang signifikan dengan kejadian stunting. Di antara balita yang tidak lagi menyusu ada perbedaan asupan zinc antara balita stunting dan normal (p<0,05). Secara multivariat balita yang tidak lagi menyusu mempunyai risiko 2 kali lebih besar mengalami stunting dibandingkan yang menyusu, setelah dikontrol umur balita, status vitamin A dan status zinc. Umur dan status menyusu merupakan efek modifikasi hubungan defisiensi vitamin A dengan kejadian stunting. Kesimpulan : Tidak terbukti secara bermakna bahwa defisiensi vitamin A dan zinc pada balita sebagai faktor risiko terjadinya stunting di NTB. Variabel yang bermakna secara sendiril maupun bersamaan terhadap kejadian stunting adalah status menyusu. Balita yang tidak menyusu mempunyai risiko 2 kali lebih besar mengalami stunting dibandingkan balita yang tidak menyusui, sedangkan umur dan status menyusu merupakan efek modifikasi hubungan defisiensi vitamin A dengan kejadian stunting.

Background: Children of 1 – 5 years old often face nutrition problems such as undernourishment, vitamin A and zinc deficiency, anemia, stunting and low mental development index (MDI). Vitamin A deficiency can cause growth disorder and declining zinc transport and mobilization in the heart meanwhile zinc is needed in retinol binding protein synthesis. If the deficiency lasts for long it can cause growth disorder as manifested in stunting incidence. Objective: To study vitamin A and zinc deficiency as risk factors for the incidence of stunting among underfives at Nusa Tenggara Barat. Method: The study was analytic observational with cross sectional design. Subject of the study were 327 underfives of 6 – 59 months at the Province of Nusa Tenggara Barat. Nutrition status was assessed through measurement of anthopometry, retinol serum level using HPLC, zinc serum level using AAS and hemoglobin using hemoCue. Data of individual characteristics and rearing pattern were obtained through interview and nutrient intake were measured using recall 2 x 24 hours. Data analysis used bivariate technique for variable related to stunting, chi square test for category data, independent t-test for ratio and logistic regression test to measure risk of some variables simultaneously related to incidence of stunting. Result: The result of bivariate analysis showed that was difference in age between stunted and normal underfives (p<0.05) . In the group of underfives that were no longer breastfed there was difference in intake of zinc between stunted and normal underfives (p<0.05). The result of multivariate analysis showed that underfives that were no longer breastfed had risk 2 times greater for being stunted after the control of age, status of vitamin A and zinc. The effect is modified by age and breast-feeding. Conclusion: There was no evidence that showed that vitamin A and zinc deficiency among underfives were risk factors for the incidence of stunting. Variable that was individually as well as simultaneously significant for the incidence of stunting was breastfeeding status. Underfives that were not breastfed had risk 2 times greater for being stunted than those that were breastfed, and the effect is modified by age and breast-feeding.

Kata Kunci : Stunting,Vitamin A,Zinc,Serum retinol,Serum zinc,Hb dan status menyusu, stunting, vitamin A, zinc, retinol serum, zinc serum, hemoglobin, breastfeeding status