Hubungan thyroid stimulating hormon dan perkembangan seks sekunder pada anak sindrom down

DIBA, Vicka Farah, dr. S. Yudha Patria, Ph.D.,Sp.A

2010 | Tesis | S2 Ilmu Kedokteran Klinik

Latar belakang : Sindrom Down (Trisomi 21) dapat mempengaruhi hampir semua sistem organ seperti jantung, endokrin, intelektual, ekstremitas dan imun. Prevalensi kejadian hipotiroid kongenital pada Sindrom Down 28 kali lebih sering dari populasi umum. Terdapat penelitian yang menunjukkan bahwa TSH (Thyroid Stimulating Hormon) di sirkulasi yang berlebihan dapat mengaktivasi FSH – R (Follicle Stimulating Hormon - Receptor) dan menstimulasi gonad yang menyebabkan terjadinya pubertas lanjut. Tujuan : Mengetahui hubungankadar TSH dan onset maturitas seksual pada anak Sindrom Down Metode : Jenis penelitian cross sectional. Subyek penelitian adalah anak Sindrom Down usia 8 – 18 tahun di SLBN Pembina Giwangan dan SLBN 3 Kalibayam Yogyakarta yang memenuhi kriteria inklusi, diperiksa maturitas seksual dan kadar kadar TSH serum dengan CMIA (Chemiluminiscence Microparticle Immuno Assay) Hasil : Dari total 62 anak Sindrom down di SLBN 3 Kalibayam Yogayakarta dan SLBN Pembina Giwangan yang dilakukan penelitian, terdapat 59 orang anak (95,2%) kadar TSH normal, 2 orang anak (3,2%) kadar TSH meningkat dan 1 orang anak (1,6%) kadar TSH menurun. Pada semua tingkat umur anak Sindrom Down ini menunujukkan kesesuaian tingkat maturitas seksualnya. Dua anak perempuan dengan peningkatan kadar TSH berusia 12 dan 18 tahun, tingkat maturitas seksualnya masih sesuai usia. Kesimpulan : Prevalensi peningkatan kadar TSH adalah 3,2%. Tidak dijumpai maturitas seksual dini pada penderita Sindrom Down dengan kadar peningkatan nilai TSH dua kali normal dan meningkat setelah usia pubertas

Background: Down syndrome is (trisomy 21) may affect almost any organs or system, such as cardiac, endocrine, intellectual, and immune system. Prevalence and incidence of congenital hypothyroidism in Down's Syndrome 28 times more frequent than normal population. There are studies showing that TSH (Thyroid Stimulating Hormone) overload in circulatory may activate FSH - R (Follicle stimulating hormone - receptor) and stimulates the gonads system that cause early puberty. Objective: To study the relationship between TSH level and sexual maturity in Down Syndrome Methode: Cross sectional study. The research subject were Down's Syndrome child aged 8- 18 years in SLBN 3 Kalibayam and SLBN Pembina Giwangan Yogyakarta that fulfilled inclusion criteria. They were examined on sexual maturity rating and TSH serum levels with CMIA (Chemiluminiscence Microparticle Immuno Assay) Results: From total 62 children with Down Syndrome in SLBN 3 Kalibayam Yogyakarta and SLBN Pembina Giwangan, there were 59 children (95.2%) with normal TSH levels, two children (3.2%) with increased TSH levels and one children (1.6%) with decreased TSH levels. There were an approriate sexual maturity with age in all Down's Syndrome children. Two young women with increased TSH levels aged 12 and 18 years old also show appropriate sexual maturity with age. Conclusion: Increasing of TSH level in Down Syndrome children at Yogyakarta is 3,2% and we havent found early sexual maturity in Down Syndrome with TSH level increase twice than normal and increase after pubertal age.

Kata Kunci : Sindrom down,Prevalensi peningkatan kadar TSH,Pubertas dini, Down syndrome, hypothyroidism, early puberty