HUBUNGAN KADAR SELENIUM (Se) DAN KADAR HORMON TIROID (T4, T3) ANAK SEKOLAH DASAR DI DAERAH ENDEMIK BERAT GAKY KABUPATEN TEMANGGUNG

Nur Ihsan, S.P, Prof. dr. Hamam Hadi, M.S., Sc.D,

2012 | Tesis | S2 Kesehatan Masyarakat/GK

Latar Belakang: Ekskresi yodium urin sebagai indikator cukup tidaknya konsumsi yodium bisa saja telah cukup baik tetapi prevalensi Gangguan Akibat Kekurangan Yodium (GAKY) bisa tetap masih tinggi. Selain yodium, selenium adalah satu mikronutrien yang paling dekat hubungannya dengan metabolisme hormon tiroid, oleh karena itu kekurangan selenium dapat memperberat kejadian GAKY. Tujuan: Mengkaji hubungan kadar selenium dan kadar hormon tiroid : triiodotironin (T3) dan tiroksin (T4). Metode: Penelitian ini merupakan penelitian kuantitatif dengan rancangan crossectional. Responden penelitian ini adalah 63 anak sekolah dasar umur 9-12 tahun di daerah endemik berat GAKY Kabupaten Temanggung. Variabel pengukuran meliputi kadar selenium diukur dengan metoda AAS. T3 dan T4 diukur dengan metoda ELISA, serta status GAKY ditentukan dengan palpasi, Hasil: Median Selenium, T4 dan T3 berturut turut adalah: 22,67 (13,68-30,06) µg/L; 8,67 (4,53-15,35) µg/L; 48,67 ng/dL ( 26,00-125,33); rata-rata rasio T3/T4: 6,22. Hasil palpasi menunjukkan 14,3 % responden menderita gondok grade 1 dan 1,6 % grade 2. Korelasi Spearman menunjukkan tidak ada hubungan yang signifikan antara kadar selenium dengan T4 (r = 0,054; p = 0,674), T3 ( r = 0,070; p = 0,583), rasio T3/T4 (r = 0,014; p = 0,911), dan juga status gondok (r = 0,045; p=0,724). Terdapat hubungan yang signifikan antara T3 dengan persentase kecukupan energi (p=0,005) dan protein (p=0,045) pada kuartil 4. Kesimpulan: Kadar selenium tidak terbukti berhubungan dengan kadar hormon tiroid (T3,T4), ratio T3/T4 dan status gondok. Terdapat hubungan antara kecukupan energi dengan kadar T3 dan kecukupan protein dengan kadar T3, dimana defisiensi energi dan protein menurunkan kadar T3.

Background: Urinary iodine excretion as an indicator of whether iodine intake sufficient or not could have been quite good but the prevalence of Iodine Deficiency Disorder (IDD) can still remain high. Apart of iodine, selenium is a micronutrient that most closely associated with thyroid hormone metabolism, thus selenium deficiency can aggravate the incidence of IDD. Objective: To study the relationship between level of selenium and thyroid hormone: tri-iodothyronine (T3) and thyroxine (T4). Design: The study used quantitative method and cross sectional design. Include 63 randomly selected elementary school children ages 9-12 years who lived in severe IDD endemic area at district of Temanggung. Selenium assessed using AAS method, thyroid hormone (T3, T4) assessed using ELISA method and IDD status assessed through palpation. Result: Median Selenium, T4 and T3 subsequently were 22.67 (13.68 to 30.06) µg/L; 8.67 (4.53 to 15.35) µg/L; 48.67 ng/dL (26, 00 to 125.33), average T3/T4 ratio: 6.22. The result of palpation showed 14.3% of respondents suffered from goiter grade 1 and 1.6% had grade 2. No significant relationship between level of selenium and T4 (r = 0.054, p = 0.674), T3 (r = 0.070, p = 0.583), T3/T4 ratio (r = 0.014, p = 0.911), and IDD status (r=0.045, p=0,724). There was a significant relationship between T3 with the percentage of energy ( p = 0.005) and protein sufficiency (p = 0.045) in quartile 4. Conclusion: There was no relationship between level of selenium and thyroid hormone levels (T3, T4), T3/T4 ratio and also with IDD status. There was relationship between level of T3 with energy and protein, where the energy and protein deficiency lowers T3 levels.

Kata Kunci : GAKY, Selenium, hormon tiroid, T3,T4