HUBUNGAN ANTARA KADAR YODIUM DALAM URIN DENGAN KADAR THYROID STIMULATING HORMONE SERUM DARAH PADA WANITA USIA SUBUR HIPOTIROID DI KABUPATEN PURWOREJO, JAWA TENGAH

OKTANIA CANDRAWATI, Dra. Tasmini, M.Kes.

2014 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Gangguan Akibat Kekurangan Yodium (GAKY) masih menjadi salah satu masalah gizi utama di Indonesia dan wanita usia subur (WUS) adalah salah satu kelompok masyarakat yang berisiko terhadap hipotiroidisme akibat GAKY. Insidensi GAKY meningkat padahal asupan yodium oleh masyarakat sudah mencukupi. Hasil pemetaaan GAKY oleh Dinkes Jawa Tengah (2003) menunjukkan bahwa Kabupaten Purworejo merupakan daerah endemik ringan GAKY. Tujuan penelitian: Untuk mengetahui hubungan antara kadar yodium dalam urin dengan kadar Thyroid Stimulating Hormone (TSH) serum darah pada wanita usia subur (WUS) hipotiroid di Kabupaten Purworejo, Jawa Tengah. Metode penelitian: Rancangan penelitian yang digunakan adalah studi kasus kontrol. Sebanyak 54 WUS usia 15-45 tahun diambil secara acak sederhana dari 5 pedukuhan di Desa Kaligintung, Kecamatan Pituruh, Kabupaten Purworejo, Jawa Tengah. Kelompok WUS dengan kadar TSH serum darah ≥3 μIU/mL termasuk dalam WUS hipotiroid (kelompok kasus) sedangkan WUS dengan kadar TSH serum <3 μIU/mL termasuk dalam WUS eutiroid (kelompok kontrol). Data diolah menggunakan analisis univariat meliputi persentase usia, indeks massa tubuh, kadar TSH serum darah, dan median kadar yodium dalam urin sedangkan analisis bivariat untuk mengetahui kadar yodium dalam urin pada WUS hipotiroid dibandingkan dengan WUS eutiroid dan untuk mengetahui hubungan antara kadar yodium dalam urin dengan kadar TSH serum darah pada WUS hipotiroid di Kabupaten Purworejo, Jawa Tengah. Hasil: Rerata kadar TSH serum darah pada WUS hipotiroid dan eutiroid sebesar 3,78±0,72 μIU/mL dan 2,44±0,55 μIU/mL sedangkan median kadar yodium dalam urin pada WUS hipotiroid dan eutiroid sebesar 79 μg/L dan 61 μg/L, tidak ada perbedaan bermakna antara median kadar yodium dalam urin pada WUS hipotiroid dibandingkan dengan WUS eutiroid (p=0,359). Hasil analisis menunjukkan tidak ada hubungan yang bermakna antara kadar yodium dalam urin dengan kadar TSH serum darah pada WUS hipotiroid di Kabupaten Purworejo, Jawa Tengah (p=0,081, r= 0,341). Kesimpulan: Tidak terdapat hubungan antara kadar yodium dalam urin dengan kadar TSH serum darah pada WUS hipotiroid.

Background: Iodine Deficiency Disorders (IDD) is still one of the major nutritional problems in Indonesia. Women of childbearing age are at risk suffering hypothyroidism as a result of IDD. The incidence of IDD is increasing whereas the iodine intake has been already sufficient. The results of the IDD mapping by the Central Java Health Office (2003) showed that Purworejo is a mild endemic area of IDD. Objective: To determine the relationships between urinary iodine excretion and serum Thyroid Stimulating Hormone (TSH) level in blood of women of childbearing age with hypothyroid in Purworejo, Central Java. Method: The design of the study is a case-control study. Fifty four women aged 15-45 years were drawn randomly from 5 hamlets in the Village Kaligintung, Sub-district Pituruh, Purworejo, Central Java. Women with serum TSH levels ≥3 μIU/mL were included as hypothyroid group (cases) whereas women with TSH serum levels <3 μIU/mL were included as euthyroid (control). The data was processed using univariate analysis as the percentage of age, body mass index, serum TSH levels, and median urinary iodine excretion levels while bivariate analysis is to compare urinary iodine excretion levels on hypothyroid group with euthyroid group, also to determine the relationships between urinary iodine excretion and serum TSH level in blood of productive age women with hypothyroid in Purworejo, Central Java. Results: The mean serum TSH levels in hypothyroid and euthyroid groups are 3.78± 072 μIU/mL and 2.44±0.55 μIU/mL while the median urinary iodine excretion levels in hypothyroid and euthyroid groups are 79 ug/L and 61 mg/L, there was no significant difference between the median urinary iodine excretion levels in the hypothyroid group compared with euthyroid group (p=0.359). The analysis showed no significant association between urinary iodine excretion and serum TSH level in blood of productive age women with hypothyroid in Purworejo, Central Java (p=0.081, r = 0.341). Conclusions: There was no relationship between urinary iodine excretion and serum TSH level in blood of productive age women with hypothyroid.

Kata Kunci : iodine levels in urine, blood serum levels of TSH, women of childbearing age, hypothyroid.