HUBUNGAN ANTARA KADAR Zn DENGAN KADAR FERRITIN & HEMOGLOBIN PADA IBU HAMEL THE CORRELATION OF BLOOD ZINC WITH FERRITIN AND HEMOGLOBIN CONCENTRATION ON PREGNANT WOMEN

Abstract

Zinc is an important trace element during pregnancy, where Zn is used for hemoglobin synthesis and intra uterine foetal growth. Previous studies had shown the effect of Zn towards the Fe metabolism. The effect of Zinc to Iron is begun from the gut. Zinc will complete with Iron during absorption in the gut. Zinc will also complete with Iron during transportation by transferin. Zinc is also important for Retinol Binding Protein synthesis that carry Vitamin A. Vitamin A is necessary for Iron mobilization from liver. The aim of this study is to investigate the corelation between serum Zinc with ferritin and hemoglobin concentrations on pregnant women. Material and Method This study is an observational study with cross-sectional design. The data were collected from the winner of Medical Faculty Diponegoro University QUE (Quality of Undergraduate Education Enhancement) Project. Subjects were 67 pregnant women who received antenatal care on Karangawen I and II Public Health Care, Demak District Central Java, with gestational period mean was 19,7 week (SD=3,42), according to the inclusion criteria which is second trimester pregnancy. Dependent variables are serum ferritin and hemoglobin concentration, whereas The independent variable is serum Zinc. Hemoglobin concentration was measured by Cyanide Free SLS Method, ferritin concentration was measured by R1A method and Zinc concentration was measured by AAS method. Statistical analyses were using Spearman corelation test and x2 test. -The level of significant was 0.05 with 80% power and 95% of confidence interval. Result and Discussion The average of Zinc concentration was 50,4 pg/dL, (normal reference of serum Zinc concentration is 50 — 120pg/d1). Thirty eight subjects (56,7%) were categorized as Zinc deficiency with average Zinc level was 18,2 1.ig/dL (SD=9,89), whereas 29 subjects (43,3%) were not Zinc deficiency with average Zinc level was 92,7 irg/dL(SI:30,45). The overall average level of ferritin was 34,7 pg/L (SD=28,80). Thirty six subjects were categorized as iron deficiency with mean ferritin level was 15,1 pg/L (SD=6,76), 31 subjects- (46,3%) have normal iron status with ferritin level was 57,5 pg/L (SD=27,81). This level is under the threshold of anemia in pregnancy category (lib < 11 g/dL) which was was 10,4 WdL (SD=0,77). Fifty three subjects (79,1%) was categorized as anemia with hemoglobin concentration was 10,2 g/dL (SD= 0,74), 14 subjects (20,9%) were nomml with hemoglobin concentration was 11,2 g/dL (SD=0,16). Spearman-Rank correlation test showed the corelation between serum Zinc and Ferritin concentration was not significant (r=0,078, p=0,531), categorical analysis by x2 also showed the corelation between serum Zinc and ferritin concentration was not significant (x2=0,612, df=1, p=0,434). Similar result also was found on corelation between serum Zinc and Hemoglobin concentration (=0,007; p=0,064), x2 also showed the corelation between serum Zinc and hemoglobin was significant (x2=3,443, df=1, p=0,064). Conclusion There is no significant corelation between serum Zinc concentration with Ferritin and Hemoglobin concentration. Sugestion Further study is needed with more parametres to find out the corelation between Zinc with serum ferritin and hemoglobin concentration. Latar Belakang Zn merupakan t•ace element yang penting pada masa kehamilan, dimana Zn diperlukan mink sintesis hemoglobin dan pertumbuhan janin. Beberapa penelitian melaporkan adanya pengard Zn terhadap metabolisme Fe, Pengaruh Zn terhadap Fe dimulai dad usus, Zn berkompetisi dengan Fe pada saat penyerapan. Selain itu Zn akan ditransport menggunakan transferin bersama dengan Fe. Zn penting untuk pembentukan Retinal Binding Protein untuk membawa vitamin A yang berperan dalam mobilisasi Fe dui hepar. Tujuan dafi penelitian ini adalah untuk mencari hubungan antara kadar Zn dengan kadar ferritin dan hemoglobin pada ibu haniil. Bahan dan Own Kerja Penelitian ini adalah penelitian observasional clengan rancangan belah lintang. Data penelitian adalah berasal dari pemenang QUE (Quality of Undergraduate Education Enhancement) Project Fakultas Kedokteran UNDIP. Subyek penelitian adalah wanita hamil di Puskesmas Karangawen I/II Kab. Demak. Jumlah subjek penelitian adalah 67 orang, refit% mum kehamilan 9,7 minggu (SD=3,42) sesuai dengan kriteria inklusi yaitu hamil trimester II. Variabel terikat penelitan adalah kadar Hb dan kadar ferritin serum. Variabel bebas adalah kadar Zn serum. Radar Hb ditentokan dengan metoda SLS bebas sianida, kadar ferritin diperiksa dengan metode R1A, sedangkan kadar Zn diperiksa dengan metode pemanasan basah menggunakan AAS. Analisa data menggunakan uji korelasi Spearman dan uji x2, Batas kemaknaan adalah p< 0,05 dengan 80% power dan 95% interval kepercayaan. Haan clan Pembabasan Pada penelitian ini diperoleh rata-rata kadar Zn serum adalah 50,4 pg/dl, (rujukan yaitu 50 — 120 mg/dL). Tiga gala delapan subyek (56,7%) dikategorikan sebagai defisiensi Zn dengan rerata kadar Zn adalah 18,2 irg/dL (SD-9,89), sedangkan 29 (43,3%) subyek tidak defisiensi Zn dengan kadar Zn 92,7 im/dL(SD-30,45). Radar ferritin serum rata-rata 34,7iig/L (SD=28,80). Tiga pulub enam subyek (53,7%) dikategorikan defisiensi besi, kadar ferritin 15,1 im/L (SD=6,76), dan 31 orang (46,3%) normal, kadar ferritin 57,5 im/L (SD=27,81). Rata-rata kadar lib pada subyek penelitian adalah dibawah nilai ambang kategori anemia (Ilb < 11 g/dL) yaitu 10,4 g/dL (SD=0,77). Lima puluh tiga subyek (79,1%) dikategorikan sebagai anemia, rerata kadar Hb 10,2 g/dL (S1:10,74), dan 14 (20,9%) orang normal dengan retool kadar Hb 11,2 g/dL (SD=0,16). Hasil uji korelasi Spearman didupatkan korelasi yang tidak bermakna anlara kadar Zn serum dengan ferritin (-0,078, 1)=0,53 I), basil uji x2 juga menunjukkan tidak ada hubungan yang bermakna (x2=0,612, de-1, v0,434). Huhungan yan tidak bermakna juga didapatkan antara kadar Zn serum dengan kadar Hb 0=0,007; v0,064), uji juga tnenunjukkan tidak ada hubungan yang bermakna (x2=3,443, df=1, p=0,064). Kesfinpulan Korelasi yang tidak bermakna antara kadar Zn dengan kadar ferritin dan kadar lib serum pada wanita hamil. Saran Pengukuran kadar Zn protoporphyrin ( ZnPP) darah. Rata Knack Anemia kehamilan, Zn, fenitin, hemoglobin