HUBUNGAN KADAR RETINOL SERUM DENGAN THYROID STIMULATING HORMONE (TSH) PADA ANAK BALITA DI DAERAH KEKURANGAN YODIUM Studi di Kecamatan Kismantoro Kabupaten Wonogiri THE ASSOCIATION BETWEEN SERUM RETINOL AND THYROID STIMULATING HORMONE (TSH) ON UNDERFIVE CHILDREN IN IODINE DEFICIENCY AREA A Studi in Kecamatan Kismantoro Kabupaten Wonogiri

Abstract

Background: In developing countries such as in Indonesia, vitamin A and iodine deficiencies often occur together. Vitamin A deficiency decreases thyroidal iodine uptake, impaired thyroglobulin synthesis and increases thyroid size. Objectives: This study aimed to examine serum retinol, Thyroid Stimulating Hormone (TSH) level and to provide evidence on the association between them in an iodine deficiency ,i.e. in Kecamatan Kismantoro, Kabupaten Wonogiri. Method: This research is an analytical descriptive study with a cross-sectional approach. Thirty seven subjects aged 6-59 months were selected randomly from 2260 underfive children. Serum TSH levels were measured using ELISA method and serum retinol levels were measured on HPLC. Data were analyzed by Pearson correlation test, with a p-value of <0.05. Results: 43.2% of the subjects had inadequate serum retinol (<30µg/dl). 10.8% of the subjects had sub-clinical vitamin A deficiency (serum retinol<20µg/dl). The mean serum retinol levels was 28.64 ± 6.8 µg/dl. 91.9% of the subjects had normal TSH level, while 5.4% were hyperthyroid (<0.4µIU/ml) and 2.7% were hypothyroid (>5.0µIU/ml). The mean serum TSH levels was 1.6 ± 1.4IU/ml. There was no association between serum retinol and log (serum TSH) levels (r=-0.199, p=0.238). Conclusions: There was no evidence on the association between serum retinol and TSH levels on these subjects. Latar Belakang : Di negara berkembang seperti Indonesia, sering terjadi kekurangan vitamin A dan kekurangan yodium secara bersama. Kekurangan vitamin A dapat menurunkan asupan yodium ke dalam tiroid dan mengganggu sintesis tiroglobulin serta meningkatkan ukuran tiroid. Tujuan : Penelitian ini bertujuan untuk mengetahui kadar retinol serum, kadar TSH dan membuktikan hubungan kadar retinol serum dengan kadar TSH di daerah kekurangan yodium, yaitu di Kecamatan Kismantoro Kabupaten Wonogiri Metode : Penelitian ini bersifat deskriptif analitik dengan pendekatan cross sectional. Tiga puluh tujuh subyek berumur antara 6-59 bulan, dipilih secara random dari 2260 balita yang tinggal di Kecamatan tersebut. Pengukuran TSH dilakukan dengan metode ELISA dan retinol serum dengan HPLC. Analisis data dilakukan dengan uji korelasi Pearson dengan taraf signifikansi p<0,05. Hasil : Sebanyak 43,2% subyek mempunyai kadar retinol serum yang tidak adekuat (≤ 30 µg/dl). 10,8% subyek termasuk dalam kategori kekurangan vitamin A tingkat sub klinis (<20 µg/dl). Rerata kadar serum retinol 28,59 ± 6,8 µg/dl, 91,9% subyek mempunyai kadar TSH normal sementara 5,4% subyek hipertiroid (TSH < 0,4 µIU/ml) dan 2,7 % subyek hipotiroid (TSH > 5,0 µIU/ml). Rerata kadar TSH 1,63 ± 1,4 µIU/ml. Tidak terdapat hubungan antara kadar retinol serum dengan log (kadar serum TSH), (r= -0,199, p=0,238). Simpulan : Tidak terbukti adanya hubungan antara kadar retinol serum dengan log (kadar serum TSH) pada subyek yang diteliti.