Tesis

Profil Zat Besi Bayi Usia 9-12 Bulan: Hubungan dengan Status Gizi dan Zat Pemacu serta Penghambat Absorpsi Besi dalam Asupan Diet = Iron Profile of 9-12 Month-Old Babies: Correlation with Nutritional Status, Enhancers and Inhibitors of Iron Absorption in Daily Dietary Intake.

Latar belakang: Anemia defisiensi besi pada usia 9-12 bulan dapat berdampak pada kualitas hidup anak di masa depan. Badan Kesehatan Dunia menganjurkan pemberian MPASI sejak usia 6 bulan, sayangnya kualitas MPASI sering tidak memadai terutama dalam hal energi, protein, dan mikronutrien. Asupan zat besi, pemacu dan penghambat absorpsi besi memengaruhi kadar besi tubuh. Penelitian mengenai status zat besi dan hubungannya dengan zat pemacu dan penghambat absoprsi dalam asupan diet pada bayi usia 9–12 bulan yang disertakan dengan analisis asupan (metode food record) belum banyak dilakukan di Indonesia. Tujuan: Mengetahui prevalens gangguan status besi, jumlah asupan harian zat besi, zat pemacu absorpsi besi (vitamin C, A) dan penghambat absorpsi besi (kalsium, seng, fitat) serta hubungannya dengan kejadian defisiensi besi, dan mengetahui hubungan status gizi dan kecukupan asupan besi harian terhadap kejadian defisiensi besi pada bayi usia 9-12 bulan. Metode: Studi potong lintang di beberapa Posyandu kecamatan Tanah Abang dan Jatinegara, sejak Juli 2017-Januari 2018, melibatkan 82 bayi usia 9-12 bulan. Asupan pemacu absorpsi zat besi (vitamin C, A) dan penghambat (fitat, kalsium, seng) dinilai dengan food record selama tiga hari dan diolah dengan program NutriSurvey ® . Subyek menjalani pengukuran antropometri, dan pengambilan sampel darah (darah perifer lengkap, LED, dan feritin serum) Hasil: Terdapat 82 subyek berpartisipasi dalam penelitian. Prevalens defisiensi besi sebesar 12,2%, dan ADB sebesar 26,8%. Tidak terbukti ada hubungan antara kecukupan asupan besi harian dengan gangguan status besi [p=0,064; PR=2,1 (0,193-1,178)] dan status gizi kurang dengan gangguan status besi [p=0,444; PR=0,729 (0,307-1,731)]. Terdapat perbedaan bermakna antara asupan harian besi total (p=0,002), besi heme (0,017), kalsium (p=0,006), dan seng (p=0,042) antara kelompok defisiensi besi dan non-defisiensi besi. Simpulan: Prevalens defisiensi besi dan ADB pada bayi usia 9-12 bulan berturutturut adalah 12,2% dan 26,8%. Tidak terbukti ada hubungan antara status gizi dan kecukupan asupan besi harian dengan gangguan status besi, namun terdapat perbedaan bermakna antara asupan harian besi total, besi heme, kalsium, dan seng antara kelompok defisiensi dan non-defisiensi besi pada populasi bayi usia 9-12 bulan.
Kata kunci: Anemia, defisiensi besi, status gizi, asupan diet, penghambat absorpsi besi, pemacu absorpsi besi.


Background: Iron deficiency anemia in 9-12 month-old babies could affect their quality of life. World Health Organization recommends complementary food to be given to babies at exactly 6 months old of age, unfortunately the quality of the food is often inadequate, esp. in fulfilling baby’s energy, protein, and micronutrient needs. Intake of iron containing food, enhancer and inhibitor of iron absorption affects iron body level. Study about iron profile and its correlation with enhancers and inhibitors of iron absorption in baby’s daily dietary intake whose analyzed by food record method is still infrequent in Indonesia. Objective: To measure the prevalence of iron deficiency and IDA, daily iron intake, daily enhancers (vitamin C and A) and inhibitors (calcium, zinc, phytate) intake, and their correlation with iron deficiency status, and to know the correlation of nutritional status and adequacy of daily iron intake with iron deficiency status in 9-12 month-old babies. Methods: A cross-sectional study was conducted in Posyandu in Tanah Abang and Jatinegara district on July 2017-January 2018. Dietary iron intake, enhancer (vitamin C, A) and inhibitor (phytate, calcium, zinc) were obtained using a 3-day food record method and analyzed with NutriSurvey ® program. Subjects underwent anthropometry measurement. Complete blood count, ESR, and ferritin serum were examined. Results: A total of 82 babies were studied. Prevalence of iron deficiency and IDA were 12,2% and 26,8%. There were no evidence of relationship between adequacy of daily iron intake (p=0,064) and undernourished condition (p=0,444) with iron deficiency status. There were statistically significant differences in total iron (p=0,002), heme iron (p=0,017), calcium (p=0,006), and zinc (p=0,042) daily intakes between iron deficiency group and non-iron deficiency group. Conclusion: The prevalence of iron deficiency and IDA were 12,2% and 26,8%. There were no evidence of relationship between adequacy of daily iron intake nor undernourished condition with iron deficiency status. There were statistically significant difference in total iron, heme iron, calcium, and zinc daily intakes between iron deficiency group and non-iron deficiency group in 9-12 month-old babies.
Keywords: Anemia, iron deficiency, nutritional status, dietary intake, iron absorption’s enhancer, iron absorption’s inhibitor.