Yusi Dwi Nurcahyani
Balai Penelitian dan Pengembangan GAKI Magelang

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HUBUNGAN FAKTOR PERBEDAAN INDIVIDUAL DAN KETERSEDIAAN GARAM DI WARUNG DENGAN PERILAKU IBU RUMAH TANGGA DALAM PENGGUNAAN GARAM BERIODIUM DI KABUPATEN PURWOREJO

Media Gizi Mikro Indonesia Vol 1, No 4 Jun (2011)
Publisher : Media Gizi Mikro Indonesia

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IDD would be serious health problem. Behavior in salt iodization was influenced by individual dijJerence and environments. Th is study will examine relationship between individual dijJerence and availability ofiodized salt in the shop with salt iodization behavior in Purworejo. Regency. Observational research with cross sectional. This research in Ngombol Village, Purworejo Regency. Research was done in Mei-November 2010. Samples were 113 household. The instrument to collect data was questionnare regarding availability of iodized salt in the shop and individual dijJerence factors. Behavior in salt iodization had significant relationship with Mother s knowledge level (X2 = 9,834, p = 0,002), but had no significant relationship with Mother s attitude (X2 = 3,681, p = 0,055), no significant with habit (t = 0,459 , P = 0,498), no significant with availability of salt (X2 = 1,985, p =0,159)Key words : individual dijJerence, availability of iodized salt, behavior, salt iodization.

HUBUNGAN ANTARA STATUS TSH IBU HAMIL DENGAN RIWAYAT KEHAMILAN DAN KELAHIRAN DI DAERAH ENDEMIK GAKI

Media Gizi Mikro Indonesia Vol 1, No 3 Des (2010)
Publisher : Media Gizi Mikro Indonesia

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Background: Excess of iodine during pregnancy can give a special problem. Diagnosis of hyperthyroidism during pregnancy can cause first-trimester spontaneous abortions, high rates ofstill births and neonatal deaths, two- to threefold increases in the frequency of low birth weight infants, preterm delivery, fetal or neonatal hyperthyroidism, and intrauterine growth retardation. Odjective: These studies examine the relationship between TSH levels in pregnant women with a history of pregnancy and birth mothers in1DD endemic areas. Method: This study is a non-intervention with cross sectional comparative design. ln previous research carried out screening for pregnant women who live in areas of endemic iodine deficiency disorder. From the results of screening found 67 pregnant women, where 32 pregnant women have a lower TSH «0.3 ulll/ml) and 35 pregnant women had normal TSH levels (0.3-3.6111U/ml). After giving birth mothers checked TSH level again and recorded the history o[his birth. Result: ln this study there was no difference for complaints during pregnancy that leads to the signs ofhyperthvroidism between group of pregnant women with low TSH and group of pregnant women with normal TSH. There was no significant difference between postpartum maternal TSH and TSH babies group ofpregnant women with low TSH and group ofpregnant women with normal TSH. There was a significant differencefor TSH mother before and after deli velJl. Conclusions: Low serum TSH value has no effect on the clinical state ofpregnant women and infants born allegedly under the influence of the increase olhCG in the .first trimester of pregnancy, is not because of the circumstances leading to hyperthyroid mothers. But in this study hCG levels pregnant women are not were measured. Key words: low TSH, pregnant women, birth mothet.

STATUS PUBERTAS DAN ANEMIA PADA REMAJA AWAL LAKI-LAKI DAN PEREMPUAN DI DAERAH ENDEMIK GAKI

Media Gizi Mikro Indonesia Vol 1, No 3 Des (2010)
Publisher : Media Gizi Mikro Indonesia

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Backround: Nutrition problems occurred at every stage of development. Department of Child and Adolescent Health WHO stated that there stilllack of attention on nutrition problems in adolescent stage. Jn the other hands, adolescent is a vulnerable stage because lack of micro nutrition in take, while needed a lot of nutrition due to rapid growth in this stage and menstrual cyclefor girls. Objective: To determine the potential associations between puberty status and anemia among early adolescent in iodine deficient area. Methods: This was a crossectional study, included 120 randomly selectedfirst grade of two junior high schools in the endemic areas of IDD in Temanggung, Central Java. Anemia status was determined by measuring Hemoglobin level in blood sampie and puberty status was obtained through questionnaire. Result: Among the samples, 25 samples (20.8%) were anemics. Girls had 1.55 times chance to had anemia than boys, but statistically not significant (OR: 1.55; 95%CJ; 0.61-3.93). Girls had anemia 1,55 times higher than boys but statistically not significant (OR: 1,55; 95%CJ; 0,61-3,93). Among boys and girls, puberty wasnt related to anemia (OR: 1,31; 95%CJ, 0,53-3.25). Stratified analysis showed that the risk for having anemia among girls who had puberty was 1.5 times higher than girls who hadnt had puberty but statistically not significant (OR: 1,5; 95%CJ; 0,61-3,93). White reversely, boys who had puberty was had lower risk of having anemia, but statisticallynotsignificant(OR: 0.57/; 95%CJ; 0,135-2.422). Conclusion: Puberty status was not related to anemia in early adolescent, but girls who had puberty showed more predisposition to had anemia. Further research needed in later stage of adolescent, especially in girls in iodine endemic area to find out more about relationship between puberty and anemia. Keywords: Anemia, Puberty, Early Adolescent, Jodine Deficiency Disorders Area

Suplementasi Besi Mampu Memperbaiki Kadar Hormon TSH Anak Sekolah di Daerah Endemik GAKI

Media Gizi Mikro Indonesia Vol 5, No 2 (2014)
Publisher : Media Gizi Mikro Indonesia

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ABSTRACT Multiple nutritional and environmental influences contribute to the prevalence and severity of IDDs in iodine deficient areas, including iron. In many developing countries, children are at high risk of both goiter and iron deficiency anemia. Iron deficiency adversely affects thyroid metabolism and may reduce the efficacy of iodized salt. The aim of this study was to investigate whether iron supplementation can improve thyrothrophin hormone in school children in iodine deficient areas. A trial of iron supplementation was carried out in an area of endemic goiter in Kertek Wonosobo (n = 35), another group given placebo (n = 35). At baseline, anthropometri, TSH, ferritin, urinary iodine excretion and level of iodized salt were measured. After 13 weeks supplementation, the same data collecting was conducted. Supplement’s compliance during the study reached 100%. Two subject were excluded from from the analysis because they have extreme bio chemical data than the overall average. Statistical test showed no differences in age and gender proportion between groups. There were no significant difference in nutritional status, level of EIU, and level of iodine in salt between groups after the intervention, but there was a significant increase in ferritin level in the iron group (31.0 vs 44.8 μg/l, p<0.05). There were a significant difference in protein and iron intake, but no significant different in energy intake.These two group did not differ in TSH level change. After taking into account the modification variable effect of adequate protein > 70% RDA, the effect of iron supplementation was proved to be effective in changing TSH level (p <0.05). Our result indicate that increase in iron status can improve TSH hormone after considering adequate protein intake (RDA). Keywords : IDD, iron supplementation, thyroid function.   ABSTRAK Di daerah yang kekurangan iodium, pengaruh gizi dan lingkungan berkontribusi pada prevalensi dan tingkat keparahan GAKI, termasuk defisiensi mikronutrien lain diantaranya zat besi. Di negara berkembang, banyak anak-anak menderita GAKI dan defisiensi besi secara bersamaan. Defisiensi besi dapat mengganggu metabolisme tiroid dan mengurangi efektivitas garam beriodum. Penelitian ini bertujuan mempelajari pengaruh suplementasi besi dosis 60 mg/minggu terhadap hormon tiroid pada anak sekolah di daerah endemik GAKI. Suplementasi besi diberikan pada anak sekolah dasar umur 9-12 tahun di daerah dengan kasus kretin, di Kertek Wonosobo (n = 35) dan kelompok lainnya mendapatkan plasebo (n = 35). Awal penelitian dilakukan pengukuran antropometri, kadar TSH, ferritin, UIE dan kadar garam. Setelah 13 minggu suplementasi dilakukan pengukuran yang sama. Tingkat kepatuhan subyek mengonsumsi bahan intervensi 100%, tetapi 2 orang dikeluarkan dari analisis karena data biokimia yang ekstrim dibandingkan rerata keseluruhan. Umur dan jenis kelamin subyek tidak berbeda secara statistik. Setelah suplementasi, status gizi, kadar UIE dan kadar iodium dalam garam tidak berbeda nyata, tetapi ada peningkatan kadar ferritin yang signifikan pada kelompok Fe (31.0 menjadi 44.8 μg/l, p <0.05). Ada perbedaan asupan protein dan zat besi yang signifikan (p <0.05) antara kelompok Fe dan plasebo, tetapi tidak pada asupan energi. Tidak ada perbedaan perubahan kadar TSH yang signifikan antara kelompok Fe dan plasebo. Setelah memperhitungkan efek modifikasi (kecukupan protein >70% AKG), terbukti suplementasi besi berpengaruh terhadap perubahan TSH (p <0.05). Peningkatan status besi dapat memperbaiki hormon TSH setelah memperhitungkan tingkat kecukupan protein (AKG). Kata kunci: GAKI, suplementasi besi, fungsi tiroid.

Pengaruh Iodium terhadap Perubahan Fungsi Tiroid dan Status Iodium

Media Gizi Mikro Indonesia Vol 5, No 1 (2013)
Publisher : Media Gizi Mikro Indonesia

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ABSTRACT Iodine is an essential element that enables the thyroid gland to produce thyroid hormones. The source of iodine in the body comes from food, iodized salt and iodine capsules. Iodized salt and iodine capsules had been used by the government in Iodine Deficiency Disorders (IDD) elimination program. However, iodine capsules prophylaxis program in the IDD endemic areas had caused symptoms of hyperthyroidism, subsequently the program was discontinued since 2009. The aim of this research to determine the effect of iodine supplementation on thyroid function and iodine status. This was quasi-experimental design, conducted in Pituruh Purworejo District. Sample of this study consisted of 85 women of childbearing age, divided into three intervention groups. Each group obtained iodized salt for one month, then continued with the provision of iodized salt and 200 mg iodine capsules in group I, iodized salt and 400 mg iodine capsules in group II, and iodized salt and shredded tuna fish 2 times a week in group III for 3 months. Thyroid status was measured by levels of TSH, FT4 analyzed with ELISA. Iodine status measured by UIE levels analyzed with spectrophotometer. Data was analyzed using General Linear Model Repeated Measure (GLM RM). After 3 months, in all three treatment groups the TSH changes were statistically significant. In FT4 hormone levels, after administration of the intervention occurred “Wolff-Chaikoff” mechanism. There were significant increase on Iodine status (UIE) (p< 0.05) in all three treatment groups. There is a change in iodine status and thyroid function after administration of three forms of iodine intervention. Keywords: iodine, TSH, FT4, UIE. ABSTRAK Iodium merupakan bahan dasar untuk membentuk hormon tiroid. Sumber iodium tubuh berasal dari makanan, garam beriodium, dan kapsul iodium. Garam beriodium dan kapsul iodium telah digunakan oleh pemerintah dalam penanggulangan Gangguan Akibat Kekurangan Iodium (GAKI). Namun peng-gunaan kapsul iodium secara tidak selektif telah menimbulkan gejala-gejala hipertiroid sehingga penggunaannya dihentikan sejak tahun 2009. Penelitian ini bertujuan untuk mengetahui efek pemberian iodium terhadap fungsi tiroid dan status iodium. Disain penelitian ini adalah quasi eksperimen dengan sampel wanita usia subur sebanyak 85 orang yang terbagi dalam tiga kelompok intervensi. Setiap kelompok dilakukan pemberian garam beriodium selama satu bulan dan dilanjutkan dengan pemberian garam beriodium dan kapsul iodium 200 mg pada kelompok I, pemberian garam beriodium dan kapsul iodium 400 mg pada kelompok II, pemberian garam beriodium dan abon ikan tuna 2 kali seminggu pada kelompok III selama 3 bulan. Subyek diukur kadar TSH dan FT4 dengan metode ELISA, serta diukur kadar iodium dalam urin (UIE) dengan metode Spektrofotometer. Analisa data menggunakan General Linear Model Repeated Measure. Setelah tiga bulan intervensi terjadi perubahan kadar TSH yang bermakna secara statistik pada ketiga kelompok perlakuan. Pada kadar hormon FT4 setelah pemberian intervensi terjadi mekanisme “Wolff-Chaikoff” dan pada kadar UIE terjadi peningkatan yang bermakna secara statistik (p<0,05) pada ketiga kelompok perlakuan. Terjadi perubahan fungsi tiroid dan status iodium setelah pemberian intervensi iodium. Kata kunci: TSH, FT4, UIE.

Pengaruh Suplementasi Ganda Iodium dan Zat Besi (Fe) terhadap Kadar Tsh, Ft4, T3 dan Ferritin Anak Sekolah Dasar

Media Gizi Mikro Indonesia Vol 6, No 2 (2015)
Publisher : Balai Penelitian dan Pengembangan Gangguan Akibat Kekurangan Iodium

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PENGARUH SUPLEMENTASI GANDA IODIUM DAN ZAT BESI (Fe) TERHADAP KADAR TSH, fT4, T3 DAN FERRITIN ANAK SEKOLAH DASAR   Effect of Iodine and Iron (Fe) Dual Supplementation on The Levels of TSH, fT4, T3 and Ferritin in Primary School Children ABSTRACT Background. Intercorrelations between iodine and iron (Fe) on the function of the thyroid gland and the status of iron (Fe) affects the effectiveness of Iodine deficiency disorders (IDD) prevention and anemia programs. Communities group prone to nutritional problems are school age children who are in growth period. Objective. This study aims to compare the effect of iodine iron (I+Fe) double supplementation with single supplementation of iodine (I) and single supplementation of iron (Fe) on the function of the thyroid gland and the status of iron (Fe). Method. The study was a randomized double-blind controlled trial. Provision of interventions done by randomization with block permutations dividing study subjects into four groups: Iodine+iron (I+Fe) dual supplement group, iodine (I) only supplement group, iron (Fe) only suplement group and placebo group. Subjects were primary school children aged 9-12 years. Interventions conducted for 13 weeks and thyroid function measured by serum levels of TSH, fT4 and T3, while the iron status based on ferritin levels. Results. Supplementation of Iodine and Iron can increase ferritin and T3 levels, while supplementation of I+FeI, I or Fe can increase levels of fT4 although it is not statistically significant. Ancova showed there is a mechanism of mutual influence between ferritin, fT4 and T3. Conclusion. There is no differences between dual supplementation of iodine and iron with single supplementation of iodine or iron in alteration of ferritin, TSH, fT4, and T3 serum. Keywords: iodine, iron, supplementation.   ABSTRAK Latar belakang. Interkorelasi antara iodium dan zat besi (Fe) terhadap fungsi kelenjar tiroid dan status zat besi (Fe) mempengaruhi efektifitas program penanggulangan Gangguan Akibat Kekurangan Iodium (GAKI) dan anemia. Kelompok masyarakat yang rawan terhadap kedua masalah gizi tersebut adalah anak usia sekolah yang sedang dalam masa pertumbuhan. Tujuan. Analisis ini bertujuan untuk membandingkan pengaruh suplementasi ganda iodium zat besi (Fe) dengan suplementasi tunggal iodium dan suplementasi tunggal zat besi (Fe) terhadap fungsi kelenjar tiroid dan status zat besi (Fe). Metode. Desain penelitian adalah randomized double blind contolled trial. Pemberian intervensi dilakukan dengan cara randomisasi dengan blok permutasi yang membagi partisipan penelitian ke dalam 4 kelompok yaitu kelompok suplementasi ganda iodium+zat besi (I+Fe), kelompok suplementasi tunggal iodium (I), kelompok suplementasi tunggal zat besi (Fe) dan kelompok placebo. Partisipan penelitian adalah anak sekolah dasar umur 9 – 12 tahun. Intervensi dilakukan selama 13 minggu dan fungsi tiroid diukur berdasarkan kadar TSH, fT4 dan T3 serum, sedangkan status besi berdasarkan kadar feritin serum. Hasil. Pemberian suplementasi Iodium dan Fe (I+Fe) dapat meningkatkan kadar feritin dan T3. Pemberian suplementasi Fe+I, I atau Fe dapat meningkatkan kadar fT4 walaupun secara statistik tidak bermakna. Uji ancova menunjukkan adamekanisme saling mempengaruhi antara feritin, fT4 dan T3. Kesimpulan. Tidak ada perbedaan nyata antara suplementasi ganda iodium zat besi (Fe) dengan suplementasi tunggal iodium atau zat besi (Fe) terhadap perubahan ferritin, TSH, fT4, dan T3 serum. Kata kunci: iodium, zat besi, suplementasi.

Hubungan Defisiensi Selenium dengan Thyroid Stimulating Hormone (TSH), Triiodothyronin (T3), dan Free Thyroxine (Ft4) pada Anak Sekolah Dasar di Daerah Endemik GAKI

Media Gizi Mikro Indonesia Vol 6, No 2 (2015)
Publisher : Balai Penelitian dan Pengembangan Gangguan Akibat Kekurangan Iodium

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HUBUNGAN DEFISIENSI SELENIUM DENGAN THYROID STIMULATING HORMONE (TSH), TRIIODOTHYRONIN (T3), DAN FREE THYROXINE (fT4) PADA ANAK SEKOLAH DASAR DI DAERAH ENDEMIK GAKI   Selenium Deficiencies Association with Thyroid Stimulating Hormone (TSH), Triiodothyronin (T3) and Free Thyroxine (fT4) Levels in Endemic IDD Areas Primary School Children ABSTRACT Background. Iodine and selenium are essential micronutrients in the formation of thyroid hormones. Selenium plays a role in the conversion of T4 to T3, that its deficiency can affect thyroid hormone metabolism and exacerbate iodine deficiency.This study aimed to determine the relationship between selenium status and thyroid hormone status of primary school children in the endemic iodine deficiency areas. Methods. This is a cross sectional design study conducted in Candiroto, Temanggung district. The subjects were 70 students of the fourth, fifth and sixth grade of three elementary schools which were randomly selected.The selenium concentration in the serum were determined using atomic absorption spectrophotometry while the TSH, fT4 and T3 were measured using enzyme linked immunosorbent assay (ELISA) method. The data were analysed using spearman correlation and linear regression. Result. It was found that selenium status on all subjects were below standard, with a median of 21.2 (13.7 to 30.1) ug/L.Thyroid status were in the normal range, with the fT4 median and TSH mean of 8.5 (4.5 to 15.3) mg/L and 3.6 (± 2.0) mIU/L respectively. T3 levels were in the category below normal on 92.9 percent subjects with median of 0.7 (0.4 to 1.9) nmol/L. Almost 90 percent of the subjects consumed substandard iodized salt (> 30 ppm). There is significant correlation between selenium levels with TSH levels (r = 0.384; p = 0.001), however there are no significant correlation between selenium with fT4 and T3. Increased in TSH levels can predict increase in selenium levels after considering other variables (R2= 0,133). Conclusion. In this study, selenium deficiency is positively associated with TSH, but not significantly associated with fT4 and T3. Keywords: free T4, IDD, selenium, schoolchildren, T3.   ABSTRAK Latar Belakang. Iodium dan selenium merupakan mikronutrien yang penting dalam pembentukan hormon tiroid. Selenium berperan dalam konversi T4 ke T3, sehingga defisiensi selenium dapat mempengaruhi metabolisme hormon tiroid dan memperberat GAKI. Penelitian ini bertujuan untuk mengetahui hubungan status selenium dan status hormon tiroid anak sekolah dasar di daerah endemik GAKI. Metode. Desain penelitian menggunakan rancangan cross sectional. Lokasi penelitian di Kecamatan Candiroto salah satu daerah endemik berat GAKI di Kabupaten Temanggung. Sebanyak 70 sampel serum darah diambil dari siswa kelas 4, 5, dan 6 pada 3 sekolah dasar yang dipilih secara acak. Kadar Selenium diukur dengan menggunakan metode atomic absorption spectrophotometry sedangkan kadar TSH, fT4, dan T3 diukur dengan menggunakan metode enzyme linked immunosorbent assay (ELISA). Analisis data menggunakan uji korelasi spearman dan regresi linier. Hasil. Hasil penelitian menunjukkan bahwa seluruhsubyek (100%) memiliki status selenium di bawah normal, dengan median 21.2 (13.7 – 30.1) μg/L. Status tiroid dalam kisaran normal, dengan median fT4 dan rerata TSH 8.5 (4.5-15.3) μg/L dan 3.6 (+ 2.0) mIU/L berturut turut, sedangkan 92.9 percent kadar T3 subyek dalam kategori di bawah normal, dengan median 0.7 (0.4-1.9) nmol/L. Sebagian besar subyek (90 %) mengkonsumsi garam yang tidak memenuhi syarat (< 30 ppm). Terdapat korelasi positif yang bermakna secara statistik antara kadar selenium dengan kadar TSH (r = 0.384; p = 0.001). Tidak terdapat korelasi antara kadar selenium dengan kadar fT4 dan T3. Analisis regresi linier selenium dengan TSH setelah memperhitungkan variabel luar menghasilkan hubungan yang signifikan antara selenium dengan TSH (R2 = 0.133). Kesimpulan. Pada penelitian ini defisiensi selenium berhubungan positif dengan TSH, tetapi tidak berhubungan signifikan dengan fT4 dan T3. Kata kunci: fT4, GAKI, selenium, anak sekolah dasar, T3.

HUBUNGAN PENGETAHUAN DAN SIKAP IBU DENGAN PENGGUNAAN KADAR GARAM BERIODIUM DAN PENGARUHNYA TERHADAP STATUS IODIUM URIN DI PONOROGO

Media Gizi Mikro Indonesia Vol 4, No 1 (2012): Edisi Desember 2012
Publisher : Balai Penelitian dan Pengembangan Gangguan Akibat Kekurangan Iodium

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In nearly all countries where iodine deficiency occurs, it is now well recognized that the most effective way to achieve the virtual elimination of IDD is through USI. Iodized salt is a safe, cost-effective, and sustainable strategy to ensure sufficient intake of iodine by all individuals. The aim of the study is measure the relationships of maternal knowledge and attitudes with the use of iodized salt and influence on urine iodine status. This was a cross sectional. The sample of this study were women of childbearing age 18-45 years old and pregnant women with gestational age from 2-9 months. The selection of districts and villages determined purposively by the by the place were emergence cases of IDD. Variables taken the level of knowledge, attitudes, content of iodized salt and urinary iodine status. The result showed that there was no relationship between level of knowledge and attitudes with the content of iodized salt. There was no relationship between level of knowledge and attitudes with urine iodine status. There is a relationship between levels of iodine in salt with urine iodine status. Salt quality monitoring needs to be done more intensively and for the low quality of salt grown withdrawn from the market, the extension shall be made by taking into account the background of the respondents, such as level of education.