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Abstrak :
Prevalensi talasemia di Indonesia cukup tinggi. Pengobatan talasemia berupa transfusi darah menyebabkan penumpukan besi di organ-organ tubuh dan kerusakan sel. Pemberian deferoxamine sebagai kelator besi banyak menimbulkan efek samping dan mahal. Oleh karena itu, diperlukan pengobatan dengan bahan yang lebih aman dan terjangkau dengan memanfaatkan bahan alami yang memiliki efek kelasi besi. Ektrak air daun Mangifera foetida L. terbukti memiliki efek kelasi terhadap feritin serum penderita talasemia, namun belum diteliti apakah ekstrak etanol daun Mangifera foetida L. juga menunjukkan efek kelasi terhadap feritin. Penelitian ini merupakan studi eksperimental pada tujuh serum pasien talasemia yang dibagi ke dalam tujuh kelompok perlakuan secara ex vivo yaitu: serum, mangiferin, mangiferin ditambah serum, ekstrak etanol 0,5 mg dan 0,75 mg, ekstrak etanol 0,5 mg dan 0,75 mg ditambah serum, namun yang akan dianalisis hanya empat kelompok yaitu: serum, mangiferin ditambah serum, ekstrak etanol 0,5 dan 0,75 mg ditambah serum. Nilai absorbansi setiap kelompok diukur menggunakan spektrofotometer dengan panjang gelombang ()=280 nm. Hasil uji statistik One Way Anova menunjukkan bahwa terdapat perbedaan bermakna antara kelompok perlakuan (p<0,001). Uji Post Hoc didapatkan hasil bahwa ekstrak etanol daun Mangifera foetida L. dosis 0,5 mg memiliki efek kelasi yang sama dengan dosis 0,75 mg (p=0,133). Ekstrak etanol daun Mangifera foetida L. dosis 0,5 mg memiliki efek kelasi yang sama dengan mangiferin murni (p=0,52), sedangkan dosis 0,75 mg memiliki efek kelasi yang berbeda (p=0,001). Perbedaan efek kelasi ini kemungkinan disebabkan oleh perbedaan dosis ekstrak etanol.

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Thalassemia has a high prevalence in Indonesia. Treatment of thalassemia with blood transfusion causing iron accumulation in the organs and damaging cells. Chelating agent, deferoxamine causes side effects and expensive. Therefore, it?s needed a safer and cheaper treatment by utilizing natural ingredients which have chelating effect. Water extract of Mangifera foetida L. leaf was proven to have the chelating effect on serum thalassemia patients, but there was no research the effects in the ethanol extract. The purpose of this study was to prove the effects of ethanol extract as a chelating agent. This study used an experimental study using seven serums of patients with thalassemia by ex vivo and devided into seven treatments: serum, mangiferin, mangiferin plus serum, etanol extract 0,5 mg and 0,75 mg, etanol extract 0,5 mg and 0,75 plus serum, however only four treatments will be analized: serum, mangiferin plus serum, etanol extract 0,5 mg and 0,75 mg plus serum. They were measured in a spectrophotometer with (SOH)=280 nm. The result by One Way Anova statistical test showed that there was significant difference between groups (p <0.001). Post Hoc test showed that the ethanol extract 0,5 mg has the same chelating effect with ethanol extract 0,75 mg (p = 0,133). Ethanol extract 0,5 mg has the same effect of iron chelation with the mangiferin (p=0,52), while ethanol extract 0,75 mg has different effect (p=0,001). The difference of chelating effect maybe caused by the difference of extract dose.

Abstrak :
ABSTRAK
Latar Belakang: Muatan besi berlebih akibat transfusi darah dan peningkatan serapan besi di saluran cerna, masih merupakan isu penting pada Thalasemia Intermedia TI , dan dikaitkan dengan berbagai komplikasi yang meningkatkan morbiditas dan mortalitas. Pemeriksaan MRI T2 hati sebagai pemeriksaaan yang tervalidasi dalam menilai Liver Iron Concentration LIC , merupakan pemeriksaan yang mahal dan tidak tersedia secara merata di Indonesia.Tujuan: Mengetahui gambaran muatan besi berlebih darah dan hati pada pasien thalasemia intermedia dewasa dan korelasi antara saturasi transferin, feritin serum, MRI T2 hati, dan LIC yang dinilai dengan pemeriksaan MRI T2 hati dengan nilai elastografi hati.Metode: Penelitian potong lintang pada pasien thalasemia intermedia dewasa dengan transfusi darah dan dengan atau tanpa kelasi besi di RSUPNCM dr. Cipto Mangunkusumo mulai dari bulan Agustus sampai dengan Oktober 2016, dengan total subyek penelitian sebanyak 45 orang. Dilakukan pemeriksaan saturasi transferin, feritin serum, elastografi hati, dan MRI T2 hati. Analisis statistik menggunakan uji korelasi Pearson dan Spearman.Hasil: Sebanyak 64,4 subyek penelitian adalah Thalasemia ?-Hb E, dengan median RIK umur 33 22 tahun. Sebanyak 84,4 subyek penelitian mendapatkan transfusi darah secara reguler. Seluruh subyek penelitian mengalami komplikasi hemosiderosis hati melalui pemeriksaan MRI T2 hati. Sebanyak 48,9 mengalami hemosiderosis hati berat, dengan nilai median MRI T2 hati 1,6 ms. rerata feritin serum adalah 2831 1828 ng/mL, dengan nilai median saturasi transferin 66 . Nilai rerata LIC melalui pemeriksaan MRI T2 adalah 15,36 7,37 mg besi/gr berat kering hati dan nilai rerata elastografi hati adalah 7,7 3,8 Kpa. Uji korelasi didaptakan terdapat korelasi nilai elastografi hati dan rerata feritin serum r = 0,651; p = 0,000 , nilai elastografi hati dan LIC r = 0,433; p = 0,003 dan korelasi negatif nilai elastografi hati dan MRI T2 hati r = -0,357; p = 0,016 .Simpulan: Terdapat korelasi antara muatan besi berlebih feritin serum dan LIC dengan nilai elastografi hati. Terdapat korelasi negatif nilai elastografi hati dengan MRI T2 hati pada pasien thalasemia intermedia dewasa.

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ABSTRACT
Background Iron overload is a common feature of thalassemia intermedia due to regular blood transfusion and increase gastrointestinal iron absorption. Early detection and adequate iron chelator can significantly decrease related morbidities and mortality due to complication from iron overload. Liver Iron Concentration LIC is the best way to measure body iron stores. MRI T2 as a validated test to identify LIC, is expensive and currently not available in all medical services in Indonesia.Objective To identify liver iron overload and correlation of transferrin saturation, serum ferritin, liver MRI T2 , and LIC with transient liver elastography in adult thalassemia intermedia patient.Methods We conducted a cross sectional study enrolling 45 patients with thalassemia intermedia with blood transfusion and with and without iron chelator therapy. The study was conducted at Cipto Mangunkusumo Hospital from August 2016 through October 2016. We performed measurements of transferrin saturation, serum ferritin level, transient liver elastography and liver MRI T2 . The Pearson and Spearman correlation test were used to evaluate the correlation transient liver elastography with transferrin saturation, serum ferritin, Liver MRI T2 , and LIC.Results As much as 64,4 of study subject are Hb E Thalasemia Intermedia with median IQR age is 33 22 years old. As much as 84,4 of study subject have regular blood transfusion. On the basis of liver MRI T2 , all studi subject suffered from liver iron overload, with 48,9 had severe liver iron overload. The median value of Liver MRI T2 was 1,6 ms. The mean serum ferritin was 2831 1828 ng mL, with median value of transferrin saturation was 66 . The mean of LIC corresponding to Liver MRI T2 and mean liver stiffness measurement was 15,36 7,37 mg Fe gr dry weight and 7,7 3,8 Kpa respectively. Liver Stiffness correlated with serum ferritin r 0,651 p 0,000 , Liver MRI T2 r 0,357 p 0,016 , and LIC r 0,433 p 0,003 . No correlation was found between liver elastography and transferrin saturation r 0,204 p 0,178 .Conclusions Serum ferritin, Liver MRI T2 , and LIC correlated with liver elastography. No correlation was found between transferin saturation and liver elastography.

Abstrak :
Transfusi darah berulang pada subjek thalassemia mayor berpotensi menyebabkan transmisi virus hepatitis B dan / atau C. Infeksi dapat menyebabkan perubahan kadar feritin serum. Penelitian ini bertujuan untuk mengetahui prevalensi infeksi varian virus hepatitis dan hubungannya dengan kadar feritin serum. Penelitian potong-lintang dilakukan dengan membandingkan kadar feritin serum antar kelompok subjek terinfeksi varian virus hepatitis pada subjek thalassemia mayor di RS Cipto Mangunkusumo Kiara Jakarta antara tahun 2006-2015. Hasil penelitian menyebutkan bahwa prevalensi infeksi hepatitis keseluruhan sebesar 10,06 subjek dan didapatkan nilai p < 0,050 dari uji komparasi antara kadar feritin serum pada kelompok subjek hepatitis B dengan hepatitis C, hepatitis B dengan hepatitis B dan C, hepatitis C dengan non-hepatitis serta hepatitis B dan C dengan non-hepatitis. Pevalensi infeksi hepatitis keseluruhan pada penelitian ini lebih rendah dibandingkan dengan penelitian lain dan terdapat hubungan yang bermakna antara kadar feritin serum pada kelompok subjek hepatitis B dengan hepatitis C, hepatitis B dengan hepatitis B dan C, hepatitis C dengan non-hepatitis serta hepatitis B dan C dengan non-hepatitis. ...... Regular blood transfusion in major thalassemia subjects potentially mediates infection of hepatitis B and or C virus. Infection can change serum ferritin level. This research intends to know the prevalence of hepatitis virus variant infection and its association with serum ferritin level. This research used cross sectional method to compare serum ferritin level within each hepatitis virus variant infection subject's groups on major thalassemia subjects in RS Cipto Mangunkusumo Kiara Jakarta within 2006 2015. Results showed that prevalence of hepatitis in total was 10.06 subjects and p value from comparison test of serum ferritin level in subject's group of hepatitis B with hepatitis C, hepatitis B with hepatitis B and C, hepatitis C with non hepatitis, and hepatitis B and C with non hepatitis is p 0,050. Prevalence of hepatitis in total was lower than prevalence value in the other studies and there were significant association of serum ferritin level in subject's group of hepatitis B with hepatitis C, hepatitis B with hepatitis B and C, hepatitis C with non hepatitis, and hepatitis B and C with non hepatitis.

Abstrak :
Latar belakang. Kadar hemoglobin pre-transfusi dan feritin serum mempengaruhi pertumbuhan anak dengan thalassemia B-mayor. Penelitian tentang thalassemia sudah dilakukan di Indonesia, namun penelitian tentang hubungan thalassemia dengan pertumbuhan fisik masih terbatas. Tujuan. Mengetahui pengaruh kadar Hb pre-transfusi dan feritin serum berpengaruh terhadap pertumbuhan fisik pasien thalassemia ?-mayor. Metode. Dilakukan bulan Agustus-Oktober 2017 pada pasien anak dengan thalassemia B-mayor yang berobat ke Thalassemia-Centre RSUD Pekanbaru. Penelitian berupa analitik observasional potong lintang, menganalisis pengaruh kadar Hb pre-transfusi dan feritin serum terhadap parameter perawakan pendek dan sangat pendek, gizi kurang dan buruk, usia tulang yang terlambat. Hasil. Subjek 41 orang, rentang usia 18-204 bulan. Jenis kelamin laki-laki lebih banyak daripada perempuan 53,7 vs 46,3. 40 subjek mengalami retardasi pertumbuhan. Terdapat korelasi bermakna antara kadar Hb pre-transfusi dengan Z-score TB/U r=0,507, p=0,001 dan LILA/U r=0,467, p=0,02. Hb pre-transfusi berpengaruh terhadap interpretasi duduk/umur p=0,007, IK95 -1,5 - -0,3, subischial leg length/umur p=0,002, namun tidak pada interpretasi rasio segmen atas/bawah dan usia tulang. Hasil berbeda pada kadar feritin yang tidak memiliki korelasi terhadap semua variabel. Simpulan. Terdapat pengaruh yang bermakna secara statistik antara kadar Hb pre-transfusi dengan parameter penelitian serta tidak terdapat pengaruh yang bermakna secara statistik antara kadar feritin serum dengan parameter tersebut. ...... Background. The level of pre transfusion hemoglobin and ferritin serum affect physical growth on patient with thalassemic mayor. Study about thalassemia is mainly reported but its relationship with physical growth is limited. Objective. The main objective of the present study was to evaluate the relationship of pre transfusion Hb and serum ferritin level in patient with thalassemic mayor. Material and method. In this analytical cross sectional study, the growth parameters weight, standing height, sitting height, subischial leg length, nutritional status, bone age were measured in 41 patients attending Thalassemia Centre at RSUD in Pekanbaru from August October 2017. Results. 41 patients with mean age 18 204 months. The results are boys dominated girls in sex criteria 53,7 vs 46,3. As much as 40 subjects have growth retardation. There rsquo s correlation in pre transfusion hemoglobin with Z score height for age r 0,507, p 0,001 and subischial length r 0,467, p 0,02. This study shows relationship in pre transfusion hemoglobin with sitting height p 0,007, IK95 1,5 0,3, subischial leg length p 0,002, but not in segment length and bone age. Serum ferritin level has no correlation to one of those parameters. Conclusion. There is a significant relationship in physical growth based on parameters mentioned above with pre transfusion Hemoglobin, but not with serum ferritin level.

Abstrak :
[ABSTRAK
Latar Belakang: Infeksi merupakan penyebab kematian yang penting pada thalassemia. Peningkatan risiko infeksi disebabkan oleh banyak faktor antara lain karena kelebihan besi dan splenektomi. Penelitian ini bertujuan mengetahui perbedaan fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi serta mengetahui hubungan fungsi fagositosis monosit dengan kadar feritin serum. Metode: Penelitian dilakukan di Departemen Patologi Klinik RSCM, Jakarta pada September 2013 ? Februari 2014. Desain penelitian potong lintang, dengan subjek penelitian pasien thalassemia mayor, terdiri dari 58 subjek pasca splenektomi dan 58 subjek non splenektomi yang telah dilakukan macthing umur dan jenis kelamin. Dilakukan pemeriksaan fagositosis monosit menggunakan E.coli yang telah diopsonisasi dan dilabel FITC sebagai target, (PhagotestTM) dan diperiksa dengan flow cytometry BD FACSCalibur. Kadar feritin serum diperiksa dengan Cobas e 601. Hasil: Median fagositosis monosit pada 58 subjek pasca splenektomi 5,03 (0,17 ? 22,79) %, dan pada 58 subjek non splenektomi 7,09 (0,11 ? 27,24) %, dan nilai p > 0.05. Kadar feritin serum pada subjek pasca splenektomi 6.724 (644,60 ? 21.835) ng/mL dan subjek non splenektomi 4.702,50 (1.381 ? 14.554) ng/mL, dan nilai p < 0.05. Hasil uji korelasi fungsi fagositosis monosit dengan kadar feritin didapatkan r = 0.13 (nilai p = 1.00). Kesimpulan: Tidak terdapat perbedaan bermakna antara fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi. Kadar feritin serum pada pasien thalassemia mayor pasca splenektomi lebih tinggi secara bermakna dibandingkan non splenektomi. Tidak didapatkan hubungan antara fagositosis monosit dengan kadar feritin serum.

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ABSTRACT
Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level. Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 ? Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601. Result : Median phagocytosis of monocyte was 5,03 (0,17 ? 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 ? 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 ? 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00). Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level.;Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level. Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 – Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601. Result : Median phagocytosis of monocyte was 5,03 (0,17 – 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 – 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 – 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00). Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level., Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level. Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 – Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601. Result : Median phagocytosis of monocyte was 5,03 (0,17 – 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 – 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 – 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00). Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level.]

Abstrak :
ABSTRAK
Latar belakang: Thalassemia merupakan suatu penyakit gen tunggal yang disebabkan oleh kerusakan pada gen dalam mengontrol produksi protein sehingga sel darah merah akan mudah pecah dan pengikatan oksigen terganggu. Hal ini akan memicu terjadinya anemia dan membutuhkan transfusi darah secara rutin dan seumur hidup. Transfusi darah rutin menyebabkan terjadinya akumulasi besi yang memicu beberapa komplikasi, salah satunya adalah gangguan pada fungsi pankreas. Tujuan: Untuk mengetahui hubungan antara profil besi dengan gangguan fungsi pankreas berupa diabetes mellitus dan gangguan toleransi glukosa pada subjek thalassemia mayor. Metode: Desain potong-lintang pada 79 subjek thalassemia mayor di Pusat Thalassemia RS Cipto Mangunkusumo Jakarta. Hasil: Dua 2,53 subjek mengalami gangguan toleransi glukosa dan 77 97,47 subjek dengan nilai toleransi glukosa normal. Nilai median feritin serum pada kelompok gangguan toleransi glukosa yakni 5595,5 2062,0-9199,0 ng/mL sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 3309,0 487,0-11247,0 ng/mL p= 0,574 . Nilai median saturasi transferin pada subjek gangguan toleransi glukosa yakni 76 52-100 sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 89 11-100 p= 0,827 . Kesimpulan: Tidak didapatkan adanya hubungan yang signifikan antara kadar feritin serum dan saturasi transferin terhadap gangguan fungsi pankreas.

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ABSTRACT
Background Thalassemia is a single gene disease that is caused by defect on gene which controls the protein production that eventually leads to red blood cell lysis and defect on oxygen binding capacity. Therefore, the patient needs regular blood transfusion during his lifetime. Regular blood transfusion causes iron accumulation that leads to complications such as defect on pancreas function. Aim To know the association between iron profile and defect on pancreas function such as diabetes mellitus and glucose intolerance in major thallassemia subjects. Methods Cross sectional design on 79 major thalassemia subjects in Thalassemia Center of RS Cipto Mangunkusumo, Jakarta. Results Two 2.53 subjects were glucose intolerant and 77 97,47 subject has a normal blood glucose. Median value of serum ferritin level in glucose intolerant subjects was 5595.5 2062,0 9199,0 ng mL meanwhile the median value of serum ferritin level in normal glucose level subjects was 3309.0 487,0 11247,0 ng mL p 0.574 . The median value of transferrin saturation in glucose intolerant patients is 76 52 100 meanwhile the median value of tranferrin saturation level in normal glucose level subjects is 89 11 100 p 0,827 . Conclusion There is no significant association between serum ferritin level and transferrin saturation and defect of pancreas function.

Abstrak :
Defisiensi besi selama kehamilan adalah salah satu defisiensi gizi yang prevalensinya tetap tinggi di dunia yaitu mencapai 70%. Berat badan kurang merupakan salah satu faktor risiko terjadinya defisiensi besi selama kehamilan. Feritin adalah protein cadangan zat besi yang disintesis oleh hati dan dapat meningkat selama peradangan. Penelitian ini bertujuan untuk mengetahui korelasi antara kadar feritin serum dengan indeks massa tubuh pada perempuan hamil trimester 1. Disain penelitian yang digunakan adalah studi potong lintang. Penelitian dilakukan di Pusat Kesehatan Masyarakat Kramat Jati, Jakarta selama bulan Oktober 2013. Pengambilan subyek dilakukan dengan cara consecutive sampling. Empat puluh tujuh perempuan hamil trimester 1 didapatkan memenuhi kriteria penelitian. Didapatkan rerata usia 27,79±4,85 tahun, diantara subyek penelitian 5 orang (10,6%) memiliki berat badan kurang, 25 orang (53,2%) berat badan normal dan 17 berat badan lebih (36,2%). Nilai tengah asupan zat besi 23,21 (8,4 ̶ 36,80) mg/hari. Asupan zat besi menunjukkan 66% subyek memiliki asupan zat besi kurang dari Angka Kecukupan Gizi (AKG) Indonesia. Nilai tengah kadar feritin serum 58,1 (4,9 ̶ 139,8) μg/L dan 6,4% subyek tergolong status feritin rendah. Hasil penelitian ini diperoleh korelasi positif tidak bermakna antara kadar feritin serum dengan indeks massa tubuh pada perempuan hamil trimester 1 (r=0,097, p=0,52).

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Iron deficiency during pregnancy is one of nutritional deficiency with high prevalence in the world, reaching up to 70%. Underweight is one of the main risk factors for iron deficiency during pregnancy. Ferritin is an iron storage protein which synthesized in the liver and can be increased during inflammation. The aim of this study was to find out the correlation between serum ferritin levels and body mass index (BMI) in pregnant woman in their first trimester. The design of the study is cross-sectional. Data collection was conducted at Kramat Jati Primary Health Care, Jakarta during October 2013. Subjects were obtained by consecutive sampling method. A total of 47 pregnant women in their first trimester subjects had met the sudy criteria. The mean of maternal age was 27,79±4,85 years, among them are 5 underweight (10,6%), 25 normal weight (53,2%) and 17 overweight (36,2%). Median of iron intake was 23,21 (8,4 ̶ 36,80) mg/day. Intake of iron showed 66% of the subjects had intake of iron less than Indonesian recomended dietary allowance (RDA). Median of serum ferritin levels was 58,1 (4,9 ̶ 139,8) μg/L, while 6,4% of the subjects were catagorized as low ferritin status. No significant correlation was found between serum ferritin levels and BMI in pregnant women in their first trimester (r=0,097, p=0,52).

Abstrak :
Latar belakang. Kelebihan zat besi akibat transfusi rutin pada penderita thalassemia mayor menyebabkan timbunan zat besi yang akan membuat kerusakan signifikan pada banyak organ, seperti hati dan kelenjar paratiroid, sehingga dapat mengganggu metabolisme vitamin D dan kalsium. Tujuan. Mengetahui hubungan antara kadar feritin serum dengan kadar 25 (OH)D dan kalsium ion pada anak thalassemia mayor. Metode. Penelitian ini adalah studi potong lintang yang dilakukan pada 64 anak thalassemia mayor usia 7-12 tahun dari bulan November hingga Desember 2020 di RS Dr. Cipto Mangunkusumo (RSCM). Feritin serum dan kalsium ion diperiksa di laboratorium patologi klinik RSCM. Pemeriksaan kadar vitamin D 25 (OH)D dengan metode Enzyme-Linked Fluorescent Assay (ELFA) dilakukan di Laboratorium Kalgen Innolab Jakarta. Hasil. Dari 64 subjek, rerata feritin serum (SB) 5537.85 (2976.17) ng/mL, rerata serum vitamin D 25 (OH)D (SB) 15,556 (5,825) ng/mL dan rerata kalsium ion (SB) 1,144 (0,079) nmol/L. Sebanyak 6,3% subjek mengalami hipokalsemia. Defisiensi vitamin D ditemukan pada 34,4% subyek dan insufisiensi pada 45,3% subyek. Koefisien korelasi Pearson antara feritin serum dan vitamin D (r = -0,020, p = 0,873), dan untuk kalsium ion (r = 0,01, p = 0,938). Kesimpulan. Hubungan antara feritin serum terhadap vitamin D dan kalsium ion tidak menunjukkan korelasi. Tingginya prevalens defisiensi vitamin D pada anak thalassemia mayor membutuhkan penanganan lebih komprehensif untuk meningkatkan kesehatan tulang, mencegah patah tulang dan potensi komplikasi terkait lainnya. .....Background. Iron overload due to routine transfusions in thalassemia major children causes iron deposits that will make significant damage to many organs, such as the liver and parathyroid glands, so that can disrupting the vitamin D and calcium metabolism. Objective. To determine the correlation between serum ferritin levels with 25 (OH)D levels and ionized calcium in thalassemia major children. Methods. This study was a cross sectional study was conducted on 64 children with thalassemia major, aged 7-12 years, from November to December 2020 at Dr. Cipto Mangunkusumo (CMH). Serum ferritin and ionized calcium patients were examined in the laboratory of Dr. Cipto Mangunkusumo. Serum 25 (OH)D examination using the Enzyme-Linked Fluorescent Assay (ELFA) method was carried out at the Kalgen Innolab Jakarta Laboratory. Results. From 64 subjects, mean serum ferritin (SD) 5537.85 (2976.17) ng/mL, mean serum vitamin D 25 (OH)D (SD) 15.556 (5.825) ng/mL and mean ionized calcium (SD) 1.144 (0.079) nmol/L. A total of 6.3% of subjects experienced hypocalcemia. Vitamin D deficiency was present in 34.4% of subjects and insufficiency in 45.3% of subjects. Pearson’s correlation coefficient between serum ferritin and vitamin D (r = -0.020, p = 0.873), and for ionized calcium (r = 0.01, p = 0.938). Conclusions. The association between serum ferritin and vitamin D and calcium ions showed no correlation. The high prevalence of 25 (OH)D deficiency in thalassemia major children requires further management to improve bone health, prevent fracture and other related potential complications.