Iron status and Hepcidin Level of normal and obese adolescents

Abstract

ABSTRAK Latar Belakang: Faktor risiko anemia pada remaja obesitas meningkat dengan adanya gangguan homeostasis besi yang terjadi, ditandai dengan kadar feritin dan kadar hepcidin tinggi namun kadar hemoglobin rendah yang disebabkan oleh adanya inflamasi kronik derajat ringan terkait obesitas. Tujuan: Penelitian ini dilakukan untuk mengetahui hubungan antara obesitas, faktor perantara yang memengaruhi, dan kejadian anemia pada remaja usia 12-15 tahun di SMP di Kota Yogyakarta. Metode: Penelitian yang dilakukan adalah penelitian observasional dengan rancangan penelitian potong lintang pada 68 siswa SMP di Kota Yogyakarta yang mempunyai status gizi normal dan obesitas. Pengukuran tinggi badan, berat badan, indeks massa tubuh, kadar hepcidin, kadar feritin, kadar hemoglobin, dan penilaian asupan zat gizi responden dilakukan dalam satu kurun waktu yang hampir bersamaan. Hasil: Persentase anemia pada kelompok normal sebesar 15,15% sedangkan pada kelompok obesitas sebesar 2,85%. Pada penelitian ini, tidak terdapat perbedaan secara signifikan pada prevalensi anemia antara remaja status gizi normal dan obesitas (p=0,074). Median data kadar hemoglobin pada kelompok normal 14,2 g/dl dan kelompok obesitas 14,5 g/dl. Kadar feritin pada kelompok obesitas lebih tinggi secara signifikan dibandingkan dengan kelompok normal, masing-masing 9,7 ng/ml pada kelompok normal, 11,59 ng/ml pada kelompok obesitas sedang dan 15,81 ng/ml kelompok obesitas berat. Terdapat perbedaan signifikan pada kadar leukosit pada kedua kelompok responden (p=0,0443), namun tidak terdapat perbedaan signifikan pada kadar hepcidin (p=0,511). Tidak terdapat korelasi antara kadar hepcidin dan feritin pada seluruh responden (p=0,396), serta terdapat korelasi positif tingkat rendah antara kadar feritin dan hemoglobin pada seluruh responden (p=0,0008). Kesimpulan: Terjadi proses inflamasi kronis derajat ringan pada kelompok obesitas, namun tidak terjadi gangguan metabolisme besi akibat inflamasi. Penelitian lebih lanjut dibutuhkan untuk menggali hubungan anemia dengan obesitas di masa dewasa. KATA KUNCI: anemia; gizi remaja; Hemoglobin; obesitas ABSTRACT Background: The risk factor for anemia in obese adolescents is increased by the presence of iron homeostatic disorder that occurs, characterized by high levels of ferritin and hepcidin levels but low hemoglobin levels which is caused by mild chronic inflammation associated with obesity. Objectives: This study was conducted to determine the relationship between obesity and intermediary factors that affect the incidence of anemia in adolescents aged 12-15 years in Junior High School, Yogyakarta. Methods: This study was observational research with a cross-sectional study design on 68 junior high school students in Yogyakarta City who had normal and obese nutritional status. Measurement of height, weight, body mass index, hepcidin levels, ferritin levels, hemoglobin levels, and assessment of nutrient intake of respondents performed in a period of time. Results: The percentage of anemia in the Normal Group (NG) was 15.15% meanwhile in the Obese Group (OG) was 2.85%. In this study, there was no significant difference in the prevalence of anemia between NG and OG (p=0.074). Median data hemoglobin levels in the NG were 14.2 g/dl and in the OG was 14.5 g/dl. Surprisingly, there was a significantly higher level of ferritin found in the OG than NG, respectively 9,7 ng/ml in NG, 11.59 ng/ml in the moderately obese group, and 15.81 ng/ml severe obese. There was a significant difference in leukocyte levels between groups (p = 0.0443), however, there was no significant difference in hepcidin levels (p=0.511). There was no correlation between hepcidin and ferritin levels in all respondents (p=0.396), and there was a low positive correlation between ferritin and hemoglobin levels in all respondents (p=0.0008). Conclusions: Low-grade chronic systemic inflammation occurs in the OG, but no iron metabolism disorder occurs due to inflammation. Further study is needed to explore the correlation between anemia and obesity in adulthood. KEYWORDS: adolescents; anaemia; Haemoglobin; obesity