Hubungan Kadar Zink Serum, Zinc Superoxide Dismutase (ZnSOD), Metallothionein, dan Poliformisme Gen Metallothionein 1A rs8052394 dengan Derajat Distres Pernapasan pada Bayi Baru Lahir dengan Usia Kehamilan 28 – 34 Minggu

Abstract

Backround: Respiratory distress is one of the leading causes of admission to the Neonatal Intensive Care Unit (NICU), particularly among preterm infants with a gestational age of less than 34 weeks. The incidence of respiratory distress increases with decreasing gestational age due to pulmonary immaturity and surfactant deficiency. In addition, this condition is associated with increased oxidative stress, which may aggravate lung injury.Zinc plays an essential role in the antioxidant defense system through the activation of the enzyme Zinc Superoxide Dismutase (ZnSOD) and the induction of Metallothionein proteins, both of which protect lung tissues from oxidative damage. Decreased serum zinc levels have been associated with a higher degree of respiratory distress in preterm infants.The Metallothionein 1A rs8052394 gene polymorphism has also been reported to influence the activity of the ZnSOD antioxidant enzyme and zinc homeostasis within cells.Based on these findings, this study aimed to analyze the relationship between serum zinc, ZnSOD, metallothionein levels, and Metallothionein 1A rs8052394 gene polymorphism with the degree of respiratory distres. aged 28 – 34 weeks Methods : This was a cross-sectional study designed to evaluate the relationship between serum zinc, Zinc Superoxide Dismutase (ZnSOD), and Metallothionein 1A rs8052394 gene polymorphism with the severity of respiratory distress in neonates aged 28–34 weeks of gestation. The study samples consisted of preterm infants admitted to the NICU of H. Adam Malik General Hospital and Prof. Chairuddin P. Lubis Hospital who met the inclusion and exclusion criteria. Sampling was carried out using a consecutive sampling technique, with umbilical cord blood collected immediately after birth. The severity of respiratory distress was assessed using the Downe Score within the first hour after resuscitation. Data were analyzed using the Shapiro–Wilk test for normality, the Kruskal– Wallis and Mann Whitney test for comparison, and Spearman’s correlation test to assess relationships between variables. A p-value <0.05 was considered statistically significant. Results:There was a strong negative correlation between serum zinc levels and the degree of respiratory distress (r = –0.895; p < 0.001). ZnSOD levels showed a very weak positive and statistically insignificant correlation with the degree of respiratory distress (r = 0.247; p = 0.172). Metallothionein levels tended to decrease in infants with severe respiratory distress, while variations in the MT1A rs8052394 gene showed a tendency toward association with distress severity, although not statistically significant. Conclusion:Serum zinc levels were significantly associated with the degree of respiratory distress in preterm infants, whereas ZnSOD, metallothionein, and MT1A rs8052394 gene polymorphism showed no significant associations. Zinc is presumed to play an important role in the antioxidant defense mechanism that protects the premature lung from stress oxidative. Keywords:Preterm infants; Respiratory distress; Serum zinc; Zinc Superoxide Dismutase (ZnSOD); Metallothionein 1A rs8052394