Korelasi Antara Vitamin D dengan Profil Lipid pada Penyandang Thalassemia Beta Mayor

Abstract

Latar belakang Penyandang thalassemia beta mayor dihubungkan dengan gangguan profil lipid dalam bentuk kadar kolesterol total, Low Density Lipoprotein (LDL), high density lipoprotein (HDL) yang lebih rendah; serta kadar trigliserida yang lebih tinggi. Hal ini berhubungan dengan peningkatan resiko komplikasi kardiovaskular. Penelitian sebelumnya menunjukkan bahwa vitamin D memberikan dampak positif terhadap profil lipid pada anak sehat. Namun, peranannya pada kelompok anak dengan resiko tinggi seperti penyandang thalassemia beta mayor masih perlu dipelajari. Tujuan Untuk menentukan adakah korelasi antara vitamin D (25-OHD) dan profil lipid pada anak penyandang thalassemia beta mayor. Metode Studi potong lintang dilakukan di rumah sakit tersier di Medan, Sumatera Utara, Indonesia dari bulan Januari hingga Maret 2018. Subjek penelitian adalah anak penyandang thalassemia beta mayor berusia di bawah 18 tahun. Pengukuran kadar serum vitamin D (25-OHD) dan kadar serum profil lipid yang meliputi kolesterol total, trigliserida, LDL, dan HDL dilakukan setelah puasa 10 – 12 jam. Analisa statistik menggunakan uji korelasi Pearson dan uji Fisher. Nilai p < 0,005 dianggap bermakna. Hasil Empat puluh lima subjek penelitian memenuhi kriteria inklusi, dengan rentang kadar serum ferritin antara 1017 hingga 13372 ng/mL. Prevalensi defisiensi vitamin D (kadar 25-OHD kurang dari 20 ng/mL)pada penelitian ini adalah 40%, dengan nilai rata-rata 20.6 (SB 5.3) ng/mL. Penanda untuk resiko kardiovaskular ditemukan meningkat, yaitu pada Atherogenic Index Plasma (0.32 + 0,25) dan rasio TC:HDL (4.2 + 1,5). Analisa statistik menunjukkan bahwa vitamin D memiliki korelasi positif dengan kolesterol total (r=0.302, p=0.044) dan HDL (r= 0.297, p=0.048). Tidak ditemukan korelasi signifikan baik antara vitamin D dengan trigliserida (p=0.305), ataupun vitamin D dengan LDL (p=0.727). Kesimpulan Vitamin D berkorelasi secara positif dengan kolesterol totaldan HDL pada anak penyandang thalassemia beta mayor. Korelasi positif terhadap HDL menunjukkan dampak positif dari vitamin D dalam menurunkan risiko komplikasi kardiovaskular.

Background Beta thalassemia major is associated with lipid profile abnormalities, presented as lower level of total cholesterol (TC), low density lipoproteins (LDL), high density lipoprotein (HDL), and higher triglyceride level; increasing risk for cardiovascular complications. The previous studies indicate that Vitamin D give positive impact on lipid profile in healthy children population. However, its role need to be determined in high risk group of children with beta thalassemia major. Objectives To determine correlation between vitamin D (25-OHD) and lipid profile among children with beta thalassemia major Methods A cross-sectional study was conducted in a general tertiary hospital in Medan, Sumatera Utara, Indonesia from January to March 2018. Subjects were children aged below 18 year-old with beta thalassemia major. The measurement of vitamin D (25-OHD) level and 10-12 hour overnight fasting serum lipid profile including total cholesterol, tryglyceride, HDL, and LDL were performed. Analysis was done using Pearson’s correlation and Fisher test. P value < 0.05 was considered significant. Results Forty-five subjects were enrolled in this study, with serum ferritin level ranged from 1017 to 13372 ng/mL. The prevalence of vitamin D deficiency (25-OHD level less than 20 ng/mL) in this study was 40%, with mean value 20.6 (SD 5.3) ng/mL. The markers for cardiovascular risk were observed to be elevated, both in Atherogenic Index Plasma (0.32 + 0,25) and TC:HDL ratio (4.2 + 1,5). Statistic analysis revealed that Vitamin D had positive correlation with total cholesterol (r=0.302, p=0.044) and HDL (r= 0.297, p=0.048). There were no significant correlation between either vitamin D and tryglyceride (p=0.305), or vitamin D and LDL (p=0.727). Conclusion Vitamin D correlated positively with total cholesterol and HDL in children with beta thalassemia major. Positive correlation to HDL indicated beneficial effect of vitamin D to reduce the risk of cardiovascular complication.