Hubungan antara Status Zat Gizi Mikro (Vitamin A, Vitamin D, Zink, Zat Besi, dan Kalsium) dengan Pertumbuhan Anak Balita di Indonesia

Abstract

Zat gizi mikro memiliki peranan penting terhadap pertumbuhan anak balita. Kekurangan zat gizi mikro merupakan salah satu faktor yang menghambat pertumbuhan dan berdampak pada kejadian stunting. Tingginya prevalensi stunting di Indonesia membuktikan bahwa terdapat masalah pertumbuhan yang tidak terlepas dari peranan zat gizi mikro. Oleh sebab itu perlu dilakukan studi untuk mempelajari status zat gizi mikro yang berperan dalam pertumbuhan anak di Indonesia. Penelitian bertujuan menganalisis hubungan antara status serum vitamin A, vitamin D, zink, zat besi, dan kalsium pada anak di Indonesia dengan pertambahan panjang/tinggi badan serta kenaikan berat badannya berdasarkan standar pertumbuhan rekomendasi WHO. Desain penelitian yang digunakan adalah potong lintang. Penelitian menggunakan data sekunder dari Riset Kesehatan Dasar Tahun 2018 dan penelitian Status Gizi Mikro Balita dan Anak Usia Sekolah Tahun 2021, berupa data konsentrasi serum retinol, 25(OH)D, zink, dan feritin serta data pengukuran antropometri panjang/tinggi badan serta berat badan. Sampel penelitian adalah anak usia 0-59 bulan, sebanyak 550 sampel. Hasil penelitian menunjukkan 77,6 % anak berusia 25-59 bulan dan 56,73 % dari total sampel berjenis kelamin laki-laki. Selain itu rata-rata tinggi dan berat badan anak berada di kisaran nilai normal sesuai usia meskipun kurang dari tinggi dan berat badan ideal sesuai standar WHO. Defisiensi vitamin A, vitamin D, zink, zat besi, dan kalsium berturut-turut adalah sebesar 7,82 %, 0,36 %, 39,27 %, 34,73 %, 8,18 %. Korelasi signifikan ditemukan antara konsentrasi 25(OH)D dengan capaian pertambahan panjang/tinggi badan anak usia 7-12 bulan dan dengan capaian kenaikan berat badan anak usia 13-24 bulan. Begitu pula antara konsentrasi zink dengan pertambahan panjang/tinggi badan anak usia 13-24 bulan (p<0,05). Disamping itu konsentrasi feritin juga menunjukkan hubungan signifikan dengan capaian pertambahan panjang/tinggi anak 0-59 bulan (p<0,05). Status vitamin D juga menunjukkan hubungan yang signifikan dengan capaian kenaikan berat badan anak usia 13-24 bulan (p<0,05). Perbedaan signifikan ditemukan pada konsentrasi retinol antara anak pendek dibandingkan normal dan anak gizi lebih dibandingkan gizi baik kelompok usia 25-59 bulan. Konsentrasi 25(OH)D juga berbeda signifikan pada anak dengan status gizi lebih dibandingkan gizi baik kelompok usia 13-24 bulan. Selain itu, interaksi 25(OH)D dan zink menunjukkan pengaruh positif terhadap pertumbuhan anak balita. Dibutuhkan studi lebih lanjut untuk mempelajari faktor gizi lainnya yang mungkin memberikan pengaruh lebih besar terhadap pertumbuhan anak balita.

Micronutrients are considered to play crucial role in linear growth of children under five years old. Micronutrient deficiencies are one of the factors that hinder growth and contribute to the incidence of stunting. The high prevalence of stunting in Indonesia indicates that growth issues are closely linked to the role of micronutrients. Therefore, it is necessary to conduct studies to examine the status of micronutrients that are important for children's growth in Indonesia. This study aims to analyze the relationship between serum levels of vitamin A, vitamin D, zinc, iron, and calcium in Indonesian children with increasing of length/height and weight gain according to WHO children growth standards. Design of study was cross-sectional using secondary data from Basic Health Research (Riskesdas) 2018 and Study of Micronutrient Status of under Five-Year and School-Age Children 2021. Blood serum sample was analyzed for retinol, 25(OH)D, zinc, ferritin, and calcium level, then categorized into vitamin A, vitamin D, zinc, iron, and calcium status respectively. Growth was calculated based on ?BW and ?BL from anthropometric data at birth to the recent. The subjects of the study were children aged 0-59 months, as many as 550 samples. The results showed 77,6% of children aged 25-59 months and 56,73% of the total sample were male. In addition, the mean of length/height and weight of the children were normal even though less than the ideal values. The growth achievement tended to decrease gradually as they grew older. Prevalence of deficiency of vitamin A, vitamin D, zinc, iron, and calcium were 7.82%, 0.36%, 39.27%, 34.73%, and 8.18% respectively. A significant correlation was found between 25(OH)D level and the increase in length/height of children aged 7-12 months, as well as with the weight gain of children aged 13-24 months. Similarly, there was a correlation between zinc level and the increase in length/height of children aged 13-24 months (p<0.05). Additionally, ferritin level also showed a significant relationship with the increase in length/height of children aged 0-59 months (p<0.05). Vitamin D status also indicated a significant relationship with the weight gain of children aged 13-24 months (p<0.05). Significant differences were found in retinol level between stunted children and those with normal height, as well as between overweight children and those with normal status in the age group of 25-59 months. The 25(OH)D level also showed significant differences in overweight compared to normal children in the age group of 13-24 months. Furthermore, the interaction between 25(OH)D and zinc demonstrated a positive effect on the growth of children. Further studies are needed to investigate other nutritional factors that may have a greater influence on the growth of children under five.