Hubungan antara Skor Paparan Matahari dan Asupan Vitamin D dengan Kadar 25(OH)D Serum pada Wanita Usia Lanjut

Abstract

Pendahuluan. Indonesia adalah negara tropis, namun prevalensi defisiensi vitamin D pada wanita usia lanjut masih cukup tinggi dikarenakan kurang terpapar sinar matahari dan asupan vitamin D yang rendah. Beberapa penelitian melaporkan bahwa subjek pedesaan memiliki kadar 25(OH)D serum lebih tinggi dibandingkan dengan subjek perkotaan. Penelitian ini bertujuan untuk menganalisis hubungan antara skor paparan matahari dan asupan vitamin D dengan kadar 25(OH)D serum pada wanita usia lanjut di komunitas pedesaan. Metode. Penelitian ini merupakan penelitian analitik cross-sectional yang melibatkan wanita usia lanjut di dua Desa di Kecamatan Wonorejo dan Kraton Kabupaten Pasuruan, pada Bulan Juni 2020 saat musim kemarau. Skor paparan matahari dihitung menggunakan kuesioner skor paparan matahari. Asupan vitamin D didapatkan dari food recall 2 x 24 jam. Kadar 25(OH)D serum diukur menggunakan chemiluminescent immuno assay. Analisis statistik menggunakan uji korelasi Spearman dan Pearson. Hasil. Sebanyak 40 subjek penelitian yang merupakan wanita berusia 60-93 tahun (median usia 70 tahun) diikutsertakan pada penelitian ini. Median skor paparan matahari adalah 14 dan median durasi terpapar matahari 40 menit. Sebanyak 90% subjek menggunakan kemeja lengan panjang dan rok panjang, dan seluruh subjek tidak pernah menggunakan tabir surya. Rerata asupan vitamin D subjek 1,73 μg/hari (simpang baku [SB] 3,21 μg/hari) dan seluruh subjek memiliki asupan vitamin D kurang. Sumber utama asupan vitamin D adalah ikan (67,5%), terutama ikan air tawar. Rerata kadar 25(OH)D serum subjek 27,75 ng/mL (SB 13,25 ng/mL), dengan 30% subjek mengalami defisiensi vitamin D. Skor paparan matahari berkorelasi positif dengan kadar 25(OH)D serum (r=0,425; p=0,006). Tidak didapatkan korelasi signifikan antara asupan vitamin D dengan kadar 25(OH)D serum (p= 0,246). Simpulan. Didapatkan hubungan positif yang bermakna antara skor paparan matahari dengan kadar 25(OH)D serum, namun tidak didapatkan hubungan yang bermakna antara asupan vitamin D dengan kadar 25(OH)D serum. Kata Kunci: asupan vitamin D, kadar 25(OH)D serum, skor paparan matahari, wanita usia lanjut. Correlation of Sun Exposure Score and Vitamin D Intake with Serum 25(OH)D Levels in Older Women Introduction. Indonesia is a tropical country, but the prevalence of vitamin D deficiency in older women is high due to the lack of sun exposure and low vitamin D intake. Some previous studies have reported that people from rural areas have higher serum 25(OH)D levels compared to those from urban areas. This study was conducted to analyze the correlation between sun exposure score and vitamin D intake with serum 25(OH)D levels of older women from rural areas. Methods. This was an analytic cross-sectional study involving older women in two villages from Wonorejo and Kraton Districts, Pasuruan Regency, in June 2020 during the dry season. The sun exposure score was calculated using a sun exposure questionnaire, vitamin D intake was obtained using the 2 x 24-h food recall, and serum 25(OH)D levels were measured using the chemiluminescent immunoassay. The data was analyzed using the Spearman and Pearson correlation test. Results. A total of 40 post-menopausal women aged 60 to 93 years (median age 70 years) were included in this study. The median sun exposure score was 14. The median time spent outdoors was 40 minutes, 90% of subjects wore long-sleeved and long skirts, and all of the subjects never put on sunscreen. The mean value of vitamin D intake was 1.73 μg/day (SD 3.21 μg/day), all of the subjects had low vitamin D intake. The primary source of their vitamin D intake was fish (67.5%), predominantly freshwater fish. The mean value of serum 25(OH)D levels was 27.75 ng/mL (SD 13.25 ng/mL), and 30% of them had vitamin D deficiency. The sun exposure score was positively correlated with serum 25(OH)D levels (r=0.425; p=0.006). Meanwhile, there was a correlation between vitamin D intake and serum 25(OH)D levels (p=0.246). Conclusion. There is a significant positive correlation between sun exposure score and serum 25(OH)D levels, but no correlation between vitamin D intake and serum 25(OH)D levels.