Peran Defisiensi Vitamin D dan Polimorfisme Fokl, Bsml, Apal serta Taql Gen Reseptor Vitamin D Terhadap Tuberkulosis Pada Anak

Budi Setiabudiawan

Sari


Latar belakang. Tuberkulosis (TB) adalah penyakit menular yang disebabkan oleh infeksi Mycobacterium
tuberculosis. Kuman bukan merupakan faktor tunggal dalam kejadian TB, tetapi harus disertai dengan faktor
lain. Defisiensi vitamin D dan polimorfisme FokI, BsmI, ApaI, serta TaqI gen reseptor vitamin D (RVD)
berperan penting dalam kerentanan seseorang terhadap TB.
Tujuan. Mengetahui peran defisiensi vitamin D dan polimorfisme FokI, BsmI, ApaI, serta TaqI gen RVD
terhadap TB anak.
Metode. Penelitian observasional dengan rancangan kasus kontrol, di RSUP Dr. Hasan Sadikin Bandung
dan RSU Cibabat Cimahi, Mei 2008 - Maret 2009. Sampel diambil secara consecutive sampling, masingmasing
42 anak. Dilakukan pemeriksaan kadar vitamin D [25-(OH)D dan 1,25-(OH)2D] serum, serta
polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD. Analisis dengan uji Chi-kuadrat, Mann-Whitney, uji
t, menghitung OR dan 95% CI, serta regresi logistik ganda.
Hasil. Angka kejadian defisiensi kadar 1,25(OH)2D serum pada kelompok kasus TB 28,6% dan kontrol
9,5% (p=0,026), OR (95% CI): 3,80 (1,11-12,98). Kejadian polimorfisme FokI gen RVD pada kelompok
kasus TB 66,7% dan kontrol 40,5%, (p=0,016), OR (95% CI): 2,94 (1,21-7,16), sedangkan ApaI, BsmI,
dan TaqI pada TB tidak bermakna (p>0,05). Variabel yang berpengaruh terhadap kejadian TB adalah
jenis kelamin OR (95% CI): 2,276 (0,841-6,161); polimorfisme FokI OR (95% CI): 2,346 (1,053-5,225);
polimorfisme ApaI OR (95% CI): 0,81 (0,912-3,593) dan defisiensi vitamin D OR (95% CI): 5,645 (1,441-
22,113). Peluang terjadinya TB pada anak perempuan dengan defisiensi vitamin D serta polimorfisme FokI
(genotipe FF) dan ApaI homozigot (genotipe aa) 0,98 pada laki-laki 0,955.
Kesimpulan. Defisiensi vitamin D (1,25(OH)2D) dan polimorfisme FokI gen RVD merupakan faktor risiko
terjadi TB anak. Perempuan dengan defisiensi vitamin D serta polimorfisme FokI dan ApaI homozigot memiliki
peluang lebih besar untuk terjadinya TB anak dibandingkan laki-laki.


Kata Kunci


defisiensi vitamin D; polimorfisme gen reseptor vitamin D (RVD); tuberkulosis anak

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DOI: http://dx.doi.org/10.14238/sp11.5.2010.317-25

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