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"Latar Belakang: Kekurangan zat besi adalah kekurangan zat gizi mikro yang paling sering terjadi pada anak di bawah usia lima tahun. Anemia pada balita di Indonesia dari tahun ke tahun semakin meningkat. Kekurangan vitamin C dapat menyebabkan IDA. Lingkungan rumah merupakan faktor penting dalam menentukan asupan gizi anak, karena 65 hingga 72% kalori harian dikonsumsi di rumah. Oleh karena itu, penelitian ini bertujuan untuk mengkaji hubungan aspek fisik dan sosial lingkungan makanan rumah dengan asupan zat besi dan vitamin C pada anak usia 2-6 tahun di Pejagalan. Metode: Penelitian observasional ini menggunakan pendekatan cross-sectional untuk mengumpulkan data sekunder dari 191 ibu dan anak di Pejagalan, Jakarta Utara. Wawancara dengan kuesioner standar digunakan untuk menentukan asupan zat besi dan vitamin C anak-anak. Kuesioner Perilaku Konsumen mengevaluasi lingkungan makanan rumah (CBQ). SPSS Versi 20 digunakan untuk korelasi Spearman dan regresi linier berganda.. Hasil: Konsumsi zat besi dan vitamin pada anak-anak lebih rendah dari asupan harian yang direkomendasikan (RDI) untuk Indonesia. Ditemukan bahwa mereka yang memiliki akses ke lebih banyak buah dan sayuran juga mengonsumsi lebih banyak zat besi dan vitamin C. Hubungan antara memantau praktik pemberian makan (p=0.024, p=0.035) dan peningkatan konsumsi zat besi dan vitamin C ditemukan. Buah, sayur, manisan, dan SSB meningkatkan asupan zat besi. Ketersediaan buah dan aksesibilitas buah (p<0.05) berhubungan dengan asupan vitamin C. Memantau perilaku makan (p=0.017) merupakan satu-satunya faktor sosial yang berhubungan dengan konsumsi zat besi dan vitamin C. Kami tidak menemukan korelasi antara konsumsi zat besi dan faktor fisik dan sosial, perilaku makan anak, atau sosiodemografi. Kesimpulan: Hanya Memantau kebiasaan makan responden mempengaruhi asupan vitamin C mereka. Peran orang tua dalam pemberian makan sangat penting dalam memastikan bahwa anak-anak mengkonsumsi makanan dalam jumlah yang cukup. Ini melibatkan pemantauan praktik makan untuk meningkatkan asupan mikronutrien anak-anak

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Background: Iron deficiency (ID) is the most frequent micronutrient deficiency in children under the age of five. Anemia among children under five years old is increasing year on year in Indonesia. Vitamin C insufficiency can induce IDA. The home environment is a critical factor in determining a child's nutritional intake, as 65 to 72% of daily calories are consumed at home. Therefore, this study aimed to assess correlation between physical and social aspects of home food environment with iron and vitamin C intake in children aged 2-6 years in Pejagalan. Methods: This observational study used a cross-sectional approach to collect secondary data from 191 mothers and children in a North Jakarta slum. Interviews with standardized questionnaires were used to determine children's iron and vitamin C intake. Consumer Behavior Questionnaire evaluated home food environment (CBQ). SPSS Version 20 was used for Spearman correlation and multiple linear regression. Result: Iron and vitamin consumption in children was lower than the recommended daily intake (RDI) for Indonesia. It was shown that those who had access to more fruits and vegetables also consumed more iron and vitamin C. A correlation between monitoring feeding practices (p=0.024, p=0.035) and increased consumption of iron and vitamin C was discovered. Fruits, vegetables, sweets, and SSB availability increased iron intake. Fruit availability (p<0.05) and fruit accessibility (p<0.05) were connected with vitamin C intake. Monitoring eating behaviors (p=0.017) was the only social factor connected with iron and vitamin C consumption. We found no correlation between iron consumption and physical and social factors, child eating behavior, or sociodemography. Conclusion: Only monitoring respondents' food habits affected their vitamin C intake. The role of parents in feeding is critical in ensuring that children consume an adequate amount of food. This involves monitoring eating practices to enhance children's micronutrient intake."

"Anemia merupakan salah satu masalah kesehatan masyarakat yang mempengaruhi penduduk di negara maju maupun berkembang. Penyebab tertinggi anemia adalah kekurangan zat besi. Anemia Defisiensi Besi (ADB) dapat menyebabkan gangguan perkembangan perilaku, kognitif, dan keterampilan psikomotori anak. Daun kelor dapat menjadi alternatif potensial dalam memenuhi kebutuhan zat besi karena memiliki kandungan zat besi 9 kali lebih banyak daripada bayam. Suplementasi bubuk daun kelor terbukti dapat menurunkan prevalensi anemia sedang dan berat berturut-turut sebesar 68,2% dan 77,9% pada anak-anak berusia di bawah 2 tahun. Pemanfaatan daun kelor sebagai tanaman obat yang memiliki berbagai manfaat bagi kesehatan umumnya masih secara tradisional. Rasa pahit pada kelor menyebabkan anak-anak tidak menyukai daun kelor. Tujuan dari penelitian ini adalah mendapatkan formula sediaan sirup ekstrak daun kelor yang memiliki stabilitas fisik dan kimia yang baik. Ekstrak daun kelor diperoleh dengan Microwave Assisted Extraction (MAE). Formula sirup dibuat dengan 3 konsentrasi propilen glikol sebagai kosolven dan pengawet. Hasil yang diperoleh menunjukkan bahwa formula 1 memiliki stabilitas fisik yang baik, dan stabilitas kimia yang paling baik dengan kandungan zat besi yang paling tinggi yaitu 2,83 mg / 30 gram ekstrak / 100 ml sediaan. Kadar zat besi yang disarankan untuk anak adalah 8-10 mg/hari sehingga ekstrak yang dibutuhkan yaitu 84,80-106,00 gram ekstrak / hari dan dosis sediaan sirup yang dibutuhkan yaitu 283-353 ml/hari.

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Anemia is one of the health problems that affect people in both developed and developing countries. The highest cause of anemia is iron deficiency. Iron Deficiency Anemia (IDA) can cause impaired development in behaviour, cognition, and psychomotor skills of children. Moringa leaves can be a potential alternative in meeting iron needs because they contain 9 times more iron content than spinach. Moringa oleifera Lam. leaf powder supplementation can reduce the prevalence of moderate and severe anemia in the by 68.2% and 77.9% in children below two years. The use of Moringa oleifera Lam. leaves as a medicinal plant with health benefits is still generally traditional. The bitter taste of Moringa oleifera Lam. leaves causes children to dislike Moringa oleifera Lam leaves. The purpose of this work was to obtain syrup formula for antianemia using Moringa leave’s extract that has physical and chemical stability. Moringa leave’s extract was obtained with Microwave-Assisted Extraction (MAE). Syrup formula was made in 3 concentration of propylene glycol as a cosolvent and preservatives. Result of this study showed that formula 1 has good physical stability, and the best chemical stability with the highest iron content, 2.83 mg/30 gram extract/100 ml. The recommended iron level for children is 8-10 mg / day, so the required extract is 84.80-106.00 grams of extract / day and the required dosage of syrup is 283-353 ml/day"

"Penyebab utama dari anemia adalah rendahnya asupan zat besi dari makanan. Salah satu cara untuk mengurangi resiko anemia zat besi adalah dengan nenambahkan fortifikan zat besi pada bahan pangan berbasis kedelai, seperti tempe, tahu, dan susu. Beberapa fortifikan zat besi yang biasa digunakan adalah besi EDTA, Glisinat, Fumarat, dan Suksinat. Namun, belum diketahui jenis dan jumlah fortifikan terbaik untuk pangan berbasis kedelai. Tujuan penelitian ini adalah menentukan fortifikan terbaik untuk fortifikasi zat besi pada pangan berbasis kedelai.dan menentukan jumlah fortifikan ideal yang ditambahkan pada sampel tempe, tahu, dan susu. Hasil penelitian menunjukkan bahwa besi EDTA merupakan fortifikan terbaik diantara besi Glisinat, fumarat, dan suksinat dengan kadar Fe 5,0709 mg/48 gram pada tempe, 1,5313 mg/30 gram pada tahu, dan 7,5684 mg/200 mL pada susu. Fortifikan ideal diperoleh dengan melakukan kombinasi dalam mengkonsumi pangan berbasis kedelai perhari, misalnya susu kedelai sebanyak 200 mL terfortifikasi 50 mg besi EDTA dengan tempe terfortifikasi 10 mg besi EDTA. Kombinasi lainnya juga bisa dilakukan untuk mencapai kadar Fe yang direkomendasikan (8-15 mg).

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The major cause of iron deficiency in human body is the low intake of iron from foods. One of strategy to overcome the iron deficiency anemia (IDA) in Indonesia is iron fortification to soya-based (i.e., soya milk, tempeh, and tofu) by adding iron fortificant. Some iron fortificants commonly used are iron EDTA, Glycinate, Fumarate, and succinate. However, number and the best fortificant in soybean basis is not yet known well. The objective of this research is to compare iron availibilty from these fortificant and to know ideal fortification in soybean basis.

The result showed that iron EDTA was the best fortificant between iron glycinate, fumarate, and succinate with iron level 5,0709 mg/48 gram in tempe, 1,5313 mg/30 gram in tofu, and 7,5684 mg/200 mL in soyamilk. The Ideal fortification was obtained by combination sample and fortificant. For example, we can consume soyamilk fortified 50 mg iron EDTA and tempe fortified 10 mg iron EDTA or another combination can be done to get iron level appropriate Reccommendation Dietary Allowance (8 -15 mg/day)."

"Defisiensi besi merupakan defisiensi nutrisi terbanyak di seluruh dunia, dengan prevalensi tertinggi pada kelompok perempuan usia reproduksi. Di Indonesia prevalensi anemia defisiensi besi pada ibu hamil 50,5%. Penting dilakukan penapisan dini sebelum terjadi anemia defisiensi besi, untuk mencegah komplikasi sistemik yang permanen, pada ibu maupun janin. Saat ini telah dikembangkan parameter ekuivalen hemoglobin retikulosit (RET-He) yang mendeteksi kadar hemoglobin dalam retikulosit. Usia retikulosit di sirkulasi hanya 24-48 jam, maka RET-He lebih menggambarkan keadaan sebenarnya dari status besi pada sumsum tulang. Saat besi di sumsum tulang menurun, RET-He akan mengalami penurunan. Pemeriksaan RET-He dilakukan pada alat hitung sel darah otomatis dan tidak memerlukan tabung darah tambahan karena dilaporkan sebagai bagian dari hitung retikulosit. Penelitian ini bertujuan untuk mendapatkan rentang nilai RET-He pada perempuan usia reproduksi, melakukan penapisan defisiensi besi pada perempuan hamil trimester I dan II menggunakan RET-He dan membandingkannya hemoglobin, feritin, dan saturasi transferin. Juga untuk mendapatkan titik potong RET-He dengan sensitivitas dan spesifisitas yang optimal pada perempuan hamil trimester I dan II. Didapatkan rentang nilai RET-He pada perempuan usia reproduksi 30,69-36,17 pg. Didapatkan 100 perempuan hamil trimester I dan II yang terdiri dari 3 kelompok berdasarkan feritin dan saturasi transferin yaitu 67 (67%) subyek tanpa defisiensi besi, 17 (17%) subyek dengan defisiensi besi tahap I, dan 16 (16%) subyek dengan defisiensi besi tahap II. Rerata ± SD kadar hemoglobin, RET-He, dan saturasi transferin adalah 12,35 ± 1,02 g/dL, 33,60 ± 1,88 pg, dan 28,63 ± 1,07%. Median(min-maks) feritin adalah 40,10 (6,24 ± 191,30) ng/mL. Dari kurva ROC untuk menentukan titik potong nilai RET-He yang memberikan sensitivitas dan spesifisitas terbaik dibandingkan dengan feritin sebagai baku emas, didapatkan RET-He dengan titik potong 33,65 pg pada sensitivitas 67% dan spesifisitas 64,18% dan area under the curve (AUC) 66,4%, serta didapatkan PPV 47,8%, NPV 79,6%, LR positif 1,86 dan LR negatif 0,52. Ditemukan perbedaan bermakna kadar RET-He antara kelompok tanpa defisiensi besi dan kelompok defisiensi besi tahap II dan antara kelompok defisiensi besi tahap I dan tahap II. Tidak terdapat perbedaan bermakna antara kelompok tanpa defisiensi besi dan kelompok defisiensi besi tahap I.

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Iron deficiency is the most common nutrient deficiency in the world, on developing and industrial countries. Population with highest risk of iron deficiencies is women in reproductive ages. In Indonesia the prevalence of iron deficiency anemia in pregnant women is 50,5%. Iron deficiency anemia in pregnancy can affect to both mother and fetus. In order to prevent permanent systemic complications, it is important to do early detection before iron deficiency anemia developed.

On early phase of iron deficiency before anemia developed, we need an additional test of ferritin, serum iron and saturation index aside from complete blood count. Nowadays people developed a parameter named reticulocyte hemoglobin equivalent (RET-He) which detect the hemoglobin in a young erythrocyte. Reticulocyte will be on circulation for only 24-48 hours, so the RET-He will give more appropriate condition of bone marrow iron. In condition where the bone marrow iron is depleted, the RET-He shows a decrease. This parameter can be tested together with CBC, so that it will not need additional blood sample.

This research aim to attain RET-He reference range on reproductive age women, to screen iron deficiency on first and second trimester pregnant women with RET-He and compare it to other parameters that available now : hemoglobin, ferritin, transferrin saturation, and to develope RET-He cut-off with optimal sensitivity and specificity.

RET-He’s reference range on reproductive women is 30,69-36,17 pg. We attained 100 I and II trimester pregnant women which can be divided into 3 groups based on ferritin and transferrin saturation : 67 women (67%) without iron deficiency, 17 women (17%) with iron deficiency stage I, and 16 women (16%) with iron deficiency stage II. Hemoglobin’s, RET-He’s and transferrin saturation’s mean ± SD are 12,35 ± 1,02 g/dL, 33,60 ± 1,88 pg, and 28,63 ± 1,07%. Ferritin’s median(min-max) are 40,10(6,24-191,30) ng/mL. Using ROC curve we found RET-He at 33,65 pg as an optimal cut-off point to differentiate iron deficiency with 67% sensitivity, 64,18% specificity, and 66,4% area under the curve (AUC).

From crosstabs table of RET-He with ferritin as gold standard and 33,65 pg as cut-off point we attained 47,8% PPV, 79,6% NPV, positive LR 1,86 and negative LR 0,52. We found significant differences of RET-He between non-iron deficiency and iron deficiency stage II groups and between iron deficieny stage I and iron deficiency stage II groups. There was no difference between non-iron deficiency and iron deficiency stage I groups."

"Female adolescents are vulnerable to iron deficiency anemia (IDA) and if it persists into their reproductive years has serious implications not only for the health of their offsprings but for their own as well. An iron supplementation is warranted in order to provide sufficient iron stores prior to pregnancy and to effect desirable birth outcomes. A communication component of the supplementation is regarded as essential for improving compliance. Therefore, an experimental community trial involving adolescent female students in two public high schools in Metro Manila was conducted between October-December 1997. The objective of the study was to asses the effect of communication on compliance to weekly iron supplementation. The students were assigned to three groups: iron plus communication (FeC group, n = 82), iron (Fe group, n = 89), and control group (n=78). The FeC and Fe groups received iron tablets containing 60 mg. Elemental iron and 250 mcg. Folic acid while the control group received placebo tablets from Physical Education Health and Music (PEHM) teachers once a week of eight subsequent weeks. Teachers assigned to the FeC group were trained communication. Comparison were made between the three groups on compliance as communication. Comparisons were made between the three groups on compliace as measured by attendance to tablet distribution and actual ingestion through stool test, record on index card and interview. Additionally, levels and prevalence of anemia were measured before and after intervention and a pre and post test about knowledge on IDA and possible causes and treatments were included. Data about side-effects, reaction from students, parents and teachers about the supplementation-communication activities and suggestions for futher improvements in conductiong such future undertaking were obtained from focus group discussions (FGDs). Comparisons of actual tablet ingestion between the three groups showed significantly higher compliance in the FeC group (P<0.001) than in the other two group as measured by record on index card and interview desoite more side effects felt. Changes from pre to post-test knowledge scores o iron were significantly greater for the FeC group (p<0.001) than in the Fe and control groups. However, hemoglobin levels improved significantly in the Fe group (p<0.05) but not in the FeC group and remained the same in the control group. Reactions obtained through focus group discussions from parent (as reported by students), teachers and the participants found the program beneficial and feasible for implementation on a larger scale. Compliance enhancing strategies and motivational approaches for adolescent female students must consider the potential influence of family, fiends and teachers as revealed by the Venn diagram in planning iron supplementation programs with communication for this target group."

"ABSTRAKLatar belakang : Sebanyak 70% dari anemia pada anak merupakan anemiamikrositik hipokrom, dan yang terbanyak adalah anemia defisiensi besi (ADB).Anemia defisiensi besi pada anak sekolah berkaitan dengan penurunan prestasibelajar. Anak dengan masalah nutrisi berisiko mengalami defisiensi besi. Asupanzat besi, pemacu dan penghambat absorpsi besi memengaruhi kadar besi. Sekolahdasar (SD) Pegangsaan 01 Jakarta Pusat merupakan sekolah negeri denganmayoritas siswa berasal dari sosial ekonomi rendah.Tujuan : Mengetahui status besi pada anak usia 6-12 tahun serta hubungannyadengan status gizi dan asupan diet.Metode : Studi potong lintang dilakukan di SD Negeri Pegangsaan 01, JakartaPusat antara bulan Maret-April 2016. Asupan pemacu absorpsi zat besi (vitaminC) dan penghambat (fitat, teh, kopi, susu) dinilai dengan food record selama tigahari, diolah dengan NutriSurvey®. Darah tepi lengkap, feritin, besi serum, totaliron binding capacity (TIBC), saturasi transferin, dan high sensitivity C-reactiveprotein (hs-CRP) diperiksakan di laboratorium.Hasil : Terdapat 115 subyek berpartisipasi dalam penelitian. Prevalens deplesibesi sebesar 4,3%, defisiensi besi tanpa anemia sebesar 14,8%, ADB sebesar1,7%. Tidak terbukti ada hubungan antara status gizi kurang dengan status besi[p=0,094; OR=2,29(0,86-6,10)], gizi lebih dan obesitas dengan status besi[p=0,050; OR=0,30(0,09-1,00)], asupan besi total dengan status besi (p=0,260),vitamin C dengan status besi (p=0,740), fitat dengan status besi (p=0,901), tehdengan status besi (p=0,931), kopi dengan status besi (p=0,624), dan susu denganstatus besi (p=0,277).Simpulan : Prevalens deplesi besi, defisiensi besi tanpa anemia, dan ADB padaanak usia 6-12 tahun berturut-turut adalah 4,3%, 14,8%, dan 1,7%. Tidak terbuktiada hubungan antara status gizi, asupan zat besi, vitamin C, fitat, teh, kopi, dan susu dengan status besi pada anak usia 6-12 tahun.

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ABSTRACTBackground : Prevalence of anemia in Indonesian school-age children is high.Approximately 70% cases are microcytic hypochromic anemia which irondeficiency anemia (IDA) are the most frequent. Iron deficiency anemia associatedwith decreased learning achievement. Children with nutritional problems at riskfor iron deficiency. Intake of enhancer and inhibitor of iron absorption affects ironbody level. Pegangsaan 01 Public School is primary school in Central Jakarta,which most of the students come from low socioeconomic family.Objective: To measure iron status in children aged 6-12 years and its relationshipwith nutritional status and dietary intake.Methods: A cross-sectional study was conducted in Pegangsaan 01 PrimarySchool, Central Jakarta, on March-April 2016. Dietary iron enhancer (vitamin C)and inhibitor (phytate, tea, coffee, milk) were obtained using a 3-days food recordand analyzed with NutriSurvey®. Complete blood count, ferritin, serum iron, totaliron binding capacity, transferrin saturation and high sensitivity C-reactive proteinwere examined.Results: A total of 115 children were studied. Prevalence of iron depletion, irondeficiency without anemia, and iron deficiency anemia were 4,3%, 14,8%, and1,7% respectively. No evidence of relationship between undernourished and ironstatus (p=0,094), overweight-obesity and iron status (p=0,050), iron intake andiron status (p=0,260), vitamin C and iron status (p=0,740), phytate and iron status(p=0,901), tea and iron status (p=0,931), coffee and iron status (p=0,624), milkand iron status (p=0,277).Conclusion: Prevalence of iron depletion, iron deficiency without anemia andiron deficiency anemia in children aged 6-12 years were 4,3%, 14,8%, and 1,7%respectively. No evidence of relationship between nutritional status, dietary intake and iron status"

"Iron deficiency anemia is prevalent in Indonesia (38-71%), particularly among the pregnant women, despite of the large scale anemia control program launched by the government since 1970’s. The anemia control program included iron supplementation, nutrition education, food fortification, and parasite control. The results of the iron supplementation program is not yet as expected. Low compliance in taking iron pills was a reason suspected as the cause of the unexpected results. Several methods had been studied to increase the number of iron pills intake. However, the synthesis of hemoglobin is not only dependenton iron from the pills but also requires other blood forming nutrients from the diets. A two phase descriptive study was conducted to study the factors influencing the iron status of pregnant women in the second trimester participating in the National Anemia Control program in three subdistricts of Bogor district. The first phase was conducted for four weeks to obtain informations on hemoglobin and serum ferritin, socioeconomic condition, daily diet and nutrients intake, knowledge on anemia, on iron pills,and on Puskesmas Services, health behaviour, ante natal care attendance, and number of iron pills intake. The number of pregnant women joining the study was 456, they attended the ante natal care clinic of the Puskesmas of three subdistricts of the district of Bogor. The prevalence of anemia (Hb"

"ABSTRAKDi Indonesia prevalensi anemia defisiensi besi masih cukup tinggi terutama pada wanita hamil, wanita dewasa, anak usia sekolah dan pra sekolah. Penelitian pada anak dari golongan ekonomi rendah, yang berusia 6 bulan - 6 tahun dengan status gizi baik, menunjukkan prevalensi anemia defisiensi besi 37,9 - 73,0 %. Pada anak yang lahir cukup bulan dengan cadangan besi yang cukup, defisiensi besi dapat berkembang mulai usia 6 bulan. Hal ini disebabkan karena meningkatnya kebutuhan besi akibat pertumbuhan yang cepat, yang tidak diimbangi dengana konsumsi yang adekuat. Terbatasnya zat besi yang didapat: dari makanan pada anak-anak yang berusia 4 bulan sampai 12 bulan menyebabkan terjadinya defisiensi besi. Jumlah zat besi yang diabsorpsi tergantung dari ketersediaan hayati (bioavailabilitas) zat besi yang dimakan. Besi heme lebih mudah diabsorpsi dari pada besi non heme. Gejala defisiensi besi pada fase paling awal ditandai dengan penurunan cadangan besi secara berangsur-angsur. Faktor diet diduga memainkan peranan yang penting untuk meningkatkan cadangan besi. Di Indonesia anak-anak yang berusia 1 tahun mulai diberi makanan biasa selain ASI dan susu formula. Pada golongan ekonomi rendah, makanan terdiri dari serelia dan kacang-kacangan yang mempunyai koefisien absorpsi besi yang rendah. Ibu-ibu di daerah perkotaan karena kesibukan bekerja, lebih cenderung memberikan anaknya susu formula yang juga mempunyai koefisien absorpsi besi yang rendah. Pada percobaan binatang (anjing) terjadi penurunan enzim sitokrom oksidase dan laktase mukosa uses pada keadaan defisiensi besi. Penurunan ini menyebabkan terjadinya fenomena malabsorpsi sekunder. Enzim laktase berfungsi untuk menghidrolisis laktosa menjadi glukosa dan galaktosa sebelum diabsorpsi. Laktosa (gala susu) hanya terdapat di dalam susu. Aktivitas enzim laktase tinggi pada waktu lahir dan periode neonatal pada seluruh mamalia. Aktivitas akan menurun sesudah periode disapih, umumnya kurang dari 1/10 puncak aktivitas, kecuali pada manusia kadar tertinggi bertahan sampai usia 5 tahun (Eropa) Sesudah periode ini aktivitas laktase dapat berlanjut terus atau mungkin menurun. Pada bangsa Afrika dan Asia laktase menurun pada usia 3 - 6 tahun (7,8)."

"Latar belakang. Anak dengan penyakit jantung bawaan (PJB) berisiko mengalami defisiensi besi dan anemia defisiensi besi (ADB) karena peningkatan kebutuhan besi akibat hipoksia kronik. Diagnosis defisiensi besi pada anak PJB sianotik mengalami tantangan karena terdapat polisitemia dan inflamasi. Reticulocyte hemoglobin equivalent (Ret-He) adalah parameter status besi yang baru dan andal, tetapi belum terdapat nilai potong untuk evaluasi status besi anak PJB sianotik.Tujuan. Mengetahui peran dan menentukan nilai potong Ret-He untuk diagnosis defisiensi besi dan ADB pada anak PJB sianotik.Metode. Penelitian ini merupakan uji diagnostik terhadap 59 anak PJB sianotik usia 3 bulan-18 tahun di RSCM dan RSAB Harapan Kita. Pengambilan darah dilakukan untuk menilai parameter hematologis (hemoglobin, hematokrit, mean corpuscular volume, mean corpuscular hemoglobin) dan biokimiawi status besi standar (feritin serum, saturasi transferin) sebagai baku emas untuk menentukan status besi, kemudian dibandingkan dengan nilai Ret-He. Kurva receiveing operating characteristic (ROC) dikerjakan untuk menentukan nilai potong Ret-He untuk diagnosis defisiensi besi dan ADB.Hasil. Median usia subjek adalah 23(3-209) bulan dengan lelaki 52,5% (n=31). Didapatkan status besi normal 27/59 (45,8%), defisiensi besi 8/59 (13,5%), dan ADB 24/59 (40,7%). Nilai potong Ret-He untuk defisiensi besi adalah 28,8 pg dengan sensitivitas 75%, spesifisitas 85,2%, NDP 60%, NDN 92%, dan AUC 0,828. Nilai potong Ret-He untuk ADB adalah 28,15 pg dengan sensitivitas 75%, spesifisitas 88,9%, NDP 85,7%, NDN 80%, dan AUC 0,824. Parameter Ret-He tetap memerlukan pemeriksaan hemoglobin dalam mendiagnosis ADB. Pada anak PJB sianotik, defisiensi besi dapat ditegakkan dengan nilai Ret-He <28,8 pg dengan hemoglobin >16,5 g/dL. Anemia defisiensi besi dapat ditegakkan dengan nilai Ret-He <28,15 pg atau Ret-He 28,15-28,8 pg dengan hemoglobin <16,5 g/dL.Kesimpulan. Reticulocyte hemoglobin equivalent dapat digunakan untuk mengevaluasi status besi anak PJB sianotik dengan nilai potong < 28,8 pg untuk defisiensi besi dan <28,15 pg untuk ADB.

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Background: Pediatric cyanotic heart disease (CHD) has a significant risk developing iron deficiency and iron deficiency anemia (IDA) due to chronic hypoxia. Diagnostic challenge occurs as polycythemia and inflammation happened. Reticulocyte hemoglobin equivalent (Ret-He) is a new and reliable parameter for iron status evaluation. However, there is no previous study regarding cut-off value in pediatric CHD population.

Objective: To evaluate the role of Ret-He and to determine cut-off points in diagnosis of iron deficiency and IDA in pediatric CHD.

Methods: A diagnostic study of 59 children aged 3 months to 18 years with CHD in Cipto Mangunkusumo Hospital and Harapan Kita Women and Children’s Hospital. The hematological parameters (hemoglobin, hematocrite, mean corpuscular volume, mean corpuscular hemoglobin) and biochemical parameters for iron status (serum ferritin, transferrin saturation) evaluated to determine iron status and then compared to the Ret-He levels. The receiver operating characteristic (ROC) analysis was done for Ret-He cut-off points.

Result: The median age of the subjects was 23(3-209) months-old with 52.5% male (n=31). Normal iron status was found in 27 (45.8%) subjects, iron deficiency in 8 (13.5%) subjects, and IDA 24 (40.7%) subjects. The Ret-He cut-off point for iron deficiency is 28.8 pg (sensitivity 75%, specificity 85.2%, PPV 60%, NPV 92%, and AUC 0.828). The Ret-He cut-off point for IDA is 28.15 pg (sensitivity 75%, specificity 88.9%, PPV 85.7%, NPV 80%, and AUC 0.824). The usage of Ret-He should be accompanied by hemoglobin. In this population, iron deficiency could be diagnosed with Ret-He <28.8 pg with hemoglobin >16.5 g/dL. While IDA could be diagnosed with Ret-He <28.15 pg or Ret-He 28.15-28,8 pg with hemoglobin <16.5 g/dL.

Conclusion. Ret-He could be used as a parameter of iron status in pediatric CHD with a cut-off value <28.8 pg for iron deficiency and <28.15 pg for IDA."

"Varian gen TMPRSS6 berasosiasi dengan status besi diplasma, tetapi efek tersebut belum dijelaskan pada anak Indonesia. Penelitian ini bertujuan menganalasis apakah SNP rs855791 (G>A) dan rs4820268 (A>G) gen TMPRSS6 berhubungan dengan status besi dan hemoglobin yang rendah dengan mengontrol asupan zat besi pada anak baduta suku Sasak. Studi crossectional ini mengeksplorasi baseline data dari randomized trial di Kabupaten Lombok Timur, sebanyak 121 subyek memenuhi syarat dalam penelitian ini. Real Time PCR, metode Taqman Assay digunakan untuk menganalisis genotip. Hasil Penelitian menunjukkan bahwa varian TMPRSS6 secara signifikan berhubungan dengan feritin, tetapi asupan zat besi lebih berkontribusi terhadap feritin dibandingkan genotipe.

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Variants in TMPRSS6 were associated with plasma iron, but their effects in Indonesian children remain elucidated. This study aim to analyze whether the TMPRSS6 SNPs rs855791 (G>A) and rs4820268 (A>G) were associated with low iron status and hemoglobin controlling for iron intake among Sasaknese. A crossectional study explored the baseline of a randomized trial in East Lombok district, 121 subjects were eligible in the study. Real Time PCR using Taqman-assay method was used for analysis of SNPs genotype. The researcher suggests that TMPRSS6 variants were significantly associated with plasma ferritin, but iron intake still more contribute to ferritin than genotype."