Kejadian Obesitas dan Hubungannya dengan Defisiensi Fe pada Anak Usia Sekolah: Tinjauan Sistematis
Occurrence of Obesity and Its Relation to Fe Deficiency in School-Age Children: A Systematic Review
Latar Belakang: Masalah kesehatan gizi di masyarakat menjadi topik krusial yang banyak dilaporakan baik pada negara maju dan berkembang. Kejadian defisiensi Fe pada anak-anak banyak dikaitkan dengan kondisi obesitas termasuk juga kelebihan berat badan (overweight), namun hubungan antar keduanya saat ini masih diidentifikasi lebih lanjut.
Tujuan: Mengidentifikasi hubungan antara obesitas pada anak usia sekolah (7-19 tahun) dengan defisiensi Fe serta parameter spesifik yang digunakan melalui tinjauan sistematik.
Metode: Penelitian ini dilakukan dengan tinjauan sistematis menggunakan tiga database yaitu PubMed, scopus dan scienceDirect. Strategi pencarian literatur dilakukan dengan Covidence software dengan memasukkan kriteria inklusi dan eksklusi yang telah ditetapkan. Lima literatur terpilih dari rentang tahun 2015 hingga 2021.
Ulasan: Kekurangan Fe didefinisikan sebagai adanya dua atau lebih nilai abnormal dari parameter berikut: (i) serum ferritin (SF) <15µg/L (ii) serum iron (SI) <10.7 µmol/l; (iii) Total iron Binding Capacity (TIBC) >62,7 µmol/l; dan (iv) %Transferrin Saturation (%Tsat) <15%. Defisiensi Fe pada kondisi obesitas terjadi melalui peningkatan mekanisme proinflamasi dan peran leptin yang dapat menurunkan ketersediaan serta penyerapan Fe dalam tubuh. Parameter (sTfR) Soluble Transferrin Receptor digunakan sebagai parameter terbaik untuk mengidentifikasi defisiensi Fe pada individu obesitas sedangkan (SF) Serum Ferritin memiliki keterbatasan sebagai indikator status besi pada anak obesitas.
Kesimpulan: Temuan ini menunjukkan bahwa kejadian obesitas pada anak-anak dapat menyebabkan peningkatan resiko defisiensi Fe. Masalah kekurangan zat besi dan obesitas menjadi masalah kesehatan masyarakat yang memiliki efek kesehatan jangka pendek dan panjang yang merugikan, terlebih anak usia sekolah yang berada pada fase pertumbuhan dan perkembangan kognitif. Parameter sTfR secara signifikan tidak dipengaruhi oleh peradangan karena adipositas sehingga dapat membedakan defisiensi Fe dari hipoferromie inflamasi.
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