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Abstract

Berbagai penelitian menunjukkan bahwa defisiensi vitamin D dan hiperpara-tiroidisme sekunder menimbulkan dampak serius pada kesehatan, antara lain meliputi osteoporosis, osteomalasia, kelemahan otot, jatuh dan fraktur osteoporotik. Tujuan penelitian ini adalah (1) mengetahui pengaruh pajanan UVB sinar matahari pada konsentrasi 25(OH)D dan hormon paratiroid (PTH) perempuan usia lanjut Indonesia. (2) mendapatkan saat dan lama pemajanan yang optimal. Penelitian uji klinik acak terbuka ini melibatkan 74 perempuan berusia 60 - 90 tahun yang tinggal di 4 panti werda di Jakarta dan Bekasi. Randomisasi dilakukan untuk memisahkan kelompok studi dan kontrol. Kelompok kontrol hanya mendapat kalsium 1000 mg/hari, sedang kelompok intervensi dipajankan dengan matahari selama 6 minggu. Hasil yang diukur sebelum dan sesudah 6 minggu pemajanan adalah konsentrasi 25(OH)D, PTH, dan ion kalsium. Ditemukan bahwa, waktu pemajanan yang optimal adalah 1 jam sebelum dan sesudah tengah hari. Prevalensi defisiensi vitamin D pada wanita usia lanjut adalah 35,1%. Pada kelompok terpajan, konsentrasi 25(OH)D meningkat lebih tinggi daripada yang tidak dipajan (51,8% vs 12,5%). Hasil tambahan adalah rerata asupan kalsium 248 mg/hari, dan rerata asupan vitamin D 28 IU/hari.

Many studies showed that vitamin D deficiency and secondary hyper-parathyroidism cause serious impact on health including osteoporosis, osteomalacia, paralysis, fall, and osteoporotic fracture. This study was conducted to compare the effect of UVB from sunlight exposure in combination with calcium supplementation, and control (calcium only) on the vitamin D status and parathyroid hormone (PTH) concentration in Indonesian elderly women. This study was a randomized clinical trial in institutionalized care unit. Subjects included 74 elderly women with a mean age 71 years. Intervention was random allocation of UVB from sunlight exposure at 0.6 MED/hour noted in the UV meter on the face and both arms and calcium 1000 mg, three times per week for 6 weeks, and without treatment (calcium 1000 mg only). Main outcome measured were fasting serum levels of 25(OH) D, PTH, and calcium ion at 0 and 6 weeks in both treatment and control groups. The incidence of vitamin D deficiency in this population study was 35.1 %. In the treatment group, 25(OH) D increased from 59.1 nmol/L to 84.3 nmol/L (mean value after 6 weeks of sunlight exposure) with only a slight increase of 25(OH) D in the control group (51.8% vs 12.5%). 25(OH)D deficient levels in 15 out 16 subjects became normal after 6 weeks of sun exposure. There was no change of PTH levels in both groups. Additional results of this study are mean calcium intake of 248 mg/day and vitamin D intake of 28 IU/day.

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