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Abstrak :
Pendahuluan: Pada usia lanjut (usila) terjadi perubahan dalam berjalan dan keseimbangan, penurunan kekuatan otot rangka, dan perlambatan integrasi sensorik dan motorik oleh sistem saraf pusat. Di sisi lain, usila rentan terhadap defisiensi vitamin D yang diketahui berkaitan dengan sistem muskuloskeletal dalam koridor fungsi mobilitas seseorang untuk melaksanakan aktivitas sehari-hari. Belem. ada penelitian mengenai konsentrasi vitamin D dan korelasinya dengan mobilitas fungsional perempuan usila. Tujuan: Menentukan konsentrasi vitamin D serum, hasil nilai uji the timed up and go (TUG), dan korelasi antara konsentrasi vitamin D serum dan nilai uji TUG perempuan usi la Metode: Penelitian di tiga panti werdha di DK1 Jakarta dan satu panti werdha di Bekasi ini dilakukan dengan desain korelatif secara potong lintang yang dilakukan pada bulan Januari 2005 terhadap perempuan berusia 60 tahun atau lebih. Uji TUG digunakan untuk menilai mobilitas fungsional dasar dengan mengukur berapa detik waktu yang diperlukan subyek untuk melakukan aktivitas berturut-turut: bangkit dari kursi bertinggi duduk 46 cm dengan sandaran lengan dan punggung, berjalan sejauh tiga meter, berbalik arah kembali menuju kursi, dan duduk kembali. Konsentrasi vitamin D serum diukur dengan metode ELBA. Sebagai variabel perancu adalah usia, indeks massa tubuh, dan konsentrasi ion kalsium serum yang diukur dengan metode NOVA. Hasil: Dari 42 perempuan usila-yang memenuhi kriteria inklusi dan eksklusi penelitian, 30 orang yang ditentukan secara random propotsional diikutsertakan dalam penelitian. Rerata (SB) konsentrasi vitamin D adalah 68,0 (SB 21,1) nmol/L, dengan konsentrasi <50 nmol/L sebesar 23,3%, nilai uji TUG 10,7 (SB 2,1) detik, IMT 22,3 (SB 3,7) kglm2, dan usia 70,2 (SB 6,4) tahun, sedangkaiu median (minimal-maksimal) konsentrasi ion kalsium serum adalah 1,095 (1,030-1,230) mmol/L. Konsentrasi vitamin D serum belum menunjukkan korelasi yang bermakna dengan TUG (r = -0,008; p = 0,968). Antara variabel perancu dan TUG juga belum menunjukkan korelasi yang bermalma. Hasil korelasi dengan TUG untuk indeks massa tubuh r = 0,014; p = 0,942, konsentrasi ion kalsium serum p = 0,287;p = 0,124, dan usia r = 0,315;p = 0,09. Simpulan: Rerata konsentrasi vitamin D serum perempuan usila dalam penelitian ini adalah 68,0 (SB 21,1) nmollL, 23,3% mengalami defisiensi vitamin D sedangkan sisanya memiliki konsentrasi vitamin D serum normal. Rerata basil nilai uji TUG perempuan usila yang diteliti adalah 10,7 (SB 2,1) detik, sebagian besar (60%) memiliki basil nilai uji TUG 10-<20 detik yang menunjukkan kemandirian _untuk berbagai . aktivitas. Konsentrasi vitamin D serum belum menunjukkan korelasi yang bermakna dengan mobilitas fungsional dasar perempuan usila, semakin tinggi konsentrasi vitamin D serum tidak diikuti dengan semakin sedikit waktu yang diperlukan untuk melakukan.uji TUG; proporsi subyek dengan nilai uji TUG <10 detik (mobilitas fungsional dengan kemandirian penuh), lebih sedikit pads responden yang mengalami defisiensi vitamin D.

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Background: In elderly there are changes both in gait and balance, muscle strength decline, and slowing of sensory and motoric integration by central nervous system. On the other hand, elderly are susceptible to vitamin D deficiency which is known associated with musculosceletal system in the light of functional mobility in order to perform daily Iiving activities independently. Study on vitamin D and its correlation with basic functional mobility in elderly women has not been conducted yet. Objective: to determine vitamin D serum concentration, the timed up and go (TUG) test score, and the correlation between vitamin D serum concentration and TUG test score of elderly women. Method: a correlative cross sectional study of institutionalized elderly women age 60 years old or greater was conducted in three nursing homes in DKI Jakarta and one nursing home in Bekasi in January 2005. TUG test was.performed to evaluate basic functional mobility by measuring the time in seconds to stand from 46 cm height armchair, walk three meters, turn around, and return to full sitting in chair. Vitamin D serum concentration was measured by ELISA method. Calcium ion serum concentration that was measured by NOVA method, age and body mass index (BMI) were confounding variables. Result: Of forty-two elderly women who met the inclusion and exclusion criteria, thirty subjects which proportional randomly assigned were participated in this study. Mean (SD) vitamin D serum concentration was 68.0 (SD 21.1) nmoUL, with concentration S50 nmolIL was 23.3%, TUG score was 10.7 (SD 2.1) seconds, BMI was 223 (3.7) kglm2, age was 70.2 (SD 6.4) years, and median (minimal-maximal) ionized calcium serum concentration was 1.095 (1.030-1.230) mmolfL. Vitamin D serum concentration had not shown significant correlation yet with TUG (r = -0.008; p = 0.968). There were also no significant correlation among the confounding variables and TUG. The correlation with TUG for BMI r = 0.014; p = 0.942, ionized calcium serum concentration p = 0.287; p = 0.124, and age r=0.315;p=0.09. Conclusion: The mean vitamin D serum concentration of elderly women in this study was 68.0 (SD 21.1) nmolIL, 23.3% had vitamin D deficiency, while the rest of other subjects still had normal vitamin D serum concentration. The mean TUG score of elderly women in this study was 10.7 (SD 2.1) seconds, more than half (60%) had TUG score 10-<20 seconds which means they were mostly independent to perform daily living activities. Vitamin D serum concentration had not shown significant correlation yet with basic functional mobility of elderly women, the higher vitamin D serum concentration was not followed by lesser time to perform TUG test; the proportion of subjects with TUG score <10 seconds (freely mobile in functional mobility) were lesser in vitamin D deficiency respondents.

Abstrak :
Dalam rangka pengembangan kontrasepsi pria, penggunaan kombinasi testosteron enantat (TE) dan progesteron pada orang Kaukasia hanya mencapai azoospermia 70% sedangkan orang Asia mencapai 100% azoospermia (Moeloek, 1998). Faktor yang mungkin dapat menimbulkan perbedaan dalam menekan produksi sperma diduga disebabkan oleh faktor genetik dan faktor lingkungan antara lain perbedaan asupan makanan antara orang Kaukasia dan orang Asia. Adapun ciri makanan negara Barat mengandung lemak dan protein tinggi sedangkan karbohidrat rendah. Sebaliknya untuk orang Asia mengandung lemak dan protein rendah, namun kandungan karbohidratnya tinggi. Dari penelitian dilaporkan bahwa asupan makanan seperti karbohidrat, lemak dan protein mempengaruhi konsentarsi SHBG (Sex Hormone Binding Globulin). SHBG adalah glikoprotein plasma, diproduksi oleh sel hati, mempunyai afinitas yang tinggi terhadap dihidrotestosteron (DI-FT) dan jugs mengikat estrogen tetapi daya ikatnya lebih rendah. Dari hasil penelitian yang dilakukan oleh Sutyarso, 1997 pada hewan coba (Macaca Fascicularis) dengan memberikan model makanan orang Asia yaitu karbohidrat 70%, protein 15% dan lemak 15%. Hasil yang diperoleh kadar testosteron bebas pada hewan coba tersebut lebih tinggi dibandingkan dengan hewan coba yang diberi makanan lemak dan protein tinggi. Oleh karena itu kami merasa perlu mengadakan penelitian pada kelompok masyarakat Pegawai Negeri Sipil Golongan I yang mengkonsumsi karbohidrat tinggi namun protein dan lemak rendah. Pengukuran konsentarsi SHBG menggunakan ImmunoRadiometric Assay (IRMA). Untuk mengetahui asupan makronutrien yaitu karbohidrat, protein dan lemak dilakukan pencatatan makanan (Food recall) selama tiga hari berturut-turut. Pengukuran kadar testosteron total dan kadar testosteron bebas menggunakan RadioImmuno Assay (RIA). Penelitian yang telah dilakukan Longcope dkk, 2000 pria dewasa di AS Body Mass Index (BMI) merupakan faktor yang dapat untuk memperkirakan (prediktor) konsentrasi SHBG di dalam tubuh.

Hasil penelitian menunjukkan bahwa konsentrasi SHBG 41,76 nmol/L. Asupan makronutrien yaitu karbohidrat 256,28 gram (56,24%), protein 43,92 gram(9,68%) dan lemak 69,28 gram (34,08%), kadar testosteron total 6,43 ng/mL, kadar testosteron bebas 22,39 pa/mL, Body Mass Index (BMI) 21,69 kg/m2. Dengan menggunakan "Pearson Correlation Coefficient" antara konsentrasi SHBG dengan karbohidrat (r=0,093), lemak (r=0,051), protein(r=0,002), kadar testosteron bebas (r=0,256), kadar testosteron total,(r=0,518) dan Body Mass Index(BMI)(r=-0,519) mempunyai hubungan. Hasil analisis Regresi Ganda antara konsentrasi SHBG dengan BMI dan kadar testosteron total mempunyai hubungan yang erat dengan tingkat signifikan 0,000 (P<0,05).

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The Relationship Between Sex Hormone Binding Globulin (SHBG) Serum Concentration With Diet Macronutrient Testosterone and Body Mass Index (BMI) in Man of Civil Servant of Grade IThe development of male contraception, the combination of using Testosterone Enantate (TE) and progestogen to Caucasian people was only have azoospermia 70% whereas Asian people only have 100% azoospermia (Moeloek, 1998). The factor which might be rised the different in emphasizing the production of sperm is caused by genetic factor and environment factor are the different of food construction between Caucasian people and Asian. The food characteristic in west country contain fat and high protein but low carbohydrate. On the other hand Asian people contain fat and low protein but high carbohydrate. From the study is reported that the food component like carbohydrate, fat and protein was effecting the SHBG concentration. SHBG (Sex Hormone Binding Globulin) is glikoprotein plasma, produced by cell liver, having a high affinities to dihydrotestosterone (DHT) and also bounding estrogen but the bounding was to low. From the study research by Sutyarso, 1997 to the experiment animal (Macaca fascicularis) by giving the food model of Asian people like carbohydrate 70%, protein 15% and fat 15%. The report that can get is the degree of free testosterone to experiment animal 15 more higher than the experiment animal who giving a food such as fat and high protein. Because of that we feel need to do research to people who work as Civil Servant of Grade I who had consumption high carbohydrate whereas protein and fat low. The measuring of SHBG concentration is using Immuno Radidmetric Assay (IRMA). To know the composition macronutrient like carbohydrate, fat and protein is doing the food registration (food recall) during continuously three days. The measuring of total testosterone concentration and free testosterone concentration are using Radioimmuno Assay (RIA).

The study research by Long cope et at, 2000 male in USA Body Mass Index (BMI) is factor how to predict the concentration of SHBG in body.The research result showed the value average of SHBG concentration 41,76 nmole/L. The composition macronutrient like carbohydrate 256,28 gram (56,24%), protein 43,92 gram(9,68%) and fat 69,28 gram(34,08%), total testosterone 6,43 ng/mL, free testosterone 22,39 pq/mL, Body Mass Index (BMI) 21,69 kg /m2. By using "Pearson Correlation Coefficient" between SHBG concentration with carbohydrate (r=0,093), fat (r=0,051), protein (r=0,002), free testosterone (r=0,256), total testosterone (r=0,518) and Body Mass Index (BMI)(r=-0,519) have relationship. The result of analysis double regression between SHBG serum concentration with Body Mass Index (BMI) and total testosterone have bight relationship with signification level 0,000 (P<0,05).