1,25 dihydroxyvitamin D dan kalsium pada akseptor depot medroxyprogesteron asetat (DMPA) berdasarkan lama pemakaian

Netti Meilani Simanjuntak; Eti Yerizel; Yusrawati Yusrawati

doi:10.22146/ijcn.34845

1,25 dihydroxyvitamin D dan kalsium pada akseptor depot medroxyprogesteron asetat (DMPA) berdasarkan lama pemakaian

https://doi.org/10.22146/ijcn.34845

Netti Meilani Simanjuntak^(1*), Eti Yerizel⁽²⁾, Yusrawati Yusrawati⁽³⁾

(1) Program Studi S2 Ilmu Kebidanan, Fakultas Kedokteran Universitas Andalas Padang
(2) Bagian Biokimia, Fakultas Kedokteran Universitas Andalas Padang
(3) Bagian Obstetri dan Ginekologi, Rumah Sakit Umum Pusat Dr. M. Djamil, Padang
(*) Corresponding Author

Abstract

Background: Long – term usage of depot medroxyprogesterone acetate (DMPA) may suppress estrogen levels causing the body to undergo hypoestrogenic. The hormone estrogen affects the metabolism of calcium and 1,25 dihydroxy vitamin D in the body. Calcium and 1,25 dihydroxy vitamin D are bone-forming vitamin and minerals.

Objective: This study aimed to analyze the relationship between 1,25 dihydroxy vitamin D and calcium on the accelerate of DMPA based on long usage.

Method: This is an observational study with cross-sectional design. A total of 70 acceporates sample was chosen by consecutive sampling and divided into 2 groups. 35 acceporates received DMPA for 1-2 years (group 1) and 35 acceporates received DMPA for 2-4 years (group 2). Serum 1,25 dihydroxy vitamin D levels examined by enzyme-linked immunoabsorbent assay (ELISA) method and serum calcium was quantified using the Calcium Arsenazo method. The research was conducted in Puskesmas Andalas and Lubuk Buaya Kota Padang between July 2017 and September 2017. The data normality was checked using Kolmogorov Smirnov and then the data were analyzed using the Spearman test.

Results: The average of 1,25 dihydroxy vitamin D in group 1 is 351.16 pg/ml and in group 2 is 289.84 pg/ml. The median concentration of calcium on samples in group 1 is 9.30 mg/dl and in Group 2 is 9.13 mg/dl.

Conclusion: There were negative significant correlations between 1,25 dihydroxy vitamin D and calcium in group 1 and group 2.

Keywords

1,25 dihydroxyvitamin D; calcium; DMPA; length of use

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References

Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Situasi dan analisis keluarga berencana. [series online] 2014 [cited 2018 Jul 30]. Available from: URL: http://www.depkes.go.id
Population Reference Bureau. World population data sheet. [series online] 2016 [cited 2018 Jul 30]. Available from: https://assets.prb.org/pdf16/prb-wpds2016-web-2016.pdf
Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Riset kesehatan dasar (RISKESDAS). 2013. Jakarta: Kemenkes RI; 2013.
Badan Koordinasi Kependudukan Keluarga Berencana Nasional. Jumlah total peserta KB aktif Provinsi Sumatera Barat tahun 2014-2016. Padang: BKKBN; 2016.
Saifuddin AB. Buku panduan praktis pelayanan kontrasepsi. Jakarta: Yayasan Bina Pustaka Sarwono Prawirhardjo; 2014.
Astarto NW, Permadi W, Madjid TH, Bayuaji H, Djuwantono T, Ritonga MA. Kupas tuntas kelainan haid. Jakarta: Sagung Seto; 2011.
World Health Organization (WHO). Technical consulation on the effects of contraceptive on bone health. Summary Report; 2005 June 20-21; Geneva, Switzerland.
Veisi F, Zangeneh M. Comparison of two different injectable contraceptive methods: depo medroxyprogesterone acetate (DMPA) and cyclofem. J Family Reprod Health 2013;7(3):109-13.
Peni EM, Pipitcahyani TI. Lama pemakaian KB suntik DMPA dan densitas tulang. Jurnal Informasi Kesehatan Indonesia 2005;34-41.
Tandra H. Osteoporosis: mengenal, mengatasi, dan mencegah tulang keropos. Jakarta: Gramedia Pustaka Utama; 2009.
Harel Z, Wolter K, Gold MA, Cromer B, Bruner A, Bone H, et al. Inadequate vitamin D status in adolescents with substansial bone mineral density loss during the use of depot medroxyprogesterone acetate injectable contraceptive: a pilot study. J Pediatric Adolesc Gynecol 2010;23(4):209-14. doi: 10.1016/j.jpag.2009.11.004.
Van Abel M, Hoenderop JG, Dardenne O, St Arnaud R, Van Os CH, Bindels RJ, et al. 1,25-dihydroxyvitamin D3-independent stimulatory effect of estrogen on the expression of ECaC1 in the kidney. J Am Soc Nephrol 2002;13(8):2102-9. doi: 10.1097/01.asn.0000022423.34922.2a
Hartingsih AD, Widiyoni I, Wuryastuti H. Keterkaitan panhisterektomi dan suplemen 1,25 Dihydroxyvitamin D3 dengan risiko urolitiasis pada tikus. Jurnal Veteriner 2012;13:313-21.
Gropper SS, Smith LJ. Advanced nutrition and human metabolism sixth edition. USA: Wadsworth Cengage Learning; 2013.
Kencana T. Perbandingan kadar estradiol dan CTX-1 serum pada akseptor KB depot medroksiprogesteron asetat (DMPA) 1-2 tahun dan 3-4 tahun [Thesis]. Padang: Universitas Andalas; 2016.
Yousefzadeh P, Shapsess SA, Wang X. Vitamin D binding protein impact on 25 hydroxyvitamin D levels under different physiologic and pathologic conditions. Int J Endocrinol 2014;2014:981581. doi: 10.1155/2014/981581.
Ganong WF. Buku ajar fisiologi kedokteran. Jakarta: EGC; 2008.
Gardner DG, Shoback D. Greenspans basic & clinical endocrinology. 9^th edition. China: The Mc Graw-Hill Companies; 2011.
Pharmacia & UpJhon Company LLC. Depo-Provera. Product monograph including patient medication information. Canada: Pfizer Canada Inc; 2016.
Collin EM. Studies on the interaction between the estrogen and vitamin D endocrine system. [series online] 2002 [cited 2018 Jul 30]. Available from: URL: https://repub.eur.nl/pub/32018/021023_Colin,%20Edgar%20Merfyn.pdf
Abrams SA, Griffin IJ, Hawthorne KM, Gunn SK, Gundberg CM, Carpenter TO. Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents. J Clin Endocrinol Metab 2005;90(10):5576-81.
Gupta KA, Jamwal V, Sakul, Maholtra P. Hypervitaminosis D and systematic manifestations: a comprehensive review. JIMSA 2014;27(4):236-7.
Chen LR, Wen YT, Kuo, Chen CL, KH. Calcium and vitamin D suplementation on bone health: current evidence and recommendations. International Journal of Gerontology 2014;8(4):183-8. doi: 10.1016/j.ijge.2014.06.001