HUBUNGAN KADAR ENZYM KHOLINESTERASE DENGAN KADAR HORMON THYROID PADA WUS DI DAERAH GONDOK ENDEMIK

S. Sukati, K. Suryati, M. Ichsan, Mucherdiyantiningsih Mucherdiyantiningsih, Djoko Kartono
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Abstract

The Relationship Between Cholinesterase Enzym and Iodine Status of Child Bearing Age Woman (CBAW) In The Endemic Goitre Area. Background: Pesticide as a pollutant substance is a goitrogenic agent. It can form a strong complex bound with iodine in the body. Women who ive in the endemic goiter, area where the iodine source in the nature is limited and frequently exposed by pesticide, can increase the prevalence of iodine deficiency disorder (IDD). Objectives: To find out the relationship between cholinesterase enzyme concentration (as an indicator of pesticide exposure in the body) and iodine status of women in the endemic goiter area. Methods: The study was conducted in Pakis sub district, Magelang Regency, Central Java on July to November 2005. The design of the research was "cross-sectional" study. Samples were 265 women of child bearing age (17-35 years old). The data collected were concentration of free T4 (FT4) , cholinesterase enzyme in plasma, intake of cyanide originated from food, concentration of urine iodine excretion (UIE), type of contraception used and nutritional status. The concentration of serum FT4 were divided into two group ( nonnal). These data were analyzed by using chi-square test with odd ratio at 95% CL. Association between independent and dependent variables by controlling other variable were analyzed by multiple logistic regression. Results: Pesticides that frequently used in the area of study was Organophosphate and Carbamat The pesticide residue on raw vegetables was Carbofuran. Its concentration was 0.056 to 55.65 mg/kg. The highest residues was found in cabbage and it had exceeded the maximum limit of permitted residue. The pesticide residue of cooked vegetables was very low. Low concentration of cholinesterase enzyme (< 3600 U/L) was found in 3.8% women. More than 29% had low iodine status. Logistic regression analysis showed that women exposed to pesticide had 33 fold greater risk for IDD than that of without any pesticide exposure. Conclusions: The highest concentration of pesticide residue was obtained on raw cabbage and raw mustard green. It ranged from 2 to 10 times of maximum limit permitted residue according to Ministry of Health. Percentage of women who exposed by pesticide (carbamat) was 3.8%. It was showed that 29.3% of woman has low iodine status. Women exposed to pesticide had 100 risk 33 fold greater than that without any cyanide exposure. Suggestions: To minimize the hazardous effect of pesticide on health, it is suggested that the vegetables should be cooked property before consuming. It is necessary to do further research by takilg account the effect of cyanide air pollution inhaled besides cyanide from food. The more intensive control of using pesticide needs to be doneperiodically. Keywords: cholinesterase enzyme, iodine status and endemic goiter
地方性甲状腺肿区育龄妇女胆碱酯酶与碘含量的关系背景:农药作为污染物是一种致甲状腺肿剂。它能在体内与碘形成很强的络合物。生活在地方性甲状腺肿地区的妇女,在自然界中碘源有限且经常接触杀虫剂的地区,可增加碘缺乏症(IDD)的患病率。目的:了解甲状腺肿大地区妇女体内胆碱酯酶浓度(农药暴露指标)与碘含量的关系。方法:2005年7 - 11月在中爪哇省马格朗县巴基斯街道进行调查。本研究设计为“横断面”研究。样本为265名育龄妇女(17-35岁)。收集的数据包括血浆游离T4 (FT4)、胆碱酯酶、食物来源氰化物摄入量、尿碘排泄浓度(UIE)、避孕方式和营养状况。将血清FT4浓度分为两组(正常组)。这些资料采用奇比为95% CL的卡方检验进行分析。采用多元逻辑回归分析自变量与因变量之间的关系。结果:研究区常用农药为有机磷和氨基丁酸酯,生蔬菜残留农药为呋喃。其浓度为0.056 ~ 55.65 mg/kg。在白菜中发现的残留量最高,超过了允许残留量的最大限量。熟菜的农药残留量很低。低浓度胆碱酯酶(< 3600 U/L)的女性占3.8%。超过29%的人碘含量低。Logistic回归分析显示,暴露于农药的妇女患IDD的风险比未暴露于农药的妇女高33倍。结论:生白菜和生芥菜的农药残留量最高。卫生部规定的最大允许残留量为2 ~ 10倍。接触杀虫剂(卡马马特)的妇女百分比为3.8%。结果显示,29.3%的女性碘含量偏低。接触过农药的女性患病风险是没有接触过氰化物的女性的33倍。建议:为尽量减少农药对健康的危害,建议蔬菜食用前应煮熟。除了食物中的氰化物外,还有必要考虑吸入的氰化物对空气污染的影响,进一步进行研究。更严格的农药使用控制需要定期进行。关键词:胆碱酯酶,碘状况,地方性甲状腺肿
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