mo-tk maret 2016
TRANSCRIPT
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VITAMIN
Modul MO-TKdr. Verawati Sudarma, MGizi., Sp.GK
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"e#i$ie%$i Vitami%
A%&'a Ke(u'upa% Gizi )a%&dia%*ur'a% + AKG
A%&'a Keutua% Gizi )a%&dia%*ur'a% %ilai mi%imal u%tu'
me%(e&a ter*adi%)a pe%)a'it.
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A%&'a Keutua%
• Nilai %omi%al zat &izi )a%& diutu'a%
a&ar tuu dapat me%*ala%'a%
metaoli$me de%&a% $empur%a
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AKG + A Keutua% Sa#et) Mar&i%0SM1
SM ter&a%tu%& dari 'o%$e%$u$,
tiap %e&ara ereda
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"e#i$ie%$i at Gizi
• ila ada (ada%&a% di&u%a'a%
–Sampai $eerapa, ter&a%tu%& *umla
(ada%&a% tuu.
• ila tida' ada (ada%&a%
• de#i$ie%$i
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A$upa% )a%& er'ura%&
4e%uru%a% 'adar dalam dara
Ga%&&ua% #u%&$i metaoli'Ga%&&ua% #u%&$i or&a%
Ga%&&ua% or&a%i' or&a% terte%tu Ga%&&ua%
6e7er$iel
Irre7er$iel
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"e#i$ie%$i 7itami% merupa'a%
$uatu ra%tai
• Mulai dari 4e%&etaua%
me%&e%ai Gizi 4e%)ediaa%
aa% ma'a%a% $ampai
pe%&&u%aa% zat &izi ole
tuu.
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. 4e%&etaua%
• Kura%& pe%&etaua% – 4e%*ela$a% pe%&e%ai zat &izi ,
$umer da% pe%&&a%ti.
• Tau – Me%&e%ai 'eia$aa%, adat
i$itiadat dll.
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2. So$ial ;'o%omi
• Ketida' mampua% u%tu'me%)edia'a% aa% ma'a%a% – Tida' mampu u%tu' memeli
• Ketida' $ediaa% aa%ma'a%a% –
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3. 4e%&olaa% aa% ma'a%a%
• Me%(u(i – >u(i 4oto%&2 – "e%&a% air me%&alir
• Mema$a'
– aa% u%tu' mema$a' – Sua$a%a a$am/a$a
• Me%)edia'a% – Terlalu lama didiam'a% dipa%a$'a% er-ula%&2.
• ?a'tu pe%)ediaa% – er$ama de%&a% ma'a%a% lai%
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. @u%&$i pe%(er%aa%
• Me%&u%)a de%&a% ai'
• @u%&$i alat (er%a
•
@u%&$i e%zim (er%a• @a'tor i%terela$i de%&a% zat &izi
• Ga%&&ua% alat (er%a )a%& eruu%&a%
de%&a% i%#e'$i atau i%#e$ta$i (a(i%&.
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5. @u%&$i tra%$port dalam tuu
• at &izi aru$ di tra%$port• Memerlu'a% a%tua%
– Sir'ula$i dara
– Kadar protei% dara – @u%&$i eerapa or&a%
metaoli'
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!. 4e%&&u%aa% Ole Tuu
•
Se$uai de%&a% AKG – $ia, *e%i$ 'elami%
• Keadaa% #i$iolo&i –
Bamil – Me%)u$ui
• Keadaa% patolo&i$ –
Ga%&&ua% metaoli' – Ga%&&ua% or&a% tuu
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I%de%ti#i'a$i
• Ma$i%&-ma$i%& ra%tai di ide%ti#i'a$i
• ila ada 'elai%a% 'ore'$i
•
ila tida' era$il
–
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Vitami% A@u%&$i
. 4e%&liata%C me%*a&a i%te&rita$ #otore$eptor pada rod D
cone reti%a2. "i#ere%$ia$i $eluler
- 4roli#era$i D matura$i $el, terutama *ar reprodu'$i D
emrio&e%e$i$
- Sel a$al
$el mu'o$a- 4ertumua% D per'ema%&a% $'eletal D *ari%&a%
lu%a'
3. Si$tem imu%ita$ muda i%#e'$i- 4eme%tu'a% mucosal mucin secretion- Imu%ita$ $eluler D umoral
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• "ampa' 'e'ura%&a% 7itami% A – A%emia pera% 7itami% A dalam moili$a$i D
tra%$por zat e$i D ematopoe$i$
–
4opula$i de#i$ie%$i 7itami% A
pre7ale%$i a%emiati%&&i
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• Ma%u$ia tida' dapat me%$i%te$i$ $e%diri
$umer dari aa% ma'a%a% $umer • Sumer
– Bewa%i e%tu' 7itami% A a'ti# iolo&i(al
7alue lei ti%&&i – Naati e%tu' pro7itami% A 0'erote%oid1
• Metaoli$me reti%oid pro'$imal u$u$
alu$
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• "e#i$ie%$i 7itami% A ter*adi $e*a' a)i aru lair $tatu$
7itami% A iu melalui 'olo$trum D ASI
• I%#e'$i mempererat de#i$ie%$i 7itami% A – %a#$u ma'a% me%uru%
– Ga%&&ua% a$orp$i
– Keutua% me%i%&'at e( 'ataoli$me
– ;'$'re$i uri% ti%&&i
• "e#i$ie%$i 7itami% A (ada%&a% 7itami% A ati E 2= F&/&
0=,=8 Fmol/&1
• eroptalmia ma%i#e$ta$i 'li%i$ o'uler de#i$ie%$i 7itami%
A
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Bahan makanan sumber :
Preformed vitamin A : hewani (hati, lemak susu, keju, telur,
cod liver oil )
Provitamin A : daun hijau tua, sayuran/buah kuning orange.akin gela! warnanya makin tinggi kandungan
karotenoidnya
A"# $ sumber %&karoten
'omat $ sumber liko!en
armasi : retinil asetat
6a$io 'o%7er$i 'arote% reti%ol $a%&at re%da
utu a%)a' $a)ur D ua
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efisiensi vitamin A * derajat gangguan mata
+ $ buta senja +-A $ erosis konjungtiva
+-B $ berak bitot
+0 $ erosis kornea
+1A $ keratomalasia
+1B $ ulserasi kornea
+" $ eroftalmia skar
+ $ ero!htalmi fundus
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• 4emeria% Vitami% A do$i$ ti%&&i $etiap ! ula%
i%&&a u$ia 5 tau% erda$ar'a% awa do$i$ti%&&i Vitami% A dia$orp$i de%&a% ai',
di$impa% di ati D dimoili$a$i $aat diutu'a%
• "o$i$
– ==.=== I u$ia !H ula% – 2==.=== I u$ia 2H5: ula% 0@eruari D
A&u$tu$1
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• @orti#i'a$i – @orti#i'a$i di mi%)a' $a)ur, mar&ari%, tepu%&, &ula
• I%ter%atio%al u%it + =,3 F& reti%ol
• 6eti%ol a(ti7it) eui7ale%t ra$io 6A; + 2
2 F& J 'arote% + F& reti%ol
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• 4ulu%&a%, d'' a%a' u$ia $e'ola %e&eri D $wa$ta di
a'arta – 85,:L i%$u#i$ie%$i 7itami% "
– 5L de#i$ie%$i 7itami% "
– E=L 'adar 7itami% " %ormal
– A%a' perempua% ri$i'o de#i$ie%$i 7itami% " lei e$ar
dia%di%&'a% de%&a% a%a' la'i-la'i.
VITAMIN "
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• 2 e%tu' 7itami% "
– "2 0er&o(al(i#erol1, Sumer tumu-tumua%
– "3 0(ole(al(i#erol1, $umer ewa%i 0i'a%, 'u%i%&
telur, dll1 D diprodu'$i $e%diri melalui papara% V
pa%*a%& &eloma%& 2:=-32= %m
• Vit "2 D "3 ma$u' 'e dalam ati diua me%*adi 25-
)dro)7itami%-" 0250OB1"1 de%&a% ma$a paru 2-3
mi%&&u
• "i &i%*al 250OB1" ,25 0OB12"
• ,25 0OB12" + e%tu' a'ti# + (al(itriol
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• @u%&$i 7itami% "
– I%te$ti%al me%i%&'at'a% pe%)erapa% >a
– Tula%& me%i%&'at'a% moili$a$i tula%&
– 4aratiroid me%e'a% produ'$i ormo% paratiroid
• 4rodu'$i 7it " di$timula$i 'adar paratiroid, >a D 4
• >a D 4 Bormo% paratiroid
. $timula$i 250OB1" me%*adi ,25 0OB12" di &i%*al
2. re$orp$i >a tula%&
• ,25 0OB12" me%i%&'at'a% –. A$orp$i >a i%te$ti%al
–. 6ea$orp$i >a di &i%*al
–. Moili$a$i >a tula%&
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• aa% ma'a%a% $umer 7itami% " – Ku%i%& telur, $almo%, tu%a, $u$u $api
• @orti#i'a$i $u$u #ormula, $u$u $o)a, mar&ari%,
$ereal
•
Supleme%ta$i 7itami% "3 lei ai' daripada"2
• >ara ma$a' mempe%&arui 'a%du%&a%
7itami% "
– "i&ore%& turu% 5=L
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• Statu$ 7itami% " pada a%a' – Kadar 250OB12 %mol/< atau %&/m<
– "e#i$ie%$i erat P2,5 051
– "e#i$ie%$i P 38,5 051
–
I%$u#i$ie%$i 38,5 H 5= 05-2=1 – Normal 2=-==
– Keleia% Q25= 0==1
– I%to'$i'a$i Q385 05=1
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• $ia tua• Kulit &elap• Mu$im/leta' &eo&ra#i$• Su%$(ree%
Kura%&papara%
V
• Mala$orp$i lema'• Oat 0#e%oarital, #e%itoi%, a%ti
retro7iral, ri#ampi$i%1• 4e%)a'it &i%*al 'ro%i'• Oe$ita$• A$upa% 7it " re%da• Statu$ 7it " mater%al
Ko%di$imedi$/#i$i'
"
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• ;tiolo&i de#i$ie%$i 7itami% " – 4rolo%&ed rea$t#eedi%& ta%pa #orti#i'a$i da%
$upleme%ta$i 7itami% "
•
6i$i'o de#i$ie%$i 7itami% " atau 'al$ium – a)i prematur
– A%a' de%&a% pe%)a'it 'ro%i$
– 4e%&oata% $teroid *a%&'a pa%*a%& atau
a%ti'o%7ul$a%.
VITAMIN "
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• Ma%i#e$ta$i 'li%i$ – a)i D rema*a pertumua% pe$at 'eutua% >a
tuu tida' i$a 'ompe%$a$i ipo'al$emia
'e*a%&, teta%i lei me%o%*ol daripada ri('et$ia
– A%a'-a%a' &e*ala ri('et$ia lei me%o%*ol daripada
&e*ala ipo'al$emia 0'are%a metaoli$me lei re%da
$ei%&&a 'adar >a dapat dipertaa%'a%1
– 6i('et$ia a%ormalita$ $tru'tur tula%& pe%)a%&&a
tuu, erup$i &i&i terlamat, 'arie$ &i&i
– Imu%ita$ tuu, 'a%'er, dll
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• "ia&%o$i$ de#i$ie%$i 7itami% " – Kli%i$
– 6adiolo&i$ 0o$teope%i, pe%ipi$a% 'orte'$ tula%&
pa%*a%&, pata tula%&, peleara%/roe'a% meta#i$etula%&1
–
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• Terapi de#i$ie%$i 7itami% "
– "o$i$ pe%&oata% 7itami% " erda$ar'a% umur a%a'
• E ula% === I/ari
• -2 ula% ===-5=== I• Q2 ula% Q5=== I
• 4e%(e&aa% de#i$ie%$i 7itami% "
– A$i $upleme%ta$i 7it " == I/ari die%ti'a% *i'a
me%dapat $u$u #ormula #orti#i'a$i 7itami% " mi%imal
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• 4apara $i%ar mataari $ee$ar $atua% mi%imal
er)temal do$e 0M;"1 )aitu mulai mu%(ul%)a
'emeraa% )a%& ri%&a% di 'ulit $uda dapat
me%i%&'at'a% 'o%$e%tra$i 7itami% " $etara d&%
$upleme%ta$i =.===-2=.=== I.
– I%te%$ita$ V di a'arta pu%(a'%)a 4'. .==-3.==
– 4apara% $i%ar mataari di mu'a D le%&a% 4'. =:.==
25 me%it atau 4' .==-3.== 5 me%it 7it "
28== I
– >e&a de#i$ie%$i 7it " papara% $i%ar mataari 5-
3=R, 2-3/mi%&&u atau 2 *am/mi%&&u
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To'$i$ita$
• Supleme%ta$i 7it " erleia% Q=.===
I/mi%&&u atau Q=== I/ari
• Ge*ala iper'al$emia, iper'al$iuria,
a%ore'$ia, %au$ea, mu%ta, au$, poliuria,
&a%&&ua% era&ai $el 'ematia%
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• Ma$a 'a%a'-'a%a% D rema*a – 4e%i%&'ata% 'eutua% e%er&i
'eutua% tiami%, rio#la7i%, %ia(i% 0u%tu'
pelepa$a% e%er&i dari 'aroidrat1 – Si%te$i$ *ari%&a% 'eutua% !, a$am
#olat, 2