DESCRIPTION OF PURINE, FAT CONSUMPTION HABIT AND WATER
INTAKE WITH HYPERURICEMIA OCCURRENCE
IN LECTURER AT POLITECHNIC
OF HEALTH PADANG
2016
By :
Juliana Putri Dwiyana (1611226009)
Tika Kurnia (1611226016)
Dera Elva Junita (1611226003)
Syafnita (1611226002)
Nutrition Department Andalas Universiti
Year 2017
Politeknik
Kesehatan Kemenkes Padang
Jurusan
Gizi
Karya
Tulis Ilmiah, Juni 2016
Juliana
Putri Dwiyana
Gambaran
Kebiasaan Konsumsi Purin, Lemak dan Asupan Air dengan Kejadian Hiperurisemia
pada Dosen Di Kampus Pusat Politeknik Kesehtan Kemenkes Padang Tahun 2016
vi+
55 halaman, 16 tabel, 1 gambar, 10 lampiran
ABSTRAK
Data Riset Kesehatan Dasar (Riskesdas) tahun 2013
menggambarkan bahwa prevalensi penyakit sendi berdasarkan diagnosis di
Indonesia sebesar 11,9 %. Prevalensi penyakit asam urat yang terjadi di
dalam kategori penyakit sendi di
Provinsi Sumatera Barat yaitu sebesar 12,7 %. Kebiasaan konsumsi purin, lemak
dan asupan air mempunyai peranan penting dalam meningkatkan kadar asam urat
dalam darah. Penelitian ini bertujuan untuk mengetahui gambaran kebiasaan
konsumsi purin, lemak dan asupan air dengan kejadian hiperurisemia.
Penelitian ini merupakan penelitian deskriptif,
dimana yang menjadi sampel adalah dosen di kampus pusat Poltekkes Kemenkes
Padang sebanyak 30 orang. Penelitian dilakukan pada bulan Agustus 2015-Juni
2016. Data kebiasaan konsumsi purin dan lemak dikumpulkan dengan menggunakan format Food Frequency Quistionnaire, sedangkan untuk asupan air
menggunakan format Food Recall 1 x 24
jam. Untuk data asam urat responden
didapatkan dari pemeriksaan dengan menggunakan uric acid test. Data yang telah dikumpulkan
selanjutnya diolah dengan menggunakan software
olah data untuk melihat gambaran kebiasaan konsumsi purin, lemak, asupan air
responden serta kejadian hiperurisemia pada dosen di Kampus Pusat Poltekkes
Kemenkes Padang.
Hasil
penelitian menggambarkan bahwa (73 %) responden
mengalami kejadian hiperurisemia. Kurang dari separuh (40 %) mempunyai
kebiasaan konsumsi purin dengan kategori sering.Kurang dari separuh (40 %)
mempunyai kebiasaan konsumsi lemak
dengan kategori sering. Kurang dari separuh (33 %) mempunyai asupan air dengan
kategori jarang.
Disarankan
agar responden dapat lebih menjaga kebiasaan makannya, terutama
makanan mengandung purin yang tinggi, seperti soto paru, hati ayam atau sapi
dan dendeng serta mengurangi konsumsi makanan yang mengandung lemak trans dan
cukup minum air.
Kata Kunci (Key Word) : Hiperurisemia, Purin, Lemak, Air
Daftar Pustaka 18 (1999-2015)
Health Polytechnic of Ministry of
Health of Padang
Department of Nutrition
Scientific Writing, June 2016
Juliana Putri Dwiyana
FOREWORD
By praying and praising the presence
of God Almighty, thanks to His blessings and grace, the writing of this
Scientific Writing can be completed by the author despite the difficulty.
Preparation and writing of
Scientific Writing is a series of educational process as a whole in D-III
Program of Nutrition Department of Health Polytechnic of Ministry of Health of
Padang. Scientific Writing is entitled "Description of
Consumption Purin Habit, Fats and Water Intake with Hyperuricemia Occurrence in
Lecturers of Central Campus at Health Polytechnic of Ministry of Health Padang
Year 2016".
On this occasion the author would
like to express his gratitude for all guidance and guidance from Mrs. Dr. Linda
M. Thaufik M.Kes and Mrs. Iswanelly Mourbas, SKM, M.Kes as mentor of this
Scientific Writing.
This
author's thanks go to:
1.
Mr. H. Sunardi, SKM, M.Kes as Director of Polytechnic of HealthPadang.
2.
Mrs. Hasneli, DCN, M.Biomed as Chairman of Nutrition Polytechnic of Health Padang.
3.
Ibu Kasmiyetti, DCN, M.Biomed as Chairman Prodi DIII Nutrition Polytechnic of
Health Padang.
4.
Mr. M. Husni Thamrin, STP, MP as Academic Advisor.
5.
Mr and Mrs lecturer and Civitas Academica Nutrition Department of Polytechnic
of Health Padang.
6.
Parents and families who have provided support morally and materially, input
and spirit in making Scientific Writing.
7.
Lecturer Polytechnic of HealthPadang who has been willing to be a respondent
and provide direction and advice during the study.
8.
Friends of D-III Nutrition Department 2013, especially class III-B which has
provided motivation and support in the preparation of Scientific Writing.
9.
Friends, brothers and sisters who have given encouragement and encouragement in
the preparation of this Scientific Writing.
The author realizes that this
Scientific Writing is still not perfect, therefore the authors expect criticism
and suggestions that build for the perfection of this Scientific Writing.
Padang,
June 2016
Author
PART I
INTRODUCTION
A. Background
Generally, gout is caused by the increased blood uric acid levels
(hyperuricemia) that has been going on for years. Uric acid levels are constantly
high can lead to gout disease / chronic gout. The attacks will continue to occur and
there is no longer attack-free period. Acute rheumatic gout can also occur due
to fluctuation or the rise and fall of blood uric acid levels abruptly.
(Susanto.2013)
The result from the Health Research
(Riskesdas) in 2013 found the prevalence of joint disease diagnosis by health
workers in Indonesia by 11.9% and by 24.7% pergejala diagnosis. The prevalence
of joint disease / arthritis / rheumatism indicates downward trend. In 2013
(24.7%) lower than in 2007 (30.3%). In West Sumatra prevalence of joint disease
incidence by diagnosis pergejala was 21.8% and 12.7% based diagnosis. It can be
seen that the prevalence of joint disease / arthritis / rheumatism based
diagnosis in West Sumatra in Indonesia on the prevalence, diagnosis based
pergejala while prevalence is decreasing. (Riskesdas.2013)
Result from Padang City Health
Department in 2012, obtained a description of the incidence of gout as many as
1,257 new events and in 2014 as many as 476 new events. (DKK Padang.2014) Based
on these result it is known that a decrease in the incidence of gout in the
city of Padang recently. Despite a decline of new events, but this joint
disease is difficult to cure. So every year, the incidence of joint disease
will continue to grow with new people who experience it.
Formerly
known gout as a disease of the elite. The amount of uric acid attack on the
elite is directly proportional to the eating patterns that generally makes them
redundant. Does not rule out also a lot of attacking people who work in
offices, professors and people with other high income developing hyperuricemia
(gout). With a high enough income they used to eat a good meal, because first
of gout is known as a disease of wealthy people who can eat a good meal.
(Susanto.2013)
Some foods and beverages known to contain high purine and can increase uric acid levels are alcohol, sardines, and offal. Hearing or similar fish (sardines) and innards are a source of compounds that potentially pose a risk. (Krisnatuti.2001)
Fat can inhibit the excretion of uric acid in the urine. Therefore, patients with gout (gouty arthritis) should be given a low-fat diet. Patients should limit fried foods and bersantan as well as avoiding the use of margarine (derived from vegetable products) or butter (derived from animal products). Fat which can be consumed preferably 15% of total calories. (Krisnatuti.2001)
A high fluid intake, especially of drinks, can help spending uric acid that can lower uric acid levels in the blood. Daily water requirement expressed as a proportion of the amount of energy released by the body in an average neighborhood. For adults, it takes as much as 1.0-1.5 ml / kcal, whereas for infants 1.5 ml / kklal. (Almatsier.2009)
B.
Problem Formulation
To know the description of purine
consumption habits, fat, water intake and incidence of hyperuricemia in the
lecturer at Campus Health Polytechnic Center of Padang Ministry of Health in
2016
C.
Purpose of Writing
1. General Purpose
To know the description of purine
consumption habits, fat, water intake and the incidence of hyperuricemia in
lecturers at the Campus Central Polytechnic Health Ministry Padang Campus
Center 2016.
2. Special Purpose
a)
Knowledge of frequency distribution of incidence of
hyperuricemia in lecturer at Campus Center of Health Polytechnic of Ministry of
Health of Padang in 2016
b)Knowledge of the frequency
distribution of purine consumption habits in lecturers at Campus Center of
Health Polytechnic of Padang Ministry of Health in 2016
c)
Knowledge of frequency distribution of fat consumption habits to lecturer at Health Polytechnic
Center Campus of Ministry of Health of Padang in 2016
d)
Knowledge of the frequency distribution of water intake to
the lecturer at Campus Center of Health Polytechnic of Ministry of Health of
Padang in 2016
e)
Knowledge of the tendency of purine consumption habits with
hyperurisemia kajadian on lecturers in Campus Center Polytechnic Health
Ministry of Health Padang in 2016
f)
Knowledge of the tendency of fat consumption habit with
hyperurisemia kajadian on lecturer at Campus Health Polytechnic Center of
Ministry of Health of Padang in 2016
g)Knowledge of the tendency of water
intake with hyperuricemia kajadian on the lecturer at the Campus Center of
Health Polytechnic Kemenkes Padang in 2016
D.
Research Benefits
1. For Researchers
Can add knowledge, insight and
experience for the author in developing the ability to conduct research.
2. For Respondents
As a source of information for
respondents about blood uric acid levels and eating habits.
E.
Scope of Research
This research is a process to know
the description of consumption habits purine, fat, water intake and the
incidence of hyperuricemia in the lecturer at Campus Center of Health
Polytechnic Kemenkes Padang in 2016.
PART II
REVIEW LITERATUR
1. Hiperurisemia
Hyperuricemia is an increase in uric acid in the blood that is above normal. The condition of hyperuricemia can occur because of, excessive tissue splitting so that very purines are released for later dimethabolisir with residual substances in the form of uric acid. Subsequent decreased uric acid excretion due to acidic urine (eg due to high consumption of fat or alcohol) or because of the excessive decline in renal function and excessive consumption of purine foods such as innards, sardines, birds, broths, nuts, chips and tape.1. (Almatsier.2009)
2. Purine Consumption
Purines
and pyrimidines are nitrogen-containing cyclic heterocyclic compounds with
carbon-containing rings and other elements (hetero atoms). Purine and
pyrimidine nucleotides are small nitrogen-containing compounds that play a very
important role in the biologic role. (Robert Murray 2009)
Almost
all food ingredients consumed by humans contain purine substances. Several
types of foods and drinks that are known to contain high purines and can
increase uric acid levels are alcohol, fish hearing, and viscera. Hearing fish
or the like (sardines) and offal are sources of compounds that potentially pose
a risk of hyperuricemia (Almatsier.2009)
3. Fat Consumption
Fat
is an organic compound that is soluble in alcohol and in other organic
solutions, but not soluble in water. Fat contains carbon, hydrogen, and oxygen.
These elements also compose carbohydrates, the ratio of oxygen to carbon and
hydrogen is lower in fat. Less fats contain oxygen, so the calories they
produce are twice as much as fat from the food they consume, but the body also
forms some fat.
(Dewi Cakrawati; 2012) High fat
content in the diet will lead to acidosis (due to the formation of ketone
bodies consisting of acetoacetic acid, β-hydroxybutyric acid and acetone) which
makes the urine more acidic and complicates the excretion of uric acid.
(Andry Harnoto 2006)
4.
Water Consumption
Body
fluids are closely related to minerals dissolved in them. All life processes
take place in body fluids that contain minerals. Body fluids are the media of
all chemical reactions in the cell. Each cell contains an intracellular fluid
(fluid outside the cell) that fits well. Extracellular fluid consists of
interstitial fluid or intercellular (mostly) contained in the sidelines of
cells and intravascular fluid in the form of blood plasma. All body fluids at
all times lose and experience replacement of parts. However, the liquid
composition in each compartment is maintained to remain in a homeostatic state.
The fluid balance in each compartment determines blood volume and pressure. (Almatsier Sunita; 2009)
High
fluid consumption, especially from beverages, can help the expenditure of uric
acid so that it can lower levels of uric acid in the blood. Sabaiknya, drinking
as much as 1.0-1,5 ml / kcal per day. In addition, vegetables and fruits that
contain lots of water, such as watermelon, cantaloupe, cantaloupe, pineapple,
starfruit, guava water, and other fruits are very well consumed. In general,
the fruits are very small or even do not contain purines
PART III
RESEARCH METHODS
This study is a descriptive study, using cross-sectional design, which among the independent variables (purine consumption habits, intake of fat and water) and the dependent variable hyperuricemia studied at bersamaan.Penelitian time this is done in the Campus Center for Health Polytechnic Kememkes Padang and the time the study began from August 2015 to June 2016. Result collection was conducted from April 13 until May 16, 2016. the study population was the entire polytechnic lecturers Padang at the campus center (Padang Nursing Department, Environmental Health and Nutrition). Sampling was done by simple random sampling method. The result collection is done by measuring the uric acid respondents directly and interviews with mengisis FFQ and Food Recall.
PART IV
RESULTS AND DISCUSSION
A.
RESULT
Samples were professors who teach on the campus of Polytechnic Center of Ministry of Health of Padang, who met the inclusion criteria as many as 30 orang.Responden in this study ranged in age from 35-65 years, with an average age of 50 years and older. Most experienced hyperuricemia age range 50-64 years. From the analysis it can be seen that the respondents with the incidence of hyperuricemia is as much as 73%. Showed that more than half (60%) of respondents rarely consume foods with purines medium category, respondents who consume fat with frequent category is as much (40%), respondents with no adequate water intake category that is as much (33%).
Can be seen in Table 14. Based on the result collected against 30 respondents, the tendency of purine consumption habits were the incidence of hyperuricemia,
Purine Consumption
|
Event category of Hyperuricemia
|
Total
|
||||
Hiperurisemia
|
Non
Hiperurisemia
|
|||||
n
|
%
|
n
|
%
|
n
|
%
|
|
Often
|
9
|
75
|
3
|
25
|
12
|
100
|
Rarely
|
13
|
72
|
5
|
28
|
18
|
100
|
Total
|
22
|
73
|
8
|
27
|
30
|
100
|
According to the table 14, known to respondents who have hyperuricemia tend to occur among respondents with moderate purine consumption habits with frequent category (75%). Compared to the rare category (72%).
Can be seen in Table 15. Based on the result collected against 30 respondents, the tendency of fat consumption habits to the incidence of hyperuricemia,
Fat consumption
|
Event category of Hyperuricemia
|
Total
|
|||||
Hiperurisemia
|
Non Hiperurisemia
|
||||||
N
|
%
|
n
|
%
|
n
|
%
|
||
Often
|
11
|
92
|
1
|
8
|
12
|
100
|
|
Rarely
|
11
|
61
|
7
|
39
|
18
|
100
|
|
Total
|
22
|
73
|
8
|
27
|
30
|
100
|
|
According to the table 15, known to respondents who have hyperuricemia tend to occur in fat consumption habits respondents with frequent category (92%). Compared to the rare category (61%)
Can be seen in Table 16. Based on the result collected against 30 respondents, the tendency of water intake with the incidence of hyperuricemia,
Water Consumption
|
Event category of Hyperuricemia
|
Total
|
||||
Hiper
urisemia
|
Non Hiper
urisemia
|
|||||
n
|
%
|
n
|
%
|
N
|
%
|
|
Not enough
|
7
|
70
|
3
|
30
|
10
|
100
|
enough
|
15
|
75
|
5
|
25
|
20
|
100
|
Total
|
22
|
73
|
8
|
27
|
30
|
100
|
According to the table 16, there is a trend in water consumption respondents experienced enough hyperuricemia (75%) slightly larger than respondents who have hyperuricemia with the category is not sufficient (70%).
B. Discussion
The average
results of blood uric acid examination of respondents by sex is high ie 7.2 mg
/ dl in female respondents and 8.4 mg / dl in male respondents. The highest
blood uric acid levels for women were 9.6 mg / dl and the lowest was 4.2 mg /
dl, while for men the highest was 11.4 mg / dl and the lowest was 6 , 4 mg /
dl.
Based on the
results of the analysis can be seen that the respondents who frequently took a
high purine not found. While respondents who often consume purine is (40%), and
rarely consume medium purine (60%). The average food consumption habits being
purine respondents is 5 times per day. Also known also the lowest consumption
of purine consumption is 3 times per day, and the highest purine consumption
habits 7 times per day.
Based on
interviews conducted, it is known that most respondents know about
hyperuricemia and food hazards that contain high purine if often consumed.
Musfira (Musfira.2016) (2015) in his research stated that respondents who
frequently consume purine most of them experienced the incidence of
hyperuricemia. Types of high purine foods most often consumed by the
respondents are meat, broth, liver and lung while for food with purine being
the most frequently consumed is tofu, chicken, kale and spinach.
The average fat
consumption habit of respondents is 6.7 times per day. The highest frequency of
fat consumption per day was 8.71 times per day and the lowest was 2.86 times
per day, in line with the concerned research, SatyaNova (Handesti.2016) (2010)
in his study found that there was a relationship between fat intake With uric
acid levels. Fat in question is trans fat in the form of palm oil, coconut
milk, butter and margarine. Most food processing respondents prefer is fried,
and almost all respondents fry using palm oil. Respondents also often consume
margarine and butter because at breakfast respondents often consume bread or
sweet cake as a snack or food interlude.
The average
water intake of respondents is 2.3L per day. Also known also the minimum intake
of water that is 1.9 L per day, and water intake at most 3.5L per day. The
tendency of respondents whose consumption of water suffers from hyperuricemia
(75%) is slightly higher than those with hyperuricemia with their inadequate
water consumption habit (70%). Based on the research there is no tendency of
respondents who experienced hyperuricemia intake of water is not sufficient.
This may happen because in this study does not consider the type of intake of
water consumed by respondents. Respondents mostly consume beverages like coffee
other than water. This is in line with the research of Prihatiningsasi, Nova
Satya (Handesti.2016) (2010) in his research found that there is no
relationship between water intake with uric acid levels.
LIMITATIONS
OF THE STUDY
In terms of
resource personnel who do not too expert in this field, because in terms of
cost if done by a more skilled personnel, researchers have limitations in terms
of cost. FFQ and food recalculated methods are used to inquire about eating
habits perceived by each respondent to have different understanding and memory
so that the possibilities for bias are quite large.
CONCLUSION
1. There is a tendency between
purine consumption habits with hyperuricemia.
2. There is a tendency between fat
consumption habits with the incidence of hyperuricemia.
3. There is no tendency between
water intake with the incidence of hyperuricemia.
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