Research Article

Pemberian kombinasi kalsium dengan asam askorbat meningkatkan kadar bone alkaline phosphatase dan osteocalcin serum dibandingkan kombinasi kalsium dengan vitamin D3 pada patah tulang panjang paska fiksasi internal di RSUP Sanglah, Bali, Indonesia

Ni Made Puspa Dewi Astawa , I Ketut Siki Kawiyana, Ketut Gede Mulyadi Ridia, Putu Astawa, I Ketut Suyasa, I Wayan Suryanto Dusak, I Gede Eka Wiratnaya

Ni Made Puspa Dewi Astawa
Program Studi Pendidikan Dokter Spesialis Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia. Email: nimade.puspadewiastawa@gmail.com

I Ketut Siki Kawiyana
Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

Ketut Gede Mulyadi Ridia
Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

Putu Astawa
Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

I Ketut Suyasa
Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

I Wayan Suryanto Dusak
Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

I Gede Eka Wiratnaya
Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Online First: December 01, 2020 | Cite this Article
Astawa, N., Kawiyana, I., Ridia, K., Astawa, P., Suyasa, I., Dusak, I., Wiratnaya, I. 2020. Pemberian kombinasi kalsium dengan asam askorbat meningkatkan kadar bone alkaline phosphatase dan osteocalcin serum dibandingkan kombinasi kalsium dengan vitamin D3 pada patah tulang panjang paska fiksasi internal di RSUP Sanglah, Bali, Indonesia. Intisari Sains Medis 11(3): 1380-1385. DOI:10.15562/ism.v11i3.785


Background: It is expected that supplementation will be able to satisfy the needs of calcium as well as improve the process of fracture healing. The goal of this study is to show the efficacy of calcium and ascorbic acid (vitamin C) combination supplements in fracture bone healing compared to calcium and vitamin D3.

Methods. This study is a randomized clinical trial involving 30 patients with long bone fractures of the lower extremity who have undergone internal fixation and are split into two classes. The calcium carbonate-ascorbic acid regiment combination was given to one group, while the calcium carbonate-vitamin D3 regiment was given to the other group. The effect of the regiment was tested on serum calcium, bone alkaline phosphatase (BAP) and osteocalcin (OC) levels. The findings were compared and interpreted statistically by SPSS version 21 for Windows.

Results. Administration of calcium carbonate and ascorbic acid combination was be able to increase serum calcium significantly (p = 0.00, 95% CI = 0.59 – 0,87), but not as strong as combination of calcium carbonate with vitamin D3. An increased level of serum BAP and OC was found significantly higher in calcium carbonate and ascorbic acid supplementation group (p value = 0,033, CI -4,18 – -0,19 for BAP, p value = 0,04, CI -2,25 – -0,49 for OC).

Conclusion. The administration of calcium carbonate and ascorbic acid combination supplement increases the serum calcium level, but not as strong as calcium carbonate and vitamin D3 combination.

 

 

Latar Belakang: Pemberian suplemen diharapkan mampu untuk memenuhi kebutuhan kalsium sekaligus mempercepat proses penyembuhan patah tulang. Penelitian ini bertujuan untuk mengetahui keefektifan suplemen kalsium dan asam askorbat (vitamin C) dalam penyembuhan tulang pasca patah tulang dibandingkan pemberian suplemen kalsium dan vitamin D3.

Metode: Penelitian ini merupakan uji klinis terandomisasi yang melibatkan 30 pasien patah tulang panjang ekstremitas bawah pasca fiksasi internal yang kemudian dibagi menjadi dua kelompok. Satu kelompok diberikan suplemen kombinasi kalsium karbonat-asam askorbat sedangkan kelompok lainnya diberikan kombinasi kalsium karbonat-vitamin D3. Efeknya terhadap kadar serum kalsium, bone alkaline phosphatase (BAP), dan osteocalcin (OC) kemudian diperiksa dan dibandingkan antara kadar sebelum dengan setelah perlakuan. Analisis statistik dilakukan dengan SPSS versi 21 untuk Windows.

Hasil: Pemberian kombinasi kalsium karbonat-asam askorbat mampu meningkatkan serum kalsium secara bermakna (p=0.00, IK 95% = 0.59 – 0,87), namun tidak lebih kuat dibandingkan kombinasi kalsium karbonat-vitamin D3. Peningkatan kadar BAP dan OC juga ditemukan lebih tinggi secara bermakna pada kelompok dengan suplementasi kalsium karbonat-asam askorbat (nilai p 0,033 IK -4,18 – -0,19 untuk BAP, nilai p = 0,04, IK -2,25 – -0,49 untuk OC) apabila dibandingkan dengan suplementasi kalsium karbonat-vitamin D3.

Simpulan: Pemberian kombinasi kalsium karbonat dan asam askorbat terbukti dapat meningkatan kadar serum kalsium, namun tidak sekuat pada kombinasi kalsium dan vitamin D3.

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