Manajemen Nutrisi Vitamin D Dan Kalsium Dalam Patofisiologi Osteomalacia: Literature Review

Abstract

ABSTRAK 

Latar Belakang: Osteomalasia adalah kelainan tulang metabolik akibat kekurangan mineral pada matriks tulang, menyebabkan nyeri dan kelemahan otot. Patofisiologinya didorong oleh defisiensi Vitamin D dan Kalsium, yang memicu peningkatan hormon paratiroid (PTH) dan mengganggu homeostasis mineral. Tinjauan komprehensif Manajemen Nutrisi diperlukan untuk mengoreksi gangguan patofisiologis ini secara efektif.

Tujuan: Meninjau bukti ilmiah prinsip Manajemen Nutrisi Vitamin D dan Kalsium, serta menganalisis efektivitasnya dalam mengoreksi patofisiologi Osteomalasia.

Metode: Penelitian ini menggunakan desain literature review naratif. Pencarian literatur dilakukan pada database utama (PubMed, ScienceDirect, Scopus) dengan kata kunci "Osteomalasia", "Vitamin D", "Kalsium", dan "Manajemen Nutrisi". Studi intervensi klinis dan review yang membahas dosis nutrisi dan status biokimia (PTH, 25(OH)D) pada pasien dewasa dimasukkan sebagai subjek penelitian. Data disintesis secara naratif.

Hasil: Tinjauan menunjukkan bahwa defisiensi Vitamin D dan Kalsium memicu peningkatan PTH dan risiko osteomalasia. Suplementasi kombinasi Vitamin D3 (1000–5000 IU/hari) dan kalsium karbonat (1000–1500 mg/hari) terbukti efektif. Intervensi ini meningkatkan kadar serum 25(OH)D, menurunkan kadar PTH dan ALP, serta memperbaiki Bone Mineral Density (BMD) dan struktur tulang. Efek suplementasi diperkuat oleh strategi non-farmakologis seperti paparan sinar matahari dan konsumsi makanan tinggi kalsium.

Kesimpulan: Manajemen Nutrisi merupakan inti penanganan Osteomalasia. Suplementasi kombinasi Vitamin D dan Kalsium terbukti paling efektif mengoreksi patofisiologi dengan menaikkan 25(OH)D, menormalisasi PTH dan ALP, serta memperbaiki kepadatan tulang dan gejala klinis. Penanganan Osteomalasia memerlukan pendekatan nutrisi yang terintegrasi, didukung pengaturan diet dan modifikasi gaya hidup jangka panjang.

ABSTRACT

Background: Osteomalacia is a metabolic bone disorder resulting from insufficient mineral content in the bone matrix, causing pain and muscle weakness. Its pathophysiology is driven by Vitamin D and Calcium deficiency, which triggers increased parathyroid hormone (PTH) and disrupts mineral homeostasis. A comprehensive review of Nutritional Management is necessary to effectively correct these pathophysiological disturbances.

Objectives: To review scientific evidence on the principles of Vitamin D and Calcium Nutritional Management and analyze its effectiveness in correcting the pathophysiology of Osteomalacia.

Methods: This study utilized a narrative literature review design. Literature search was conducted across major databases (PubMed, ScienceDirect, Scopus) using the keywords "Osteomalacia", "Vitamin D", "Calcium", and "Nutritional Management". Clinical intervention studies and reviews discussing nutritional dosage and biochemical status (PTH, 25(OH)D) in adult patients were included as research subjects. Data were synthesized using narrative analysis.

Outcome: The review shows that Vitamin D and Calcium deficiency triggers increased PTH and risk of osteomalacia. Combined supplementation of Vitamin D3 (1000–5000 IU/day) and calcium carbonate (1000–1500 mg/day) is proven effective. This intervention increases serum 25(OH)D levels, reduces PTH and ALP levels, and improves Bone Mineral Density (BMD) and bone structure. The supplement effects are further reinforced by non-pharmacological strategies like sun exposure and high calcium food intake.

Conclusion: Nutritional Management is central to Osteomalacia treatment. Combined Vitamin D and Calcium supplementation is proven most effective, correcting pathophysiology by increasing 25(OH)D, normalizing PTH and ALP, and improving bone density and clinical symptoms. Osteomalacia management requires an integrated nutritional approach, supported by long term dietary regulation and lifestyle modifications.