Sains Malaysiana 42(8)(2013):
1191–1200
Bone
Resorption Marker Status of Pre and Postmenopausal Malay Women in Kelantan
and
Its Corresponding Risk Factors
(Status Petanda Resorpsi Tulang dalam Kalangan Wanita Melayu Pra
dan Pascamenopaus
di Kelantan dan Faktor Risiko yang Sepadan)
Hermizi Hapidin*
Biomedicine Programme, School of Health Sciences, Universiti
Sains Malaysia, Health Campus
16150 Kubang Kerian, Kelantan, Malaysia
Hawa Mahmood & Sakinah Harith
Dietetic Programme, School of Health Sciences, Universiti
Sains Malaysia, Health Campus
16150 Kubang Kerian, Kelantan, Malaysia
Diserahkan: 20 Jun 2012 /Diterima: 16 Disember 2012
ABSTRACT
Menopause is the most prevalent cause of accelerated bone loss in
women. Biochemical markers of bone resorption can be used clinically to predict
future bone loss. This study aimed to determine the level of bone resorption
markers in healthy pre and postmenopausal Malay women and determine their
association with the risk. A total of 150 healthy women were recruited for this
study (51 pre and 99 postmenopausal subjects). Data on socioeconomic, lifestyle
habit and clinical were gained by personal interview. Fasting serum was
collected to measure both C-telopeptide (CTx) and N-telopeptide (NTx) of type 1
collagen. Both markers were highly correlated with each other (r=0.568, p<0.001).
Both intra- and inter-assay coefficient of variations (CV) of NTx were higher
than those of CTx (8% and 12% vs 6% and 5%). The mean CTx values of pre and
postmenopausal subjects were comparable with the expected values (0.2833
(0.1769) ng/mL and 0.4323 (1.851) ng/mL compared with 0.287 and 0.438 ng/mL,
respectively). The NTx value for premenopausal subjects were higher than the
expected values (15.2 (8.10) compared to 12.6 (3.20) nM BCE). The median was
19.929 nM BCE.
The mean CTx and NTx levels of postmenopausal subjects were significantly lower
than premenopausal subjects (p<0.05). The risk factors for bone
resorption in this population were duration of menopause, marital status, body
mass index (BMI),
physical activity and education level. In conclusion, postmenopausal women
showed a higher bone resorption, indicating higher bone loss. Increasing
education and physical activity intervention might be effective to ensure
better health in Malaysian older population.
Keywords: Bone resorption marker (NTx, CTx);
Malay; postmenopausal; premenopausal
ABSTRAK
Menopaus adalah faktor utama yang mempercepatkan kadar hakisan
tulang dalam kalangan wanita. Petanda biokimia bagi hakisan tulang boleh
digunakan secara klinikal untuk meramal kehilangan jisim tulang. Objektif
kajian ini adalah untuk mengenal pasti aras resorpsi tulang wanita pra dan
pascamenopaus serta mengenal pasti faktor risiko resorpsi tulang dalam golongan
ini. Seramai 150 subjek terlibat dalam kajian ini (51 pra dan 99
pascamenopaus). Data sosioekonomi, gaya hidup dan data klinikal diperoleh
melalui temu bual secara individu. Serum subjek ketika berpuasa digunakan untuk
menentukan petanda resorpsi tulang N- dan C- ‘terminal telopeptides of type 1
collagen’ (NTx dan CTx). Kedua-dua petanda resorpsi tulang ini mempunyai
perkaitan yang tinggi (r=0.568, p<0.001). Kedua-dua ‘intra’
dan ‘inter-assay’ pekali ubah (CV) untuk NTx adalah lebih tinggi berbanding
CTx (8% dan 12% vs 6% dan 5%). Nilai min CTx wanita pra- dan pascamenopaus
dalam kajian ini sebanding dengan nilai jangkaan (0.2833 (0.1769) ng/mL dan
0.4323 (1.851) ng/mL berbanding 0.287 dan 0.438 ng/mL). Nilai NTx bagi wanita
pramenopaus adalah lebih tinggi berbanding nilai jangkaan (15.2 (8.10)
berbanding 12.6 (3.20) nM BCE). Nilai median adalah 19.929 nM BCE.
Nilai min CTx dan NTx bagi subjek pascamenopaus adalah lebih tinggi berbanding
subjek pramenopaus (p<0.05). Faktor risiko resorpsi tulang bagi
populasi ini adalah tempoh pascamenopaus, status perkahwinan, indeks jisim
badan (BMI),
aktiviti fizikal dan tahap pendidikan (p<0.05). Kesimpulannya, wanita
pascamenopaus mempunyai aras petanda resorpsi tulang yang menggambarkan kadar
kehilangan tulang yang lebih tinggi. Meningkatkan tahap pendidikan dan
intervensi aktiviti fizikal mungkin merupakan langkah yang berkesan bagi
memastikan kesihatan tulang yang lebih baik dalam kalangan populasi warga tua
di Malaysia.
Kata kunci: Melayu; pascamenopaus; petanda resorpsi tulang (NTx,
CTx); pramenopaus
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*Pengarang
untuk surat-menyurat; email: hermizi@kck.usm.my
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