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


Received: 20 Jun 2012 /Accepted: 16 December 2012



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


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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