Displaying publications 1 - 20 of 56 in total

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  1. Nawawi HM, Yazid TN, Ismail NM, Mohamad AR, Nirwana SI, Khalid BA
    Malays J Pathol, 2001 Dec;23(2):79-88.
    PMID: 12166596
    The objectives of this study were to: (i) evaluate the diagnostic sensitivity and specificity of the biochemical bone markers: serum total alkaline phosphatase (TALP), bone specific alkaline phosphatase (BSALP) and urinary deoxypyridinoline (Dpyr) in postmenopausal osteoporosis, (ii) compare the bone turnover of postmenopausal osteoporotic patients without and with hormone replacement therapy (HRT) against controls and (iii) identify the correlation between these bone markers and bone mineral density (BMD). We examined 42 postmenopausal women with BMD proven osteoporosis and 35 control subjects. Serum TALP, BSALP and urinary Dpyr were measured. All three biochemical bone markers showed comparable moderate diagnostic sensitivity but Dpyr had the highest diagnostic specificity. There were significantly higher serum TALP, BSALP and urinary Dpyr levels in non-HRT treated patients compared to controls (p<0.005, <0.0001 and <0.005 respectively). There were no significant differences in the levels of all three bone markers between HRT treated patients and control subjects. There was no significant correlation between TALP, BSALP or Dpyr and BMD in both controls and patients. In conclusion, the biochemical bone markers are not useful in diagnosis of postmenopausal osteoporosis but may have a role in monitoring progress and response to treatment. HRT treatment reduces bone turnover of postmenopausal osteoporosis.
    Matched MeSH terms: Osteoporosis, Postmenopausal/blood*; Osteoporosis, Postmenopausal/urine*
  2. Chee WS, Suriah AR, Chan SP, Zaitun Y, Chan YM
    Osteoporos Int, 2003 Oct;14(10):828-34.
    PMID: 12915959
    Dietary studies often report low calcium intake amongst post-menopausal Malaysian women and calcium deficiency has been implicated as part of the etiology of age-related bone loss leading to osteoporosis. Therefore, the objective of this study was to examine the effectiveness of high calcium skimmed milk (Anlene Gold, New Zealand Milk, Wellington, New Zealand) to reduce bone loss in Chinese postmenopausal women. Two hundred subjects aged 55-65 years and who were more than 5 years postmenopausal were randomized to a milk group and control group. The milk group consumed 50 g of high calcium skimmed milk powder daily, which contained 1200 mg calcium (taken as two glasses of milk a day). The control group continued with their usual diet. Using repeated measures ANCOVA, the milk supplement was found to significantly reduce the percentage of bone loss at the total body compared to the control group at 24 months (control -1.04%, milk -0.13%; P<0.001). At the lumbar spine, the percentage of bone loss in the control group was significantly higher (-0.90%) when compared to the milk (-0.13%) supplemented group at 24 months (P<0.05). Similarly, milk supplementation reduced the percentage of bone loss at the femoral neck (control -1.21%, milk 0.51%) (P<0.01) and total hip (control -2.17%, milk -0.50%) (P<0.01). The supplemented group did not experience any significant weight gain over the 24 months. The serum 25-hydroxy vitamin D level improved significantly (P<0.01) from 69.1 +/- 16.1 nmol/l at baseline to 86.4 +/- 22.0 nmol/l at 24 months in the milk group. In conclusion, ingestion of high calcium skimmed milk was effective in reducing the rate of bone loss at clinically important lumbar spine and hip sites in postmenopausal Chinese women in Malaysia. Supplementing with milk had additional benefits of improving the serum 25-hydroxy vitamin D status of the subjects.
    Matched MeSH terms: Osteoporosis, Postmenopausal/ethnology; Osteoporosis, Postmenopausal/physiopathology; Osteoporosis, Postmenopausal/prevention & control*
  3. Lim PS, Ong FB, Adeeb N, Seri SS, Noor-Aini MY, Shamsuddin K, et al.
    Osteoporos Int, 2005 Dec;16(12):2069-79.
    PMID: 16234999 DOI: 10.1007/s00198-005-2003-4
    The aim of this study was to identify risk factors associated with osteoporosis in urban midlife Malaysian women and to assess the effectiveness of lifestyle intervention in bone loss prevention with hormone replacement therapy (HRT) as a positive control. A total of 514 disease-free, uterus-intact, non-HRT-using women aged 45 years and older were recruited into the study. After initial bone mineral density (BMD) assessments, they were randomized into three groups: GI (control), G2 (lifestyle intervention), and G3 (lifestyle intervention with HRT). The study group was composed of 67.5% Chinese, 27.8% Malay, and 4.2% Indians with a mean age of 51.07+/-5.28 years. Two-fifths were postmenopausal, and the prevalence of osteoporosis was 24.1%, seen predominantly at the hip. Postmenopausal women had significantly lower mean BMD and a higher incidence of osteoporosis compared with the premenopausal women, 42.1% vs. 11.1% (p<0.0005). A lower incidence of osteoporosis was found in women who took calcium supplementation regularly as opposed to those who do not, 18.7% vs. 29.3% (p=0.036). Age and a greater postmenopausal duration showed a significant negative association with BMD, whereas higher family income, weight, body mass index, and waist and hip circumference were positively correlated. After 18-20 months, the effect of intervention was assessed based on BMD values of 279 women at baseline and after intervention. Lifestyle intervention alone was effective in premenopausal women, preventing over 90% of spinal bone loss compared with the controls, who lost 11.6% (0.046 g/cm2) bone mass with similar losses of hip bone, 2.0% (0.026 g/cm2) vs. 1.5% (0.020 g/cm2). Premenopausal women on HRT also showed a substantial decrease in spine and hip BMD, 18.6% (0.081 g/cm2) and 9.0% (0.122 g/cm2), respectively. The lifestyle intervention program retarded postmenopausal bone loss by 21% and 37% compared with controls, who lost 9.6% (0.141 g/cm2) and 6.0% (0.138 g/cm2) bone mass at the spine and hip. In comparison, lifestyle intervention with HRT increased postmenopausal BMD by 12.7% (0.216 g/cm2) at the spine and 1.9% (0.042 g/cm2) at the hip. The changes in hip BMD were influenced by current age, ethnicity, and income, while intervention had the strongest effect on spine BMD changes. In conclusion, lifestyle intervention prevented spinal bone loss in premenopausal women and retarded postmenopausal spine and hip bone loss compared with controls. The benefits of physical activity on spine and hip BMD highlight its potential as a safe and cost-effective alternative to HRT, which is not advocated because of its potential adverse effects.
    Matched MeSH terms: Osteoporosis, Postmenopausal/ethnology; Osteoporosis, Postmenopausal/epidemiology; Osteoporosis, Postmenopausal/prevention & control
  4. Kung AW, Pasion EG, Sofiyan M, Lau EM, Tay BK, Lam KS, et al.
    Curr Med Res Opin, 2006 May;22(5):929-37.
    PMID: 16709314 DOI: 10.1185/030079906X104768
    OBJECTIVE: The number of hip fractures is expected to double in the next 20 years, with current estimates that Asia will account for 37% of these cases. As bone mineral density (BMD) may be used as a measure of fracture risk, we sought to compare the effects of teriparatide with salmon calcitonin treatment on changes in BMD, biochemical bone markers, and safety in postmenopausal Asian women with osteoporosis.
    METHODOLOGY: A total of 104 patients (n = 47 teriparatide [20 g/day subcutaneously] and n = 57 calcitonin [100 IU/day subcutaneously]) were enrolled in Hong Kong, Singapore, Philippines, Malaysia, and Thailand. Calcium (> or = 500 mg/day) and vitamin D (200-400 IU/day) supplements were taken throughout the 6-month controlled, randomized study.
    RESULTS: Teriparatide was associated with a 5.03 +/- 4.77% increase in lumbar spine BMD (p < 0.0001, mean +/- SD change from baseline), whereas changes in lumbar spine BMD for patients on calcitonin were not statistically significant (mean change of 0.36 +/- 4.12%, p = 0.16). Comparison of the two groups indicated that teriparatide treatment improved lumbar spine BMD statistically significantly more than calcitonin (p < 0.0001). No statistically significant changes were observed for total hip or femoral neck BMD. Serum bone-specific alkaline phosphatase (BSAP) increased by 55.9% (median change from baseline, p < 0.0001) in the teriparatide group, and remained stable with calcitonin (5.0% change, p = 0.24); osteocalcin increased by 156.15% (median change from baseline, p < 0.0001) with teriparatide, and decreased with calcitonin (-15.25%, p = 0.03). Similar rates of adverse events were observed, with nausea and dizziness the most commonly reported for both groups (teriparatide versus calcitonin, 13.0% versus 23.2% p = 0.21, 10.9% versus 21.4% p = 0.19, respectively). There were no clinically relevant changes observed in laboratory parameters.
    CONCLUSIONS: Both treatments were similarly tolerated, however teriparatide was associated with greater increases in lumbar spine BMD and bone formation markers, demonstrating the unique mechanism of action and safety of this treatment for osteoporosis in these Asian women.
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy*; Osteoporosis, Postmenopausal/physiopathology
  5. Ting GP, Tan SY, Chan SP, Karuthan C, Zaitun Y, Suriah AR, et al.
    J Nutr Health Aging, 2007 Jan-Feb;11(1):69-73.
    PMID: 17315084
    A previous study on a randomized controlled trial in 173 postmenopausal Chinese women in Kuala Lumpur showed that milk supplementation was effective to reduce bone loss at the total body, lumbar spine, femoral neck and total hip compared to the control group on a usual diet (Chee et al. 2003).
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy*; Osteoporosis, Postmenopausal/prevention & control
  6. Pasion EG, Sivananthan SK, Kung AW, Chen SH, Chen YJ, Mirasol R, et al.
    J. Bone Miner. Metab., 2007;25(2):105-13.
    PMID: 17323180
    We evaluated adherence with raloxifene therapy compared with daily bisphosphonate in Asian postmenopausal women at increased risk of osteoporotic fractures. In this 12-month observational study conducted in Asia (Hong Kong, Malaysia, Pakistan, Philippines, Singapore, Taiwan), 984 postmenopausal women (aged 55 years or older) were treated with raloxifene 60 mg/day (n = 707; 72%) or daily bisphosphonate (alendronate 10 mg/day; n = 206; 21%, or risedronate 5 mg/day; n = 71; 7%) during their normal course of care. Patients were assessed at baseline, 6, and 12 months. Baseline characteristics (including age, race, education, menopausal status, and baseline fractures) were comparable between the raloxifene and bisphosphonate groups. More women on raloxifene completed the study compared with those on bisphosphonate (50.2% versus 37.5%; P < 0.001). Patients also took raloxifene for a longer period than bisphosphonate (median, 356 versus 348 days; P = 0.011). Compared with those taking bisphosphonate, significantly fewer patients taking raloxifene discontinued the study because of stopping treatment (5.7% versus 10.1%, P = 0.017) or changing treatment (2.8% versus 9.7%, P < 0.001). Inconvenient dosing was reported as a primary reason for discontinuation due to stopping or changing treatment in 19 (6.9%) bisphosphonate patients compared with 0 raloxifene patients. The percentage of patients who had consumed 80% or more of their study medication was similar for raloxifene patients (48-56 weeks; 95.2%) and bisphosphonate patients (48-56 weeks; 93.3%). More raloxifene patients responded that they were satisfied with their medication than bisphosphonate patients at 48-56 weeks (P = 0.002). We concluded that Asian postmenopausal women at increased risk of osteoporotic fractures showed a greater propensity to remain on raloxifene compared with bisphosphonate. The women on raloxifene exhibited lower discontinuation rates and higher treatment satisfaction.
    Matched MeSH terms: Osteoporosis, Postmenopausal/prevention & control*
  7. Shuid AN, Chuan LH, Mohamed N, Jaarin K, Fong YS, Soelaiman IN
    Asia Pac J Clin Nutr, 2007;16(3):393-402.
    PMID: 17704019
    Palm oil is shown to have antioxidant, anticancer and cholesterol lowering effects. It is resistant to oxidation when heated compared to other frying oils such as soy oil. When a frying oil is heated repeatedly, it forms toxic degradation products, such as aldehydes which when consumed, may be absorbed into the systemic circulation. We have studied the effects of taking soy or palm oil that were mixed with rat chow on the bone histomorphometric parameters of ovariectomised rats. Female Sprague-Dawley rats were divided into eight groups: (1) normal control group; (2) ovariectomised-control group; (3) ovariectomised and fresh soy oil; (4) ovariectomised and soy oil heated once; (5) ovariectomised and soy oil heated five times; (6) ovariectomised and fresh palm oil; (7) ovariectomised and palm oil heated once; (8) ovariectomised and palm oil heated five times. These oils were mixed with rat chow at weight ratio of 15:100 and were given to the rats daily for six months. Ovariectomy had caused negative effects on the bone histomorphometric parameters. Ingestion of both fresh and once-heated oils, were able to offer protections against the negative effects of ovariectomy, but these protections were lost when the oils were heated five times. Soy oil that was heated five times actually worsens the histomorphometric parameters of ovariectomised rats. Therefore, it may be better for postmenopausal who are at risk of osteoporosis to use palm oil as frying oil especially if they practice recycling of frying oils.
    Matched MeSH terms: Osteoporosis, Postmenopausal/prevention & control*
  8. Lim SK, Kung AW, Sompongse S, Soontrapa S, Tsai KS
    Curr Med Res Opin, 2008 Jan;24(1):99-106.
    PMID: 18028585
    OBJECTIVE: To review data on the prevalence of vitamin D inadequacy and its causes in postmenopausal women in Eastern Asia.

    RESEARCH DESIGN AND METHOD: Data were obtained from the published biomedical literature as well as abstracts and posters presented at scientific meetings. Using MEDLINE, EMBASE and BIOSIS databases (to July 2007), epidemiological studies were identified using the search terms: 'human', 'vitamin D', 'vitamin D deficiency', 'vitamin D inadequacy', 'vitamin D insufficiency' and 'hypovitaminosis D', 'osteomalacia' and 'osteoporosis'. Additional references were also identified from the bibliographies of published articles.

    RESULTS: The prevalence of vitamin D inadequacy in studies of postmenopausal women (ambulatory or with osteoporosis or related musculoskeletal disorders) in Eastern Asia ranged from 0 to 92%, depending on the cut-off level of serum 25-hydroxycholecalciferol [25(OH)D] that was applied (range < or =6-35 ng/mL [< or = 15-87 nmol/L]). One large international study found that 71% of postmenopausal women with osteoporosis in Eastern Asia had vitamin D inadequacy, defined as serum levels of 25(OH)D < 30 ng/mL (75 nmol/L). Prevalence rates using this cut-off level were 47% in Thailand, 49% in Malaysia, 90% in Japan and 92% in South Korea. High prevalences of vitamin D inadequacy were evident in two studies using a lower 25(OH)D level cut-off value of < 12 ng/mL (30 nmol/L) - 21% in China and 57% in South Korea. Dietary deficiency and inadequate exposure or reactivity to sunlight (due to lifestyle choices, cultural customs and/or aging) were identified as important risk factors for vitamin D inadequacy.

    CONCLUSIONS: Non-uniform, epidemiological studies indicate a high prevalence of vitamin D inadequacy in postmenopausal women in Eastern Asia. Recommended remedial approaches are education campaigns and broad-based provision of vitamin D supplementation.

    Matched MeSH terms: Osteoporosis, Postmenopausal/etiology; Osteoporosis, Postmenopausal/epidemiology
  9. Lai PS, Chua SS, Chan SP, Low WY
    Maturitas, 2008 Jun 20;60(2):122-30.
    PMID: 18508210 DOI: 10.1016/j.maturitas.2008.04.006
    OBJECTIVES: To design a valid and reliable questionnaire, the Malaysian Osteoporosis Knowledge Tool (MOKT), to assess the knowledge of postmenopausal osteoporotic women in Malaysia, on osteoporosis and its treatment.
    METHODS: A 40-item instrument was designed and tested in this study. The scores ranged from 1 to 40, which were then converted into percentage. This was administered to 88 postmenopausal osteoporotic women who were taking alendronate (patient group) and 43 pharmacists (professional group). The MOKT was administered again to the patient group after 1 month.
    RESULTS: Flesch reading ease was 57, which is satisfactory, while the mean difficulty factor+/-S.D. was 0.73+/-0.25, indicating that the MOKT is moderately easy. Internal consistency of the instrument was good with Cronbach's alpha=0.82. The test and retest scores showed no significant difference for 38 out of the 40 items, indicating that the questionnaire has achieved a stable reliability. Level of knowledge on osteoporosis and its treatment was good with a mean score+/-S.D. of 69.0+/-13.9 and 81.6+/-9.5 in the patient and professional group, respectively. The difference in knowledge scores between the two groups was statistically significant (p<0.001).
    CONCLUSIONS: In conclusion, the 40-item questionnaire (MOKT) is a reliable and valid instrument for measuring knowledge on osteoporosis in the Malaysian setting. Therefore, it can be used to identify individuals in need of educational interventions and to assess the effectiveness of education efforts as part of osteoporosis management.
    Matched MeSH terms: Osteoporosis, Postmenopausal*
  10. Nazrun, A.S., Khairunnur, A., Norliza, M., Norazlina, M., Iman Nirwana, S.
    Medicine & Health, 2008;3(2):247-255.
    MyJurnal
    Oxidative stress has been associated with postmenopausal osteoporosis which pre-disposes to risk of fracture. Palm tocotrienol is a potent antioxidant and has the poten-tial to be used for treatment of post-menopausal osteoporosis. The aim of the study is to determine if palm tocotrienol supplementation could alleviate oxidative stress in ovariectomised rat model and improve its bone strength. The rats were di- vided into four groups: (i) sham-operated  group (SHAM) (ii) ovariectomised-control group (OVX) (iii) ovariectomised and given 60mg/kg α-tocopherol by oral gavage (OVX + ATF) (iv) ovariectomised and given 60mg/kg palm tocotrienols by oral gavage (OVX + PTT). After eight weeks of treatment, blood samples were taken to measure oxida-tive status (MDA, SOD and GPX) while the femurs were biomechanically tested for strength and resistance to fracture. Ovariectomy was shown to induce oxidative stress as shown by the raised MDA levels and reduced GPX activity. Palm tocotrienols seemed to offer protection against the ovariectomy-induced oxidative stress as shown by the suppression of MDA levels and raised GPX and SOD activities in the OVX+PTT group. In comparison, α-tocopherol was only able to raise the SOD but not as high as palm tocotrienols. The biomechanical tests have shown that ovariectomy has not af-fected the bone strength significantly after eight weeks. Palm tocotrienols supplemen-tation for eight weeks was effective in preventing oxidative stress in a post-meno-pausal rat.
    Matched MeSH terms: Osteoporosis, Postmenopausal
  11. Liu JM, Wai-Chee Kung A, Chan SP, Zhu HM, Zhang ZL, Wu YY, et al.
    Bone, 2009 Sep;45(3):460-5.
    PMID: 19464401 DOI: 10.1016/j.bone.2009.05.014
    Strontium ranelate is a new effective anti-osteoporotic treatment having a unique mode of action, reducing bone resorption while promoting continued bone formation, with a broad range of anti-fracture efficacy at vertebral as well as peripheral sites. In Phase III studies, it has proven its early and sustained efficacy against vertebral fractures in Caucasians along with a significant increase in lumbar bone mineral density (BMD). The aim of this randomized double-blind study was to demonstrate the efficacy of strontium ranelate (2 g/day) on lumbar spine bone mineral density and the clinical and biological safety in Asian postmenopausal osteoporotic patients compared to placebo over 1 year. Three hundred and twenty-nine eligible women from mainland China, Hong Kong and Malaysia were randomized into the study. The baseline characteristics were similar in the treatment and placebo groups: mean age of 66.2+/-6.5 years, time since menopause 17.6+/-7.2 years. In the Full Analysis Set (FAS, N=302), the mean baseline lumbar L2-L4 BMD was 0.715+/-0.106 g/cm(2) in the strontium ranelate group and 0.708 +/- 0.109 g/cm2 in the placebo group. The mean baseline femoral neck BMD was 0.575+/-0.074 g/cm2 and 0.566+/-0.069 g/cm2 respectively and mean total hip BMD was 0.642+/-0.080 g/cm2 and 0.631 +/-0.088 g/cm2 respectively. The overall compliance was 91.4% in the study drug group, and 97.4% in the placebo group. After 1 year of treatment, the lumbar spine, femoral neck and total hip BMD in the treated group was significantly increased by 3-5% as compared to placebo. Strontium ranelate was well tolerated. The most frequently reported emergent adverse events were comparable in both groups (60.4% versus 60.0%), with majority of them being mild gastrointestinal disorders. There were no clinically relevant changes in laboratory tests, such as blood routine, hepatic and renal function. It is thus concluded that the effects of 2 g/day strontium ranelate on BMD and its safety profile in this cohort of postmenopausal osteoporotic Asian women were consistent with results obtained from Caucasian women in which the efficacy on the reduction in risk of fracture has been proven.
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy*; Osteoporosis, Postmenopausal/ethnology; Osteoporosis, Postmenopausal/physiopathology
  12. Lai PS, Chua SS, Chan SP, Low WY, Wong IC
    Maturitas, 2010 Jan;65(1):55-63.
    PMID: 19962839 DOI: 10.1016/j.maturitas.2009.10.006
    OBJECTIVES: To develop and validate the Osteoporosis Patient Satisfaction Questionnaire (OPSQ) and to assess the opinion of postmenopausal osteoporotic women towards pharmaceutical care.
    METHODS: A 16-item instrument was designed. Each response consists of a five-point Likert-like scale with higher scores indicating greater satisfaction. The face and content validity was established via consultation with an endocrinologist and three pharmacists as well as feedback from participants in a preliminary study. Postmenopausal osteoporotic women taking bisphosphonates were recruited and randomly allocated to the intervention (n=90) and control groups (n=90). Pharmaceutical care was provided at month 2 to the intervention group while the control group received standard pharmacy services. The OPSQ was administered at month 6 (end of the intervention period), to assess patients' satisfaction. Factor analysis was performed using varimax rotation. Internal reliability was established using Cronbach's alpha. Construct validity was performed by using the Mann-Whitney U test.
    RESULTS: The internal reliability of the OPSQ produced a Cronbach's alpha of 0.86. Factor analysis identified one component in the OPSQ, which measured patient satisfaction. The intervention group showed significantly better overall OPSQ score than the control group (91.89+/-7.22% versus 84.32+/-7.48%, p<0.001). This indicates that the OPSQ was able to differentiate between participants who received pharmaceutical care from those who did not.
    CONCLUSIONS: The 16-item OPSQ developed in this study has high internal reliability and is a valid instrument for assessing osteoporotic women's satisfaction with pharmaceutical care service in Malaysia.
    Matched MeSH terms: Osteoporosis, Postmenopausal/prevention & control; Osteoporosis, Postmenopausal/therapy*
  13. Lai P, Chua SS, Chan SP
    Osteoporos Int, 2010 Oct;21(10):1637-56.
    PMID: 20379700 DOI: 10.1007/s00198-010-1199-0
    A systematic review was conducted to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women. Evidence available indicates that such interventions are effective in improving the quality of life, medication compliance, and calcium intake, but effect on other outcomes is less conclusive.

    INTRODUCTION: The purpose of this study is to conduct a systematic review to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women.

    METHODS: Randomized controlled trials (RCTs) published in English between year 1990 and 2009 were identified. Types of patient outcome used as assessment included quality of life (QOL), bone mineral density (BMD), medication compliance and persistence, knowledge level, and lifestyle modification.

    RESULTS: Twenty four RCTs met the inclusion criteria. Seven studies assessed interventions by physiotherapists, six by physicians, seven by nurses, three by multi-disciplinary teams and one by dietitians. Variability in the types and intensity of interventions made comparison between each study difficult. Collectively, these studies provided some evidence to show that interventions by healthcare professionals improved the QOL medication compliance and calcium intake of patients but its effects on BMD, medication persistence, knowledge, and other lifestyle modifications were less conclusive.

    CONCLUSIONS: From this review, it was found that some outcome measures of such non-drug interventions still required further studies. Future studies should use validated instruments to assess the outcomes, with focus on common definitions of interventions and outcome measures, more intensive one-to-one interventions, appropriate control groups, adequate randomization procedures, and also provide information on effect size.
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy; Osteoporosis, Postmenopausal/rehabilitation*
  14. Alwi SA, Rubiah ZS, Lee PY, Mallika PS, Haizal MN
    Climacteric, 2010 Dec;13(6):553-60.
    PMID: 19958163 DOI: 10.3109/13697130903470319
    To determine the usage of hormone replacement therapy (HRT) and knowledge about HRT among women of Sarawak in Malaysia.
    Matched MeSH terms: Osteoporosis, Postmenopausal/prevention & control
  15. Chan SP, Scott BB, Sen SS
    PMID: 20977729 DOI: 10.1186/1471-2474-11-248
    BACKGROUND: Osteoporosis treatment guidelines recommend calcium and vitamin D supplementation for both prevention as well as treatment, however, compliance with these guidelines is often unsatisfactory. This study investigated the opinion of Asian physicians and Asian patients regarding vitamin D and calcium and patients' use of both.
    METHODS: Physicians selected from Malaysia, Taiwan, Philippines, Korea and Singapore were asked to grade the significance of vitamin D and calcium in the treatment of osteoporosis and their patients' use of these supplements. In addition, physicians recruited seven eligible osteoporotic women to answer a questionnaire to determine their use of vitamin D and calcium, and their attitudes and beliefs regarding these supplements.
    RESULTS: In total, 237 physicians and 1463 osteoporosis patients completed the questionnaire. The results revealed that 22% of physicians in Malaysia, 12% in Taiwan, 72% in the Philippines, 50% in Korea and 24% in Singapore rated the importance of vitamin D supplementation as being extremely important. For calcium, 27% of physicians in Malaysia, 30% in Taiwan, 80% in the Philippines, 50% in Korea and 38% in Singapore rated the importance as being extremely important. Forty-three percent of patients in Malaysia, 38% in Taiwan, 73% in the Philippines, 35% in Korea and 39% in Singapore rated the importance of vitamin D as being extremely important. For calcium, 69% of patients in Malaysia, 58% in Taiwan, 90% in the Philippines, 70% in Korea and 55% in Singapore rated the importance as being extremely important. In addition, results of the patient questionnaire revealed that only a very small number regularly took both supplements. In addition, the results indicated that, with the exception of patients from the Philippines, the majority of patients had no or infrequent discussion with their physician about vitamin D and calcium.
    CONCLUSIONS: There is generally suboptimal appreciation by both physicians and patients of the importance of vitamin D and calcium for maintenance of bone health as reflected in the low number of patients who reported regularly taking these supplements. Recognition of this problem should translate to appropriate action to improve education for both physicians and patients, with a goal to increase use of these supplements among Asian patients with osteoporosis.
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy*; Osteoporosis, Postmenopausal/prevention & control; Osteoporosis, Postmenopausal/psychology
  16. Shuid AN, Ping LL, Muhammad N, Mohamed N, Soelaiman IN
    J Ethnopharmacol, 2011 Jan 27;133(2):538-42.
    PMID: 20971181 DOI: 10.1016/j.jep.2010.10.033
    AIM OF THE STUDY: Postmenopausal osteoporosis is mainly treated with estrogen replacement therapy (ERT). However, ERT causes side effects, mainly breast cancer, uterine cancer and thromboembolic problems. Labisia pumila var. arata (LPva), a herb with phytoestrogenic effects has the potential to be used as an alternative agent to ERT. This study was conducted to determine the effects of LPva on bone biochemical markers and bone calcium content in ovariectomised rats.
    MATERIALS AND METHODS: Thirty two Wistar rats were divided into 4 groups, with 8 rats in each group. The first group was sham operated (Sham), the second group was ovariectomised (OVX), the third (LPva) and fourth group (ERT) were also ovariectomised and given LPva 17.5 mg/kg and Premarin(®) 64.5 μg/kg, respectively. Blood samples were taken before and after treatment to measure osteocalcin and C-terminal telopeptide of type 1 collagen levels using ELISA while the fifth lumbar bone samples were taken to measure bone calcium content using the Atomic Absorption Spectrophotometer (AAS).
    RESULTS: The osteocalcin levels were significantly higher in both the LPva and ERT groups compared to the OVX group. The CTX levels were significantly lower in both the LPva and ERT groups compared to the OVX group. However, only the ERT group had significantly higher bone calcium level compared to the OVX group.
    CONCLUSION: The supplementation of 17.5 mg/kg of LPva to ovariectomised rats for 8 weeks was able to prevent the changes in bone biochemical markers but failed to prevent the bone calcium loss induced by ovariectomy.
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy*; Osteoporosis, Postmenopausal/metabolism
  17. Shan LP, Bee OF, Suniza SS, Adeeb N
    Sex Reprod Healthc, 2011 Apr;2(2):77-82.
    PMID: 21439525 DOI: 10.1016/j.srhc.2010.11.004
    BACKGROUND: Osteoporotic fracture is a major health burden. Early diagnosis and management would improve the quality of life and reduce costs to the society.
    OBJECTIVE: We aimed to identify risk factors associated with osteoporosis followed by development and validation of a screening tool in the hope of providing an appropriate regime to detect low bone density (BMD) in Malaysia.
    METHODOLOGY: Between November 1999 and November 2002, 514 healthy women aged ≥ 45 with intact uterus, non-HRT users were recruited. Following BMD testing, a screening tool was developed. For validation, 72 women were recruited from June 2003 to December 2003.
    RESULTS: Age and a longer duration postmenopause were negatively linked to BMD. Higher family income, BMI, waist and hip circumference were positively correlated. A score of ≥ 4, the screening tool had a sensitivity of 73.2%, a specificity of 61.6% for identifying women with low BMD (T score ≤ -2) plus a sensitivity of 80.2% in selecting women with osteoporosis. The tool enabled a 45.9% reduction in unnecessary DEXA testing. Validation of the screening tool showed a negative predictive value of 97.8%, sensitivity and specificity of 87.5% and 70.3%, respectively.
    CONCLUSION: The Malaysian Osteoporosis Screening Tool (MOST) is relatively simple. Its usage may reduce unnecessary DEXA test.
    Matched MeSH terms: Osteoporosis, Postmenopausal/diagnosis*
  18. Lai PS, Chua SS, Chew YY, Chan SP
    J Clin Pharm Ther, 2011 Oct;36(5):557-67.
    PMID: 21916908 DOI: 10.1111/j.1365-2710.2010.01210.x
    Studies have shown that comprehensive interventions by pharmacists can improve adherence and persistence to osteoporosis therapy, but the association between adherence and bone turnover markers (BTMs) has never been studied. Therefore, the aim of this study was to evaluate the effects of pharmaceutical care on medication adherence (and its effects on BTMs), as well as persistence of postmenopausal osteoporotic women to prescribed bisphosphonates.
    Matched MeSH terms: Osteoporosis, Postmenopausal/drug therapy*
  19. Potu BK, Nampurath GK, Rao MS, Bhat KM
    Clin Ter, 2011;162(4):307-12.
    PMID: 21912817
    The aim of our study was to see the efficacy of petroleum ether extract of Cissus quadrangularis (CQ) on development of osteopenia in ovariectomy induced Wistar rats.
    Matched MeSH terms: Osteoporosis, Postmenopausal
  20. Muslim D, Mohd E, Sallehudin A, Tengku Muzaffar T, Ezane A
    Malays Orthop J, 2012 Mar;6(1):35-9.
    PMID: 25279040 MyJurnal DOI: 10.5704/MOJ.1203.011
    The Osteoporosis Self-Assessment Tool for Asians (OSTA) score has been developed to identify women at risk of osteoporosis. It can be used as a screening tool for patients at risk who would benefit from bone mineral density measurement and treatment. It was developed based on data from eight countries including Malaysia. However, most subjects were of Chinese (59%). This study evaluated the performance of OSTA among 152 post-menopausal Malay women. OSTA score calculation and DEXA scan were performed. Our results showed that the OSTA score is a good predictor of patients at risk of osteoporosis based on BMD measurements at the proximal femur. Instrument sensitivity was 87.5%, specificity was 95.8%, positive predictive value (PPV) was 0.538, negative predictive value (NPV) was 0.993, and the area under the receiver operating characteristic curve (ROC) was 0.895. We conclude that use of the OSTA score in postmenopausal Malay women is effective and has adequate sensitivity and specificity.
    Matched MeSH terms: Osteoporosis, Postmenopausal*
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