Efek Kapsul Ekstrak Etanol Kulit Buah Delima (Punica granatum L.) terhadap Penanda Pembentukan dan Kualitas Tulang pada Wanita Pascamenopause
AbstractStudies of pomegranate peel (Punica granatum L.), which contain ellagic acid, suggest its ability to increase osteoblast, calcium, and phosphorus in ovariectomized rats. The effects of the pomegranate peel extracts on postmenopausal women was not known. This study was aimed to evaluate the effect of pomegranate peel ethanol extract capsules in the modulation of bone formation and bone quality markers in postmenopausal women. This study is a pilot study of 1st phase of clinical trial using parallel, randomized, double-blind, and placebo controlled design, with 30 subjects. Subjects were randomized to receive commercial capsules of pomegranate peel ethanol extract 2 × 1100 mg/ day or placebo, for 8 weeks. Levels of osteocalcin, calcium, and phosphorus were examined before and after treatment. This study showed that administration of the capsules in postmenopausal women tends to reduce blood osteocalcin level (4,129±5,66 ng/mL on placebo group versus 1,79±5,04 ng/mL on punica group, p=0,245), has not significant on blood calcium level (9,13±0,36 mg/dL placebo group versus 9,21±0,39 mg/dL punica group, p=0,379), has not significant on blood phosphorus level (3,93±0,38 mg/dL placebo group versus 4,12±0,41 mg/dL on punica group, p=0,138), does not affect the function of liver and kidney, and was well tolerated. In conclusion, the commercial capsules is safe, potentially reduce marker of bone formation serum level,and increase bone quality on postmenopausal women.
Jagtap VR, Ganu JV, Nagane NS. BMD and serum intact osteocalcin in postmenopausal osteoporosis women. Indian Journal Clinical Biochemistry. 2011; 26: 70-73.
Lacey Jr JV, Mink PJ, Lubin JH, Sherman ME, Troisi R, Hartge P, et al. Menopausal hormone replacement therapy and the risk of ovarian cancer. JAMA. 2002; 288: 334–41.
Al-Anazi AF, Qureshi VF, Javaid Kh, Qureshi Sh. Preventive effects of phytoestrogens against postmenopausal osteoporosis as compared to the available therapeutic choices: An overview. J Nat Sci Biol Med. 2011 Jul-Dec; 2(2): 154–63.
Purdie D. Postmenopausal osteoporosis: hormones and other therapies. London: Taylor Francis Group; 2013
Sreekumar, Thankayyan, Santhosh, Baddireddi, Sreeharshan. Pomegranate extract demonstrate a selective estrogen receptor modulator profile in human tumor cell lines and in vivo models of estrogen deprivation. Journal of Nutritional Biochemistry. 2013; 23: 725–32.
Lim TK. Edible Medicinal and Non-Medicinal Plants. London: Springer; 2012.
Bahtiar A, Sunarmi, Razalifha, Qomariah N, Wuyung, Arsianti. Polar Fraction of Punica granatum L. peel extract increased osteoblast number on ovariectomized rat bone. International Journal of Herbal Medicine. 2014; 2 (1): 65-70
Patel RK, Patel VR, Patel MG. Development and validation of a RP-HPLC method for the simultaneous determination of Embelin, Rottlerin and Ellagic Acid in Vidangadi churna. Journal of Pharmaceutical Analysis. 2012; 2 (5): 366-71
Lee J, Vasikaran S. Current recommen-dations for laboratory testing and use of bone turnover markers in management of osteoporosis. Annals Laboratory Medicine. 2012; 32: 105-12.
Civitelli R, Armamento-Villareal R, Napoli N. Bone turnover markers: understanding their value in clinical trials and clinical practice. Osteoporosis international. 2009 Jun 1;20(6):843-51.
Atalay S, Elci A, Kayadibi H, Onder C, Aka. Diagnostic utility of osteocalcin, undercarboxylated osteocalcin, and alkaline phosphatase for osteoporosis in premenopausal and postmenopausal women. Annals of Laboratory Medicine. 2012; 32: 23-30.
Arifin Z, Hestiantoro A, Baziad A. Pemberian susu yang difortifikasi kalsium kadar tinggi vitamin D dalam memperbaiki perombakan tulang perempuan pasca-menopause. Majalah Obstetri Ginekologi Indonesia. 2010; 34: 31-8.
Siddiqui S, Arshad M. Osteogenic potential of punica granatum through matrix mineralization, cell cycle progression and runx2 gene expression in primary rat
osteoblasts. DARU Journal of Pharmaceutical Sciences. 2014 Nov 20;22(1):72.
Kini U, Nandeesh BN. Physiology of bone formation, remodeling, and metabolism. Springer, Verlag Berlin Heidelberg; 2012.
Martin E, Miller M, Krebsbach L, Beal JR, Schwartz GG, Sahmoun AE. Serum calcium levels are elevated among women with untreated postmenopausal breast cancer. Springer Science Business; 2009.
Fazlini MF, Suriah AR, Zaitun Y, Kandiah M, Chee WS, Chan YM, Chan SP. Calcium supplementation amongst postmenopausal women: Effect on serum calcium, phosphorus and magnesium level. International Food Research Journal. 2013; 20 (1): 477-80
Hamdi RA. Evaluation of serum osteocalcin level in iraqi postmenopausal women with primary osteoporosis. Journal Faculty of Medicine Baghdad. 2013; 55 (2): 166-9
Sherwood L. Fundamentals of Human Physiology. Jakarta: EGC; 2011.
Herbalism, Phytochemistry, and Ethnopharmacology. New York: Science Publisher; 2011.
Media Hannemann A, Friedrich N, Ittermann T, Nauck M. Reference intervals for serum osteocalcin concentrations in adult men and women from the study of health in Pomerania. BMC Endocrine Disorders. 2013; 13 (11): 1-9.
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