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"ABSTRAKLatihan naik turun bangku LNTB dan latihan jalan kaki LJK adalah aktivitas bersifat weight bearing yang dapat meningkatkan massa tulang. Kedua latihan fisik tersebut memiliki karakter biomekanik yang berbeda yang akan memengaruhi proses formasi dan resorbsi tulang. Densitas massa tulang rendah berhubungan dengan polimorfisme gen TNFSF11 dan TNFRSF11B.Penelitian ini bertujuan untuk menganalisis pengaruh perbedaan peningkatan kadar osteokalsin sebagai petanda formasi dan penurunan CTX-1 sebagai petanda resorbsi setelah LNTB dan LJK dan pengaruh polimorfisme gen TNFSF11 SNPs-290C>T, -643C>T, -693G>C dan gen TNFRSF11B SNPs 163A>G, 950T>C, 1181G>C terhadap perbedaan peningkatan kedua petanda. Disain penelitian adalah studi eksperimental. Subjek penelitian adalah perempuan osteopenia sebanyak 59 orang yang diberi LNTB 30 subjek dan LJK 29 subjek dan ditentukan secara acak. Kadar osteokalsin dan serum diukur pra dan pascalatihan setelah 12 sesi selama 3 bulan latihan. Identifikasi polimorfisme gen TNFSF11 dan gen TNFRSF11B dianalisis dengan metode PCR dilanjutkan RFLP. Perbedaan peningkatan kadar osteokalsin dan CTX-1 diuji dengan uji T-tidak berpasangan. Hubungan polimorfisme dengan perubahan kadar osteokalsin dan CTX-1 dianalisis dengan odds ratio. Analisis haplotype dan uji Kruskall Wallis dilakukan untuk melihat hubungan pasangan haplotype dengan kadar osteokalsin dan CTX-1. Kadar osteokalsin dan CTX-1 setelah latihan pada kedua kelompok latihan meningkat p < 0,05 . Peningkatan CTX-1 setelah LNTB lebih kecil dibanding LJK p < 0,05 . Tidak ditemukan hubungan antara polimorfisme gen TNFSF11 dan gen TNFRSF11B dengan perubahan kadar osteokalsin dan CTX-1 p>0,05 Meskipun tidak bermakna, terdapat kecenderungan alel heterozigot/resesif berhubungan dengan peningkatan kadar osteokalsin, alel homozigot dominan berhubungan penurunan kadar CTX-1, serta haplotype gen TNFRSF11B dan haplotype gen TNFSF11 dengan perubahan osteokalsin dan CTX-1. Kedua latihan fisik terbukti dapat meningkatkan formasi tulang. LNTB mencegah resorbsi tulang lebih baik dibanding LJK. Polimorfisme mungkin memengaruhi formasi dan resorbsi tulang akibat latihan fisik. LNTB dan LJK meningkatkan osteokalsin. Peningkatan CTX-1 setelah LNTB lebih rendah dari LJK. Perubahan osteokalsin tidak berhubungan dengan polimorfisme gen TNFSF11 dan TNFRSF11B sedangkan perubahan CTX-1 tidak dipengaruhi polimorfisme gen TNFSF11 tetapi terdapat hubungan antara haplotype ATG dengan ACG dan GCC gen TNFRSF11B dengan perubahan CTX-1. Kata Kunci: gen TNFRSF11B, gen TNFSF11, karakter biomekanik, latihan naik turun bangku, polimorfisme, remodeling tulang

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Bench step exercise BSE and walking exercise WE have a different biomechanical characteristics that can affect bone formation and resorbtion. Low bone mass density was associated with TNFSF11 SNPs 290C T, 643C T, 693G C and TNFRSF11B 163A G, 950T C, 1181G C genes polymorphism.The purpose of the studi is to analyze the difference effect of BSE and WE on changes in bone formation osteocalcin and bone resorbtion CTX 1 markers and the association of TNFSF11 and TNFRSF11B genes polymorphism. This is an experimetal study involving 59 postmenopausal women with osteopenia. Participants were grouped randomly according to the type of exercise bench step exercise 30 subjects and walking exercise 29 subjects . Subjects performed exercise for 12 sessions in 3 months. Osteocalcin and CTX 1 serum was measured pre and post exercise. The TNFSF11 gene and TNFRSF11B gene polymorphism was identified by PCR and RLFP methods. The difference in changes on osteocalcin and CTX 1 between groups were analysed by independent T test. Association between changes in osteocalcin and CTX 1 polymorphism and haplotype were analysed using odss ratio and Kruskall Wallis, respectively. Osteocalcin and CTX 1 increased significantly after BSE and WE P 0.05 , with no difference between group. BSE increased CTX 1 lower than WE P 0.05 . There is no association between polymorphism and the changes on osteocalcin and CTX 1 levels after BSE and WE P 0.05 . However, some tendencies were observed. Heterozygous recessive alleles had association with increased osteocalcin, homozygous dominant alleles had association with decreased CTX 1, haplotype TNFRSF11B gene had associaton with changes in osteocalcin and CTX 1 levels, whereas haplotype TNFSF11 gene with changes in CTX 1 level only. This results indicate that both BSE and WE increased bone formation. TNFSF11 gene polymorphism did not affect changes in formation and resorbtion after BSE and WE. Both exercises increased osteocalcin but was not different even though level of CTX 1 in BSE is lesser compared to WE. TNFSF11 gene polymorphism did not associate to the changes in osteocalcin and TNFRSF11B gene polymorphism did not associate to the changes in osteocalcin despite haplotype ATG had association with ACG and GCC in TNFSF11B gene for the changes in CTX 1 level after BSE and WE. Keywords Bench step exercise, biomechanical character, bone remodelling, gene TNFRSF11B, gene TNFSF11, polymorphism"

"Pendahuluan: Salah satu faktor risiko penyakit osteoporosis pada wanita menopause adalah faktor genetik polimorfsme Tumor Necrosis Factor Alpha TNF-α. Tujuan: Penelitian ini bertujuan untuk melihat ada atau tidaknya polimorfisme dan perbedaan polimorfisme gen TNF-α-308G/A pada wanita pascamenopause dengan osteoporosis. Metode: 100 bahan biologis tersimpan 50 sampel wanita pascamenopause dengan osteoporosis dan 50 sampel individu sehat dianalisa menggunakan teknik PCR-RFLP dengan enzim retriksi NcoI, selanjutnya data diuji secara statistik menggunakan uji Chi-square. Hasil: Ditemukan banyak genotip AG baik pada kelompok osteoporosis dan kontrol. Pada kelompok osteoporosis tidak ditemukan genotip GG dan terdapat 76 genotip AG serta 24 genotip AA. Pada kelompok kontrol, terdapat 8 genotip GG, 82 genotip AG, dan 5 genotip AA. Kesimpulan: Terdapat polimorfisme genetik TNF-α-308G/A pada wanita menopause dengan osteoporosis, namun tidak terdapat perbedaan bermakna pada polimorfisme antara wanita pascamenopause dengan osteoporosis dan individu sehat p = 0.117 di populasi Indonesia.

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Introduction: One of the risk factor for osteoporosis in postmenopausal woman is genetic polymorphism factor which is Tumor Necrosis Factor Alpha TNF.

Objectives: This research aims to look for genetic polymorphism and differentiate the distribution TNF 308G A gene polymorphism in postmenopausal woman with osteoporosis.

Methods: 100 stored biological samples 50 samples of postmenopausal woman with osteoporosis and 50 healthy control samples were analyzed with PCR RFLP technique using NcoI restriction enzyme, and subsequently assessed with statistical analysis using Chi square test.

Result: AG genotype was found with the highest amount in both samples. The postmenopausal group has 76 of AG genotype, 24 of AA genotype, and no GG genotype was found. The healthy control group has 8 of GG genotype, 82 of AG genotype, and 5 of AA genotype. Based on Fisher Extract test, there is no significant association between TNF 308G A and postmenopausal osteoporosis p value 0.117.

Conclusion: The genetic polymorphism of TNF 308G A in postmenopausal woman was found, but the polymorphism didn rsquo t have any association with osteoporosis in Indonesia populations. "

"Osteoporosis is a silent disease, i.e. the disease will progress without symptoms or pain until bones start to break. Densitometry examinations to diagnose osteoporosis is relatively expensive for most people in Indonesia. Kusdhany et al have produced a mandibular density index specific for Deutero-Malay postmenopausal women (POSTUR-P). This index can be used to predict osteoporosis risk in mandibular and other bones. The objective of this research was to try out POSTUR-P before using it in the community. The study was a diagnostic test, on 31 Teratai clinic postmenopausal patients of Ciptomangunkusumo Hospital between 50-75 years of age from June to October 2014 and fulfilling inclusion criteria. Densitometry on lumbal and femur bones was used as a gold standard. The result of this study showed that POSTUR-P has high sensitivity and moderate specificity, and appears to be a good screening tool to indicate osteoporosis cases."

"Indonesian Journal of Dentistry 2006: Edisi Khusus KPPIKG XIV: 148-154Removable Partial Denture Management on Post-Menopause Osteoporotic FemaleOsteoporosis a condition of generalized skeletal fragility caused by diminishing bone amount and disturbance in bone microarchitecture with implication that the bone ability to withstand forces is decreased.This condition leads to more bone resorption. Some researches show that this condition also affects jaw bone. Therefore we must take this condition into consideration during prosthodontic treatment. Dental prostheses are made to restore stomatognatic function as well to preserve what was left including residual alveolar bone. The ability ofdental prostheses to preserve residual alveolar bone differs according to type of prostheses. The case presented here proposing the treatment of an osteoporotic old female in Prosthodontic Clinic FKG Ul with removable partial denture. Considerations inselecting the type and design of dental prostheses and attempts to modif, factors that might play a role in bone resorption in connection with patient's physical and psychological status will be discussed. Thorough examination, careful planning and good communication with patient can provide optimum result."

"Osteoporosis adalah kondisi yang ditandai dengan berkurangnya massa tulang, yang salah satu penyebabnya adalah faktor genetik. Polimorfisme genetik MTHFR C677T dilaporkan terlibat dalam penurunan Bone Mineral Density. Untuk melihat apakah terdapat gambaran dan polimorfisme MTHFR C677T pada wanita pascamenopause dengan osteoporosis, serta hubungannya, dilakukan analisis polimorfisme pada 100 sampel wanita pascamenopause dengan menggunakan teknik PCR-RFLP. Sampel berada dalam Hardy-Weinberg equilibrium, dengan genotip CC56%, CT40%, TT4% pada kelompok normal, dan genotip CC 74,7%, CT 25,3%, TT 0% pada kelompok osteoporosis. Hasil uji chi-square p>0,05, sehingga disimpulkan terjadi polimorfisme pada wanita pascamenopause dengan osteoporosis, namun tidak terdapat hubungan yang bermakna antara keduanya.

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Osteoporosis is a condition that is characterized by reduced bone mass. Previous studies have shown that the MTHFR C677T polymorphism may be involved in the development of osteoporosis. The aim of this study was to characterise the distribution of this polymorphism in 100 Indonesian postmenopausal women. The polymorphism was analyzed using PCR-RFLP technique. The observed genotypes were consistent with Hardy-Weinberg equilibrium and included 56% CC, 40%CT and 4%TT for normal postmenopausal women, and 74.7% CC, 25.3% CT, 0% TT for postmenopausal women with osteoporosis. The results suggest that the MTHFR C677T polymorphism is not significantly associated with osteoporosis (p>0.05)."

"Wanita postmenopause merupakan populasi yang berisiko osteoporosis dipengaruhi oleh berbagai faktor antara lain adalah polimorfisme genetik IL 10. Tujuan Menganalisis hubungan polimorfisme genetik IL 10 C627A dengan risiko osteoporosis pada wanita postmenopause. Bahan dan Cara Penelitian ini menggunakan 100 sampel DNA tersimpan dari serum darah wanita postmenopause SNP dari gen IL 10 C627A diperiksa dengan PCR dan RFLP dengan enzim restriksi RsaI.Hasil Frekuensi alel polimorfisme mengikuti Hardy Weinberg Equilibrium dan hasil uji statistik dengan Chi Square menunjukkan nilai p 0 322 0 05. Kesimpulan Terlihat gambaran polimorfisme genetik Il 10 C627A namun tidak ada hubungan antara polimorfisme genetik Il 10 C627A dengan risiko osteoporosis.

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A population of postmenopausal women at risk of osteoporosis is influenced by various factors one of which is IL 10 genetic polymorphism Objective. This study was conducted to analyze the relationship between genetic polymorphisms IL 10 C627A with the risk of osteoporosis in postmenopausal women. Materials and Method This study used 100 sampels of DNA stored from postmenopausal women SNP from IL 10 C627A was checked by PCR and RFLP with RsaI restriction enzyme.

Result The frequencies of allele polymorphism which followed Hardy Weinberg Equilibrium and the result of Chi square test showed no significant p 0 05 Conclusion. This study showed genetic polymorphism of IL 10 C627A but no correlation between genetic polymorphism IL 10 C627A with the risk of osteoporosis."

"Osteoporosis merupakan penyakit yang ditandai dengan menurunnya kepadatan tulang Bone Mineral Density BMD dan kerusakan pada jaringan tulang. Salah satu faktor penyebab osteoporosis adalah faktor genetik Polimorfisme IL 8 diketahui berhubungan dengan penurunan masa tulang. Penelitian ini bertujuan untuk mengetahui gambaran polimorfisme genetik IL 8 A251T pada wanita postmenopause dan mengetahui hubungannya dengan risiko osteoporosis. Metode dan jenis penelitian ini adalah deskriptif dengan analisis laboratorik. Sampel berasal dari bahan biologis tersimpan Jumlah sampel yang digunakan sebanyak 100 sampel DNA wanita postmenopause dengan75 osteoporosis dan 25 sampel normal Pemeriksaan polimorfisme genetik IL 8 A251T ini menggunakan metode Polymorphism Chain Reaction PCR dan dilanjutkan dengan Restriction Fragment Length Polymorphism RFLP dengan menggunakan enzim Vsp1. Hasil pemotongan dianalisis menggunakan elektroforesis dengan bubuk agarose 3 dan divisualisasi menggunakan Gel Doc. Hasil penelitian ini menunjukan bahwa pada kelompok normal terdapat genotip AA 36 genotip AT 20 dan genotip TT 44 Sedangkan Pada kelompok osteoporosis terdapat genotip AA 18,6 AT 46,7 dan TT 37,4. Berdasarkan hasil uji statistic chi square menunjukan hubungan tidak bermakna p 0 05 antara polimorfisme IL 8 dengan risiko osteoporosis. Maka disimpulkan bahwa ditemukan gambaran polimorfisme IL 8 pada wanita postmenopause namun polimorfisme IL 8 tidak berhubungan dengan risiko osteoporosis.

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Osteoporosis is indicated by the reduction of Bone Mineral Density BMD and destruction of bone tissue. One of the factors inducing osteoporosis is the genetic factor IL 8 is known to have a correlation with reduction bone mass. The purpose of this study was to determine the distribution of IL 8 genetic polymorphism in postmenopausal woman and the correlation with osteoporosis risk factor This study used descriptive study with laboratorical analysis.

The samples used were the stored biological material. This study used 100 samples of stored DNA of postmenopausal woman. There are 75 samples with osteoporosis and 25 with normal BMD Genetic polymorphism of IL 8 ndash A251T was using PCR RFLP method in which RFLP method used the restriction enzyme Vsp1. Then it was analyzed with electrophoresis using 3 agarose gel and visualized by Gel Doc.

The analysis result showed that the normal group had 23 genotype AA 40 AT and 37 TT In the osteoporosis group had 18,6 genotype AA 4, 7 genotype AT and 37,4 genotype TT. Based on Chi square test showed insignificant correlation p 0 05 between IL 8 genetic polymorphism and osteoporosis risk factor. The conclusion there was a distribution of IL 8 genetic polymorphism in postmenopausal woman but IL 8 genetic polymorphism did not have any correlation with osteoporosis risk factor."

"Gen P16INK4A merupakan gen yang berfungsi menghentikan siklus sel dan mengakibatkan cellular senescence yang berperan pada proses penuaan dan munculnya age-related disease salah satunya pada jaringan muskuloskeletal.Penelitian ini bertujuan menganalisis hubungan antara status metilasi gen P16INK4A dengan osteoporosis sebagai salah satu age-related disease. 181 sampel DNA wanita pasca menopause (68 sampel osteoporosis dan 113 sampel non-osteoporosis) dianalisis dengan teknik MS-PCR. 12 sampel (6,6%) fully methylated, 164 sampel (90,6%) partially methylated, dan 5 sampel (2,8%) fully unmethylated. Terjadi metilasi gen P16INK4A pada wanita pascamenopause, namun tidak terdapat hubungan yang signifikan antara status metilasi gen P16INK4A dengan osteoporosis pada wanita pasca menopause (p=0.652).

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P16INK4A is a tumor suppressor gene which function is stopping the cell cycle that cause on cellular senescence which plays role on aging process and agerelated disease in musculoskeletal organs.

This research has purpose to analyze the relationship between methylation status of P16INK4A gene with osteoporosis as one of the age-related disease. 181 DNA sample (68 osteoporosis and 113 nonosteoporosis) from postmenopausal women has been analyzed using MS-PCR technique. 12 (6,6%) carried fully methylated, 164 (90,6%) carried partially methylated, and 5 (2,8%) carried fully unmethylated. There is no significant association between methylation status of P16INK4A gene and osteoporosis in postmenopausal women (p=0,652)."

"ABSTRAK Latar Belakang: Pasien Diabetes Mellitus DM tipe 2 memiliki peningkatan risiko terjadinya fraktur yang dikenal dengan istilah diabetoporosis. Pemeriksaan Bone Mass Densitometry BMD dinilai tidak superior dalam mendiagnosis diabetoporosis mengingat nilai BMD pada DM tipe 2 dapat normal bahkan meningkat. Beberapa penanda diharapkan dapat menggambarkan kualitas tulang secara non invasif. Peran AGEs dan reseptornya dinilai penting dalam proses diabetoporosis. Namun demikian, penelitian mengenai penanda AGEs dan reseptornya pada pasien DM tipe 2 masih tergolong sangat sedikit serta belum adanya penelitian yang membandingkan kadar AGEs dan reseptornya pada pasien DM tipe 2 dan subjek normal.Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan kadar pentosidine serum, esRAGE serum, rasio esRAGE/pentosidine serum antara pasien DM tipe 2 dan subjek normal, serta korelasi rasio esRAGE/pentosidine serum terhadap P1NP serum sebagai penanda peningkatan risiko diabetoporosis.Metode: Penelitian ini merupakan studi potong lintang terhadap 38 perempuan DM tipe 2 belum menopause, berusia 35 tahun dengan diagnosis DM tipe 2 yang berobat di Poli Metabolik Endokrin RSCM, Klaster Diabetes Kencana RSCM, RSUP Persahabatan, RSUK Tugu Koja, RSUK Kemayoran, dan Puskesmas Jatinegara. Sebagai kelompok non DM adalah 36 perempuan non DM dengan rentang usia yang sama. Pengambilan sampel dilakukan secara simple random sampling terhadap darah yang terkumpul. Pemeriksaan Pentosidine serum dan esRAGE dilakukan dengan metode ELISA sedangkan pemeriksaan P1NP dilakukan dengan menggunakan metode ECLIA.Hasil Penelitian: Pasien DM tipe 2 memiliki kadar pentosidine lebih tinggi p=0,028 , kadar esRAGE yang lebih rendah p=0,248 , serta rasio esRAGE/pentosidine yang lebih rendah p=0,001 daripada subjek normal. Rerata kadar pentosidine serum pada DM tipe 2 dan subjek normal adalah 5406 1911 pmol/ml dan 3145 1892 pmol/ml; sedangkan median rasio esRAGE/pentosidine serum adalah 0,03 pg/pmol dan 0,06 pg/pmol. Tidak terdapat korelasi antara rasio esRAGE/pentosidine dengan kadar P1NP serum.Kesimpulan: Kondisi hiperglikemia pada DM tipe 2 menyebabkan tingginya kadar pentosidine serum yang tidak diimbangi dengan peningkatan kadar esRAGE serum. Secara khusus, terjadi penurunan rasio esRAGE/pentosidine serum pada pasien DM tipe 2 perempuan dan tidak ditemukan korelasi antara rasio esRAGE/pentosidine serum dengan kadar P1NP serum sebagai penanda formasi tulang.

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ABSTRACT Background: Diabetes Mellitus type 2 T2DM patients have an increased risk of fracture known as diabetoporosis. Examination of Bone Mass Densitometry BMD is considered not superior in diagnosing diabetoporosis since the BMD value in type 2 DM can be normal and even increased. Some markers are expected to describe bone quality in a non invasive manner. The role of AGEs and their receptors is considered important in the process of diabetoporosis. However, research on the role of AGEs and their receptors in T2DM patients is still lacking and there was no study comparing AGEs and their receptors in T2DM and non T2DM patients before.Aim: The aim of this study is to determine the difference of serum pentosidine level, serum esRAGE, serum esRAGE/pentosidine ratio between T2DM and non T2DM patients, and correlation of serum esRAGE/pentosidine ratio to serum P1NP as a marker of increased risk of diabetoporosis.Method: This is a cross-sectional study on 38 premenopausal females with T2DM with a minimum age of 35 years with symptoms or diagnosis of T2DM for more than 5 years, seen for treatment at Endokrin Metabolik Klinik at RSCM, Klaster Diabetes RSCM Kencana, RSUP Persahabatan, RSUK Tugu Koja, RSUK Kemayoran, and Puskesmas Jatinegara. Healthy controls are 36 non-DM females with similar age range. Sampling was done by simple random sampling. Serum pentosidine and serum esRAGE measurement were done by ELISA method and serum P1NP measurement was done by ECLIA method.Results: T2DM patients had higher serum pentosidine levels p=0.028 , lower serum esRAGE p=0.248 , as well as lower esRAGE/pentosidine p=0.001 ratios than non T2DM. Serum pentosidine in T2DM and non T2DM is 5406 1911 pmol/ml and 3145 1892 pmol/ml; whereas median ratio of serum esRAGE/pentosidine was 0.03 pg/pmol and 0.06 pg/pmol. There was no correlation between ratio serum esRAGE/pentosidine and serum P1NP in T2DM patients.Conclusions: Hyperglycemia in T2DM patients lead to high serum pentosidine levels that are not followed by elevated serum esRAGE levels. In combination, there was a decrease level of serum esRAGE/pentosidine ratio in T2DM patients. No correlation was seen between level of serum esRAGE/pentosidine ratio and level of P1NP as a marker for bone formation in T2DM patients. "

"ABSTRAKMiR-21 diketahui berperan dalam proliferasi dan diferensiasi osteoklas, namun peran ekspresi miR-21 serum pada osteoporosis masih belum jelas. Penelitian sebelumnya mendapatkan bahwa ekspresi miR-21 serum berkorelasi positif dengan densitas mineral tulang pada penderita osteoporosis pascamenopause, tetapi penelitian tersebut tidak menganalisis faktor-faktor lainnya yang terlibat dalam osteoporosis pascamenopause.Penelitian ini bertujuan untuk mengetahui peran ekspresi miR-21 serum, konsentrasi RANKL, OPG, TGF- ? 1, sklerostin, rasio RANKL/OPG, kalsium serum dan aktivitas fisis terhadap densitas mineral tulang belakang pada perempuan pascamenopause hipoestrogenik dengan osteoporosis dibandingkan dengan tanpa osteoporosis, dengan point of interest pada ekspresi miR-21 serum.Penelitian ini dilakukan dengan disain uji potong lintang komparatif, di RSUD Ulin Banjarmasin, pada bulan Agustus 2015 sampai Juli 2016. Subjek dibagi menjadi 2 kelompok yaitu perempuan pascamenopause hipoestrogenik dengan osteoporosis dan tanpa osteoporosis. Pengambilan sampel dilakukan dengan metode consecutive. Pemeriksaan ekspresi miR-21 serum menggunakan metode absolute quantification real-time PCR. Analisis statistik menggunakan uji korelasi Spearman, Mann-Whitney U test dan regresi linear berganda.Subjek dibagi menjadi 2 kelompok yaitu perempuan pascamenopause hipoestrogenik dengan osteoporosis PMOP dan tanpa osteoporosis PMNOP masing-masing sebanyak 60 subjek. Median ekspresi miR-21 serum pada PMOP lebih tinggi secara bermakna dibandingkan dan PMNOP p = 0,001 . Ekspresi miR-21 serum, RANKL, rasio RANKL/OPG dan aktivitas fisis berkorelasi bermakna dengan nilai BMD pada PMOP. Aktivitas fisis sedang berkorelasi negatif bermakna dengan ekspresi miR-21 serum pada PMOP dan PMNOP. Analisis regresi linear berganda menggunakan metode backward stepwise mendapatkan persamaan regresi linear: BMD = 1,373 - 0,085 Ln.miR-21 - 0,176 Log 10.RANKL R2 = 52,5 .Simpulan. Ekspresi miR-21 serum pada perempuan pascamenopsuse hipoestrogenik dengan osteoporosis terbukti lebih tinggi dibandingkan dengan tanpa osteoporosis. Ekspresi miR-21 serum terbukti memberikan pengaruh negatif terhadap nilai BMD tulang belakang pada perempuan pascamenopause hipoestrogenik dengan osteoporosis sebesar 8,5 , dengan persamaan regresi linear BMD = 1,373 - 0,085 Ln.miR-21 - 0,176 Log10.RANKL. Persamaan ini dapat menjelaskan nilai BMD tulang belakang sebesar 52,5 . Kata kunci: BMD, miR-21 serum, Osteoporosis, Pascamenopause

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ABSTRACTMiR-21 is known to play a role in osteoclast proliferation and differentiation, but the role of serum miR-21 expression in osteoporosis remains unclear. Previous research found that serum miR-21 expression was positively correlated with bone mineral density in postmenopausal osteoporosis patients, but the study did not analyze other factors involved in postmenopausal osteoporosis.This study aimed to determine the role of serum miR-21 expression, concentration of RANKL, OPG, TGF- ? 1, sclerostin and serum calcium, RANKL/OPG ratio, and physical activity on bone mineral density of spine in hypoestrogenic postmenopausal women with osteoporosis compared to no osteoporosis, with point of interest on the expression of serum miR-21.This study was conducted by comparative cross sectional design, conducted at Ulin General Hospital Banjarmasin, from August 2015 until July 2016. The subjects were divided into 2 groups of hypoestrogenic postmenopausal women with osteoporosis and without osteoporosis. Sampling was done by consecutive method. Examination of serum miR-21 expression using absolute quantification real-time PCR method. Statistical analysis using Spearman correlation test, Mann-Whitney U test and multiple linear regression.The subjects were divided into 2 groups of hypoestrogenic postmenopausal women with osteoporosis PMOP and without osteoporosis PMNOP each as many as 60 people. Median of serum miR-21 expression at PMOP group was significantly higher compared to PMNOP group p = 0.001 . Serum miR-21 expression, RANKL, RANKL/OPG ratio and physical activity were significantly correlated with BMD values ? ? ? ?in PMOP group. Moderate physical activity was significantly negative correlated with serum miR-21 expression. Multiple linear regression multivariate analysis using backward stepwise method obtained linear regression equation BMD = 1,373 - 0,085 Ln.miR-21 - 0,176 Log10.RANKL R2 = 52,5 .Conclusion. Serum miR-21 expression in hypoestrogenic postmenopausal women with osteoporosis has been shown to be higher compared with no osteoporosis. Serum miR-21 expression proved to have a negative effect on spinal BMD values in hypoestrogenic postmenopausal women with osteoporosis of 8.5 , with linear regression equation BMD = 1.373 - 0.085 Ln.miR-21 - 0.176 Log10.RANKL. This equation can explain the value of spinal BMD by 52.5 . Keywords: BMD, Osteoporosis, postmenopausal, serum miR-21 "