200 & 800

Memenuhi Kebutuhan Kalsium untuk

Mempertahankan Kekuatan Tulang

Ossein-Hidroxyapatite

Tulang Kuat dan Sehat selama

Kehamilan, Menyusui dan Usia Senja

Muhammad Ambar Abidin, Apt Medical Affairs Dept.

National Osteoporosis Foundation1 : a disease characterized by low bone

mass and microarchitectural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures.

World Health Organization (1994)2 :

bone mineral density T-score lower than -2,5 standard deviations from the mean peak adult bone mass (i.e. A woman in her 30's).

1. National Osteoporosis Foundation (US). Clinicians Guide to Prevention and Treatment of Osteoporosis: NOF; 2008

2. WHO. Report of a WHO Study Group. WHO Technical Report Series 843; 1994

- Jakarta 34,4 - 38%

- Surabaya 26%

- 2 dari 5 org Indonesia terancam osteoporosis

- Peningkatan usia lanjut 414 % (Indonesia)

- Masalah : menopause, andropause, osteopenia, osteoporosis dan penyakit tua yang menyertai.

Prof Ichramsyah. Symposium 2006

Pregnancy?

When you're pregnant, your developing baby

needs calcium to build strong bones and teeth;

to grow a healthy heart, nerves, and muscles;

and to develop a normal heart rhythm and

blood-clotting abilities.

If you don't get enough calcium in your diet

when you're pregnant, your baby will draw it

from your bones, which may impair your own

health later on.

Calcium needs in Pregnancy: 1000 mg 1300 mg per day

1% : Calcium vascular contraction vasodilation

muscle function

nerve transmission

intracellular signaling

hormonal secretion

And other critical metabolic functions

99% : Calcium stored in the bones and teeth where it

supports their structure and function

Supplemental calcium is available in a variety of different forms. Salts : Calcium Carbonate, Calcium

citrate, Calcium Gluconate, Calcium Phosphate

Complex/matrix: Ossein-Hydroxyapatite (OHC)

Ca Supplement contains variety Elemental Calcium ammounts

Most of Salts Ca supplement has low bioavailability

This is due to the complex, highly regulated system that the human uses to absorb calcium

The rates of ionization and absorption of different calcium salts are similar

when averaged over several studies, calcium absorption is limited to about one quarter to one third of ingested dose. carbonate, from 26.4% to 29%,

citrate/malate from 32% to 37%,

citrate 23.5%,

lactate/gluconate 24.5%,

OSSEIN HYDROXYAPATITE (OHC)??

Calcium Salts ionized, soluble Active Transport

Passive Diffusion

Ossein Hydroxyapatite complex

Active Transport Passive Diffusion

Active transport mechanism accounts for most

of the absorption of calcium at low and moderate

intake levels

Ossoral mengandung Ossein-hydroxyapatite

Complex

Ossein-hydroxyapatite ( OHC ) terdiri dari:

- Hydroxyapatite/Hydroxyl-apatite

(kalsium dan fosfor)

- Kolagen

- Protein/peptida

200 & 800

Ossein-Hidroxyapatite

Hydroxyapatite/Hydroxyl-apatite

Ca5(PO4)3(OH)

Terdiri dari kalsium dan fosfor

Terdapat pada tulang dan gigi, membuat

matriks tulang sehingga tulang menjadi kuat

Lebih dari 50% berat tulang, merupakan bentuk

modifikasi dari Hydroxyapatite (mineral tulang)

Bone Builder

PENGGUNAAN SEBAGAI SUPLEMENT

Kebutuhan akan suplemen kalsium

tinggi, tapi banyak ditemukan

kandungan logam berat pada

suplemen kalsium

Second-generation of calcium

supplement (was derived from Bovine)

Bone implant, dental implant, etc

Kolagen

Suatu material yang diperlukan untuk

membantu kekuatan peregangan dari

tulang rawan

Protein/Peptida

Insulinlike Growth Factor I dan II ( IGF )

mediator bagi growth hormon yang sangat berguna untuk diferensiasi osteoblast dan kondrosit

Transforming Growth factor Beta (TGF- )

Protein yang juga mengatur diferensiasi dari sel-sel di tubuh termasuk sel tulang

Osteocalcin

Protein yang diproduksi oleh osteoblast. Protein ini khusus memproduksi sel tulang yang baru

Tinggi kadar dalam darah menunjukan adanya proses aktif pembentukan tulang

Protein/Peptida

Ossoral 200

Tiap tablet salut gula mengandung:

Ossein hidroxyapatite 200 mg

Ossoral 800

Tiap kaplet salut selaput mengandung:

Ossein hidroxyapatite 800 mg

200 & 800

Ossein-Hidroxyapatite

Ossoral 200

3 x 1 2 tablet sehari (600-1200mg)

Ossoral 800

2 x 2 4 kaplet sehari untuk osteoporosis (3200-

6400mg)

1 x 1 2 kaplet sehari untuk yang lain (800-1600mg)

Dosis

Indikasi Sebagai suplemen kekurangan kalsium dan fosfor pada

keadaan :

Osteoporosis primer dan sekunder

patah tulang termasuk pembentukan callus yang

lambat

Mengatur keseimbangan Ca/P pada masa kehamilan

dan menyusui

Kontra indikasi

Hipersensitif terhadap OHC

Penderita hiperkalsemia atau hiperkalsiuria

Efek samping Belum ditemukan efek yang spesifik

Comparison of the Effects of Ossein-Hydroxyapatite Complex and Calcium Carbonate on Bone Metabolism in Women with Senile Osteoporosis: A

Randomized, Open-Label, Parallel-Group, Controlled, Prospective Study

.

Abstract Background and Objective: Calcium and vitamin D supplementation is recommended in patients with osteopenia and osteoporosis. One group that could benefit from this treatment is women with senile osteoporosis. Two sources of supplementary calcium are ossein-hydroxyapatite complex (OHC) and calcium carbonate, but, to date, their comparative effects on bone metabolism have not been studied in women with senile osteoporosis. The objective of this study was to compare the effects of OHC and calcium carbonate on bone metabolism in women with senile osteoporosis. Methods: This was a randomized, open-label, parallel-group, controlled, prospective study to compare the effects of OHC (treatment group) and calcium carbonate (control group) on bone metabolism. Patients were included between 2000 and 2004 and followed up for a maximum of 3 years. The study was carried out at the bone metabolism unit of two university hospitals in

Barcelona, Spain. Subjects were women aged >65 years with densitometric osteoporosis of the lumbar spine or femoral neck. The treatment group received open-label OHC at a dose of two 830mg tablets every 12 hours (712mg elemental calcium per day). The control group received open-label calcium carbonate at a dose of 500mg of elemental calcium every 12 hours (1000mg elemental calcium per day). Both groups also received a vitamin D supplement (calcifediol 266g) at a dose of one vial orally every 15 days. Biochemical markers of bone remodelling (osteocalcin by electrochemiluminescence, tartrate-resistant acid phosphatase using colorimetry) were measured at baseline and annually for 3 years. Bone mineral density (BMD) at the lumbar spine and femoral neck was also measured. Results: One hundred and twenty women were included (55 in the OHC group and 65 in the calcium carbonate group), of

whom 54 completed 3 years of follow-up. Levels of serum osteocalcin increased to a greater extent in the OHC group compared with the calcium carbonate group (by a mean

SD of 0.84

3.13ng/mL at year 2 and 1.86

2.22ng/mL at year 3 in the OHC group compared with a mean

SD decrease of 0.39

1.39ng/mL at year 2 and an increase of 0.31

2.51ng/mL at year 3 in the calcium carbonate group); the differences between treatment groups were statistically significant (p

Absorption of calcium as the carbonate and citrate salts, with some

observations on method. Heaney RP, Dowell MS, Barger-Lux MJ.

Author information

Abstract Calcium supplement use has increased and there is confusion about the relative absorbability

of various sources. Absorbability of calcium from the carbonate and citrate salts was

compared at 300 mg and 1000 mg calcium loads, ingested as part of a light breakfast meal.

Absorption was measured at the high load both by tracer appearance in serum and by the

absorptive increment in urinary calcium, and at the low load by the tracer method only.

Subjects were 37 healthy adult men and women, studied as outpatients, and each tested on

both salts at the same load. Mean tracer absorption (+/- SD) for both salts combined was

36.0% at the 300 mg load and 28.4% at the 1000 mg load. In both experiments the observed

mean difference in absorption between salts was very small. By the tracer method the within-

subject difference (carbonate less citrate) was +3.3% +/- 1.2% of the ingested dose (mean +/-

SEM; P < 0.05) at the high load, and at the low load, 3.6% +/- 2.7% (NS). Combining the

two experiments yielded zero difference between sources. By the urinary calcium increment

method, the mean difference between salts at the 1000 mg load was 1.8 +/- 4.1 mg (NS).

Side-by-side comparisons of the two methods revealed that the tracer method was 3 times

more sensitive than the urinary increment method. We conclude that, when taken with

food, calcium from the carbonate salt is fully as absorbable as from the citrate, and that

the urinary increment method is not sufficiently sensitive to be useful in comparing sources

in free-living subjects.

Osteoporos Int. 1999;9(1):19-23

http://www.ncbi.nlm.nih.gov/pubmed?term=Heaney%20RP%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Heaney%20RP%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Heaney%20RP%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Dowell%20MS%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Dowell%20MS%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Dowell%20MS%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Barger-Lux%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Barger-Lux%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Barger-Lux%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Barger-Lux%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed?term=Barger-Lux%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025http://www.ncbi.nlm.nih.gov/pubmed/10367025

Terima kasih

47

Komposisi lengkap

Asam folat 1 mg

Betakaroten 10.000 IU

Vitamin B1 3 mg

Vitamin B2 3,4 mg

Nikotinamid 20 mg

Vitamin B6 2 mg

Kalsium-D-pantotenat 7,5 mg

Kalsium karbonat 100 mg

Vitamin B12 4 mcg

Vitamin D3 400 mg

Vitamin K1 50 mcg

Biotin 30 mcg

Copper gluconate 0,1 mg

Iron Polymaltose Complex (IPC) 30 mg

DHA (docahexaenoic acid) dari algae 40mg

ARA (arachidonic acid) 8 mg

Tiap kapsul lunak mengandung:

Penggunaan: Multivitamin dan mineral selama masa kehamilan

dan menyusui yang mengandung DHA dan ARA

untuk nutrisi otak

Dosis dan cara pemberian: Ibu hamil dan menyusui:

1 kapsul lunak per hari setelah makan

Kontraindikasi: Pada pasien yang hipersensitif terhadap salah

satu komponen produk.

Terima kasih