Calsium Supplementation with Rasbora sp. to Prevent Loss of Bone Mineral Density during Gonadotropin Releasing Hormone Agonist Long-term Treatment

Abstract

Objective: To observe the benefit of calcium supplementation overcoming the hypoestrogenic effect of Gonadotropin-releasing hormone (GnRH) agonist, using a standardized regimen and Rasbora sp. (local: Seluang fish) as a natural source of calcium. Methods: This study included 24 reproductive-aged (15-49 years old) females on subcutaneous agonist GnRH leuprolide acetate 11,25 mcg regimen. Bone mineral density was measured twice within three months, before and after the first agonist GnRH treatment. Subjects were classified into three groups of daily supplementations: placebo containing Saccharum lactis, ground powder of 500 mg of calcium, or ground powder of dried Rasbora sp containing 500 mg of calcium. Measurement pre- and postsupplementation were performed using the bone quality index with Osteosys of Sonost 3000. Results: Following three months of observation, subjects receiving placebo had a decreased bone mineral density of -22,7201 compared to those who received 500 mg calcium supplementation and fish powder with a calcium content of 500 mg (-4,4570 and -3,3634, respectively). The homogeneity test showed a significance level of 0.031, and ANOVA resulted in a significant difference between the three classes. Post Hoc showed a significant difference between calcium lactate supplementation 18,26 + 3,20 (p = 0.001) and Seluang fish powder 19,36 + 3,20 (p = 0.000). Both forms of calcium lactate and fish powder supplementation had no significant differences. Conclusion: Both calcium supplementations of calcium lactate powder and natural resources help maintain bone mineral density during GnRH agonist treatment. Seluang fish (Rasbora sp.), which is abundant in Indonesia and commonly consumed by the Indonesians, especially in South Borneo, has a similar potency to pharmaceutical 500 mg calcium lactate products. Fishery product contains other beneficial trace elements, such as 84 mg of calcium (Ca), 6,81 % of magnesium (Mg), 13,4 mg of iron (Fe), and 3.97 % of zinc (Zn).