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Is there an Association between Dietary Micronutrients Intake and Bone Fractures among Malaysian Reproductive-Age Women? The PURE Malaysia Study Cover

Is there an Association between Dietary Micronutrients Intake and Bone Fractures among Malaysian Reproductive-Age Women? The PURE Malaysia Study

Annals of Global Health
Volume 90 (2024): Issue 1
By: Zaleha Md Isa,  Nur Atiqah Mohd Ahwan,  Noor Hassim Ismail,  Rosnah Ismail,  Azmi Mohd Tamil,  Mohd Hasni Jaafar,  Nafiza Mat-Nasir,  Nik Munirah Nik Mohd Nasir,  Nurul Hafiza Ab Razak and  Khairul Hazdi Yusof  
Open Access
|Sep 2024
Figures & tables

Figures & Tables

Figure 1

Flow chart of sample selection.

Table 1

General characteristics of reproductive age women (N = 1,730).

CHARACTERISTICSN (%)MEDIAN (IQR: 25TH, 75TH PERCENTILE)
Sociodemography
Age (year)43.00
(39, 46)
Age category (year)
35–39468 (27.1)
40–44652 (37.7)
45–49610 (35.2)
Location
Urban783 (45.3)
Rural947 (54.7)
Education level
Low1,377 (79.6)
High353 (20.4)
Employment status# (n = 1,424)
Employed701 (49.2)
Unemployed723 (50.8)
Marital status
Currently married1,582 (91.4)
Single and/or widowed148 (8.6)
BMI
Obese392 (22.7)26.23 (22.88, 29.60)
Non-obese1,338 (77.3)
Co-morbidity (diabetes mellitus)
Yes102 (5.9)
No1,628 (94.1)
Co-morbidity (hypertension)
Yes247 (14.3)
No1,483 (85.7)
Lifestyle
Active smoking# (n = 1,725)
Yes35 (2.0)
No1,690 (98.0)
Passive smoking# (n = 1,691)
Yes678 (40.1)
No1,013 (59.9)
Physical activity# (n = 1,628)
Low
(<600 MET)		1,048 (64.4)
High
(≥600 MET)		580 (35.6)
Micronutrients
Phosphorus
<RNI 700 mg/day202 (11.7)1,365.13 (913.62, 1929.78)
≥RNI 700 mg/day1,528 (88.3)
Vitamin K
<RNI 55 μg/day1,484 (85.8)14.72 (3.76, 34.14)
≥RNI 55 μg/day246 (14.2)
Calcium
<RNI 1,000 mg/day1,471 (85.0)578.80 (375.27, 805.89)
≥RNI 1,000 mg/day259 (15.0)
Magnesium
<RNI 320 mg/day1,725 (99.7)28.21 (14.97, 53.38)
≥RNI 320 mg/day5 (0.3)
Vitamin C
<RNI 70 mg/day490 (27.3)105.98 (62.43, 178.23)
≥RNI 70 mg/day1,257 (72.7)

[i] *significant at p-value <0.05; #the total numbers (n) are not equal to 1,730 due to missing values

Table 2

Factors associated with bone fractures among reproductive-age women (N = 1,730).

CHARACTERISTICSBONE FRACTURES, N (%)
YESNOP-VALUE
Age category (year)
35–3920 (4.3)448 (95.7)0.274
40–4418 (2.8)634 (97.2)
45–4926 (4.3)584 (95.7)
Location
Urban28 (3.6)755 (96.4)0.805
Rural36 (3.8)911 (96.2)
Education level
Low46 (3.3)1,521 (96.1)0.118
High18 (5.1)145 (98.0)
Employment status# (n = 1,424)
Employed25 (3.6)676 (96.4)0.660
Unemployed29 (4.0)694 (96.0)
Marital status
Currently married61(3.9)1,521 (96.1)0.260
Single and/or widowed3 (2.0)145 (98.0)
BMI
Obese17 (4.3)375 (95.7)0.447
Non-obese47 (3.5)1,291 (96.5)
Co-morbidity (diabetes mellitus)
Yes8 (7.8)94 (92.2)0.044a*
No56 (3.4)1,572 (96.6)
Co-morbidity (hypertension)
Yes10 (4.0)237 (96.0)0.754
No54 (3.6)1,429 (96.4)
Lifestyle
Active smoking# (n = 1,725)
Yes1 (2.9)34 (97.1)1.000a
No62 (3.7)1,628 (96.3)
Passive smoking# (n = 1,691)
Yes43 (6.3)635 (93.7)<0.001*
No17 (1.7)996 (98.3)
Physical activity# (n = 1,628)
Low36 (3.4)1,012 (96.6)0.845
High21 (3.6)559 (96.4)
Micronutrients
Minerals
Calcium mg/day
<RNI 1,000 mg/day55 (3.7)1,416 (96.3)0.836
≥RNI 1,000 mg/day9 (3.5)250 (96.5)
Trace elements
Phosphorus mg/day
<RNI 700 mg/day5 (2.5)197 (97.5)0.327
≥RNI 700 mg/day59 (3.9)1,469 (96.1)
Magnesium mg/day
<RNI 320 mg/day64 (3.7)1,661 (96.3)1.000a
≥RNI 320 mg/day0 (0)5 (100.0)
Vitamins
Vitamin C mg/day
<RNI 70 mg/day23 (4.7)467 (95.3)0.168
≥RNI 70 mg/day41 (3.3)1,199 (96.7)
Vitamin K μg/day
<RNI 55 μg/day58 (3.9)1,426 (96.1)0.258
≥RNI 55 μg/day6 (2.4)240 (97.6)

[i] *Significant at p-value <0.05; a = Yates correction; #the total numbers (n) are not equal to 1,730 due to missing values

Table 3

Predictors of bone fractures among reproductive-age women.

CHARACTERISTICSBONE FRACTURES, N = 64 (3.7%)
SIMPLE LOGISTIC REGRESSIONMULTIPLE LOGISTIC REGRESSION
CRUDE OR 95% CIWALD (DF)P-VALUEADJ OR 95% CIWALD (DF)P-VALUE
Age category (year)
35–391
40–440.636 (0.333, 1.216)1.873 (1)0.171
45–490.997 (0.550, 1.810)0.000 (1)0.993
Residency
Urban0.938 (0.567, 1.552)0.061 (1)0.805
Rural1
Education level
Low1
High1.555 (–0.890, 2.716)2.403 (1)0.121
Employment status#
Employed1
Unemployed0.885 (0.513, 1.527)0.193 (1)0.661
Marital status#
Currently married1.938 (0.601, 6.255)1.226 (1)0.268
Single and/or widowed1
BMI
Obese1.245 (0.707, 2.194)0.576 (1)0.448
Non-obese1
Co-morbidity (diabetes mellitus)
Yes2.389 (1.107, 5.157)4.921 (1)0.027*2.580 (1.173, 5.672)5.559 (1)0.018*
No11
Co-morbidity (hypertension)#
Yes1.117 (0.561, 2.223)0.099 (1)0.754
No1
Lifestyle Active smoking#
Yes0.772 (0.104, 5.733)0.064 (1)0.801
No1
Passive smoking#
Yes3.967 (2.243, 7.017)22.434 (1)<0.001*4.012 (2.265, 7.107)22.673 (1)<0.001*
No11
Physical activity
Low1.056 (0.611, 1.827)0.038 (1)0.845
High1
Micronutrients
Minerals
Calcium mg/day
<RNI 1,000 mg/day1.079 (0.527, 2.211)0.043 (1)0.836
≥RNI 1,000 mg/day1
Trace elements
Phosphorus mg/day
<RNI 700 mg/day0.632 (0.251, 1.594)0.946 (1)0.331
≥RNI 700 mg/day1
Magnesium mg/day
<RNI 320 mg/day62245871.77 (0.000)0.000 (1)0.999
≥RNI 320 mg/day1
Vitamins
Vitamin C
mg/day
<RNI 70 mg/day1.440 (0.855, 2.427)1.879 (1)0.170
≥RNI 70 mg/day1
Vitamin K μg/day
<RNI 55 μg/day1.627 (0.694, 3.812)1.255 (1)0.263
≥RNI 55 μg/day1

[i] *Significant at p-value <0.05

PUREProspective Urban and Rural Epidemiological Study
RESTURisk Epidemiological Study
FFQsFood Frequency Questionnaires
RNIRecommended Nutrient Intakes
PHRIPopulation Health Research Institute
MyFCDMalaysian Food Composition Database
USDAUnited States Department of Agriculture
IPAQInternational Physical Activity Questionnaire
METMetabolic Equivalent
BMIBody Mass Index
T2DMType 2 Diabetes Mellitus
BMDBone Mineral Density
BMCBone Mineral Content
MANSMalaysian Adult Nutrition Survey
DOI: https://doi.org/10.5334/aogh.4445 | Journal eISSN: 2214-9996
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Language: English
Submitted on: Mar 31, 2024
Accepted on: Aug 5, 2024
Published on: Sep 4, 2024
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
bone fractures,
reproductive-age women,
micronutrient,
vitamin,
cross-sectional

© 2024 Zaleha Md Isa, Nur Atiqah Mohd Ahwan, Noor Hassim Ismail, Rosnah Ismail, Azmi Mohd Tamil, Mohd Hasni Jaafar, Nafiza Mat-Nasir, Nik Munirah Nik Mohd Nasir, Nurul Hafiza Ab Razak, Khairul Hazdi Yusof, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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