Association of bone turnover C-terminal telopeptide levels, 25-hydroxyvitamin D concentrations and calcium intake in Malaysian adolescents

Abdul Majid, Hazreeen and Mustapa Kamal Basha, Muzaitul Akma and C. E. Bragt, Marjolijn and G. H. M. van den Heuve, Ellen and Jalaludin, Muhammad Yazid (2025) Association of bone turnover C-terminal telopeptide levels, 25-hydroxyvitamin D concentrations and calcium intake in Malaysian adolescents. Frontiers in Nutrition, 12 (not applicable -Frontiers does not use issue numbers). pp. 1-12. ISSN 2296861X

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Abstract

Introduction: The C-terminal telopeptide (CTX), vitamin D, and calcium intake are key factors in bone health research. This study aimed to investigate these associations among adolescents. Methods: A cross-sectional study was conducted involving 1,234 students (15-year-olds) from public schools in Selangor, Perak, and Kuala Lumpur, Malaysia. The levels of CTX, 25-hydroxyvitamin D (25(OH)D), and several biomarkers were measured. The seven-day diet history was applied to the habitual dietary intake of the participants. Results: A generalized linear model was used to quantify the relationship between 25(OH)D concentrations and calcium intake with CTX levels. The results showed that the CTX log concentration was higher in females than males (mean±SD; 1.32±0.47 ng/mL vs. 1.24±0.44 ng/mL). Regarding vitamin D, the percentage of participants with 25(OH)D concentrations below 50 nmol/L was higher among females than males (91.9% vs. 45.4%). In terms of calcium intake, all participants consumed less than 50% (indicating low calcium intake) of the recommended amount, with intakes ranging from 282.0 mg/day to 543.1 mg/day. No significant association was found between 25(OH)D levels below 50 nmol/L and CTX concentrations (p-value > 0.1), but there was a significant association between CTX levels and calcium intake status (β=0.161, p-value < 0.01). Conclusion: This study suggests that higher bone turnover, indicated by elevated CTX levels, is associated with low calcium intake but not with low 25(OH)D levels.

Item Type:	Article (Journal)
Uncontrolled Keywords:	bone turnover, C-terminal telopeptide (CTX), Vitamin D, calcium intake, adolescents
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC620 Specialties of Internal Medicine-Nutritional Diseases
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Nursing > Department of Professional Nursing Studies Kulliyyah of Nursing
Depositing User:	Dr. Muzaitul Akma Mustapa Kamal Basha
Date Deposited:	12 Dec 2025 09:33
Last Modified:	12 Dec 2025 09:33
Queue Number:	2025-12-Q684
URI:	http://irep.iium.edu.my/id/eprint/125451

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