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Title: Polymorphism of the vitamin D receptor gene and corticosteroid-related osteoporosis.
Austin Authors: Ho, Y V;Briganti, E M;Duan, Yunbo;Buchanan, Russell R C ;Hall, S;Seeman, Ego 
Affiliation: Austin and Repatriation Medical Centre, Heidelberg, University of Melbourne, Australia
Issue Date: 16-May-1999
Publication information: Osteoporosis International : A Journal Established As Result of Cooperation Between the European Foundation For Osteoporosis and the National Osteoporosis Foundation of The Usa; 9(2): 134-8
Abstract: Corticosteroid therapy (CST) is associated with reduced intestinal calcium absorption, bone loss and increased fracture risk. As polymorphisms of the vitamin D receptor (VDR) gene may be associated with bone mineral density (BMD) and intestinal calcium absorption, we asked whether patients with a given VDR genotype receiving CST may be at increased or decreased risk for corticosteroid-related bone loss and osteoporosis. We measured areal BMD (g/cm2) by dual-energy X-ray absorptiometry in 193 women (50 premenopausal, 143 postmenopausal) and 70 men with rheumatoid arthritis (n = 44), obstructive airway diseases (n = 128) and other corticosteroid-treated diseases (n = 91). All patients received a cumulative dose greater than 1.8 g per year or a minimum of 5 mg daily of prednisolone or equivalent for at least 1 year. VDR alleles were typed by polymerase chain reaction assay based on the polymorphic BsmI and TaqI restriction sites. BMD in patients was expressed as a Z-score (mean +/- SEM) derived from age- and gender-matched controls. BMD was reduced in patients at the lumbar spine (bb, -0.52 +/- 0.12; Bb, -0.47 +/- 0.11; BB, -0.65 +/- 0.18 SD; p < 0.01), femoral neck (bb, -0.46 +/- 0.10; Bb, -0.34 +/- 0.10; BB, -0.54 +/- 0.14 SD; p < 0.01), Ward's triangle (bb, -0.44 +/- 0.10; Bb, -0.31 +/- 0.10; BB, -0.45 +/- 0.13 SD; p < 0.01), and trochanter (bb, -0.50 +/- 0.10; Bb, -0.30 +/- 0.10; BB, -0.44 +/- 0.14 SD; p < 0.01). However, there was no significant difference in the deficit in BMD in any of the genotypes, either before or after adjusting for age, sex, body mass index, disease type, age at onset of disease, disease duration, cumulative steroid dosage, smoking status and dietary calcium intake. Similarly, there were no detectable differences between the BsmI genotypes and the rate of bone loss in 79 patients with repeated BMD measurements at an interval of 4-48 months. The data suggest that the VDR genotypes may not be a means of identifying patients at greater risk of corticosteroid-related bone loss.
Gov't Doc #: 10367040
DOI: 10.1007/s001980050126
Journal: Osteoporosis International
Type: Journal Article
Subjects: Adolescent
Aged, 80 and over
Anti-Inflammatory Agents.adverse effects
Arthritis, Rheumatoid.drug therapy
Bone Density
Cross-Sectional Studies
Longitudinal Studies
Lung Diseases, Obstructive.drug therapy
Middle Aged
Osteoporosis.chemically induced
Polymorphism, Genetic
Prednisone.adverse effects
Receptors, Calcitriol.genetics
Appears in Collections:Journal articles

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