We evaluated the interaction effects between the estrogen receptor a gene (ER-a), vitamin D receptor gene (VDR), age and sex on bone mineral density (BMD) in a sample of 340 unrelated males and 297 unrelated females from 401 Chinese nuclear families. Polymorphisms of PvuII and XbaI in the ER-a gene and ApaI in the VDR gene were detected by RFLP, and ERa genotype was defined by the haplotype reconstructed according to the two loci. In the females, significant ER-VDR gene interaction (P<0.05) was found on the lumbar spine BMD. Such interaction might account for approximately 1.0% of the BMD variation. At the femoral neck and trochanter, significant ER-age interaction effects were observed, which might explain 0.3% BMD variation for both skeletal sites. In the males, significant VDR-age interaction was found on femoral neck BMD (P<0.05), and it accounted for 0.6% BMD variation. These interaction effects were largely dependent on gender groups, suggesting there may exist ER-VDR-sex, ER-age-sex, and VDR-age-sex complex interactions in our Chinese sample.Keywords Interaction AE ER-a gene AE VDR gene AE Bone mineral density (BMD) AE Age AE Sex
IntroductionOsteoporosis is among the major health problems throughout the world. It is characterized by low bone mineral density (BMD) and microarchitectural deterioration of bone structure (Kanis et al. 1994). BMD variation is under strong genetic determination with heritability of over 50% (Recker and Deng 2002). A number of candidate genes associated with BMD have been identified, such as estrogen receptor a (ER-a), vitamin D receptor (VDR), calcitonin receptor, collagen type 1 a1 (COL1A1), interleukin-6, transforming growth factor b1, and others (Ralston 2002;Liu et al. 2003). Among them, polymorphisms of PvuII and XbaI sites in the ER-a gene (ER-PvuII and ER-XbaI), and ApaI site in the VDR gene (VDR-ApaI) have been the most extensively studied genetic markers in relation to BMD variation (Ralston 2002;Liu et al. 2003). However, the results so far have been largely inconsistent and controversial.To some extent, the association between a candidate gene and BMD may depend on other factors, such as environment, gene-gene and gene-nongenetic factor interactions (Ralston 2002;Liu et al. 2003). Gene-gene interaction implies that genotypic effects of one locus may depend on the genotype of the other locus (or loci), while gene-nongenetic factor interaction means that only under particular conditions, such as specific age or sex, will the genotypes affect phenotypes. If such interaction effects exist and are not taken into account, they could confound, and even bias, the associations between the candidate genes and the phenotypes (Deng et al. 1998). Gene-gene interactions between the VDR, ER-a, and COLIA1 genes, as well as the interactions between genes and nongenetic factors, e.g., sex, age, race, calcium intake, vitamin D supplements, hormone replacement therapy (HRT), and exercise, were recently documented (Graafmans et al. 1997; Giguere et al. 2000; Efstathiadou et al. ...