Vitamin D Receptor Gene Polymorphism: Correlation with Bone Mineral Density in a Brazilian Population with Insulin-Dependent Diabetes Mellitus

Hauache, Omar M.; Lazaretti-Castro, Marise; Andreoni, Solange; Gimeno, Suely G A; Brandão, Cynthia; Ramalho, Ana Claudia; Kasamatsu, Teresa S.; Kunii, Ilda; Hayashi, Lilian Fukusima; Dib, Sérgio Atala; Vieira, José Gilberto H.

doi:10.1007/s001980050055

Cited by 43 publications

(25 citation statements)

References 29 publications

(23 reference statements)

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“…The overall prevalence of alleles was 16% BB , 44% Bb and 40% bb . Although the Brazilian population is considered ethnically heterogeneous, the distribution of alleles in the present series agrees well with those previously reported for normal Brazilian premenopausal women and diabetic patients [26, 51]and also with most of the studies on Caucasian patients [30]. …”

Section: Discussionsupporting

confidence: 80%

Vitamin D Receptor Gene Polymorphism and Bone Mineral Density in Hypercalciuric Calcium-Stone-Forming Patients

Heilberg

Teixeira

Martini

et al. 2001

Nephron

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Reduced bone mineral density (BMD) and an increased risk of vertebral fracture have been reported in calcium-stone-forming (CSF) patients presenting with idiopathic hypercalciuria. We investigated the association between BsmI vitamin D receptor (VDR) polymorphism and BMD in 68 hypercalciuric CSF patients (35 males and 33 premenopausal females, mean age ± SD = 39 ± 10 years). BMD was measured at lumbar spine (L₂–L₄) and femur neck sites using dual energy X-ray absorptiometry. A 72-hour dietary record and a 24-hour urine sample were obtained from each patient to determine calcium intake and excretion. The allelic frequency found for the sample as a whole was 16% BB, 44% Bb and 40% bb. Mean BMD values did not significantly differ among BB, Bb and bb patients at L₂–L₄ (1.162 ± 0.10, 1.133 ± 0.11 and 1.194 ± 0.19 g/cm², mean ± SD, respectively) or at neck sites (0.920 ± 0.11, 0.931 ± 0.15 and 0.982 ± 0.15 g/cm², respectively). Calcium intake and excretion were also not significantly different among the three genotypes. Patients were then divided into two groups, normal BMD, T-score ≧–1 (n = 34) and low BMD, T-score <–1 (n = 34), to further evaluate the allele influence on previous bone loss. Despite a trend for a higher mean BMD at spine or neck sites for patients with one or two b alleles when compared to BB patients, the difference did not reach statistical significance. The distribution of BB, Bb and bb genotypes in the low-bone-mass group (15, 47 and 38%, respectively) was similar to that in the normal-bone-mass group (18, 41 and 14%, respectively). These data suggest that BsmI VDR polymorphism does not play an important role in the bone loss seen in hypercalciuric CSF patients.

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Section: Discussionsupporting

confidence: 80%

Vitamin D Receptor Gene Polymorphism and Bone Mineral Density in Hypercalciuric Calcium-Stone-Forming Patients

Heilberg

Teixeira

Martini

et al. 2001

Nephron

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“…Previous studies of type 1 diabetes did not focus on women close to the menopausal transition, during which bone loss due to aging often occurs, although similar reductions in BMD were observed (3)(4)(5)(6)(7)(8)(9)(10). A 1-SD decrease in BMD is associated with a twoto threefold hip fracture increase, particularly for women immediately after menopause (31,32).…”

Section: Statistical Analysesmentioning

confidence: 80%

“…Worse glycemic control in type 1 diabetes was generally not related to lower BMD (4 -12,17,22). Genetic variants in the vitamin D receptor (8) or collagen type 1 ␣-1 (9) are possibly associated with low BMD in type 1 diabetes. Decreased BMD in middle-aged type 1 diabetic women could be due to increased bone turnover (16,23,24), but recent studies do not find this (10,22,25).…”

mentioning

confidence: 99%

Middle-Aged Premenopausal Women With Type 1 Diabetes Have Lower Bone Mineral Density and Calcaneal Quantitative Ultrasound Than Nondiabetic Women

et al. 2006

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OBJECTIVE -To determine whether middle-aged premenopausal women with type 1 diabetes had more self-reported fractures and lower bone mineral density (BMD) compared with nondiabetic women.RESEARCH DESIGN AND METHODS -Participants were premenopausal women aged 35-55 years with type 1 diabetes (n ϭ 67; 32.2 Ϯ 5.3 years duration) and without diabetes (n ϭ 237). Total hip, femoral neck, whole-body, and spine BMD were measured by dual X-ray absorptiometry. Calcaneal broadband ultrasound attenuation (BUA) was assessed with quantitative ultrasound.RESULTS -Women with type 1 diabetes were more likely to report a fracture after age 20 years compared with nondiabetic women (33.3 vs. 22.6%; age-adjusted odds ratio 1.89 [95% CI 1.02-3.49]). Type 1 diabetes was associated with lower total hip BMD (0.890 vs. 0.961 g/cm 2 ; P Ͻ 0.001), femoral neck BMD (0.797 vs. 0.847 g/cm 2 ; P ϭ 0.001), whole-body BMD (1.132 vs. 1.165 g/cm 2 ; P Ͻ 0.01), and lower calcaneal BUA (71.6 vs. 84.9 dB/MHz; P Ͻ 0.001) after multivariate adjustment. BMD was 3-8% lower in type 1 diabetic compared with control women and calcaneal BUA was 15% lower. Spine BMD and biomarkers of bone remodeling were not significantly different between groups. In the type 1 diabetic women, reduced monofilament detection and blindness were both associated with lower BMD.CONCLUSIONS -Lower BMD in premenopausal women with type 1 diabetes may substantially increase their risk of developing osteoporosis after menopause. Type 1 diabetic women should be targeted for osteoporosis screening and possible fracture prevention as they transition through menopause. Diabetes Care 29:306 -311, 2006T he impact of the menopause transition on osteoporosis in type 1 diabetes is not well established. The Nord-Trodelag Health Survey (1) and the Iowa Women's Health Survey (2) found a 7-and 12-fold increase in hip fractures, respectively, in older type 1 diabetic women. Type 1 diabetes was associated with ϳ10% lower bone mineral density (BMD) compared with nondiabetic adults (3-10) in most but not all studies (11-13), though many include only small numbers of cases and lack adjustment for traditional osteoporosis risk factors (e.g., lower body weight and smoking). Few investigations (3,5,13) of type 1 diabetes and BMD focus exclusively on middleaged and postmenopausal women, those at highest risk for osteoporosis and fractures.Evidence exists for the role of diabetes complications of peripheral neuropathy (6,12,14,15), retinopathy (14,16 -18), and nephropathy (14,17,19) in osteoporosis. Peripheral measures of bone, such as calcaneal quantitative ultrasound (QUS) (20,21), could be more affected by peripheral vascular disease or peripheral neuropathy (15). Worse glycemic control in type 1 diabetes was generally not related to lower BMD (4 -12,17,22). Genetic variants in the vitamin D receptor (8) or collagen type 1 ␣-1 (9) are possibly associated with low BMD in type 1 diabetes. Decreased BMD in middle-aged type 1 diabetic women could be due to increased bone turnover (16,23,24), but recent studie...

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“…O mesmo grupo, em dois outros trabalhos (31,32), não encontrou uma prevalência maior do genótipo associado à menor massa óssea (BB) numa população de idosos com fraturas femurais nem a osteopenia observada em diabéticos insulino-dependentes estava relacionada ao polimorfismo.…”

Section: Genéticaunclassified

Fatores envolvidos no pico de massa óssea

Brandão

Vieira

1999

Arq Bras Endocrinol Metab

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A massa óssea de um indivíduo adulto, que está estreitamente relacionada ao risco de fraturas osteoporóticas, depende da diferença entre o pico de massa óssea alcançado no final do período de maturação sexual e esquelética, e as perdas acumuladas durante a vida. A enorme variabilidade observada no pico de massa óssea da adolescência está relacionada, principalmente, a fatores genéticos, mas também a parâmetros antropométricos, como peso e altura, hábitos dietéticas, influências hormonais diversas, atividade física, uso de medicamentos e doenças intercorrentes. A identificação dos fatores envolvidos na aquisição do pico de massa óssea na infância e adolescência e a compreensão deste longo período de maturação esquelética, permitirão a criação de estratégias para prevenção da osteoporose. (Arq Bras Endocrinol Metab 1999;43/6: 401-408) Unitermos: Pico de massa óssea; Densidade mineral óssea em crianças e adolescentes ABSTRACT Bone mass in the adult life, which is closely related to osteoporotic fracture risk, depends on the differences between the peak bone mass attained at the end of the sexual and skeletal maturation and the rate of involutional bone mass. The great variability in peak bone mass observed at adolescence is related not only to genetic factors, but also to diet, hormonal status, anthropometric variables, as weight and height, physical activity, drugs and intercurrent diseases. The identification of the factors involved with the acquisition of the peak bone mass and the comprehension of this long period of skeletal maturation will indicate strategies for prevention of osteoporosis. (Arq Bras Endocrinol Metab 1999;43/6: 401-408) Keywords: Peak bone mass; BMD in children and adolescents A INCIDÊNCIA DE FRATURAS OSTEOPORÓTICAS está estreitamente relacionada à massa óssea do indivíduo, que depende tanto da velocidade de perda durante a vida quanto da quantidade de tecido ósseo presente no final da puberdade e início da vida adulta. A enorme variância no pico de massa óssea é explicada não só por fatores hereditários, como também por sexo, raça, hábitos dietéticos, atividade física, influências hormonais diversas, composição corporal de massa magra e gordurosa, doenças intercorrentes, uso crônico de medicamentos. A compreensão do longo processo de maturação óssea que ocorre na infância e adolescência vai permitir identificar os fatores passíveis de alguma intervenção e a criação de estratégias para prevenção precoce da osteoporose. Se o ganho mineral ósseo puder ser otimizado durante a puberdade, é provável que o indivíduo adulto esteja menos susceptível a sofrer as devastadoras complicações da osteoporose.

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Vitamin D Receptor Gene Polymorphism: Correlation with Bone Mineral Density in a Brazilian Population with Insulin-Dependent Diabetes Mellitus

Cited by 43 publications

References 29 publications

Vitamin D Receptor Gene Polymorphism and Bone Mineral Density in Hypercalciuric Calcium-Stone-Forming Patients

Vitamin D Receptor Gene Polymorphism and Bone Mineral Density in Hypercalciuric Calcium-Stone-Forming Patients

Middle-Aged Premenopausal Women With Type 1 Diabetes Have Lower Bone Mineral Density and Calcaneal Quantitative Ultrasound Than Nondiabetic Women

Fatores envolvidos no pico de massa óssea

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