Background Corticosteroid therapy (CST) is a risk factor for developing decreased bone mineral density (BMD). Previous studies suggest that VDR genotipe is involved on loossing BMD.
Objectives To investigate the influence of VDR genotype in changes of BMD induced by CST.
Methods In 53 patients (age 41,7 ± 12,6) without osteoporosis, who received a dose greater than 5 mg daily of prednisone or equivalent for 3 months (mean dose 1,9 g). VDR genotypes were determined by PCR to demonstrate the presence (b) or absence (B) of a restriction target for Bsm I, in intron 7. Bone mineral density (BMD) by DEXA at spine, femoral neck (FN) and Ward´s triangle (WT) were measured baseline and 3 months after CST and expressed as a Z- score.
Results The BMD was reduced 3 months after CST (cumulative steroid dosage, mass index, and age was adjusting) without significant difference in both VDR groups: bb, and bB-BB; (Z- score before/3 months after) at Spine: 0,40/0,17 bb; 0,32/0,10 bB-BB; FN: 0,87/0,75 bb; 0,40/0,15 bB-BB; WT: 0,84/0,86 bb; 0,22/0,14 bB-BB. However, when the patients were adjusting to receive more or lesser than 1,3 g cumulative dose, those patients had bb genotype and greater dose had significant lower BMD at WT (p < 0,05), respective bB- BB genotypes.
Conclusion Data suggest that the VDR genotype identifies the patients with greater risk to bone loss when high corticosteroids dose is used.
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