Variation in femoral length is associated with polymorphisms in RUNX2 gene

Anthropometric correlations between parts of the upper and lower limb: models for personal identification in a Sudanese population

PURPOSE

Identification of a deceased individual is an essential component of medicolegal practice. However, personal identification based on commingled limbs or parts of limbs, necessary in investigations of mass disasters or some crimes, is a difficult task. Limb measurements have been utilized in the development of biological parameters for personal identification, but the possibility to estimate the dimensions of parts of limbs other than hands and feet has not been assessed. The present study proposes an approach to estimate the dimensions of various parts of limbs based on other limb measurements.

METHODS

The study included 320 Sudanese adults, with equal representation of men and women. Nine limb dimensions were measured (five based on the upper limb, four based on the lower limb), and extensive statistical analysis of the distribution of values was performed.

RESULTS

The results showed that all of the measured dimensions were sexually dimorphic and that there was a significant positive correlation between the dimensions of various parts of limbs. Regression models (direct and stepwise) were developed to estimate the dimensions of parts of limbs based on measurements pertaining to one or more other parts of limbs.

CONCLUSIONS

The study revealed that the dimensions of parts of the upper and lower limb can be estimated from one another. These findings can be used in medicolegal practice and extended to constructive surgery, orthopedics, and prosthesis design for lost limbs.

A study of the anthropometric correlations between upper limb measurements for personal identification in Sudanese population

The presence of multiple isolated commingled fleshed limbs or limb parts generates a significant challenge for forensic investigators in wars, mass disasters, and criminal assaults in the process of identification. Although upper limb measurements have been used to establish individual identity in terms of sex and stature with high success, there is a scarcity of data concerning the correlations within upper limb parts. Hence, this study aims to assess the relationships within upper limb parts and develop regression formulae to reconstruct the parts from one another. The study participants were 376 Sudanese adults (187 males and 189 females). The results of this study indicated significant sexual dimorphism for all variables. The results indicated a significant correlation within the upper limb parts. Linear and multiple regression equations were developed to reconstruct the upper limb parts in the presence of a single or multiple dimension(s) from the identical limb. Multiple regression equations generated better reconstructions than simple equations. These results are significant in forensics and orthopedic reconstructive surgery.

Polyalanine repeat polymorphism in RUNX2 is associated with site-specific fracture in post-menopausal females

Runt related transcription factor 2 (RUNX2) is a key regulator of osteoblast differentiation. Several variations within the RUNX2 gene have been found to be associated with significant changes in BMD, which is a major risk factor for fracture. In this study we report that an 18 bp deletion within the polyalanine tract (17A>11A) of RUNX2 is significantly associated with fracture. Carriers of the 11A allele were found to be nearly twice as likely to have sustained fracture. Within the fracture category, there was a significant tendency of 11A carriers to present with fractures of distal radius and bones of intramembranous origin compared to bones of endochondral origin (p = 0.0001). In a population of random subjects, the 11A allele was associated with decreased levels of serum collagen cross links (CTx, p = 0.01), suggesting decreased bone turnover. The transactivation function of the 11A allele showed a minor quantitative decrease. Interestingly, we found no effect of the 11A allele on BMD at multiple skeletal sites. These findings suggest that the 11A allele is a biologically relevant polymorphism that influences serum CTx and confers enhanced fracture risk in a site-selective manner related to intramembranous bone ossification.

Common polymorphisms rather than rare genetic variants of the Runx2 gene are associated with femoral neck BMD in Spanish women

RUNX2 is a transcription factor essential for osteoblast differentiation and skeletal morphogenesis. Its mutation creates cleidocranial dysplasia (CCD), a disorder characterized by skeletal abnormalities and bone mineral density (BMD) alterations. The purpose of the present study has been to clarify whether polymorphisms affecting this gene could be associated with changes in BMD in women. To that end, we performed an association study of BMD values from 776 women with two single nucleotide polymorphisms (SNPs) located at P2 promoter (-1025 T>C) and at exon 2 (+198 G>A), and with a deletion polymorphism (17Ala>11Ala), also located at exon 2. We found an association of -1025 T>C SNP with femoral neck BMD (FN-BMD), being the women of TC/CC genotype who have higher BMD than women of TT genotype (P = 0.006). This association was independent of age, weight, menopausal status, or hormone replacement therapy (HRT) use as shown by regression analysis. When women of highest versus lowest quartile of BMD were compared, this association became more evident (P = 0.002), extending also to +198 G>A SNP (GA/AA women with higher FN-BMD; P < 0.05). In addition, we describe herein three novel rare variants in the polyglutamine domain of RUNX2 protein: an in-frame insertion and two deletions in exon 2, resulting in the insertions of 7 and deletions of 7 and 5 glutamines, respectively. These variants do not produce CCD, increased frequency of bone fracture, or BMD alterations. In conclusion, common polymorphisms in Runx2 are associated with FN-BMD. Nevertheless, rare variants that modify the polyglutamine domain of RUNX2 neither have any effect on BMD nor produce the CCD phenotype. These results underscore the significance of polymorphisms in the 5'-region of Runx2 in the determination of FN-BMD.

Dose-dependent effects of Runx2 on bone development

Runx2 controls the commitment of mesenchymal cells to the osteoblastic lineage. Distinct promoters, designated P1 and P2, give rise to functionally similar Runx2-II and Runx2-I isoforms. We postulate that this dual promoter gene structure permits temporal and spatial adjustments in the amount of Runx2 isoforms necessary for optimal bone development. To evaluate the gene dose-dependent effect of Runx2 isoforms on bone development, we intercrossed selective Runx2-II(+/-) with nonselective Runx2-II(+/-)/Runx2-I(+/-) mice to create compound mutant mice: Runx2-II(+/-), Runx2-II(+/-)/Runx2-I(+/-), Runx2-II(-/-), Runx2-II(-/-)/Runx2-I(+/-), Runx2-II(-/-)/Runx2-I(-/-). Analysis of the different Runx2-deficient genotypes showed gene dose-dependent differences in the level of expression of the Runx2 isoforms. In addition, we found that Runx2-I is predominately expressed in the perichondrium and proliferating chondrocytes, whereas Runx2-II is expressed in hypertrophic chondrocytes and metaphyseal osteoblasts. Newborn mice showed impaired development of a mineralized skeleton, bone length, and widening of the hypertrophic zone that were proportionate to the reduction in total Runx2 protein expression. Osteoblast differentiation ex vivo was also proportionate to total amount of Runx2 expression that correlated with reduced Runx2 binding to the osteocalcin promoter by quantitative chromatin immunoprecipitation analysis. Functional analysis of P1 and P2 promoters showed differential regulation of the two promoters in osteoblastic cell lines. These findings support the possibility that the total amount of Runx2 derived from two isoforms and the P1 and P2 promoters, by regulating the time, place, and amount of Runx2 in response to changing environmental cues, impacts on bone development.

The developmental basis of skeletal cell differentiation and the molecular basis of major skeletal defects

Vertebrate skeletal differentiation retains elements from simpler phyla, and reflects the differentiation of supporting tissues programmed by primary embryonic development. This developmental scheme is driven by homeotic genes expressed in sequence, with subdivision of skeletal primordia driven by a combination of seven transmembrane-pass receptors responding to Wnt-family signals, and by bone morphogenetic family signals that define borders of individual bones. In sea-dwelling vertebrates, an essentially complete form of the skeleton adapted by the land-living vertebrates develops in cartilage, based on type II collagen and hydrophilic proteoglycans. In bony fishes, this skeleton is mineralized to form a solid bony skeleton. In the land-living vertebrates, most of the skeleton is replaced by an advanced vascular mineralized skeleton based on type I collagen, which reduces skeletal mass while facilitating use of skeletal mineral for metabolic homeostasis. Regulation of the mammalian skeleton, in this context, reflects practical adaptations to the needs for life on land that are related to ancestral developmental signals. This regulation includes central nervous system regulation that integrates bone turnover with overall metabolism. Recent work on skeletal development, in addition, demonstrates molecular mechanisms that cause developmental bone diseases.

Family-based association study of polymorphisms in the RUNX2 locus with hand bone length and hand BMD

Osteoporosis is characterized by reduced bone strength. Bone size and bone mineral density (BMD) are major bone strength determinants. Identification of genes affecting the variability of these traits should improve prognosis and management of osteoporosis. This research was aimed to test the hypothesis of association of radiographic hand bone length (BL) and BMD with polymorphisms in the RUNX2 locus. Four SNPs linked to the two RUNX2 promoters were genotyped in 212 nuclear Caucasian families. These SNPs and four pairwise haplotypes were tested for association with eight BL and BMD traits, adjusted for covariates. We observed significant associations between polymorphisms linked to the RUNX2 P1 promoter and BL mean values for three studied bone groups: all 18 bones, proximal and medial bones (p = 0.0118, 0.0085, and 0.0056, respectively). Mean BMD values for all 18 bones, proximal and medial bones were associated with polymorphisms linked to the RUNX2 P2 promoter (p = 0.0032, 0.0077, 0.0007, respectively). Associations with BL and BMD mean values for medial and proximal bones remained significant even after correction for multiple testing. This study provides evidence of the association between polymorphisms linked to the two RUNX2 promoters and variability of hand BL and BMD. The results suggest independent roles for the two RUNX2 promoters in the determination of the traits studied.

A method for determining skeletal lengths from DXA images

BACKGROUND

Skeletal ratios and bone lengths are widely used in anthropology and forensic pathology and hip axis length is a useful predictor of fracture. The aim of this study was to show that skeletal ratios, such as length of femur to height, could be accurately measured from a DXA (dual energy X-ray absorptiometry) image.

METHODS

90 normal Caucasian females, 18-80 years old, with whole body DXA data were used as subjects. Two methods, linear pixel count (LPC) and reticule and ruler (RET) were used to measure skeletal sizes on DXA images and compared with real clinical measures from 20 subjects and 20 x-rays of the femur and tibia taken in 2003.

RESULTS

Although both methods were highly correlated, the LPC inter- and intra-observer error was lower at 1.6% compared to that of RET at 2.3%. Both methods correlated positively with real clinical measures, with LPC having a marginally stronger correlation coefficient (r2 = 0.94; r2 = 0.84; average r2 = 0.89) than RET (r2 = 0.86; r2 = 0.84; average r2 = 0.85) with X-rays and real measures respectively. Also, the time taken to use LPC was half that of RET at 5 minutes per scan.

CONCLUSION

Skeletal ratios can be accurately and precisely measured from DXA total body scan images. The LPC method is easy to use and relatively rapid. This new phenotype will be useful for osteoporosis research for individuals or large-scale epidemiological or genetic studies.

Skeletal remodeling in health and disease

The use of genetically manipulated mouse models, gene and protein discovery and the cataloguing of genetic mutations have each allowed us to obtain new insights into skeletal morphogenesis and remodeling. These techniques have made it possible to identify molecules that are obligatory for specific cellular functions, and to exploit these molecules for therapeutic purposes. New insights into the pathophysiology of diseases have also enabled us to understand molecular defects in a way that was not possible a decade ago. This review summarizes our current understanding of the carefully orchestrated cross-talk between cells of the bone marrow and between bone cells and the brain through which bone is constantly remodeled during adult life. It also highlights molecular aberrations that cause bone cells to become dysfunctional, as well as therapeutic options and opportunities to counteract skeletal loss.

A bivariate whole-genome linkage scan suggests several shared genomic regions for obesity and osteoporosis

CONTEXT

A genome-wide bivariate analysis was conducted for body fat mass (BFM) and bone mineral density (BMD) in a large Caucasian sample. We found some quantitative trait loci shared by BFM and BMD in the total sample and the gender-specific subgroups, and quantitative trait loci with potential pleiotropy were disclosed. BFM and BMD, as the respective measure for obesity and osteoporosis, are phenotypically and genetically correlated. However, specific genomic regions accounting for their genetic correlation are unknown.

OBJECTIVE

To identify systemically the shared genomic regions for BFM and BMD, we performed a bivariate whole-genome linkage scan in 4498 Caucasian individuals from 451 families for BFM and BMD at the hip, spine, and wrist, respectively. Linkage analyses were performed in the total sample and the male and female subgroups, respectively.

RESULTS

In the entire sample, suggestive linkages were detected at 7p22-p21 (LOD 2.69) for BFM and spine BMD, 6q27 (LOD 2.30) for BFM and hip BMD, and 11q13 (LOD 2.64) for BFM and wrist BMD. Male-specific suggestive linkages were found at 13q12 (LOD 3.23) for BFM and spine BMD and at 7q21 (LOD 2.59) for BFM and hip BMD. Female-specific suggestive LOD scores were 3.32 at 15q13 for BFM and spine BMD and 3.15 at 6p25-24 for BFM and wrist BMD.

CONCLUSIONS

Several shared genomic regions for BFM and BMD were identified here. Our data may benefit further positional and functional studies, aimed at eventually uncovering the complex mechanism underlying the shared genetic determination of obesity and osteoporosis.

Sex determination from hand and foot bone lengths

Numerous studies have addressed sex estimation from the hands and feet with varying results. These studies have utilized multiple measurements to determine sex from the hands and feet, including measures of robusticity (e.g., base width and midshaft diameter). However, robusticity measurements are affected by activity, which can disguise underlying patterns of sexual dimorphism. The purpose of this study is to investigate the utility of length measurements of the hands and feet to estimate sex. The sample consists of white females (n=123) and males (n=136) from the Terry Collection. Discriminant function analysis was used to classify individuals by sex. The left hand outperformed both the right hand and foot producing correct classification rates exceeding 80%. Surprisingly, the phalanges were better sex discriminators than either the metacarpals or metatarsals. This study suggests that length measures are more appropriate than robusticity measures for sex estimation.