Associations of IDUA and PTCH1 with Bone Mineral Density, Bone Turnover Markers, and Fractures in Chinese Elderly Patients with Osteoporosis

A case-control study coupling with meta-analysis elaborates decisive association between IGF-1 rs35767 and osteoporosis in Asian postmenopausal females

BACKGROUND

Osteoporosis (OP) is prevalent in postmenopausal women. Several studies investigated the association between IGF-1 polymorphisms and OP among postmenopausal females with conflicting outcomes.

OBJECTIVE

To investigate whether the IGF-1 (rs35767, rs2288377, rs5742612) were associated with OP in postmenopausal females.

METHODS

In case-control study, 95 OP cases and 222 healthy controls were recruited between March 2015 and July 2019. OP was diagnosed based on WHO criteria for diagnosis of OP as T score of bone mineral density (BMD) ≤-2.5; normal, as T score of BMD ≥-1. IGF-1 SNPs were genotyped by iPLEX Gold SNP genotyping. To be solid, related studies from PubMed, Embase, Cochrane, Web of science, and previous meta-analysis up until November 2020, along with our case-control study, were incorporated into a meta-analysis with criteria of significance using odds ratios (ORs) with corresponding 95% confidence intervals (CI) to evaluate risk factor of SNPs on OP. TSA was used to estimate the sample sizes required to achieve a conclusion.

RESULTS

In dominant model of our case-control study, we found nonsignificant association of rs35767 [Adj-OR: 0.95 (95% CI: 0.56-1.60)], rs2288377 [Adj-OR: 1.15 (95% CI: 0.67-1.97)], and rs5742612 [Adj-OR: 1.07 (95% CI: 0.62-1.83)] with OP in postmenopausal females. However, integration of our case-control study and 3 published studies, rs35767 [OR: 1.24 (95% CI: 1.05-1.47)] showed a conclusively risk association with OP in postmenopausal females judged by TSA with 2267 Asians.

CONCLUSIONS

This study demonstrates a crucial sample to conclude that IGF-1 rs35767 is significantly associated with OP in postmenopausal women.

IDUA Gene Variants and Response to Zoledronic Acid Treatment in Chinese Women with Postmenopausal Osteoporosis

Purpose

Alpha-L-iduronidase (IDUA) rs3755955 and rs6831280 polymorphisms have been demonstrated to be associated with bone mineral density (BMD). However, no study has investigated the association of these two polymorphisms with osteoporosis (OP) susceptibility in Chinese postmenopausal women.

Patients and Methods

IDUA gene polymorphisms were genotyped in 278 women with OP and 303 healthy controls via polymerase chain reaction and Sanger sequencing.

Results

Our data indicated that IDUA rs3755955 and rs6831280 polymorphisms increased the risk of OP in homozygous, dominant, and allelic models. We observed lower lumbar spine BMD in younger women with the AA genotype of rs3755955 polymorphism. Finally, mutant genotypes with rs6831280 polymorphism were more sensitive to zoledronic acid treatment, and the treatment effect was significant in terms of BMD levels.

Conclusion

In conclusion, IDUA rs3755955 and rs6831280 polymorphisms demonstrated susceptibility to OP in Chinese postmenopausal women. IDUA rs6831280 polymorphism caused differences in response to zoledronic acid treatment.

Comparison of Percutaneous Kyphoplasty with or without Pedicle Screw Fixation in Osteoporotic Thoracolumbar Vertebral Fractures: A Retrospective Study

Background

Osteoporotic thoracolumbar compression fractures have become a great social burden due to the aging tendency of population. This study is aimed at comparing the clinical and radiological outcomes of percutaneous kyphoplasty with or without pedicle screw fixation in patients with osteoporotic thoracolumbar fractures. Hypothesis. There is a difference in clinical outcomes between percutaneous kyphoplasty with pedicle screw fixation and percutaneous kyphoplasty.

Methods

This retrospective study included 87 patients who received percutaneous kyphoplasty with or without pedicle screw fixation between October 2015 and October 2017 at Ningbo No.6 Hospital and were followed for 2 years. A total of 40 patients received percutaneous kyphoplasty with pedicle screw fixation (PKPF group), and the other 47 patients had percutaneous kyphoplasty only (PKP group). The outcomes were measured using the visual analogue scale (VAS), Oswestry Disability Index (ODI), Cobb angle (CA), and anterior vertebra height rate (AVHr), which were calculated at preoperative admission and each follow-up visit. Complications including postoperative back pain, refracture, and fixation failure were collected from medical records.

Results

There was no significant difference in baseline characteristics or preoperative data between the two groups (p < 0.05) but significantly better improvements in VAS, ODI, CA, and AVHr at 12- and 24-month follow-up visits in the PKPF group compared with those of the PKP group. 23 (48.9%) patients in the PKP group had complications, whereas only 5 (12.5%) patients in the PKPF group presented complications including 2 postoperative back pain and 1 fixation failure (p = 0.04).

Conclusions

PKPF obtained longer correction and better improvement in VAS, ODI, and CA in patients with osteoporotic thoracolumbar vertebral fractures than PKP.

Bone mineral density of proximal femur in adult Chinese females

OBJECTIVE

This study was designed to establish bone mineral density (BMD) reference data of proximal femur, research the effect of age, height and weight on BMD of proximal femur, and estimate the prevalence of osteoporosis in a Chinese female population. In addition we compared the results with Lebanese and USA white women reference data.

METHODS

Our study was conducted at one center, including 1578 Chinese women, aged 20-79years. We measured the BMD for proximal femur using dual-energy X-ray absorptiometry, and then established a reference database of proximal femur and set up regression equations of age, height and weight for BMD at proximal femur to research the effects of age, height and weight on BMD. After that, we calculated the standardized BMD and compared them with Lebanese and USA white women reference data.

RESULTS

The peak BMD occurred in the age range 30-39 years for femoral neck and Ward's triangle, and 40-49 years for trochanter in Chinese women, which were later than in Lebanese and USA white women. The BMD of proximal femur in Chinese women were lower than Lebanese and USA white women in most age ranges. Weight profoundly influenced BMD in all age groups, and age and height mainly effected BMD in older age groups. The standardized prevalence of osteoporosis among Chinese women of 50-79 years old was 9.6% in femoral neck, which was higher than Lebanese but lower than USA white women.

CONCLUSION

The BMD database of proximal femur in Chinese women we established is normative and different from Lebanese and USA white women reference data, which provides more reliable information on the prevalence of osteoporosis in China.

Associations of LRP5 Gene With Bone Mineral Density, Bone Turnover Markers, and Fractures in the Elderly With Osteoporosis

Objective: The study aimed to explore the associations of rs4988300 and rs634008 in the low-density lipoprotein receptor-related protein 5 (LRP5) gene with bone mineral density (BMD), bone turnover markers (BTM), and fractures in elderly patients with osteoporosis (OP). Methods: Our study included 328 unrelated OP patients with or without fractures. Genomic DNA was extracted for genotyping. BTM levels were assessed by electrochemiluminescence (ECL). Dual-energy X-ray absorptiometry (DXA) was employed to measure BMD in the lumbar spine (LS) and proximal femur. Basic features between the OP and fracture groups were analyzed using the t-test. The Chi-square test was performed to analyze the differences in allele and genotype frequencies. The associations of single-nucleotide polymorphisms (SNPs) with BMD and BTM in the subgroups were investigated by the analysis of covariance (ANCOVA) adjusted for confounding factors. Results: In both females and males, individuals with fractures exhibited higher BTM levels and lower BMD values than those with OP (P < 0.05). The allele and genotype frequencies of rs4988300 in the subgroups were significantly different (P < 0.05). In both females and males suffering from OP, participants with rs4988300 GG or rs634008 TT presented lower procollagen I N-terminal propeptide (PINP) levels (P < 0.05). Women with OP carrying rs4988300 GG exhibited lower BMD values at FN and TH (P < 0.05). In both females and males with fractures, individuals carrying rs4988300 GG genotype or rs634008 TT genotype exhibited lower PINP levels and BMD values at FN and TH than those with other genotypes (P < 0.05). Conclusions: Rs4988300 and rs634008 polymorphisms in the LRP5 gene are associated with bone phenotypes in the elderly with OP or fractures.