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Azhuvalappil S, Prasad R, Sahadevan P, Pradhan H, Rai P, Sundarakumar JS. Sex-specific differences in the association between APOE genotype and metabolic syndrome among middle-aged and older rural Indians. Metabol Open 2024; 22:100281. [PMID: 38659620 PMCID: PMC11035107 DOI: 10.1016/j.metop.2024.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
Background Metabolic syndrome (MetS), characterized by elevated blood pressure, high blood glucose, excess abdominal fat, and abnormal cholesterol or triglyceride levels, significantly increases the risk of various non-communicable diseases. This study focuses on understanding the sex-specific association between Apolipoprotein E (APOE) polymorphism and MetS among middle-aged and older adults in rural southern India. Methods This cross-sectional study utilized data from the Centre for Brain Research-Srinivaspura Aging, Neuro Senescence, and COGnition (CBR-SANSCOG) study. Participants (n = 3741) underwent comprehensive clinical assessments and blood investigations, including APOE genotyping. MetS was defined using the National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III) and the Consensus criteria. Statistical analyses, including chi-square tests, ANCOVA, and logistic regression, were conducted to explore the association of APOE genotype with MetS and its components, stratified by sex. Results Females carrying the APOE E4 allele had 1.31-fold increased odds of MetS (95 % CI: 1.02,1.69, p = 0.035) according to the NCEP ATP III criteria but not when the Consensus criteria were applied. The study also noted sex-specific differences in the association of APOE with various MetS components, including lipid levels and waist circumference. Discussion Our findings reveal a sex-specific association between the APOE E4 allele and MetS, with only females having an increased risk. This study contributes to the understanding of the genetic underpinnings of MetS and highlights the importance of considering sex-specific differences in MetS research and its prevention strategies. This study underscores the complexity of MetS etiology and emphasizes the need for further research to elucidate the role of genetic, environmental, and lifestyle factors in its progression, particularly in sex-specific contexts.
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Affiliation(s)
- Shilna Azhuvalappil
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
- Indian Institute of Science Education and Research (IISER), Kolkata, 741246, India
| | - Raghav Prasad
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Pravin Sahadevan
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Hitesh Pradhan
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Pooja Rai
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
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Seo JW, Yoon SK, Lim HH, Shin W, Kim W, Min YK, Yoon BK. Modulation of Bone Mineral Density and Its Response to Menopausal Hormone Therapy according to the Apolipoprotein E Genotype in Postmenopausal Korean Women. J Menopausal Med 2024; 30:37-43. [PMID: 38714492 PMCID: PMC11103072 DOI: 10.6118/jmm.23033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/31/2023] [Accepted: 01/15/2024] [Indexed: 05/10/2024] Open
Abstract
OBJECTIVES Genetic factors are a major cause of osteoporosis. The present study evaluated the association of the apolipoprotein E (ApoE) genotype with bone mineral density (BMD) and its response to menopausal hormone therapy (MHT) in postmenopausal Korean women. METHODS This retrospective cohort study included 172 postmenopausal women with no endocrine diseases, medications, or lifestyles that would affect bone metabolism and who were continuously treated with MHT for at least 2 years. BMDs were measured at baseline and periodically. RESULTS Linear regression analysis demonstrated similar baseline BMDs at the lumbar spine, but significantly lower at the femur neck and total hip in the ApoE ε4 carrier than in the noncarrier group, after controlling for age, body mass index, and history of MHT usage. Overall, the Wilcoxon signed rank test demonstrated that MHT increased the BMD percentage change at all three regions, and the Generalized Estimating Equation (GEE) demonstrated significant time trends at the lumbar spine and femur neck. ApoE ε4 noncarriers exhibited a significant time trend in BMD changes at the femur neck, whereas ε4 carriers exhibited a time trend at the lumbar spine. However, BMD changes at each time point were comparable at all regions between the groups. Notably, GEE adjusted for baseline characteristics and BMD revealed a significant interaction effect of time and ApoE ε4 allele in BMD changes at the femur neck. CONCLUSIONS Postmenopausal Korean women carrying the ApoE ε4 allele demonstrated a lower hip BMD compared with ε4 noncarriers. Furthermore, the ε4 allele may modulate hip BMD responses to MHT.
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Affiliation(s)
- Jong-Wook Seo
- Department of Obstetrics and Gynecology, National Health Insurance Ilsan Hospital, Goyang, Korea
| | - Sun-Kee Yoon
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Hyun Hye Lim
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Whan Shin
- Department of Obstetrics and Gynecology, CHA Bunding Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Woosun Kim
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Ki Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Koo Yoon
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Valencia-Olvera AC, Maldonado Weng J, Christensen A, LaDu MJ, Pike CJ. Role of estrogen in women's Alzheimer's disease risk as modified by APOE. J Neuroendocrinol 2023; 35:e13209. [PMID: 36420620 PMCID: PMC10049970 DOI: 10.1111/jne.13209] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/29/2022] [Accepted: 10/13/2022] [Indexed: 12/15/2022]
Abstract
Alzheimer's disease (AD) is characterized by numerous sexual dimorphisms that impact the development, progression, and probably the strategies to prevent and treat the most common form of dementia. In this review, we consider this topic from a female perspective with a specific focus on how women's vulnerability to the disease is affected by the individual and interactive effects of estrogens and apolipoprotein E (APOE) genotype. Importantly, APOE appears to modulate systemic and neural outcomes of both menopause and estrogen-based hormone therapy. In the brain, dementia risk is greater in APOE4 carriers, and the impacts of hormone therapy on cognitive decline and dementia risk vary according to both outcome measure and APOE genotype. Beyond the CNS, estrogen and APOE genotype affect vulnerability to menopause-associated bone loss, dyslipidemia and cardiovascular disease risk. An emerging concept that may link these relationships is the possibility that the effects of APOE in women interact with estrogen status by mechanisms that may include modulation of estrogen responsiveness. This review highlights the need to consider the key AD risk factors of advancing age in a sex-specific manner to optimize development of therapeutic approaches for AD, a view aligned with the principle of personalized medicine.
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Affiliation(s)
- AC Valencia-Olvera
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - J Maldonado Weng
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - A Christensen
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089 USA
| | - MJ LaDu
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - CJ Pike
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089 USA
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Kim SA, Kweon SS, Choi JS, Rhee JA, Lee YH, Nam HS, Jeong SK, Park KS, Ryu SY, Choi SW, Kim HN, Song HR, Oh SH, Cauley JA, Shin MH. Association of APOE Genotype with Bone Mineral Density in Men and Women: The Dong-gu and Namwon Studies. Chonnam Med J 2016; 52:59-63. [PMID: 26866001 PMCID: PMC4742611 DOI: 10.4068/cmj.2016.52.1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/11/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022] Open
Abstract
Many studies have investigated relationships between APOE genotype and bone mineral density (BMD). However, the results of these studies have been inconsistent. Few studies have been carried out in Asian populations. We studied the relationship of the APOE gene polymorphism and BMD in two large population-based studies. The datasets included the Dong-gu Study (3575 men and 5335 women) and the Namwon Study (2310 men, 3512 women). Lumbar spine and femoral neck BMD were measured by dual-energy X-ray absorptiometry. APOE genotypes were analyzed by polymerase chain reaction–restriction fragment length polymorphism. The APOE genotypes were classified into APOE E2 (E2/E2 and E2/E3), APOE E3 (E3/E3), and APOE E4 (E3/E4 and E4/E4). The genotype distribution of the study population was in Hardy-Weinberg equilibrium. There were no significant differences among APOE genotype groups in lumbar and femoral neck BMD in either cohort. Our data do not support the hypothesis that the APOE genotype is associated with BMD.
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Affiliation(s)
- Sun A Kim
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jin-Su Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jung-Ae Rhee
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science Wonkwang University College of Medicine, Iksan, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University Medical School, Daejeon, Korea
| | - Seul-Ki Jeong
- Department of Neurology & Research Institute of Clinical Medicine, Chobuk National University-Chonbuk National University Hospital, Jeonju, Korea
| | - Kyeong-Soo Park
- Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Hee Nam Kim
- Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Korea
| | - Hye-Rim Song
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Su-Hyun Oh
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.; Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Korea
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Zhang SQ, Zhang WY, Ye WQ, Zhang LJ, Fan F. Apolipoprotein E gene E2/E2 genotype is a genetic risk factor for vertebral fractures in humans: a large-scale study. INTERNATIONAL ORTHOPAEDICS 2014; 38:1665-9. [PMID: 24880936 DOI: 10.1007/s00264-014-2380-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 05/07/2014] [Indexed: 01/04/2023]
Abstract
PURPOSE Although many studies have been performed to evaluate whether or not apolipoprotein E gene (APOE) polymorphisms are differentially associated with bone mineral density (BMD) and fractures, the results have been conflicting. This large-scale study was performed to investigate whether a relationship exists between APOE polymorphisms and risk of fracture. METHODS A hospital-based case-control study was conducted in 3,000 patients with fractures and 3,000 age- and gender-matched healthy controls. Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay was applied to assess the APOE gene polymorphisms. RESULTS Patients with fractures had a significantly higher frequency of APOE E2/E2 genotype [odds ratio (OR) = 2.02, 95% confidence interval (CI) = 1.30, 3.14; P = 0.002] than healthy controls. When stratifying by fracture type, it was found that patients with vertebral fractures had a significantly higher frequency of APOE E2/E2 genotype (OR = 2.86, 95% CI = 1.73, 4.73; P < 0.001). No significant differences were found in nonvertebral (hip or wrist or other) fractures. CONCLUSIONS Our study suggests that APOE E2/E2 genotype is a potential genetic risk factor for vertebral fractures in humans.
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Affiliation(s)
- Shu Qi Zhang
- Department of Nursing, Changhai Hospital Affiliated to the Second Military Medical University, NO.168 Changhai Road, Shanghai, 200433, China
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Niemeier A, Schinke T, Heeren J, Amling M. The role of apolipoprotein E in bone metabolism. Bone 2012; 50:518-24. [PMID: 21798384 DOI: 10.1016/j.bone.2011.07.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 06/23/2011] [Accepted: 07/08/2011] [Indexed: 10/18/2022]
Abstract
Apolipoprotein E (apoE) is a major structural apolipoprotein of several lipoprotein classes. Over the last 13 years, numerous studies have focused on the question whether human apoE affects bone phenotypes and, more recently, whether apoE regulates bone metabolism in mice. Here, we first provide a brief background introduction into the structure, established physiological and pathophysiological functions of apoE, and will then discuss the new aspects of the emerging role of apoE in bone.
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Affiliation(s)
- Andreas Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Abstract
CONTEXT A strong genetic influence on bone mineral density has been long established, and modern genotyping technologies have generated a flurry of new discoveries about the genetic determinants of bone mineral density (BMD) measured at a single time point. However, much less is known about the genetics of age-related bone loss. Identifying bone loss-related genes may provide new routes for therapeutic intervention and osteoporosis prevention. EVIDENCE ACQUISITION A review of published peer-reviewed literature on the genetics of bone loss was performed. Relevant studies were summarized, most of which were drawn from the period 1990-2010. EVIDENCE SYNTHESIS Although bone loss is a challenging phenotype, available evidence supports a substantial genetic contribution. Some of the genes identified from recent genome-wide association studies of cross-sectional BMD are attractive candidate genes for bone loss, most notably genes in the nuclear factor κB and estrogen endocrine pathways. New insights into the biology of skeletal development and regulation of bone turnover have inspired new hypotheses about genetic regulation of bone loss and may provide new directions for identifying genes associated with bone loss. CONCLUSIONS Although recent genome-wide association and candidate gene studies have begun to identify genes that influence BMD, efforts to identify susceptibility genes specific for bone loss have proceeded more slowly. Nevertheless, clues are beginning to emerge on where to look, and as population studies accumulate, there is hope that important bone loss susceptibility genes will soon be identified.
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Affiliation(s)
- Braxton D Mitchell
- Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
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Peter I, Crosier MD, Yoshida M, Booth SL, Cupples LA, Dawson-Hughes B, Karasik D, Kiel DP, Ordovas JM, Trikalinos TA. Associations of APOE gene polymorphisms with bone mineral density and fracture risk: a meta-analysis. Osteoporos Int 2011; 22:1199-209. [PMID: 20533025 PMCID: PMC3144470 DOI: 10.1007/s00198-010-1311-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 05/03/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED To determine the association of the Apolipoprotein E (APOE) E4 gene polymorphism with bone mineral density (BMD) and fractures we conducted a meta-analysis of 17 reports. Despite lower trochanteric and lumbar BMD in APOE4 carriers, there is insufficient evidence to support a consistent association of APOE with bone health. INTRODUCTION APOE has been studied for its potential role in osteoporosis risk. It is hypothesized that genetic variation at APOE locus, known as E2, E3, and E4, may modulate BMD through its effects on lipoproteins and vitamin K transport. The purpose of this study was to determine the association of the APOE-E4 gene polymorphism with bone-related phenotypes. METHODS We conducted a meta-analysis that combined newly analyzed individual data from two community-based cohorts, the Framingham Offspring Study (N = 1,495) and the vitamin K clinical trial (N = 377), with 15 other eligible published reports. Bone phenotypes included BMD measurements of the hip (total hip and trochanteric and femoral neck sites) and lumbar spine (from the L2 to L4 vertebrae) and prevalence or incidence of vertebral, hip, and other fractures. RESULTS In sex-pooled analyses, APOE4 carriers had a 0.018 g/cm(2) lower weighted mean trochanteric BMD than non carriers (p = 0.0002) with no evidence for between-study heterogeneity. A significant association was also detected with lumbar spine BMD (p = 0.006); however, inter-study heterogeneity was observed. Associations with lumbar spine and trochanteric BMD were observed predominantly in women and became less significant in meta-regression (p = 0.055 and 0.01, respectively). There were no consistent associations of APOE4 genotype with BMD at other skeletal sites or with fracture risk. CONCLUSIONS Based on these findings, there is insufficient evidence to support a strong and consistent association of the APOE genotype with BMD and fracture incidence.
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Affiliation(s)
- I Peter
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York 10029, USA.
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Singh M, Singh P, Singh S, Juneja PK, Kaur T. A susceptible haplotype within APOE gene influences BMD and intensifies the osteoporosis risk in postmenopausal women of Northwest India. Maturitas 2011; 67:239-44. [PMID: 20663622 DOI: 10.1016/j.maturitas.2010.06.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 05/15/2010] [Accepted: 06/19/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND The association of apolipoprotein E (APOE) genotypes with bone mineral density (BMD) and risk of osteoporosis have remained unclear. The influence of APOE gene polymorphisms on BMD as genetic mediators of osteoporosis risk needs to be explored in Indian postmenopausal females where this disease is rising rampantly. METHODS AND RESULTS The present study investigated the role and relevance of four pertinent APOE single nucleotide polymorphisms: 5'UTR G/C (rs440446), Int2 G/A (rs769450), Exon4 T/C (rs429358), Exon4C/T (rs7412) in DEXA verified 133 osteoporotic, 57 osteopenic and 83 normal postmenopausal females of India, who were not taking hormone replacement therapy. Minor allele frequencies of rs440446 and rs429358 were higher in osteoporotic females (0.31, 0.18) than osteopenic (0.29, 0.15) and females having normal bone mass (0.16, 0.07). Disease association analysis revealed a susceptibility haplotype CGTC (in order of rs440446, rs769450, rs429358, rs7412) and the carriers of this haplotype has higher risk of osteopenia (OR 3.53, 95% CI 1.21-11.0, P=0.017) and osteoporosis (OR 3.61, 95% CI 1.53-9.48, P=0.002) after adjusting the confounding effect of age, BMI and years since menopause. Females who possess either one copy or two copies of the haplotype have lesser BMD values of lumbar spine (0.88 and 0.85 g/cm(2)) and femoral neck (0.84 and 0.82 g/cm(2)) than those females who possess zero copy (0.9 and 0.87 g/cm(2), respectively). CONCLUSIONS The present study exposed a susceptibility haplotype CGTC, within APOE gene, which was found to be associated with BMD and risk of osteopenia and osteoporosis in postmenopausal females of India.
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Affiliation(s)
- Monica Singh
- Department of Human Biology, Punjabi University, Patiala, Punjab, India.
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Jeong IK, Cho SW, Kim SW, Choi HJ, Park KS, Kim SY, Lee HK, Cho SH, Oh BH, Shin CS. Lipid profiles and bone mineral density in pre- and postmenopausal women in Korea. Calcif Tissue Int 2010; 87:507-12. [PMID: 20976443 DOI: 10.1007/s00223-010-9427-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 09/22/2010] [Indexed: 10/18/2022]
Abstract
Although it has been hypothesized that an atherogenic lipid profile might be associated with lower bone mineral density (BMD), the previous results are controversial. We investigated the association between lipid profile and BMD in premenopausal and postmenopausal women in a large Korean population. This study considered 10,402 women who underwent measurements of lipid profile and BMD from October 2003 to October 2005 at Healthcare System Gangnam Center, Seoul National University Hospital. Participants with potential confounding factors affecting BMD (n = 3,128) were excluded. The associations between lipid profiles (total cholesterol [TC], low-density lipoprotein [LDL-C] and high-density lipoprotein [HDL-C] cholesterol, and triglyceride [TG]) and BMD at various skeletal sites (lumbar spine [L1-L4], proximal total hip, femoral neck, and trochanter) were explored by Pearson's correlation and partial correlation, adjusting for age, body mass index, and menarche age. Multiple linear regression analyses adjusting for all other covariates were also performed. Data on 4,613 premenopausal and 2,661 postmenopausal women aged 20-91 years were finally included in the analysis. In multivariate analyses, there was no significant relationship between lipid profiles and BMD, except that HDL-C was positively associated with BMD at only the lumbar spine in postmenopausal women and that the quartiles of TG were negatively associated with BMD at the total hip and trochanter in only premenopausal women. We conclude that although there were some weak associations between lipid profiles and BMD, the results of this study hardly support the hypothesis that an atherogenic lipid profile is associated with osteoporosis.
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Affiliation(s)
- In-Kyong Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Republic of Korea
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Tong TYY, Yong RYY, Goh VHH, Liang S, Chong APL, Mok HPP, Yong EL, Yap EPH, Moochhala S. Association between an intronic apolipoprotein E polymorphism and bone mineral density in Singaporean Chinese females. Bone 2010; 47:503-10. [PMID: 20546958 DOI: 10.1016/j.bone.2010.05.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 04/26/2010] [Accepted: 05/17/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Apolipoprotein E (ApoE) is implicated in the pathogenesis of osteoporosis. OBJECTIVE To investigate possible association of the non-classical APOE gene +113C/G (rs440446) intron 1 enhancer polymorphism with bone mineral density (BMD) in a homogeneous Chinese population in Singapore. METHODS A total of 655 volunteers, males and females, aged between 31 and 72 years, from the public participated. BMD was measured using dual-energy X-ray absorptiometry and APOE +113C/G (rs440446) genotypes were determined by Sequenom MassARRAY system. To adjust for potential confounders, anthropometric, demographic, and lifestyle determinants were obtained, and serum lipids and E(2) were measured. RESULTS The +113C/G (rs440446) polymorphism within the APOE gene was associated with BMD in Chinese Singaporean females only. Females with the heterozygous CG genotype were significantly associated with reduced total, lumbar spine, and femoral neck of hip BMD, after multilevel adjustment of confounders. The association was stronger in the spine than in the hip. When females were stratified according to WHO classification for osteoporosis, those with CG and GG genotypes had increased risk (OR 3.50 and 2.22, respectively) of developing osteopenia/osteoporosis in the lumbar spine. Serum lipids did not explain the influence of APOE +113 C/G (rs440446) on BMD. CONCLUSION This study demonstrated an association between APOE +113C/G (rs440446) polymorphism with measures of BMD in Singaporean Chinese females.
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Affiliation(s)
- Terry Y Y Tong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, 119074, Singapore.
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Giaginis C, Tsantili-Kakoulidou A, Theocharis S. Peroxisome proliferator-activated receptors (PPARs) in the control of bone metabolism. Fundam Clin Pharmacol 2007; 21:231-44. [PMID: 17521292 DOI: 10.1111/j.1472-8206.2007.00486.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Peroxisome proliferator-activated receptors (PPARs) are ligand-activated nuclear transcription factors that regulate the storage and catabolism of dietary fats. PPARs constitute molecular targets for the treatment of human metabolic disorders, and also play a crucial role in inflammatory-related disease and cancer. Recent evidence has revealed the presence of three different PPAR isotypes (alpha, beta/delta, and gamma) in different cells of the bone tissue, as well as the possible role of PPAR ligands in bone turnover. In the present review, the latest knowledge of the expression of PPARs in bone tissue and the diverse effects of PPAR ligands on bone metabolism is summarized. PPARs, especially of the gamma isotype, could be targets for the treatment of diverse bone diseases such as osteoporosis and osteopenia related to either diabetes or aging.
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Affiliation(s)
- Costas Giaginis
- Department of Forensic Medicine and Toxicology, Medical School, University of Athens, 75 Mikras Asias Street, Athens 11527, Greece
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Hirasawa H, Tanaka S, Sakai A, Tsutsui M, Shimokawa H, Miyata H, Moriwaki S, Niida S, Ito M, Nakamura T. ApoE gene deficiency enhances the reduction of bone formation induced by a high-fat diet through the stimulation of p53-mediated apoptosis in osteoblastic cells. J Bone Miner Res 2007; 22:1020-30. [PMID: 17388726 DOI: 10.1359/jbmr.070330] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
UNLABELLED Osteoblast apoptosis increased in the tibias of apoE(-/-) mice fed with a high-fat diet, decreasing bone formation. The expression of p53 mRNA in marrow adherent cells increased. LDL or oxidized LDL increased apoptosis in the calvarial cells of apoE(-/-) mice. The increase in p53-mediated apoptosis is apparently related to a high-fat diet-induced osteopenia in apoE(-/-) mice. INTRODUCTION The effects of high-fat loading and the apolipoprotein E (apoE) gene on bones have not been elucidated. We hypothesized that apoE gene deficiency (apoE(-/-)) modulates the effects of high-fat loading on bones. MATERIALS AND METHODS We assessed this hypothesis using wildtype (WT) and apoE(-/-) mice fed a standard (WTS and ApoES groups) or a high-fat diet (WTHf and ApoEHf groups). The concentration of serum lipid levels and bone chemical markers were measured. Histomorphometry of the femurs was performed using microCT and a microscope. Bone marrow adherent cells from the femurs were used for colony-forming unit (CFU)-fibroblastic (CFU-f) assay and mRNA expressions analysis. The apoptotic cells in the tibias were counted. TUNEL fluorescein assay and Western analysis were performed in cultures of calvarial cells by the addition of low-density lipoprotein (LDL) or oxidized LDL. RESULTS In the ApoEHf group, the values of cortical bone volume and trabecular and endocortical bone formation of the femurs decreased, and urinary deoxypyridinoline increased. Subsequent analysis revealed that the number of apoptotic cells in the tibias of the ApoES group increased, and more so in the ApoEHf group. The ratio of alkaline phosphatase-positive CFU-f to total CFU-f was decreased in the ApoEHf group. p53 mRNA expression in adherent cells of the apoE(-/-) mice increased and had a significantly strong positive correlation with serum LDL. TUNEL fluorescein assay of osteoblastic cells revealed an increase of apoptotic cells in the apoE(-/-) mice. The number of apoptotic cells in the apoE(-/-) mice increased with the addition of 100 microg/ml LDL or oxidized LDL. The p53 protein expression in apoE(-/-) cells exposed to 100 microg/ml LDL or oxidized LDL increased. CONCLUSIONS We concluded that apoE gene deficiency enhances the reduction of bone formation induced by a high-fat diet through the stimulation of p53-mediated apoptosis in osteoblastic cells.
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Affiliation(s)
- Hideyuki Hirasawa
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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14
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Bagger YZ, Rasmussen HB, Alexandersen P, Werge T, Christiansen C, Tankó LB. Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se? Osteoporos Int 2007; 18:505-12. [PMID: 17109061 PMCID: PMC1820757 DOI: 10.1007/s00198-006-0255-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Accepted: 10/09/2006] [Indexed: 01/02/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Epidemiological observations suggest links between osteoporosis and risk of acute cardiovascular events and vice versa. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. We investigated whether serum lipids and polymorphism in the ApoE gene modifying serum lipids could be a biological linkage. METHODS This was an observational study including 1176 elderly women 60-85 years old. Women were genotyped for epsilon (epsilon) allelic variants of the ApoE gene, and data concerning serum lipids (total cholesterol, triglycerides, HDL-C, LDL-C, apoA1, ApoB, Lp(a)), hip and spine BMD, aorta calcification (AC), radiographic vertebral fracture and self-reported wrist and hip fractures, cardiovascular events together with a wide array of demographic and lifestyle characteristics were collected. RESULTS Presence of the ApoE epsilon 4 allele had a significant impact on serum lipid profile, yet no association with spine/hip BMD or AC could be established. In multiple regression models, apoA1 was a significant independent contributor to the variation in AC. However, none of the lipid components were independent contributors to the variation in spine or hip BMD. When comparing the women with or without vertebral fractures, serum triglycerides showed significant differences. This finding was however not applicable to hip or wrist fractures. After adjustment for age, severe AC score (>or=6) and/or manifest cardiovascular disease increased the risk of hip but not vertebral or wrist fractures. CONCLUSION The contribution of serum lipids to the modulators of BMD does not seem to be direct but rather indirect via promotion of atherosclerosis, which in turn can affect bone metabolism locally, especially when skeletal sites supplied by end-arteries are concerned. Further studies are needed to explore the genetic or environmental risk factors underlying the association of low triglyceride levels to vertebral fractures.
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Affiliation(s)
- Y Z Bagger
- Center for Clinical and Basic Research A/S, Ballerup Byvej 222, DK-2750, Ballerup, Denmark.
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15
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Abstract
There is compelling evidence to suggest that both the development of bone to peak bone mass at maturity and subsequent loss depend on the interaction between genetic, hormonal, environmental and nutritional factors. The major part (≤80%) of the age-specific variation in bone turnover and bone density is genetically determined. However, the notion of genetic determinant is of little value unless the specific genes that are involved can be identified. Most work in this area of osteoporosis research has focused on the candidate gene approach, which has identified several candidate genes for osteoporosis, including genes encoding the vitamin D receptor (VDR), oestrogen receptors (α and β), apolipoprotein E, collagen type I α 1 and methylenetetrahydrofolate reductase, amongst many others. However, in general, findings from numerous studies of the association between such genes and various bone variables have been inconsistent. In addition to possible gene—gene interactions it is likely that there are interactions between these genes and certain environmental factors, especially nutrition, that may mediate expression of bone-related phenotypes. While these potential interactions add a level of complexity to our understanding of these apparent genetic effects on bone, identification of a role for genetic factors without knowledge of their interaction with nutrients can do little to advance prevention and treatment of osteoporosis. This information is especially important because, unlike genotype, diet and nutrition can be modified. The aim of the present review is to critically evaluate current knowledge relating to candidate genes for osteoporosis, with particular emphasis on their interaction with nutrients and dietary factors in determining bone health.
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Affiliation(s)
- Siobhán Cusack
- Department of Food and Nutritional Sciences, University College, Cork, Republic of Ireland
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16
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Giaginis C, Tsantili-Kakoulidou A, Theocharis S. Peroxisome proliferator-activated receptor-γ ligands as bone turnover modulators. Expert Opin Investig Drugs 2007; 16:195-207. [PMID: 17243939 DOI: 10.1517/13543784.16.2.195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PPAR-gamma ligands are being used for the treatment of human metabolic disorders; they also exert anti-inflammatory and antineoplastic properties that are now being explored in clinical studies. Recent data have further extended the crucial role of PPAR-gamma and its ligands in bone turnover. This review summarises the latest knowledge of the expression of PPAR-gamma in bone tissue and the regulatory effect of diverse synthetic and natural PPAR-gamma ligands on bone formation and resorption. Taking into account the data so far, PPAR-gamma ligands seem to be able to contribute to the treatment of various bone disorders including osteoporosis, as well as diabetic and age-related osteopoenia.
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Affiliation(s)
- Costas Giaginis
- University of Athens, Department of Forensic Medicine and Toxicology, Medical School, 75 Mikras Asias Street, Athens 11527, Greece.
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17
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Brownbill RA, Ilich JZ. Lipid profile and bone paradox: higher serum lipids are associated with higher bone mineral density in postmenopausal women. J Womens Health (Larchmt) 2006; 15:261-70. [PMID: 16620185 DOI: 10.1089/jwh.2006.15.261] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous studies suggest a relationship between cardiovascular disease (CVD) and osteoporosis; however, the mechanism of the relationship and whether serum lipids are positively or negatively associated with bone mineral density (BMD) are unclear. METHODS We investigated the relationship among serum lipids, dietary saturated fat, BMD of various skeletal sites, and markers of bone turnover. This was a cross-sectional analysis in 136 Caucasian, healthy, postmenopausal women, who were not taking lipid-lowering medications or drugs affecting bone metabolism. BMD at multiple skeletal sites was assessed by DXA. Concentration of serum triglycerides, cholesterol, osteocalcin (OC), and undercarboxylated osteocalcin (UOC) and urinary cross-linked N-telopeptides were analyzed by routine methods. Saturated fat, total calcium (food and supplements), total vitamin K, alcohol, and energy intake were estimated using 3-day dietary records. Physical activity was assessed and used as a confounder with other anthropometric measurements. RESULTS Serum triglycerides were positively related to femoral shaft BMD and serum cholesterol to total body BMD (p < 0.05). Also, subjects with serum triglycerides above the median had significantly higher BMD in femoral Ward's triangle than those below the median (p = 0.037, by ANCOVA). Subjects with a serum cholesterol level of > or =240 mg/dL (cutoff for increased risk for CVD) had significantly higher BMD at the total body and at all sites of the femur (except neck). There was no relationship between serum lipids and markers of bone turnover. Saturated fat intake was not associated with BMD of any skeletal site. CONCLUSIONS These findings indicate that higher levels of serum triglycerides and cholesterol are positively associated with BMD of various skeletal sites. The mechanism of this association is not clear, and studies are needed to clarify this relationship.
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Affiliation(s)
- R A Brownbill
- University of Connecticut, School of Allied Health, Storrs, USA
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18
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Efstathiadou Z, Koukoulis G, Stakias N, Challa A, Tsatsoulis A. Apolipoprotein E polymorphism is not associated with spinal bone mineral density in peri- and postmenopausal Greek women. Maturitas 2005; 48:259-64. [PMID: 15207892 DOI: 10.1016/j.maturitas.2004.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2003] [Revised: 12/16/2003] [Accepted: 01/12/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A number of studies have shown a positive relation between ApoE gene and osteoporosis or fracture risk but this finding has not been uniform in all populations studied. The aim of the present study was to determine the possible effect of ApoE gene polymorphism on spinal bone mineral density and metabolic bone markers in Greek women. METHODS One hundred and forty-seven healthy peri- and postmenopausal women (mean age 54.3 +/- 7.8 years) participated in the study. In all participants, ApoE gene genotype was determined and spinal bone mineral density (BMD) as well as biochemical bone markers were measured. The ApoE genotypes distribution was 0.7% (n = 1) for E2/2, 5.4% (n = 8) for E2/3, 2% (n = 3) for E2/4, 73.5% (n = 108) for E3/3, 16.3% (n = 24) for E3/4 and 2% (n = 3) for E4/4. Participants were divided in two groups according to the presence of the E4 haplotype: E4 carriers (n = 30) and E4 non-carriers (n = 117). RESULTS Spinal BMD was similar in the two groups, after adjusting for age, weight, height and years since menopause (mean +/- S.D., 0.835 +/- 0.16 g/cm2 in E4 non-carriers versus 0.831 +/- 0.16 g/cm2 in E4 carriers, P = 0.99). Serum osteocalcin levels did not differ significantly in the two groups (median (interquartile range, IQR), 0.55 (0.58) nmol/l in E4 non-carriers versus 0.51 (0.43) nmol/l in E4 carriers), whereas urinary hydroxyproline/creatinine ratio was significantly higher in the E4 non-carriers group (median (IQR), 5.18 (6.04) micromol/mmol in E4 non-carriers versus 1.73 (3.45) micromol/mmol in E4 carriers, P < 0.01). Urinary pyridinoline/creatinine and deoxypyridinoline/creatinine ratios, measured in a subgroup of 51 women, were similar between ApoE carriers and non-carriers, respectively (median (IQR), 25.1 (9.3) nmol/mmol in E4 non-carriers versus 21.8 (7) nmol/mmol in E4 carriers and 6.7 (3.1) nmol/mmol in E4 non-carriers versus 7 (2.2) nmol/mmol in E4 carriers). CONCLUSION In conclusion, in a Greek female postmenopausal population, ApoE gene does not seem to play an important role in determining BMD and neither does it affect the majority of metabolic bone markers.
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Affiliation(s)
- Z Efstathiadou
- Division of Endocrinology, Department of Internal Medicine, University of Ioannina School of Medicine, Ioannina, Greece
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19
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Grainger DJ, Reckless J, McKilligin E. Apolipoprotein E Modulates Clearance of Apoptotic Bodies In Vitro and In Vivo, Resulting in a Systemic Proinflammatory State in Apolipoprotein E-Deficient Mice. THE JOURNAL OF IMMUNOLOGY 2004; 173:6366-75. [PMID: 15528376 DOI: 10.4049/jimmunol.173.10.6366] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Apolipoprotein E (apoE) is a 34-kDa glycoprotein involved in lipoprotein transport through interaction with the low-density lipoprotein receptor and related receptors. Recently, it has become clear that apoE binding to its receptors plays a role both in development and in control of the immune system. In this study, we show that apoE modulates the rate of uptake of apoptotic cells by macrophages. In vitro, apoE-deficient macrophages ingest less apoptotic thymocytes (but not latex beads) than wild-type macrophages, and this defect can be corrected by addition of exogenous apoE protein. In vivo, the number of dying macrophages is increased in a range of tissues, including lung and brain. Possibly in response to the larger numbers of persistent apoptotic bodies, the number of live macrophages in these tissues are also increased compared with those of wild-type control mice. In addition to the significant changes in macrophage population dynamics we observed, levels of the proinflammatory cytokine TNF-alpha and the positive acute phase reactant fibrinogen are also elevated in the livers from apoE-deficient mice. In contrast, neither deletion of the gene encoding the LDL receptor nor cholesterol feeding of wild-type mice affected either the number of apoptotic bodies or the number of live macrophages. We conclude that apoE deficiency results in impaired clearance of apoptotic cell remnants and a functionally relevant systemic proinflammatory condition in mice, independent of its role in lipoprotein metabolism. Any similar reduction of apoE activity in humans may contribute to the pathogenesis of a wide range of chronic diseases including atherosclerosis, dementia, and osteoporosis.
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Affiliation(s)
- David J Grainger
- Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Road, Cambridge CB2 2QQ, United Kingdom.
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20
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Long JR, Liu PY, Liu YJ, Lu Y, Shen H, Zhao LJ, Xiong DH, Deng HW. APOE haplotypes influence bone mineral density in Caucasian males but not females. Calcif Tissue Int 2004; 75:299-304. [PMID: 15549644 DOI: 10.1007/s00223-004-0034-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2004] [Accepted: 03/29/2004] [Indexed: 10/26/2022]
Abstract
Low bone mineral density (BMD) is one of the most important risk factors for osteoporosis. Apolipoprotein E (APOE) has been considered as a candidate gene for osteoporosis because of its influence on osteoblast uptake of lipoprotein-borne vitamin K. Using the quantitative transmission disequilibrium test QTDT, we examined linkage and/or association of APOE and BMD at the lumbar spine and the total hip in a sample of 387 Caucasian nuclear families with 715 parents and 953 children. The children were aged 20-50 years and female offspring were premenopausal as well. Four single nucleotide polymorphisms (SNP1-4) in the APOE gene, 4-locus haplotypes and 2-locus haplotypes (epsilon1, epsilon2, epsilon3, epsilon4 isoforms, reconstructed by SNP3 and SNP4) were analyzed. In the whole sample and the female offspring families we found no evidence of linkage or association for either single SNP or haplotype with BMD at the two studied skeletal sites. In the male offspring families, within-family associations were observed at the haplotypes CGTC (P = 0.001), GGTT (P = 0.002), and GATC (P = 0.006) for the lumbar spine BMD, and GATC (P = 0.008) for the total hip BMD. These data suggested that in our studied Caucasian population, APOE may have effects on BMD variation in males but not females. Further studies with a larger sample size are required to confirm such results.
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Affiliation(s)
- Ji-Rong Long
- Osteoporosis Research Center, Creighton University, Omaha, NE 68131, USA
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21
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Sottile V, Seuwen K, Kneissel M. Enhanced marrow adipogenesis and bone resorption in estrogen-deprived rats treated with the PPARgamma agonist BRL49653 (rosiglitazone). Calcif Tissue Int 2004; 75:329-37. [PMID: 15549648 DOI: 10.1007/s00223-004-0224-8] [Citation(s) in RCA: 151] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2003] [Accepted: 02/17/2004] [Indexed: 11/28/2022]
Abstract
Thiazolidinediones are insulin-sensitizing agents and in clinical use for the treatment of type II diabetes. Under specific experimental conditions, these molecules induce adipogenic differentiation of mesenchymal precursor cells at the expense of osteoblasts in vitro, suggesting possible negative effects on the skeleton. We measured effects of the thiazolidinedione BRL49653 on bone tissue of intact and estrogen-deprived skeletally mature adult female Wistar rats (6-9 months old). Weight gain and decreased plasma triglyceride levels confirmed the effectiveness of the treatment. However, no change in bone mass or fat marrow volume was observed in intact rats treated for 8 weeks with 5, 10, or 20 mg/kg of BRL49653. Study of marrow cultures established at necropsy revealed a higher responsiveness to adipogenic differentiation protocols of cultures established from the 10-mg/kg group compared to vehicle control. In a second study, the effects of thiazolidinedione treatment on the skeleton of estrogen-deprived rats were investigated. Application of 10 mg/kg of BRL49653 for 12 weeks resulted in enhanced bone loss (+31%; pQCT) and increased fat marrow volume (+117%; histomorphometry) compared to vehicle-treated OVX control. Interestingly, osteoblast number was comparable in both cases. Bone resorption parameters were significantly increased in the treatment group (+27% osteoclast number, +30% eroded surface). Enhanced bone loss due to treatment was consistently observed in the tibia, femur, and the lumbar spine. Our data indicate that thiazolidinediones may enhance bone loss induced by estrogen deprivation.
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Affiliation(s)
- V Sottile
- Novartis Institutes for Biomedical Research, Novartis Pharma AG, CH-4002, Basel, Switzerland
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22
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Heikkinen AM, Niskanen LK, Salmi JA, Koulu M, Pesonen U, Uusitupa MIJ, Komulainen MH, Tuppurainen MT, Kröger H, Jurvelin J, Saarikoski S. Leucine7 to proline7 polymorphism in prepro-NPY gene and femoral neck bone mineral density in postmenopausal women. Bone 2004; 35:589-94. [PMID: 15336593 DOI: 10.1016/j.bone.2004.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2003] [Revised: 04/02/2004] [Accepted: 05/05/2004] [Indexed: 10/26/2022]
Abstract
Neuropeptide Y (NPY) is a versatile neurotransmitter that has recently been shown to regulate bone metabolism in animal and in vitro studies. We studied the influence of leucine7-to-proline7 (Leu7/Pro7) polymorphism of the NPY signal peptide gene on bone mineral density (BMD) before and after a 5-year hormone replacement therapy (HRT) in 316 early postmenopausal women participating in a randomized controlled trial nested in the population-based Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study. The participants were randomized into two treatment groups: the HRT group (n = 146) received a sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate and calcium lactate, 500 mg/day (equal to 93 mg Ca2+) alone or in combination with vitamin D3, 100-300 IU/day. The non-HRT group (n = 170) received calcium lactate, 500 mg alone or in combination with vitamin D3, 100-300 IU/day. BMDs of the lumbar spine (L2-4) and proximal femur were measured by using dual X-ray absorptiometry (DXA). The frequency of Leu7/Pro7 polymorphism was 15.2%. At baseline, there were no significant differences in the lumbar or femoral neck BMD between the subjects who had Leu7Pro7 polymorphism and the normal subjects. After 5 years, the BMD of the femoral neck remained unaltered and that of the lumbar spine increased by 1.7% in the HRT group, whereas both BMDs were decreased by 4-5% in the non-HRT group. After 5 years, the femoral neck BMD was significantly lower in those with the wild-type NPY polymorphism than in those with Leu7/Pro7 polymorphism (P = 0.040) in the non-HRT group. In the HRT group, the changes in BMD were quite modest and not significantly modified by Leu7/Pro7 genotype. We conclude that the Leu7/Pro7 polymorphism in NPY signal gene may favorably affect femoral neck BMD in postmenopausal women.
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Affiliation(s)
- Anna-Mari Heikkinen
- Department of Obstetrics and Gynecology, Kuopio University Hospital, FIN-70211 Kuopio, Finland
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23
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Schoofs MWCJ, van der Klift M, Hofman A, van Duijn CM, Stricker BHC, Pols HAP, Uitterlinden AG. ApoE gene polymorphisms, BMD, and fracture risk in elderly men and women: the Rotterdam study. J Bone Miner Res 2004; 19:1490-6. [PMID: 15312249 DOI: 10.1359/jbmr.040605] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2003] [Revised: 10/21/2003] [Accepted: 02/19/2004] [Indexed: 11/18/2022]
Abstract
UNLABELLED To study the association between the ApoE gene polymorphism and osteoporosis, we performed an association study in 5,857 subjects from the Rotterdam Study. We did not observe an association between the ApoE polymorphism and osteoporosis in this study, which is thus far the largest study on ApoE and osteoporosis. INTRODUCTION The E*4 allele of the E*2, E*3, E*4 protein isoform polymorphism in the gene encoding apolipoprotein E (ApoE) has previously been associated with an increased fracture risk. We investigated the association between the ApoE polymorphism and BMD, bone loss, and incident fractures as part of the Rotterdam Study a prospective population-based cohort study of diseases in the elderly. MATERIALS AND METHODS The study population consisted of 5,857 subjects (2,560 men; 3,297 women) for whom data on ApoE genotypes, confounding variables, and follow-up of nonvertebral fractures were available. Data on femoral neck and lumbar spine BMD were available for 4,814 participants. Genotype analyses for bone loss (defined as annualized percent change in BMD at the hip and lumbar spine) and BMD were performed using ANOVA. Fractures were analyzed using a Cox proportional-hazards model and logistic regression. All relative risks were adjusted for age and body mass index. RESULTS AND CONCLUSIONS The genotype distribution of the study population was in Hardy-Weinberg equilibrium (p = 0.98) and did not differ by gender. At baseline, mean BMD of the lumbar spine and femoral neck did not differ between the ApoE genotypes of men and women. Bone loss (mean follow-up, 2.0 years) did not differ by ApoE genotype for women and men. During a mean follow-up of 6.6 years, 708 nonvertebral fractures (198 hip fractures and 179 wrist fractures) and 149 incident vertebral fractures occurred. No consistent differences in the distribution of alleles could be observed between subjects with or without these fractures. Our data do not support the hypothesis that the ApoE*4 risk allele is associated with BMD, increased bone loss, or an increased risk of osteoporotic fractures.
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Affiliation(s)
- Mariette W C J Schoofs
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 300 DR, The Netherlands
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24
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Abstract
Several conclusions can be drawn from this article, the most important of which are as follows: 1. Low bone mass is widely prevalent among older men and women and is associated with important fracture consequences. 2. The prevalence of osteoporosis and fracture is projected to increase over the next several decades. 3. Although Caucasian women are at greatest risk, substantial numbers of men and women of non-Caucasian heritage are also affected. 4. The population burden of disease consequences, including mortality, morbidity, and social and personal cost, is anticipated to increase as well. 5. In the group at greatest risk (Caucasian women), osteoporosis and fracture have well-established risk factors, many of which are modifiable. 6. Relevance of these risk factors for groups other than Caucasian women appears likely but requires further investigation. 7. Personal and societal costs associated with osteoporosis are enormous; as such, identification of persons at risk and prevention and treatment of this disease should be public health priorities.
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Affiliation(s)
- Lois E Wehren
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 West Redwood Street, Suite 200, Baltimore, MD 21201, USA.
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25
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Alagiakrishnan K, Juby A, Hanley D, Tymchak W, Sclater A. Role of vascular factors in osteoporosis. J Gerontol A Biol Sci Med Sci 2003; 58:362-6. [PMID: 12663699 DOI: 10.1093/gerona/58.4.m362] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Osteoporosis is a silent epidemic in the world today. With the increase in the elderly population, there will be an increase in the prevalence of osteoporosis, and so the need for focused preventive strategies should become a public health priority. Prophylactic therapy and risk-factor reduction is important, as this is likely to be cost effective. There are scientific observations that point out that vascular dysfunction seen with aging may be related to the pathogenesis of osteoporosis. Here we review this relationship from a different angle. We think aggressive control of vascular risk factors in addition to the known existing osteoporosis risk factors may help to reduce the morbidity and mortality associated with this disease.
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26
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Zajícková K, Zofková I, Hill M, Horínek A, Nováková A. Apolipoprotein E 4 allele is associated with low bone density in postmenopausal women. J Endocrinol Invest 2003; 26:312-5. [PMID: 12841538 DOI: 10.1007/bf03345178] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Apolipoprotein E (Apo E) genotypes have been associated with a number of involutional disorders. Recently some studies have examined whether the Apo E 4 allele might play a role in the pathophysiology of postmenopausal osteoporosis. However, association analysis between Apo E genotypes, BMD, bone loss or fracture risk have not brought universal findings. The aim of this study was, therefore, to determine the relationship between the presence or absence of Apo E 4 allele and BMD in postmenopausal women of Caucasian origin. We studied 113 women, age 62.5 +/- 8.9 yr, who underwent measurement of hip and spine BMD by dual-energy absorptiometry (DXA, g/cm2). Apo E genotypes were assessed by PCR amplification and by restriction typing with Cfol enzyme. The Apo E allele frequencies in the study population were as follows: E2 0.084, E3 0.845, E4 0.071. Because the Apo E 4 allele was associated with osteoporosis in previous studies, the probands were dichotomized by the presence or absence of Apo E 4 allele. After adjustment for BMI and years since menopause BMD at the lumbar spine varied significantly by Apo E 4 status. Women with Apo E 4 allele had significantly lower BMD at the lumbar spine than women with no Apo E 4 allele (p<0.003, ANCOVA). In contrast, there were no significant differences in BMD at the hip comparing women with or without the Apo E 4 allele. To conclude, these data may support the importance of Apo E 4 allele in determining postmenopausal spine bone mass.
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Affiliation(s)
- K Zajícková
- Institute of Endocrinology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
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27
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Abstract
Osteoporosis has a strong genetic component, and clinical studies have shown that heritable factors play a key role in regulating bone mineral density, ultrasound properties of bone, skeletal geometry, and bone turnover and contribute to the pathogenesis of osteoporotic fracture. In most cases, osteoporosis is caused by the combined effects of several different genes and their interaction with environmental influences, but it can occasionally occur as the result of mutations in a single gene. Genes that have been implicated in the regulation of bone mass in humans include the genes encoding lipoprotein receptor-related protein 5, sclerostin, transforming growth factor beta-1, collagen Ialpha1, vitamin D receptor, tumor necrosis factor receptor 2, and the estrogen receptor alpha. From a clinical standpoint, advances in knowledge about the genetic basis of osteoporosis are important because they offer the prospect of developing genetic markers for the assessment of fracture risk and the opportunity to identify molecules that will be used as targets for the design of new drugs for the prevention and treatment of bone disease.
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Affiliation(s)
- Omar M E Albagha
- Department of Medicine and Therapeutics, University of Aberdeen Medical School, Aberdeen AB25 2ZD, UK.
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Wilson SG, Reed PW, Bansal A, Chiano M, Lindersson M, Langdown M, Prince RL, Thompson D, Thompson E, Bailey M, Kleyn PW, Sambrook P, Shi MM, Spector TD. Comparison of genome screens for two independent cohorts provides replication of suggestive linkage of bone mineral density to 3p21 and 1p36. Am J Hum Genet 2003; 72:144-55. [PMID: 12478480 PMCID: PMC378619 DOI: 10.1086/345819] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2002] [Accepted: 10/24/2002] [Indexed: 02/01/2023] Open
Abstract
Low bone mineral density (BMD) is a major risk factor for osteoporotic fracture. Studies of BMD in families and twins have shown that this trait is under strong genetic control. To identify regions of the genome that contain quantitative trait loci (QTL) for BMD, we performed independent genomewide screens, using two complementary study designs. We analyzed unselected nonidentical twin pairs (1,094 pedigrees) and highly selected, extremely discordant or concordant (EDAC) sib pairs (254 pedigrees). Nonparametric multipoint linkage (NPL) analyses were undertaken for lumbar spine and total-hip BMD in both cohorts and for whole-body BMD in the unselected twin pairs. The maximum evidence of linkage in the unselected twins (spine BMD, LOD 2.7) and the EDAC pedigrees (spine BMD, LOD 2.1) was observed at chromosome 3p21 (76 cM and 69 cM, respectively). These combined data indicate the presence, in this region, of a gene that regulates BMD. Furthermore, evidence of linkage in the twin cohort (whole-body BMD; LOD 2.4) at chromosome 1p36 (17 cM) supports previous findings of suggestive linkage to BMD in the region. Weaker evidence of linkage (LOD 1.0-2.3) in either cohort, but not both, indicates the locality of additional QTLs. These studies validate the use, in linkage analysis, of large cohorts of unselected twins phenotyped for multiple traits, and they highlight the importance of conducting genome scans in replicate populations as a prelude to positional cloning and gene discovery.
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Affiliation(s)
- S. G. Wilson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - P. W. Reed
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - A. Bansal
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - M. Chiano
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - M. Lindersson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - M. Langdown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - R. L. Prince
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - D. Thompson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - E. Thompson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - M. Bailey
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - P. W. Kleyn
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - P. Sambrook
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - M. M. Shi
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
| | - T. D. Spector
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; Sequenom, San Diego; LifeSciences Advisory Group LLC, Wellesley, MA; Institute of Bone and Joint Research, University of Sydney, Sydney; Twin and Genetic Epidemiology Research Unit, St Thomas’ Hospital, London
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Lui LY, Stone K, Cauley JA, Hillier T, Yaffe K. Bone loss predicts subsequent cognitive decline in older women: the study of osteoporotic fractures. J Am Geriatr Soc 2003; 51:38-43. [PMID: 12534843 DOI: 10.1034/j.1601-5215.2002.51007.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To determine whether the rate of bone loss predicts subsequent cognitive decline independently of baseline bone mass and whether apolipoprotein E (ApoE) genotype explains the association. DESIGN A prospective cohort study. SETTING Clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Pittsburgh, Pennsylvania; and Portland, Oregon. PARTICIPANTS Four thousand four hundred sixty-two women aged 70 and older (mean = 75.8) participating in the Study of Osteoporotic Fractures. MEASUREMENTS Total hipbone mineral density (BMD) was measured 2 and 6 years after enrollment (mean follow-up = 3.5 years), and expressed as annualized percentage rate of bone change. A modified Mini-Mental State Examination (mMMSE) was administered at 6 and 10 years (mean follow-up = 4.5 years) and defined cognitive decline as a decline of three or more points on repeat mMMSE score. ApoE genotype information was available on 883 women. RESULTS Cognitive decline occurred in 12% of the women with the least bone loss (by quartile), 14% in the second, 16% in the third, and 20% in those with the greatest bone loss. After adjustment for age, education, stroke, functional status, estrogen use, body mass index, and smoking, the results were similar. Those who lost the most BMD were almost 40% more likely than women in the lowest quartile to develop cognitive decline in the multivariate model (odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.1-1.8). A similar association between hipbone loss and cognitive decline was observed in the multivariate model further adjusting for ApoE e4 (OR = 1.5, 95% CI = 0.8-2.7). CONCLUSIONS Women with more rapid hipbone loss were more likely to develop cognitive decline than those who had lower rate of loss (or who gained bone mass). Differences in functional status, estrogen use, and ApoE did not explain this association. Further investigation is needed to determine the mechanisms that link osteoporosis and cognitive decline.
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Affiliation(s)
- Li-Yung Lui
- Department of Medicine, University of California at San Francisco, San Francisco, California 94105, USA.
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Abstract
Osteoporosis is a common multifactorial disorder of reduced bone mass. The disorder in its most common form is generalized, affecting the elderly, both sexes, and all racial groups. Multiple environmental factors are involved in the pathogenesis. Genes also play a major role as reflected by heritability of many components of bone strength. Quantitative phenotypes in bone strength in the normal population do not conform to a monogenetic mode of inheritance. The common form of osteoporosis is generally considered to be a polygenic disorder arising from the interaction of common polymorphic alleles at quantitative trait loci, with multiple environmental factors. Finding the susceptibility genes underlying osteoporosis requires identifying specific alleles that coinherit with key heritable phenotypes in bone strength. Because of the close correspondence among mammalian genomes, identification of the genes underlying bone strength in mammals such as the mouse is likely to be of major assistance in human studies. Identification of susceptibility genes for osteoporosis is one of several important approaches toward the long-term goal of understanding the molecular biology of the normal variation in bone strength and how it may be modified to prevent osteoporosis. As with all genetic studies in humans, these scientific advances will need to be made in an environment of legal and ethical safeguards that are acceptable to the general public.
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Affiliation(s)
- Munro Peacock
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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Human Apolipoprotein E concentration in response to diseases and therapeutic treatments. Drug Dev Res 2002. [DOI: 10.1002/ddr.10065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
A genetic component clearly contributes to bone mass determination by influencing peak bone mass acquisition or, to a lesser degree, bone loss later in life. The analysis of genetic markers for osteoporosis is complex because multiple genes are involved and because osteoporosis is a multifactorial disease. The influence of a number of candidate gene alleles on bone mass has been studied in various populations. Results have been inconsistent and, at times, contradictory, as illustrated by studies on the vitamin D receptor gene. The most conclusive finding is the association linking the Sp1 polymorphism of type I collagen to bone mineral density and osteoporotic fractures. Polymorphisms of other genes either have very little influence or remain unexplored. In all likelihood, the best predictive value will be obtained by using a combination of several gene polymorphisms.
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Affiliation(s)
- S Roux
- Rheumatology Department, CHU de Bicêtre, Le Kremlin-Bicetre, France
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Abstract
Menopause is the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is estimated that perhaps 50 million women worldwide will go into menopause annually. Atherosclerotic cardiovascular disease, osteoporotic fractures and Alzheimer's dementia are common chronic disorders after menopause, representing major health problems in most developed countries. Apart from being influenced by environmental factors, these chronic disorders recognize a strong genetic component, and there are now considerable clinic evidences that these disorders are related to low hormonal milieu of postmenopausal women. Here, we review up-to-date available data suggesting that genetic variation may contribute to higher susceptibility to four sporadic chronic syndromes such as osteoporosis (OP), osteoarthritis (OA), Alzheimer's disease (AD) and coronary artery disease (CAD). For these four syndromes candidate genes that today appear as major loci in genetic susceptibility encode for proteins specific of a given system, as the vitamin D receptor (VDR) gene for the skeleton and, therefore, OP or angiotensin converting enzyme (ACE) for the cardiovascular system and, therefore, CAD. The investigation of gene polymorphisms in various pathological conditions typical of postmenopause offer an explanation not only of their genetic inheritance but also of their co-segregation in given individuals. In this view, it may be possible to identify a common set of genes whose variants contribute to a common genetic background for these different disorders. Ideal candidates appear genes of the estrogen response cascade [i.e. estrogen receptor (ERs), enzymes involved in estrogen metabolism or co-activators and co-inhibitors]. All together this information may represent the basis both for future recognition of individuals at risk and for the pharmacogenetic driving of drug responsiveness.
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Affiliation(s)
- F Massart
- Scuola Superiore S. Anna of Pisa, Pisa, Italy
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D'Amelio P, Pescarmona GP, Gariboldi A, Isaia GC. High density lipoproteins (HDL) in women with postmenopausal osteoporosis: a preliminary study. Menopause 2001; 8:429-32. [PMID: 11723416 DOI: 10.1097/00042192-200111000-00008] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Since a previous study showed an inverse correlation between high density lipoproteins (HDL) and bone mineral density (BMD), we searched for a possible relationship between HDL level and the presence of postmenopausal osteoporosis. DESIGN We measured HDL levels in 37 women with postmenopausal osteoporosis, and compared them with a control group of 43 healthy postmenopausal women. The HDL levels were compared between the two groups using Student's t test and were correlated with BMD by Pearson's coefficient. To avoid possible selection bias, we compared patients and controls for body mass index by chi 2 test. The sensitivity and specificity of HDL level higher than 65 mg% (positive test) or lower than 45 mg% (negative test) was compared with double emission x-ray absorptiometry (considered the gold standard in the measurement of BMD). RESULTS The level of HDL was significantly higher in the osteoporotic patients than in the controls (67.7 +/- 15.5 mg% vs 58.3 +/- 11.6 mg%, p = 0.0039). HDL was inversely correlated with BMD (r = -0.29, p = 0.0083). HDL higher than 65 mg% has a high specificity (77%) for patients with osteoporosis, while HDL lower than 45 mg% has a high sensitivity (97%) in detecting subject without osteoporosis. CONCLUSIONS Our preliminary data suggest an interesting, as yet unexplained association between HDL and bone mineral density in postmenopausal women.
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Affiliation(s)
- P D'Amelio
- Department of Internal Medicine, University of Torino, Italy
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Gerdes LU, Vestergaard P, Hermann AP, Mosekilde L. Regional and hormone-dependent effects of apolipoprotein E genotype on changes in bone mineral in perimenopausal women. J Bone Miner Res 2001; 16:1906-16. [PMID: 11585357 DOI: 10.1359/jbmr.2001.16.10.1906] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We studied 479 perimenopausal Danish women aged 45-58 years to examine differences between APOE genotypes with respect to (1) baseline total body bone mineral density (BMD) and densities measured in five different regions (ultradistal forearm, proximal forearm, lumbar spine, femoral neck, and total hip region); (2) serum levels of alkaline phosphatase, bone isoenzyme alkaline phosphatase, osteocalcin, parathyroid hormone (PTH), 25-hydroxyvitamin D, and urine hydroxyproline/creatinine excretion ratio; and (3) changes in bone mineral during 5 years of follow-up. Baseline BMDs were identical, whereas serum levels of alkaline phosphatase and its bone isoenzyme were higher in women with APOE 2-2 and APOE 2-3 than in women with APOE 3-3 and APOE 3-4 and lower in women with APOE 4-4. Among women not receiving hormonal-replacement therapy (HRT; n = 262), those with APOE 2-2 and APOE 2-3 had 30-40% lower rates of femoral neck and total hip bone mineral loss than women with APOE 3-3 and APOE 3-4, whereas the rates of mineral loss in other skeletal regions did not differ between these APOE genotypes. Women with APOE 4-4 appeared to have lower rates of bone mineral loss in all regions. Women treated with hormones throughout the follow-up period (n = 113) gained bone mineral, and women with APOE 3-4 and APOE 4-4 gained relatively more mineral than other women. A comparison of untreated and treated women with APOE 2-3, APOE 3-3, and APOE 3-4 suggests a possible modification of the effect of APOE genotype by HRT. In conclusion, the common APOE polymorphism has a complex effect on bone metabolism in perimenopausal Danish women including possible modification by hormone use: (1) among women not receiving HRT, those with APOE*2 have lower bone mineral losses in the femoral neck and hip region than other women, and (2) among women receiving HRT, those with APOE*4 gain more bone mineral than other women.
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Affiliation(s)
- L U Gerdes
- Department of Internal Medicine and Cardiology, Aarhus University Hospital, Denmark
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Affiliation(s)
- E E Hobson
- Department of Medicine and Therapeutics, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
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Influence des apports en oligoéléments, protéines, lipides, glucides et vitamines sur le métabolisme osseux. ACTA ACUST UNITED AC 2000. [DOI: 10.1016/s1169-8330(00)00006-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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38
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Siest G, Bertrand P, Herbeth B, Vincent-Viry M, Schiele F, Sass C, Visvikis S. Apolipoprotein E polymorphisms and concentration in chronic diseases and drug responses. Clin Chem Lab Med 2000; 38:841-52. [PMID: 11097338 DOI: 10.1515/cclm.2000.122] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Apolipoprotein (apo) E is an important circulating and tissue protein involved in cholesterol homeostasis and many other functions. The common polymorphism in the coding region of the gene, four polymorphisms in the promoter region, other additional single nucleotide polymorphisms, as well as several apo E variants have been identified. The common coding polymorphism strongly influences the lipid metabolism and the circulating concentration of apo E itself. This polymorphism is at the origin of the implication of apo E in cardiovascular and neurodegenerative diseases, but also of the relation of apo E with longevity. Probably due to its many metabolic and functional consequences, apo E polymorphism has been shown to influence the responses of patients to several drugs (fibrates, statins, hormone replacement therapy, anti-Alzheimer drugs) or environmental interventions (black tea, alcohol, diet). Apo E genotyping may be clinically helpful in defining the risk of patients and their responses to therapeutics. Finally, circulating apo E concentration appears to be altered in diseases and can be modulated by some of the drugs cited above. This parameter can thus also give interesting clinical information and could be a therapeutic target, providing it is validated. At the present time, we cannot exclude that apo E concentration may be the most prominent apo E parameter to be considered in health and disease, while apo E polymorphisms would represent only secondary parameters influencing apo E concentration.
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Affiliation(s)
- G Siest
- Centre de Médecine Préventive, Université Henri Poincaré Nancy I, INSERM U525, Vandoeuvre-lès-Nancy, France.
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