Raloxifene administration in post-menopausal women with osteoporosis: effect of different BsmI vitamin D receptor genotypes.
BACKGROUND
The vitamin D receptor (VDR) gene polymorphism has been considered a factor influencing the effectiveness of the anti-osteoporotic treatments. The aim of this study was to correlate the effectiveness of raloxifene treatment in post-menopausal women with osteoporosis to BsmI VDR genotypes.


METHODS
Between January and August 2000, 75 Italian osteoporotic women were enrolled and treated with raloxifene at a dose of 60 mg/day. At entry and after 1 year of treatment, lumbar bone mineral density (BMD), serum osteocalcin (OC) and urinary creatinine-corrected free deoxypyridinoline (DPD) levels were evaluated. DNA was extracted from blood and analysed with restriction endonuclease BsmI for VDR gene.


RESULTS
After treatment, a significant increase in lumbar BMD and a significant reduction in serum OC and urinary DPD levels were observed. The percentage of change (mean +/- SD) in lumbar BMD, and in serum OC and urinary DPD levels was significantly different in homozygous bb (1.58 +/- 0.80, -5.15 +/- 2.36 and -7.71 +/- 2.89 for BMD, OC and DPD respectively) in comparison with BB (4.13 +/- 2.26, -13.59 +/- 4.68 and -15.16 +/- 4.65 for BMD, OC and DPD respectively) BsmI VDR genotypes. Heterozygous Bb VDR patients showed an intermediate percentage (mean +/- SD) of BMD, serum OC and urinary DPD change (2.49 +/- 1.54, -8.69 +/- 2.60 and -10.52 +/- 2.56 for BMD, OC and DPD respectively) not significantly different in comparison with homozygous BB and bb.


CONCLUSIONS
In post-menopausal women with osteoporosis the effectiveness of raloxifene treatment on bone metabolism seems to be controlled by different BsmI VDR genotypes.
Palomba
Stefano
S
Department of Obstetrics & Gynaecology, University of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
Numis
Fabio Giuliano
FG
Mossetti
Giuseppe
G
Rendina
Domenico
D
Vuotto
Pietro
P
Russo
Tiziana
T
Zullo
Fulvio
F
Nappi
Carmine
C
Nunziata
Vincenzo
V
D000368:Aged; D000596:Amino Acids / Q000652:urine; D015519:Bone Density; D004311:Double-Blind Method; D005260:Female; D005838:Genotype; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D008159:Lumbar Vertebrae / Q000378:metabolism; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism; D011110:Polymorphism, Genetic; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D018167:Receptors, Calcitriol / Q000235:genetics*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*
D000596:Amino Acids; D018167:Receptors, Calcitriol; D020845:Selective Estrogen Receptor Modulators; D015675:Osteocalcin; D020849:Raloxifene Hydrochloride; C036020:deoxypyridinoline