title: The implication of assessing a polymorphism in estrogen receptor alpha gene in the risk assessment of osteoporosis using a screening tool for osteoporosis in Asians.
abstract: Both genetic and environmental factors interact to determine bone mass and the risk for developing postmenopausal osteoporosis. Recently, an Asian-specific tool, the Osteoporosis Self-Assessment Tool for Asians (OSTA), has been developed to assess the risk of osteoporosis in women. An index is calculated by multiplying the difference in body weight in kilograms and age in years by 0.2 and disregarding the decimal digits. The risk of osteoporosis is classified as high, intermediate or low according to the OSTA index less than -4, -4 to -1 and greater than -1. In the present study we examined how a single nucleotide polymorphism (SNP) in exon 8 of the estrogen receptor alpha (ERalpha) gene affected the predictive value of the OSTA index. Subjects consisted of 358 postmenopausal women who were at least 55 years old. BMDs were measured by DXA, and the SNP in the ERalpha gene was assessed by PCR-RFLP. When considering both the OSTA index and ERalpha genotype in a logistic regression model, it was found that both the OSTA index and the ERalpha genotype independently contributed to the risk of osteoporosis. The odds ratios were 1.58 (95% CI 1.26-1.91) and 2.51 (95% CI 1.42-4.44) for one unit decrement in the OSTA index and each copy of the A allele of the ERalpha genotype, respectively. The joint effect conformed more to a multiplicative model of interaction than an additive model. This suggests that persons with the high-risk genotype are at far greater risk of developing osteoporosis with advancing age or decreasing body weight, the two variables from which the OSTA index is derived. Targeting preventive measures for osteoporosis subjects with risk factors and also disease-susceptibility alleles is likely to be more cost effective.
authors.affiliation: Department of Medicine and Research Center, Ramathibodi Hospital, Mahidol University, Rama 6 Rd, Rajthevi, 10400 Bangkok, Thailand. rabpk@mahidol.ac.th
authors.forename: Boonsong
authors.initials: B
authors.lastname: Ongphiphadhanakul
authors.forename: Suwannee
authors.initials: S
authors.lastname: Chanprasertyothin
authors.forename: Penpan
authors.initials: P
authors.lastname: Payattikul
authors.forename: Sunee
authors.initials: S
authors.lastname: Saetung
authors.forename: Rajata
authors.initials: R
authors.lastname: Rajatanavin
mesh_terms: D000368:Aged; D044466:Asian People; D015519:Bone Density; D047628:Estrogen Receptor alpha; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000208:ethnology / Q000235:genetics* / Q000503:physiopathology; D011110:Polymorphism, Genetic; D015995:Prevalence; D011960:Receptors, Estrogen / Q000235:genetics*; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology
chemical_list: D047628:Estrogen Receptor alpha; D011960:Receptors, Estrogen