title: Secondary hyperparathyroidism is associated with vitamin D receptor polymorphism and bone density after renal transplantation.
abstract: Immunosuppresive treatment and secondary hyperparathyroidism (SHPT) are considered among the most important pathogenetic factors for post-renal transplant bone disease. The aim of this study was to investigate the relationships among vitamin D receptor (VDR) gene polymorphism, parathyroid hormone (PTH) levels and bone density in renal transplant recipients. We enrolled 75 patients (50 male and 25 female, mean age 47+/-11 years) who had undergone kidney transplantation 53+/-4 months before. All patients underwent an evaluation of the main biochemical parameters of bone metabolism as well bone densitometry. VDR alleles were typed by a PCR assay based on a polymorphic BsmI restriction site. When patients were categorized according to the VDR genotype (BB, Bb, bb), serum creatinine and the cumulative doses of immunosuppressive drugs were similar across the groups. PTH levels higher than 80 pg/ml were found in 53.6% of the patients, with the highest values being detected in the bb VDR genotype (P<0.05). PTH was significantly correlated to urinary NTx values. Bone density was low in the whole population; however, spinal bone density was lower in the bb subgroup (P<0.02). In the whole population, only PTH (P<0.05) and body mass index (P<0.01) were independent predictors of spinal bone density. Grouping patients by the VDR gene polymorphism, only PTH continued to be an independent predictor of spinal bone density in the bb allele subgroup (R(2) Adj.=0.17). We can conclude that the VDR genotype polymorphism affects bone density of renal transplant recipients via its effects on the severity of SHPT.
authors.affiliation: Service of Nuclear Medicine, S. Maria della Misericordia Rovigo Hospital, Istituto Oncologico Veneto, Viale Tre Martiri, 140, I-45100 Rovigo, Italy. domenico.rubello@libero.it
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
authors.forename: Angela
authors.initials: A
authors.lastname: D'Angelo
authors.forename: Martino
authors.initials: M
authors.lastname: Nobile
authors.forename: Gianni
authors.initials: G
authors.lastname: Carraio
authors.forename: Paolo
authors.initials: P
authors.lastname: Rigotti
authors.forename: Francesco
authors.initials: F
authors.lastname: Marchini
authors.forename: Martina
authors.initials: M
authors.lastname: Zaninotto
authors.forename: Luca
authors.initials: L
authors.lastname: Dalle Carbonare
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sartori
authors.forename: Otello
authors.initials: O
authors.lastname: Nibale
authors.forename: Angelo
authors.initials: A
authors.lastname: Carpi
mesh_terms: D000328:Adult; D015519:Bone Density; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology* / Q000235:genetics; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D018167:Receptors, Calcitriol / Q000235:genetics*
chemical_list: D018167:Receptors, Calcitriol