[The implementation of personalized treatment for osteoporosis].
OBJECTIVE
To establish personalized treatment of osteoporosis.


METHODS
A T869-->C polymorphism in exon 1 of the transforming growth factor-beta1 gene, which results in a Leu-->Pro substitution at amino acid 10, is reported to be associated with the rate of bone loss as well as the response to active vitamin D treatment. Therefore, we determined this single nucleotide polymorphism (SNP) to estimate the need of active vitamin D treatment. We also determined serum level of 25 hydroxy-vitamin D to evaluate a degree of vitamin D fulfillment. Based on these data, we categorized postmenopausal patients into four groups; C homozygote with vitamin D deficiency patients to whom 1 microg/day active vitamin D was administered, C homozygote without vitamin D deficiency patients or those who bore at least one T-allele with vitamin D deficiency to whom 0.5 microg/day active vitamin D was administered, and patients who bore at least one T-allele without vitamin D deficiency to whom no drug was given. The patients were checked up every 6 months with regard to changes in bone mineral density and occurrence of fresh fractures.


RESULTS
The SNP was associated with prevalent vertebral fractures; the frequency of the T allele was significantly greater in patients with vertebral fractures. Furthermore, the serum level of 25 hydroxy-vitamin D was significantly lower in patients with vertebral fractures, which were observed in 17 out of 34 patients who bore at least one T-allele as well as vitamin D deficiency, while only 2 of 15 homozygous C-allele carriers without vitamin D deficiency suffered from fractures.


CONCLUSIONS
These findings suggest that the SNP in combination with the serum level of 25 hydroxy-vitamin D can predict fracture risk in postmenopausal osteoporosis.
Mori
Seijiro
S
Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital.
Chiba
Yuko
Y
Yamamoto
Seizo
S
Hosoi
Takayuki
T
Horiuchi
Toshiyuki
T
Kamimiya
Fumi
F
Tamura
Yoshiaki
Y
Araki
Atsushi
A
Ito
Hideki
H
D000368:Aged; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy*; D020641:Polymorphism, Single Nucleotide; D053773:Transforming Growth Factor beta1 / Q000235:genetics
D053773:Transforming Growth Factor beta1