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Korean Journal of Obstetrics & Gynecology 2003;46(5):984-990.
Published online May 1, 2003.
The Relationship between Vitamin D Receptor Gene Polymorphisms and the Effect of Hormone Replacement Therapy on Bone Mineral Density in Postmenopausal Korean Women.
Jung Gu Kim, Seok Hyun Kim, Young Min Choi, Shin Yong Moon, Jin Yong Lee
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Abstract
OBJECTIVE
to investigate whether vitamin D receptor (VDR) gene polymorphisms are associated with the effect of hormone replacement therapy (HRT) on bone mineral density (BMD) in postmenopausal Korean women. METHODS: The BsmI, ApaI, and TaqI polymorphisms were analyzed by restriction fragment length polymorphism (RFLP) and poly (A) polymorphism by GeneScan and direct DNA sequencing in 304 postmenopausal Korean women who received sequential HRT for 1 year. Serum bone alkaline phosphatase, CrossLaps, osteocalcin and 1,25 (OH)2 vitamin D3 levels were measured by immunoassay and BMD at the lumbar spine and femoral neck by dual energy X-ray absorptiometry before and after HRT of 1 year. RESULTS: The BsmI and TaqI polymorphisms were significantly associated with annual percentage changes in BMD at the lumbar spine. The bb and TT genotype showed a significantly lower percentage changes in BMD of lumbar spine than the Bb and Tt genotype. Annual percentage change in BMD at the lumbar spine was significantly lower in the bT haplotype homozygote women than in women who did not bT haplotype allele, but the bT haplotype genotypes were not distributed differently among HRT-responders and HRT-nonresponders (women who lose more than 3% of bone mass per year). No significant association between annual BMD changes in at all skeletal site and the ApaI or poly (A) polymorphism was observed. There were no significant differences in the 6 month percentage changes in 1,25 (OH)2 vitamin D3 or bone turnover markers among any of the genotypes analyzed. CONCLUSIONS: The VDR bT haplotype allele is associated with the effect of HRT on BMD at the lumbar spine in Korean women.
Key Words: Postmenopausal women, VDR gene polymorphism, BMD change, HRT


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