Nephrology Dialysis Transplantation, Vol 13, Issue 8 2077-2080, Copyright © 1998 by Oxford University Press
H Karkoszka, J Chudek, P Strzelczyk, A Wiecek, H Schmidt-Gayk, E Ritz and F Kokot
Background. It has been suggested that the vitamin D
receptor (VDR) gene BsmI-polymorphism is a genetic determinant of bone
metabolism. Design. To test this hypothesis, the
relationship between VDR genotypes, bone mineral density (baseline and
after 18 months) and parameters of calcium metabolism and bone turnover
were investigated prospectively in 88 haemodialysed patients not receiving
active vitamin D metabolites. Methods. Whole body,
lumbar spine and femoral neck bone mineral density (BMD) were assessed by
dual energy X-ray absorptiometry (DEXA). In addition calcium, phosphorus,
25(OH)D3, 1,25(OH)2D3, osteocalcin serum concentrations, alkaline
phosphatase activity and intact, 1,84 PTH levels were measured.
Results. VDR genotype BB, Bb and bb were found in 27,
49 and 24% of patients. Initial BMD (g/cm2) of whole
body, lumbar spine and femoral neck did not differ between genotypes (whole
body: BB 1.055 ± 0.120, Bb 1.082 ± 0.102, bb 1.128
± 0.120; lumbar spine: BB 1.075 ± 0.199, Bb 1.079
± 0.185, bb 1.099 ± 0.170; femoral neck: BB 0.808
± 0.160, Bb 0.862 ± 0.127, bb 0.842 ±
0.125; mean ± SD), but the decrease of whole body and femoral
neck BMD during 18 months was significantly (P
< 0.02) different between the genotype groups (whole body: BB -0.048
± 0.028, Bb -0.031 ± 0.029, bb -0.024 ±
0.023; femoral neck BB -0.044 ± 0.069, Bb -0.032 ±
0.081, bb -0.012 ± 0.029 g/cm2).
Conclusions. This preliminary study suggests faster
mineral loss in BB genotype of VDR in haemodialysed patients.
Keywords: bone mineral density; haemodialysis; vitamin
D receptor gene polymorphism
PRELIMINARY REPORTS
Does the vitamin D receptor genotype predict bone mineral loss in haemodialysed patients?
Department of Nephrology, Endocrinology and Metabolic Diseases, Silesian University School of Medicine, Katowice, Poland; Department of Nephrology, Ruprecht-Karl University and Endocrine Laboratory, Laboratory Group, Heidelberg, Germany; Correspondence to: F Kokot, Department of Nephrology, Endocrinology and Metabolic Diseases, Silesian University School of Medicine, ul. Francuska 20/24, 40-027 Katowice, Poland
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