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Early Postmenopausal Bone Loss Is Associated with Pvu II Estrogen Receptor Gene Polymorphism in Finnish Women: Effect of Hormone Replacement Therapy
Author(s) -
Salmén Timo,
Heikkinen AnnaMari,
Mahonen Anitta,
Kröger Heikki,
Komulainen Marja,
Saarikoski Seppo,
Honkanen Risto,
Mäenpää Pekka H.
Publication year - 2000
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.2000.15.2.315
Subject(s) - medicine , femoral neck , endocrinology , bone mineral , osteoporosis , hormone replacement therapy (female to male) , estrogen , bone density , population , testosterone (patch) , environmental health
Genetic factors regulate bone mineral density (BMD) and possibly the development of osteoporosis. An association between estrogen receptor (ER) polymorphism, BMD, and postmenopausal hormone replacement therapy (HRT) has not been established. Therefore, we studied the influence of the ER genotype on BMD before and after a 5‐year HRT in a placebo‐controlled, population‐based, randomized group of 322 early postmenopausal women. The participants were randomized into two treatment groups: the HRT group ( n = 145) received a sequential combination of 2 mg estradiol valerate and 1 mg CPA with or without vitamin D 3 , 100–300 IU + 500 mg calcium lactate/day (equal to 93 mg Ca 2+ ), and the non‐HRT group ( n = 177) received calcium lactate, 500 mg alone or in combination with vitamin D 3 , 100–300 IU/day. Pvu II restriction fragment length polymorphism (RFLP) of the ERα was determined using polymerase chain reaction (PCR). BMDs of the lumbar spine (L2–4) and proximal femur were measured by using dual‐energy X‐ray absorptiometry (DXA). At the baseline, there were no significant differences in the lumbar or femoral neck BMDs between the three ER Pvu II genotype groups ( PP,Pp,pp ). After 5 years, the BMD of the femoral neck remained unaltered and that of the lumbar spine increased by 1.7% in the HRT group, whereas both BMDs were decreased by 4–5% in the non‐HRT group. The ER genotype did not modulate the femoral neck BMD change during the follow‐up. In contrast, in the non‐HRT‐group the lumbar spine BMD decreased more in subjects with the ER genotypes PP ( 6.4%) and Pp ( 5.2%) than in subjects with the pp genotype (2.9%) ( p = 0.002). In the HRT group, the relative changes of the lumbar spine BMD were similar in all three ER genotype groups. Thus without HRT, the pp genotype was associated with a smaller decrease in the lumbar spine BMD than the Pp and PP genotypes. Long‐term HRT seemed to eliminate the ER genotype‐related differences in the BMD. We conclude that subjects with the ER PvuII genotypes PP and Pp may have a greater risk of relatively fast bone loss after menopause than those with the pp genotype and that they may preferentially derive benefit from HRT. (J Bone Miner Res 2000;15:315–321)