Objective: To examine factors, in addition to bone mineral density (BMD), such as the common calcium-sensing receptor (CASR) gene polymorphisms, associated with vertebral fracture (VFx) risk in primary hyperparathyroidism (PHPT). . Design and Methods: Cross-sectional analysis of 266 Caucasian PHPT seen as outpatients. Calcium (sCa)-phosphate metabolism parameters were measured. BMD was assessed by dual-energy X-ray absorptiometry (DXA, expressed as Z-Score) at lumbar spine (Z-LS) and femoral neck (Z-FN), morphometric VFx by radiograph and CASR A986S/R990G genotypes by PCR amplification and genomic DNA sequencing. Results: Fractured patients (n=100, 37.6%) had lower sCa (10.8±0.7 mg/dL) and Z-LS BMD (-1.0±1.44), higher age (61±10 yrs) and prevalence (51%) of ≥1 S alleles of the CASR A986S single nucleotide polymorphism (SNP; AS/SS), than those not fractured (n =166, 11.2±1.0 mg/dL, -0.57±0.97, 58±13 yrs and 38% AS/SS, respectively, P<0.05 for all comparisons). Logistic regression, with VFx as dependent variable, showed independent risks associated with increased age (OR 1.03, 95% CI 1.01 - 1.06, P=0.006), decreased sCa (OR 1.86, 95% CI 1.28 - 2.7, P=0.001) and Z-LS BMD (OR 1.4, 95% CI 1.12 - 1.7, P=0.002) and presence of AS/SS (OR 1.8, 95% CI 1.1 - 2.9, P=0.05). The presence of two out of three (age ≥58 yr, sCa <10.8 and Z-LS BMD ≤ -1.0, and AS/SS genotype,) gave an overall OR of 4.2, 95% CI 2.25 - 7.85, P<0.0001). Conclusions: In PHPT, VFx is associated positively with age, negatively with sCa and spinal BMD, and presence of at least one copy of the CASR A986S SNP.
Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism / C., Eller Vainicher; C., Battista; V., Guarnieri; S., Muscarella; S., Palmieri; A. S., Salcuni; G., Guglielmi; S., Corbetta; Minisola, Salvatore; A., Spada; G. N., Hendy; D. E. C., Cole; I., Chiodini; A., Scillitani. - In: EUROPEAN JOURNAL OF ENDOCRINOLOGY. - ISSN 1479-683X. - STAMPA. - 171:3(2014), pp. 399-406. [10.1530/eje-14-0343]
Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism.
MINISOLA, Salvatore;
2014
Abstract
Objective: To examine factors, in addition to bone mineral density (BMD), such as the common calcium-sensing receptor (CASR) gene polymorphisms, associated with vertebral fracture (VFx) risk in primary hyperparathyroidism (PHPT). . Design and Methods: Cross-sectional analysis of 266 Caucasian PHPT seen as outpatients. Calcium (sCa)-phosphate metabolism parameters were measured. BMD was assessed by dual-energy X-ray absorptiometry (DXA, expressed as Z-Score) at lumbar spine (Z-LS) and femoral neck (Z-FN), morphometric VFx by radiograph and CASR A986S/R990G genotypes by PCR amplification and genomic DNA sequencing. Results: Fractured patients (n=100, 37.6%) had lower sCa (10.8±0.7 mg/dL) and Z-LS BMD (-1.0±1.44), higher age (61±10 yrs) and prevalence (51%) of ≥1 S alleles of the CASR A986S single nucleotide polymorphism (SNP; AS/SS), than those not fractured (n =166, 11.2±1.0 mg/dL, -0.57±0.97, 58±13 yrs and 38% AS/SS, respectively, P<0.05 for all comparisons). Logistic regression, with VFx as dependent variable, showed independent risks associated with increased age (OR 1.03, 95% CI 1.01 - 1.06, P=0.006), decreased sCa (OR 1.86, 95% CI 1.28 - 2.7, P=0.001) and Z-LS BMD (OR 1.4, 95% CI 1.12 - 1.7, P=0.002) and presence of AS/SS (OR 1.8, 95% CI 1.1 - 2.9, P=0.05). The presence of two out of three (age ≥58 yr, sCa <10.8 and Z-LS BMD ≤ -1.0, and AS/SS genotype,) gave an overall OR of 4.2, 95% CI 2.25 - 7.85, P<0.0001). Conclusions: In PHPT, VFx is associated positively with age, negatively with sCa and spinal BMD, and presence of at least one copy of the CASR A986S SNP.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
