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- Title
Estrogen Receptor (ER) Gene Polymorphism May Predict the Bone Mineral Density Response to Raloxifene in Postmenopausal Women on Chronic Hemodialysis.
- Authors
Heilberg, Ita Pfeferman; Hernandez, Eddy; Alonzo, Evelyn; Valera, Raquel; Ferreira, Larissa Gorayb; Gomes, Samirah Abreu; Bellorin-Font, Ezequiel; Weisinger, Jose R.
- Abstract
The estrogen receptor (ER) gene has been considered as a candidate genetic marker for osteoporosis, and PvuII and XbaI polymorphisms of the ERα gene have been associated with low bone mineral density (BMD). We investigated whether ER polymorphism could predict the response of BMD in 28 postmenopausal women on hemodialysis with marked osteopenia or osteoporosis, randomized to receive raloxifene, a selective estrogen receptor modulator (SERM), or placebo for 1 year. BMD was assessed by dual X-ray absorptiometry and PvuII and XbaI restriction fragment-length polymorphism of the ER gene was determined using polymerase chain reaction. Baseline lumbar spine or femoral neck BMD parameters were not different between patients presenting either homozygous PP or xx when compared with heterozygous Pp or Xx genotypes. After 1 year, patients on raloxifene, presenting with PP or xx genotypes (but not those with Pp or Xx), showed a significantly higher mean lumbar spine BMD (0.942±0.18 vs. 0.925± 0.17g/cm², p<.01) and lower serum pyridinoline (19.7±9.7 vs. 30.6±16.5 nmol/L, p<.02) when compared with baseline values. No changes were detected in the placebo-treated patients or in the femur neck sites. In conclusion, after 1 year on raloxifene, postmenopausal osteoporotic women on chronic hemodialysis, homozygous for the P or x (PP or xx) alleles of the ER, exhibited a better lumbar spine BMD response and decreased serum pyridinoline values when compared with heterozygous women (Pp or Xx), suggesting that ERα allelic variants may explain, at least in part, the different outcomes after treatment of osteoporosis with SERM.
- Subjects
SELECTIVE estrogen receptor modulators; OSTEOPOROSIS; ISOHORMONES; HEMODIALYSIS; OSTEOPENIA; BONE diseases
- Publication
Renal Failure, 2005, Vol 27, Issue 2, p155
- ISSN
0886-022X
- Publication type
Academic Journal
- DOI
10.1081/jdi-48241