Abstract
Steroid osteoporosis is a serious medical and economic problem. At the same time, osteoporosis is a polygenic disorder.
Aim: To assess effectiveness of steroid osteoporosis prevention by antiresorptive agents (ARA - Bisphosphonates, Calcitonin) in patients with IPF with different genetic predisposition to osteoporosis.
Subjects: 114 patients with IPF, 19 males, 95 females, age 56.7±10.6 years, treated with Corticosteroids (CS).
Methods: Bone mineral density (BMD) measuring by DEXA, patients' questionnaires and genotyping were used. Genomic DNA was isolated from peripheral leukocytes. We investigated 5 SNPs by PCR-RFLP analysis in 4 genes: vitamin D receptor, collagen type1 alpha1, calcitonin receptor and osteocalcin.
Results: Severity of BMD loss and bone fractures occurrence strongly correlated with CS cumulative dose (p=0.010 and p=0.001, respectively). Multiple regression analysis showed significant influence of only VDR-FokI on BMD (p=0.009), and BGLAP was about significant (p=0.081). Environmental factors, firstly ARA intake, seems to have stronger influence on BMD than genes (adjusted R2=0.065).
Conclusion: ARA administration is necessary for all patients with IPF, irrespectively of genotype. VDR-FokI analysis is useful to reveal subjects with increased risk of osteoporosis in order to more active BMD loss prevention. Further efforts are required to clarify weight of BGLAP.
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