Effectiveness of alendronate treatment in postmenopausal women with osteoporosis: relationship with BsmI vitamin D receptor genotypes

• Published in: Clinical endocrinology (Oxford) Vol. 58; no. 3; pp. 365 - 371
• Main Authors: Palomba, Stefano, Numis, Fabio Giuliano, Mossetti, Giuseppe, Rendina, Domenico, Vuotto, Pietro, Russo, Tiziana, Zullo, Fulvio, Nappi, Carmine, Nunziata, Vincenzo
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-03-2003
• Subjects: Aged; Alendronate - therapeutic use; Amino Acids - urine; Biomarkers - blood; Biomarkers - urine; Bone Density; Creatinine - urine; Female; Humans; Lumbar Vertebrae; Middle Aged; Osteocalcin - blood; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - genetics; Osteoporosis, Postmenopausal - physiopathology; Polymorphism, Genetic; Prospective Studies; Receptors, Calcitriol - genetics; Treatment Outcome
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1046/j.1365-2265.2003.01724.x

Summary
objective To assess whether there is a relationship between the effectiveness of alendronate treatment in postmenopausal women with osteoporosis and BsmI vitamin D receptor (VDR) genotypes.
design Prospective baseline‐controlled clinical trial.
patients Sixty‐eight Italian osteoporotic women were enrolled and treated with alendronate at a dose of 10 mg/day for 12 months.
measurements At entry and after treatment, lumbar bone mineral density (BMD) and serum osteocalcin (OC) and urinary deoxypyridinoline/creatinine ratio (DPD‐Cr) levels were evaluated. DNA was extracted from blood and analysed for the BsmI polymorphism of the VDR gene.
results The mean percentage (% ± SD) change from baseline in lumbar BMD was significantly higher (P < 0·01) in bb than in BB BsmI VDR genotypes (7·92 ± 4·31 vs. 3·40 ± 1·81). No significant difference in lumbar BMD was observed in Bb VDR patients (6·01 ± 3·89) in comparison with other groups. The mean percentage of change in serum OC and urinary DPD‐Cr levels was significantly (P < 0·01) lower in individuals with bb than in those with BB BsmI VDR genotypes (−14·34 ± 2·87 vs.−10·39 ± 1·43 and −9·61 ± 5·56 vs.−4·61 ± 2·31). No significant difference in serum OC and urinary DPD‐Cr levels was observed in Bb VDR patients (−12·31 ± 2·11 and −6·52 ± 2·65) in comparison with other groups.
conclusion The different BsmI vitamin D receptor genotypes modify the pharmacological response to alendronate treatment in postmenopausal women with osteoporosis.