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Erschienen in: Osteoporosis International 5/2015

01.05.2015 | Original Article

RANKL and OPG gene polymorphisms: associations with vertebral fractures and bone mineral density in premenopausal systemic lupus erythematosus

verfasst von: A. C. Bonfá, L. P. C. Seguro, V. Caparbo, E. Bonfá, R. M. R. Pereira

Erschienen in: Osteoporosis International | Ausgabe 5/2015

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Abstract

Summary

Premenopausal women with systemic lupus erythematosus (SLE) have a higher prevalence of low bone mineral density and vertebral fractures. Multiple genetic loci for osteoporotic fracture were identified in recent genome-wide association studies. This study provides a novel data demonstrating that receptor activator of NF-κB ligand (RANKL)/osteoprotegerin (OPG) polymorphisms likely plays an important role in the bone remodeling process in SLE premenopausal women.

Introduction

The purpose of this study was to evaluate single-nucleotide polymorphisms (SNPs) of the RANKL, RANK, and OPG genes in premenopausal SLE patients and their association with sRANKL and OPG serum levels, vertebral fractures, and bone mineral density (BMD).

Methods

A total of 211 premenopausal SLE patients (American College of Rheumatology (ACR) criteria) and 154 healthy controls were enrolled. SNPs of RANKL 290A>G (rs2277438), OPG 1181G>C (rs2073618), 245T>G (rs3134069), 163A>G (rs3102735), and RANK A>G (rs3018362) were obtained by real-time PCR. sRANKL/OPG serum levels were determined by ELISA. BMD and vertebral fractures were evaluated by dual-energy X-ray absorptiometry (DXA).

Results

SLE patients and controls had similar frequencies of the RANKL 290 G allele (p = 0.94), OPG 1181 C allele (p = 0.85), OPG 245 G allele (p = 0.85), OPG 163 G allele (p = 0.78), and RANK G allele (p = 0.87). Further analysis of the SLE patients revealed that the frequency of the RANKL 290 G allele was lower in patients with fractures than that in patients without fractures (28.1 vs 46.9 %, p = 0.01). In addition, the frequency of the OPG 245 G allele was higher in patients with low BMD than that in patients with normal BMD (31.4 vs 18.1 %, p = 0.04). No association of OPG 1181 G>C, OPG 163 A>G, and RANK A>G SNPs with BMD/fractures was found. Additionally, no association was observed between RANKL/OPG/RANK SNPs and sRANKL/OPG serum levels.

Conclusions

Our study provides novel data demonstrating that RANKL/OPG genetic variations appear to play a role in bone remodeling, particularly in its major complication, fracture, in premenopausal patients with SLE.
Literatur
1.
Zurück zum Zitat Lee C, Ramsey-Goldman R (2005) Osteoporosis in systemic lupus erythematosus mechanisms. Rheum Dis Clin North Am 31:363–385CrossRefPubMed Lee C, Ramsey-Goldman R (2005) Osteoporosis in systemic lupus erythematosus mechanisms. Rheum Dis Clin North Am 31:363–385CrossRefPubMed
2.
Zurück zum Zitat Sinigaglia L, Varenna M, Girasole G, Bianchi G (2006) Epidemiology of osteoporosis in in Rheumatic diseases. Rheum Dis Clin North Am 32:631–658CrossRefPubMed Sinigaglia L, Varenna M, Girasole G, Bianchi G (2006) Epidemiology of osteoporosis in in Rheumatic diseases. Rheum Dis Clin North Am 32:631–658CrossRefPubMed
3.
Zurück zum Zitat Pereira RM, Carvalho JF, Canalis E (2010) Glucocorticoid-induced osteoporosis in rheumatic diseases. Clinics (Sao Paulo) 65:1197–1205CrossRef Pereira RM, Carvalho JF, Canalis E (2010) Glucocorticoid-induced osteoporosis in rheumatic diseases. Clinics (Sao Paulo) 65:1197–1205CrossRef
4.
Zurück zum Zitat Regio P, Bonfá E, Takayama L, Pereira R (2008) The influence of lean mass in trabecular and cortical bone in juvenile onset systemic lupus erythematosus. Lupus 17:787–792CrossRefPubMed Regio P, Bonfá E, Takayama L, Pereira R (2008) The influence of lean mass in trabecular and cortical bone in juvenile onset systemic lupus erythematosus. Lupus 17:787–792CrossRefPubMed
5.
Zurück zum Zitat Sinigaglia L, Varenna M, Binelli L, Zucchi F, Ghiringhelli D, Fantini F (2000) Bone mass in systemic lupus erythematosus. Clin Exp Rheumatol 18:S27–S34 Sinigaglia L, Varenna M, Binelli L, Zucchi F, Ghiringhelli D, Fantini F (2000) Bone mass in systemic lupus erythematosus. Clin Exp Rheumatol 18:S27–S34
6.
Zurück zum Zitat Bultink IEM, Lems WF, Kostense PJ, Dijkmans BAC, Voskuyl AE (2005) Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Arthritis & Rheumatism 54:2044–2050CrossRef Bultink IEM, Lems WF, Kostense PJ, Dijkmans BAC, Voskuyl AE (2005) Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Arthritis & Rheumatism 54:2044–2050CrossRef
7.
Zurück zum Zitat Arko B, Prezelj J, Komel R, Kocijancic A, Hudler P, Marc J (2002) Sequence variations in the osteoprotegerin gene promoter in patients with postmenopausal osteoporosis. J Clin Endocrinol Metab 87:4080–4084CrossRefPubMed Arko B, Prezelj J, Komel R, Kocijancic A, Hudler P, Marc J (2002) Sequence variations in the osteoprotegerin gene promoter in patients with postmenopausal osteoporosis. J Clin Endocrinol Metab 87:4080–4084CrossRefPubMed
8.
Zurück zum Zitat Lacey DL, Timms E, Tan HL, Kelley MJ, Dunstan CR, Burgess T et al (1998) Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell 93:165–176CrossRefPubMed Lacey DL, Timms E, Tan HL, Kelley MJ, Dunstan CR, Burgess T et al (1998) Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell 93:165–176CrossRefPubMed
9.
Zurück zum Zitat Mencej-Bedrac S, Prezelj J, Marc J (2011) TNFRSF11B gene polymorphisms 1181G>C and 245T>G as well as haplotype CT influence bone mineral density in postmenopausal women. Maturitas 69:263–267CrossRefPubMed Mencej-Bedrac S, Prezelj J, Marc J (2011) TNFRSF11B gene polymorphisms 1181G>C and 245T>G as well as haplotype CT influence bone mineral density in postmenopausal women. Maturitas 69:263–267CrossRefPubMed
10.
Zurück zum Zitat Bezerra MC, Carvalho JF, Prokopowitsch AS, Pereira RM (2005) RANK, RANKL and osteoprotegerin in arthritic bone loss. Braz J Med Biol Res 38:161–170CrossRefPubMed Bezerra MC, Carvalho JF, Prokopowitsch AS, Pereira RM (2005) RANK, RANKL and osteoprotegerin in arthritic bone loss. Braz J Med Biol Res 38:161–170CrossRefPubMed
11.
Zurück zum Zitat Lane NE (2006) Therapy Insight: osteoporosis and osteonecrosis in systemic lupus erythematosus. Nat Clin Pract Rheumatol 2:562–569CrossRefPubMed Lane NE (2006) Therapy Insight: osteoporosis and osteonecrosis in systemic lupus erythematosus. Nat Clin Pract Rheumatol 2:562–569CrossRefPubMed
12.
Zurück zum Zitat Bhalla AK (2010) Management of osteoporosis in a pre-menopausal woman. Best Pract Res Clin Rheumatol 24:313–327CrossRefPubMed Bhalla AK (2010) Management of osteoporosis in a pre-menopausal woman. Best Pract Res Clin Rheumatol 24:313–327CrossRefPubMed
13.
Zurück zum Zitat Tan W, Wu H, Zhao J, Derber LA, Lee DM, Shadick NA et al (2010) A functional RANKL polymorphism associated with younger age at onset of rheumatoid arthritis. Arthritis Rheum 62:2864–2875CrossRefPubMedCentralPubMed Tan W, Wu H, Zhao J, Derber LA, Lee DM, Shadick NA et al (2010) A functional RANKL polymorphism associated with younger age at onset of rheumatoid arthritis. Arthritis Rheum 62:2864–2875CrossRefPubMedCentralPubMed
14.
Zurück zum Zitat Styrkarsdottir U, Halldorsson BV, Gretarsdottir S, Gudbjartsson DF, Walters GB, Ingvarsson T et al (2008) Multiple genetic loci for bone mineral density and fractures. N Engl J Med 358:2355–2365CrossRefPubMed Styrkarsdottir U, Halldorsson BV, Gretarsdottir S, Gudbjartsson DF, Walters GB, Ingvarsson T et al (2008) Multiple genetic loci for bone mineral density and fractures. N Engl J Med 358:2355–2365CrossRefPubMed
15.
Zurück zum Zitat Langdahl BL, Carstens M, Stenkjaer L, Eriksen EF (2002) Polymorphisms in the osteoprotegerin gene are associated with osteoporotic fractures. J Bone Miner Res 17:1245–1255CrossRefPubMed Langdahl BL, Carstens M, Stenkjaer L, Eriksen EF (2002) Polymorphisms in the osteoprotegerin gene are associated with osteoporotic fractures. J Bone Miner Res 17:1245–1255CrossRefPubMed
16.
Zurück zum Zitat Piedra M, García-Unzueta MT, Berja A, Paule B, Lavin BA, Valero C, Riancho JA, Amado JÁ (2011) Single nucleotide polymorphism of the OPG/RANKL system genes in primary hyperparathyroidism and their relatioship with bone mineral density. BMC Med Genet 20:168CrossRef Piedra M, García-Unzueta MT, Berja A, Paule B, Lavin BA, Valero C, Riancho JA, Amado JÁ (2011) Single nucleotide polymorphism of the OPG/RANKL system genes in primary hyperparathyroidism and their relatioship with bone mineral density. BMC Med Genet 20:168CrossRef
17.
Zurück zum Zitat Nguyen TV, Eisman JA (2013) Genetic profiling and individualized assessment of fracture risk. Nat Rev Endocrinol 9:153–161CrossRefPubMed Nguyen TV, Eisman JA (2013) Genetic profiling and individualized assessment of fracture risk. Nat Rev Endocrinol 9:153–161CrossRefPubMed
18.
Zurück zum Zitat Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277CrossRefPubMed Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277CrossRefPubMed
19.
Zurück zum Zitat Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640CrossRefPubMed Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640CrossRefPubMed
20.
Zurück zum Zitat Gladman DD, Goldsmith CH, Urowitz MB, Bacon P, Fortin P, Ginzler E et al (2000) The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for Systemic Lupus Erythematosus International Comparison. J Rheumatol 27:373–376PubMed Gladman DD, Goldsmith CH, Urowitz MB, Bacon P, Fortin P, Ginzler E et al (2000) The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for Systemic Lupus Erythematosus International Comparison. J Rheumatol 27:373–376PubMed
21.
Zurück zum Zitat Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML et al (2008) International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone 43:1115–1121CrossRefPubMed Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML et al (2008) International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone 43:1115–1121CrossRefPubMed
22.
Zurück zum Zitat Obrant KJ, Bengnér U, Johnell O, Nilsson BE, Sernbo I (1989) Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 44:157–167CrossRefPubMed Obrant KJ, Bengnér U, Johnell O, Nilsson BE, Sernbo I (1989) Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 44:157–167CrossRefPubMed
23.
Zurück zum Zitat Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148CrossRefPubMed Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148CrossRefPubMed
24.
Zurück zum Zitat Domiciano DS, Figueiredo CP, Lopes JB, Kuroishi ME, Takayama L, Caparbo VF et al (2013) Vertebral fracture assessment by dual X-ray absorptiometry: a valid tool to detect vertebral fractures in community-dwelling older adults in a population-based survey. Arthritis Care Res (Hoboken) 65:809–815CrossRef Domiciano DS, Figueiredo CP, Lopes JB, Kuroishi ME, Takayama L, Caparbo VF et al (2013) Vertebral fracture assessment by dual X-ray absorptiometry: a valid tool to detect vertebral fractures in community-dwelling older adults in a population-based survey. Arthritis Care Res (Hoboken) 65:809–815CrossRef
25.
26.
Zurück zum Zitat Kirkwood BR, Sterne JAC (2006) Essential medical statistics, 2nd edn. Blackwell Science, Massachusetts, USA, p 502 Kirkwood BR, Sterne JAC (2006) Essential medical statistics, 2nd edn. Blackwell Science, Massachusetts, USA, p 502
27.
Zurück zum Zitat Hosmer DW, Lemeshow S (2000) Applied logistic regression, 2ath edn. Wiley, New York, p 320CrossRef Hosmer DW, Lemeshow S (2000) Applied logistic regression, 2ath edn. Wiley, New York, p 320CrossRef
28.
Zurück zum Zitat Yeap SS, Fauzi AR, Kong NC, Halim AG, Soehardy Z, Rahimah S et al (2009) Influences on bone mineral density in Malaysian premenopausal systemic lupus erythematosus patients on corticosteroids. Lupus 18:178–181CrossRefPubMed Yeap SS, Fauzi AR, Kong NC, Halim AG, Soehardy Z, Rahimah S et al (2009) Influences on bone mineral density in Malaysian premenopausal systemic lupus erythematosus patients on corticosteroids. Lupus 18:178–181CrossRefPubMed
29.
Zurück zum Zitat Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthr Care Res (Hoboken) 62:1515–1526CrossRef Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthr Care Res (Hoboken) 62:1515–1526CrossRef
30.
Zurück zum Zitat Chugh PK (2013) Management of women with systemic lupus erythematosus. Maturitas 75:207–214CrossRefPubMed Chugh PK (2013) Management of women with systemic lupus erythematosus. Maturitas 75:207–214CrossRefPubMed
31.
Zurück zum Zitat Lopes JB, Fung LK, Cha CC, Gabriel GM, Takayama L, Figueiredo CP, Pereira RM (2012) The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study. Clinics (Sao Paulo) 67:1401–1406CrossRef Lopes JB, Fung LK, Cha CC, Gabriel GM, Takayama L, Figueiredo CP, Pereira RM (2012) The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study. Clinics (Sao Paulo) 67:1401–1406CrossRef
32.
Zurück zum Zitat Miyagawa H, Yamai M, Sakaguchi D, Kiyohara C, Tsukamoto H, Kimoto Y et al (2008) Association of polymorphisms in complement component C3 gene with susceptibility to systemic lupus erythematosus. Rheumatology 47:158–164CrossRefPubMed Miyagawa H, Yamai M, Sakaguchi D, Kiyohara C, Tsukamoto H, Kimoto Y et al (2008) Association of polymorphisms in complement component C3 gene with susceptibility to systemic lupus erythematosus. Rheumatology 47:158–164CrossRefPubMed
33.
Zurück zum Zitat Kim JG, Kim JH, Kim JY, Ku SY, Jee BC, Suh CS, Kim SH, Choi YM (2007) Association between osteoprotegerin (OPG), receptor activator of nuclear factor-kappaB (RANK), and RANK ligand (RANKL) gene polymorphisms and circulating OPG, soluble RANKL levels, and bone mineral density in Korean postmenopausal women. Menopause 14(5):913–918CrossRefPubMed Kim JG, Kim JH, Kim JY, Ku SY, Jee BC, Suh CS, Kim SH, Choi YM (2007) Association between osteoprotegerin (OPG), receptor activator of nuclear factor-kappaB (RANK), and RANK ligand (RANKL) gene polymorphisms and circulating OPG, soluble RANKL levels, and bone mineral density in Korean postmenopausal women. Menopause 14(5):913–918CrossRefPubMed
34.
Zurück zum Zitat Rhee EJ, Yun EJ, Oh KW, Park SE, Park CY, Lee WY, Park SW, Kim SW, Baek KH, Kang MI (2010) The relationship between receptor activator of nuclear factor-kappaB ligand (RANKL) gene polymorphism and aortic calcification in Korean women. Endocr J 57(6):541–549CrossRefPubMed Rhee EJ, Yun EJ, Oh KW, Park SE, Park CY, Lee WY, Park SW, Kim SW, Baek KH, Kang MI (2010) The relationship between receptor activator of nuclear factor-kappaB ligand (RANKL) gene polymorphism and aortic calcification in Korean women. Endocr J 57(6):541–549CrossRefPubMed
35.
Zurück zum Zitat Kearns AE, Khosla S, Kostenuik PJ (2008) Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulation of bone remodeling in health and disease. Endocr Rev 29:155–192CrossRefPubMedCentralPubMed Kearns AE, Khosla S, Kostenuik PJ (2008) Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulation of bone remodeling in health and disease. Endocr Rev 29:155–192CrossRefPubMedCentralPubMed
36.
Zurück zum Zitat Hawa G, Brinskelle-Schmal N, Glatz K, Maitzen S, Woloszczuk W (2003) Immunoassay for soluble RANKL (receptor activator of NF-B ligand) in serum. Clin Lab 49:461–463PubMed Hawa G, Brinskelle-Schmal N, Glatz K, Maitzen S, Woloszczuk W (2003) Immunoassay for soluble RANKL (receptor activator of NF-B ligand) in serum. Clin Lab 49:461–463PubMed
37.
Zurück zum Zitat Ueland T, Bollerslev J, Wilson SG, Dick IM, Islam FM, Mullin BH et al (2007) No associations between OPG gene polymorphisms or serum levels and measures of osteoporosis in elderly Australian women. Bone 40:175–181CrossRefPubMed Ueland T, Bollerslev J, Wilson SG, Dick IM, Islam FM, Mullin BH et al (2007) No associations between OPG gene polymorphisms or serum levels and measures of osteoporosis in elderly Australian women. Bone 40:175–181CrossRefPubMed
38.
Zurück zum Zitat Jørgensen HL, Kusk P, Madsen B, Fenger M, Lauritzen JB (2004) Serum osteoprotegerin (OPG) and the A163G polymorphism in the OPG promoter region are related to peripheral measures of bone mass and fracture odds ratios. J Bone Miner Metab 22:132–138CrossRefPubMed Jørgensen HL, Kusk P, Madsen B, Fenger M, Lauritzen JB (2004) Serum osteoprotegerin (OPG) and the A163G polymorphism in the OPG promoter region are related to peripheral measures of bone mass and fracture odds ratios. J Bone Miner Metab 22:132–138CrossRefPubMed
Metadaten
Titel
RANKL and OPG gene polymorphisms: associations with vertebral fractures and bone mineral density in premenopausal systemic lupus erythematosus
verfasst von
A. C. Bonfá
L. P. C. Seguro
V. Caparbo
E. Bonfá
R. M. R. Pereira
Publikationsdatum
01.05.2015
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 5/2015
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3029-x

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