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Influence of the Vitamin D Receptor Gene Polymorphism on Bone Loss in Men after Liver Transplantation

Jordi Guardiola, MD; Xavier Xiol, MD; Richard Sallie, MD, FRACP; Joan M. Nolla, MD; Daniel Roig-Escofet, MD; Eduardo Jaurrieta, MD; and Luis Casais, MD
[+] Article and Author Information

From Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Barcelona, Spain; and National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.


Acknowledgments: The authors thank Drs. J. Fiter, J. Escribá, and E. Cabré for technical and statistical assistance.

Grant Support: In part by a research grant from the CIRIT (Generalitat de Catalunya) (Dr. Guardiola).

Requests for Reprints: Jordi Guardiola, MD, Gastroenterology Unit, Hospital Comarcal de L'Alt Penedès, Espirall s/n, 08720 Vilafranca del Penedès, Barcelona, Spain. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Guardiola: Gastroenterology Unit, Hospital Comarcal de L'Alt Penedès, Espirall s/n, 08720 Vilafranca del Penedès, Barcelona, Spain.

Drs. Xiol and Casais: Department of Gastroenterology, Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Feixa Llarga s/n, 08907 L'Hopitalet de Llobregat, Barcelona, Spain.

Dr. Sallie: The Liver Unit, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Room 4D-52, Building 10, Bethesda, Maryland 20892.

Drs. Nolla and Roig-Escofet: Department of Rheumatology, Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Feixa Llarga s/n, 08907 L'Hopitalet de Llobregat, Barcelona, Spain.

Dr. Jaurrieta: Department of General Surgery, Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Feixa Llarga s/n, 08907 L'Hopitalet de Llobregat, Barcelona, Spain.


Ann Intern Med. 1999;131(10):752-755. doi:10.7326/0003-4819-131-10-199911160-00006
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Background: Bone loss is a frequent complication after liver transplantation.

Objective: To investigate whether vitamin D receptor gene polymorphism influences bone loss in men after liver transplantation.

Design: Prospective cohort study.

Setting: University hospital.

Patients: 55 male candidates for liver transplantation.

Measurements: Lumbar spine bone mineral density was measured before and 3, 6, 12, and 24 months after liver transplantation. Vitamin D receptor genotype was determined by restriction endonuclease BsmI.

Results: Vitamin D receptor genotypes were significantly associated with post-transplantation changes in bone mineral density (P = 0.028). Within 3 months after transplantation, patients with the genotypes Bb or BB showed a vertebral bone loss substantially greater than that in patients with the bb genotype (between-group difference in the percentage change with respect to baseline bone mineral density, 3.7% [95% CI, 0.6% to 6.9%]). In 3 to 24 months after transplantation, bone mineral density increased steadily in the three allelic groups.

Conclusions: Vitamin D receptor gene polymorphism influences bone loss after liver transplantation. Patients with the bb genotype are, to some extent, protected against post-transplantation bone loss.

Figures

Grahic Jump Location
Figure.
Bone mineral density (BMD) of lumbar spine before and after liver transplantation in patients withbb(left) andBb/BB(center) genotypes and mean percentage change from pretransplantation bone mineral density (right) in patients withbb(squares) andBb/bb(circles) genotypes.

In the right panel, the bars indicate the 95% CI for each value, and the values between the curves indicate the number of patients evaluated.

Grahic Jump Location

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Summary for Patients

Genetics Influence Bone Loss after Liver Transplant

The summary below is from the full report titled “Influence of the Vitamin D Receptor Gene Polymorphism on Bone Loss in Men after Liver Transplantation.” It is in the 16 November 1999 issue of Annals of Internal Medicine (volume 131, pages 752-755). The authors are J. Guardiola, X. Xiol, R. Sallie, J.M. Nolla, D. Roig-Escofet, E. Jaurrieta, and L. Casais.

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