Han K O, Moon I G, Kang Y S, Chung H Y, Min H K, Han I K
Department of Internal Medicine, Samsung Cheil Women's Healthcare Center, Seoul, Korea.
J Clin Endocrinol Metab. 1997 Apr;82(4):991-5. doi: 10.1210/jcem.82.4.3879.
Hormone replacement therapy (HRT) prevents bone loss in postmenopausal women, but some women are resistant to therapy. A recently reported case of severe estrogen resistance caused by a germline mutation at the estrogen receptor (ER) gene locus suggests the possibility that other variants of the ER gene could be responsible for resistance to HRT and could also be an answer to the heritable components of bone density. Three restriction fragment length polymorphisms (RFLPs) at the ER gene locus, represented as BstUI (or B variant), PvuII, and XbaI, and their relationship to bone mineral density (BMD) and estrogen responsiveness to HRT were examined in 248 healthy postmenopausal women, aged 41-68 yr (mean +/- SD, 52.0 +/- 4.6 yr) in Korea. The BstUI restriction site was not found in Korean women. The distribution of the PvuII and XbaI RFLPs was as follows: PP, 35 (14.1%); Pp, 136 (54.8%); pp, 77 (31.1%) and XX, 18 (7.3%); Xx, 72 (29.0%); and xx, 158 (63.7%), respectively (capital letters signify the absence of and lower case letters signify the presence of the restriction site of each RFLP). There was no significant relation between ER genotypes and z score values of lumbar spine BMD. Also, no significant genotypic differences were found in the change in lumbar spine BMD and those in biochemical markers before and after 1 yr of HRT. These data indicate no significant effects of ER genotypes on BMD and estrogen responsiveness after HRT.
激素替代疗法(HRT)可预防绝经后女性的骨质流失,但有些女性对该疗法有抗性。最近报道的一例由雌激素受体(ER)基因位点的种系突变导致的严重雌激素抗性病例表明,ER基因的其他变体可能是HRT抗性的原因,也可能是骨密度遗传成分的答案。在韩国248名年龄在41 - 68岁(平均±标准差,52.0±4.6岁)的健康绝经后女性中,检测了ER基因位点的三种限制性片段长度多态性(RFLP),分别为BstUI(或B变体)、PvuII和XbaI,以及它们与骨矿物质密度(BMD)和雌激素对HRT反应性的关系。在韩国女性中未发现BstUI限制性位点。PvuII和XbaI RFLP的分布如下:PP,35例(14.1%);Pp,136例(54.8%);pp,77例(31.1%)和XX,18例(7.3%);Xx,72例(29.0%);xx,158例(63.7%),(大写字母表示每个RFLP限制性位点的缺失,小写字母表示其存在)。ER基因型与腰椎BMD的z评分值之间无显著关系。此外,在HRT 1年后,腰椎BMD的变化以及生化标志物的变化在基因型上也未发现显著差异。这些数据表明,ER基因型对HRT后的BMD和雌激素反应性无显著影响。