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Association between vitamin D receptor gene polymorphisms, falls, balance and muscle power: results from two independent studies (APOSS and OPUS)

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Abstract

Summary

Fall prevention is a key strategy for reducing osteoporotic fractures. We investigated the association between vitamin D receptor (VDR) polymorphisms and reported falls in postmenopausal women. Bsm1 polymorphisms were associated with falls, balance and muscle power measurements. These results may explain some of the excess fracture risk associated with VDR in some studies.

Introduction

Fall prevention is a key strategy for reducing osteoporotic fractures. It has been suggested that vitamin D supplementation may reduce the incidence of falls by reducing body sway and increasing muscle power. The vitamin D receptor gene is a well-studied candidate gene for osteoporosis. We investigated the association between VDR polymorphisms and reported falls in postmenopausal women.

Methods

Falls data were collected in two separate population cohorts. Five polymorphisms of the VDR gene were analysed (Cdx-2, Fok-1, BsmI, Taq1 and Apa1) in the Aberdeen Prospective Osteoporosis Screening Study (APOSS) cohort. Results found in APOSS were then validated in an independent cohort—the Osteoporosis and Ultrasound (OPUS) study (Bsm1 and Fok1 only), where muscle power and balance were also measured.

Results

Carriers of the ‘B’ allele (Bsm1) showed an increased risk for falls. In APOSS, this was statistically significant for visit 3 multiple falls (p = 0.047) and for recurrent falls (p = 0.043). Similar results were found in OPUS for visit 1 falls (p = 0.025) and visit 1 multiple falls (p = 0.015). Bsm1 polymorphisms were also associated with balance and muscle power measurements.

Conclusions

In conclusion, these results demonstrate an association between the Bsm1 polymorphism and risk of falling that may explain some of the excess fracture risk associated with VDR in some studies.

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Acknowledgements

APOSS study: Thanks go to all the research nurses involved in the APOSS study. Additional thanks for Dr Alison J Black for checking the 25(OH)D and PTH results. Professor William Fraser is thanked for conducting the analysis of the 25(OH)D and PTH samples.

OPUS study: We would like to thank the following members of the OPUS teams at the five participating centres for their contributions: Rosie Reid, Shani Mason, Lindsay Ross, Catherine Paterson, Jennifer Scott and Lana Gibson (Aberdeen); Gabriele Armbrecht, Tilo Blenk, Jessica von der Gablentz, Christina Kahl; Reinhard Barkmann, Wolfram Timm, Christian Graeff and Carsten Rose (Kiel); Sami Kolta (Paris) and Jackie Clowes, Margaret Paggiosi, Nicky Peel and Debbie Swindell (Sheffield). Aubrey Blumsohn measured vitamin D metabolites and PTH in the OPUS study. This project was supported by Sanofi-Aventis, Eli Lilly, Novartis, Pfizer, Proctor and Gamble Pharmaceuticals and Roche.

Conflicts of interest

None.

Author information

Author notes

  1. F. McGuigan

    Present address: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

Authors and Affiliations

  1. Bone and Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK

    R. Barr, H. Macdonald, A. Stewart, F. McGuigan & D. M. Reid

  2. Academic Unit of Bone Metabolism, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK

    A. Rogers & R. Eastell

  3. Centre Muscle & Bone Research, Charité-Campus Benjamin Franklin, Free University and Humboldt University, Berlin, Germany

    D. Felsenberg

  4. Medizinische Physik, Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany

    C. Glüer

  5. Centre d’Evaluation des Maladies Osseuses, Service de Rhumatologie, Hôpital Cochin, Université René Descartes, Paris, France

    C. Roux

  6. Division of Applied Medicine, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK

    D. M. Reid

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  1. R. Barr
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Corresponding author

Correspondence to D. M. Reid.

Additional information

Rebecca Barr, Helen Macdonald and Alison Stewart contributed equally to the study.

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Barr, R., Macdonald, H., Stewart, A. et al. Association between vitamin D receptor gene polymorphisms, falls, balance and muscle power: results from two independent studies (APOSS and OPUS). Osteoporos Int 21, 457–466 (2010). https://doi.org/10.1007/s00198-009-1019-6

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  • DOI: https://doi.org/10.1007/s00198-009-1019-6

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