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Genetics of Osteoporosis

Genetik der Osteoporose

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Zusammenfassung

Osteoporose ist charakterisiert durch eine Abnahme der Knochenmasse, -funktion und -architektur, die zu einer erhöhten Knochenfrakturgefährdung führt. Obwohl die Erkrankung multifaktoriell bedingt ist, wird u.a. die Knochendichte, als klassischer Surrogatparameter für das Osteoporoserisiko, zu 60–80 % genetisch determiniert. Neben Zwillings- und Familienstudien gibt es "Whole-Genome"-Screens, die Genorte für die Osteoporose aufspüren können. Kandidatengene des Knochenstoffwechsels, wie der Collagen-TypI-alpha1-Locus, Lactoseintoleranz- oder Östrogenrezeptor-Gen sind Teil eines Spektrums von genetischen Charakteristika, die nun in großen epidemiologischen Untersuchungen wie etwa dem "GENOMOS"-Projekt der EU mit über 50.000 Probanden hinsichtlich Osteoporose-Risikoprädiktion und möglicher pharmakogenetischer Bedeutung getestet werden. Mit dem vertieften Wissen um genetische Determinanten des Knochenstoffwechsels sind populationsspezifische genetische Risikoprofile für Osteoporose denkbar, die auch Umweltfaktoren und ihre Interaktion mit den genetischen Gegebenheiten einschließen. Mit den neuen Möglichkeiten genetischer Analysen sollten daher sowohl die Diagnostik als auch neue, besser angepassten Präventions- und Therapiestrategien bei Osteoporose möglich sein.

Summary

Osteoporosis is a systemic skeletal disease comprising rarefaction of bone structure and loss of bone mass, finally leading to increased fracture risk. As a part of its multifactorial aetiology, twin and family studies have demonstrated an important genetic component of osteoporosis regarding many parameters of bone properties e. g. bone mineral density, with a heredity of 60–80 %. Whole genome screens, linkage analysis and candidate gene research have contributed to our current knowledge about genetic loci in osteoporosis. Genotyping of collagen alpha I, lactose intolerance or estrogen receptor alpha alleles are under investigation for their importance in individual and epidemiological practice, e. g. the European Union "GENOMOS" project with more than 50.000 subjects. In future, improved genotyping methods and design strategies as well as large scale epidemiological studies in the general population will bring the genetics of complex diseases such as osteoporosis to a point of success comparable to where mendelian genetics now firmly resides. Given the potential of these new techniques, a paradigm shift may occur both in diagnosis and prevention as well as in individualized treatment aspects of osteoporosis.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Endocrinology and Nuclear Medicine, Endocrinological-Nuclear-Medical Laboratory, Graz, Austria

    Barbara Obermayer-Pietsch

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  1. Barbara Obermayer-Pietsch
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Correspondence to Barbara Obermayer-Pietsch.

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Obermayer-Pietsch, B. Genetics of Osteoporosis. Wien Med Wochenschr 156, 162–167 (2006). https://doi.org/10.1007/s10354-005-0249-2

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  • DOI: https://doi.org/10.1007/s10354-005-0249-2

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