Skip to main content

Advertisement

SpringerLink
Log in

Low bone mineral density and vitamin d deficiency correlated with genetics and other bone markers in female Turkish immigrants in Germany

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Patients with osteoporosis have a low bone mass resulting in an increased risk for bone fractures, morbidity and mortality. One hundred thirty-one female pre-menopausal participants (98 Turkish immigrants living in Germany in comparison with 33 age-matched healthy Germans) were recruited for this study which explored vitamin D deficiency and specific genetic modifications of bone metabolism. The subjects were investigated for their femoral and lumbar bone mineral density (BMD) by dual-energy X-ray absorptiometry (DEXA) of the right total femur and the lumbar spine. Serum levels of osteologic parameters were determined: parathormone (PTH), calcium (Ca), osteocalcin (OC), phosphate (P), alkaline phosphatase (AP), beta-crossLaps (CL), tartrate-resistant acid phosphatase isoform 5b (TRAP5b), and 25-vitamin D3 (25-OH D3). The Bsml- and Fokl-polymorphisms of the vitamin D receptor (VDR) gene and the collagen type I alpha 1 (COLIA1)-gene polymorphism were also genotyped. An extremely high prevalence of vitamin D deficiency could be found in the immigrant cohort (87.8 %). Osteoporosis but not osteopenia was more prevalent in this group. Among immigrants with osteoporosis, TRAP5b was elevated in 42.9 % and beta-CL in 28.6 %. Only the Fokl FF-genotype of the VDR polymorphism was significantly more prevalent among the Turkish women, Ff-genotyped immigrants showed significantly decreased BMD. A significant correlation between the COLIA1-gene polymorphism and BMD could not be identified in the two groups. Vitamin D deficiency and osteoporosis appear to be dominant and unrecognized problem among female Turkish immigrants in Germany. Therefore, in this population, osteologic parameters and BMD should be routinely analyzed and deficiencies be treated immediately.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haussler MR, Whitfield GK, Haussler CA, Hsieh JC, Thompson PD, Selznick SH, Dominguez CE, Jurutka PW (1998) The nuclear vitamin D receptor: biological and molecular regulatory properties revealed. J Bone Miner Res 13:325–349

    Article  CAS  PubMed  Google Scholar 

  2. Uitterlinden AG, Fang Y, Van Meurs JB, Pols HA, van Leeuwen JP (2004) Genetics and biology of vitamin D receptor polymorphisms. Gene 338:143–156

    Article  CAS  PubMed  Google Scholar 

  3. Slattery ML (2007) Vitamin D receptor gene (VDR) associations with cancer. Nutrition Rev 65:S102–104

    Article  Google Scholar 

  4. Holick MF (2004) Vitamin D: importance in the prevalence of cancer, type 1 diabetes, heart disease and osteoporosis. Am J Clin Nutr 79:363–371

    Google Scholar 

  5. Meyer HE, Falch JA, Sogaard AJ, Haug E (2004) Vitamin D deficiency and secondary hyperthyreoidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway. The Oslo Health Study. Bone 35:412–417

    Article  CAS  PubMed  Google Scholar 

  6. Norman AW (2008) From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 88:491–499

    Article  Google Scholar 

  7. Labuda M, Fujiwara TM, Ross MV, Morgan K, Garcia-Heras J, Ledbetter DH, Hughes MR, Glorieux FH (1992) Two hereditary defects related to vitamin D metabolism map to the same region of chromosome 12q13-14. J Bone Miner Res 7:1447–1453

    Article  CAS  PubMed  Google Scholar 

  8. Davis CD (2008) Vitamin D and cancer: current dilemmas and future research needs. Am J Clin Nutr 88:565–569

    Google Scholar 

  9. Morrison NA, Qi JC, Tokita A, Kelly PJ, Crofts L, Nguyen TV, Sambrook PN, Eisman JA (1994) Prediction of bone density from vitamin D receptor alleles. Nature 367:284–287

    Article  CAS  PubMed  Google Scholar 

  10. Hustmeyer FG, Peacock M, Hui S, Johnston SS, Christian J (1994) Bone mineral density in relation to polymorphism at the vitamin D receptor gene locus. J Clin Invest 94:2130–2134

    Article  Google Scholar 

  11. Gross C, Eccleshall TR, Mallory PJ, Villa ML, Marcus R, Feldmann D (1996) The presence of a polymorphism at the translation initiation site of the vitamin D receptor gene is associated with low bone mineral density in postmenopausal Mexican-American women. J Bone Miner Res 11:1850–1855

    Article  CAS  PubMed  Google Scholar 

  12. Bartley J (2008) Prevalence of vitamin D deficiency among patients attending a multidisciplinary tertiary pain clinic. N Z Med J 121:57–62

    PubMed  Google Scholar 

  13. Lips P (2007) Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 103:620–625

    Article  CAS  PubMed  Google Scholar 

  14. Erkal MZ, Wilde J, Bilgin Y, Akinci A, Demir E, Bödecker RH, Mann M, Bretzel RG, Stracke H, Holick MF (2006) High prevalence of vitamin D deficiency, secondary hyperparathyreoidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int 17:1113–1140

    Article  Google Scholar 

  15. Francis RM, Selby PL (1997) Osteomalacia. Baillieres Clin Endocrinol Metab 11:145–163

    Article  CAS  PubMed  Google Scholar 

  16. Solomon E, Hiorns L, Sheer D, Rowe D (1984) Confirmation that the type I collagen gene on chromosome 17 is COL1A1 (alpha 1(I), using a human genomic probe. Ann Hum Genet 48:39–42

    Article  CAS  PubMed  Google Scholar 

  17. Grant SFA, Reid DM, Blake G, Herd R, Fogelman I, Ralston SH (1996) Reduced bone density and osteoporosis associated with a polymorphic Sp1 binding site in the collagen type a1 gene. Nat Genet 14:203–205

    Article  CAS  PubMed  Google Scholar 

  18. Langdahl BL, Ralston SH, Grant SFA, Eriksen EF (1998) An Sp1 binding site polymorphism in the COLIA1 gene predicts osteoporotic fractures in both men and women. J Bone Miner Res 13:1384–1389

    Article  CAS  PubMed  Google Scholar 

  19. Siris ES, Selby PL, Saag KG, Borgström F, Herings RM, Silverman SL (2009) Impact of osteoporosis treatment adherence on fracture rates in North America and Europe. Am J Med 122:3–13

    Article  Google Scholar 

  20. Gronholz MJ (2008) Prevention, diagnosis and management of osteoporosis-related fracture: a multifactorial osteopathic approach. J Am Osteopath Assoc 108:575–585

    PubMed  Google Scholar 

  21. Seemann E, Hopper JL, Bach LA (1989) Reduced bone mass in daughters of women with osteoporosis. N Engl J Med 320:554–558

    Article  Google Scholar 

  22. Pocock NA, Eisman JA, Hopper JL, Yeates MG, Sambrook PN, Eberl S (1987) Genetic determinants of bone mass in adults. A twin study. J Clin Invest 80:706–710

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Evans RA, Marel GM, Lancaster EK, Kos S, Evany N, Won SYP (1988) Bone mass in relatives of osteoporotic patients. Ann Intern Med 109:870–873

    Article  CAS  PubMed  Google Scholar 

  24. Ralston SH, Uitterlinden AG, Brandi ML, Balcells S, Langdahl BL, Lips P, Lorenc R, Obermayer-Pietsch B, Scollen S, Bustamante M, Husted LB, Carey AH, Diez-Perez A, Dunning AM, Falchetti A, Karczmarewicz E, Kruk M, van Leeuwen JP, van Meurs JB, Mangion J, McGuigan FE, Mellibovsky L, del Monte F, Pols HA, Reeve J, Reid DM, Renner W, Rivadeneira F, van Schoor NM, Sherlock RE, Ioannidis JP (2006) GENOMOS Investigators. Large-scale evidence for the effect of the COLIA1 Sp1 polymorphism on osteoporosis outcomes: the GENOMOS study. PLoS Med 3(4):e90

    Article  PubMed  PubMed Central  Google Scholar 

  25. Rizzoli R, Bonjour JP, Ferrari SL (2001) Osteoporosis, genetics and hormones. J Mol Endocrinol 26:79–94

    Article  CAS  PubMed  Google Scholar 

  26. Obermayer-Pietsch BM, Lange U, Tauber G, Frühauf G, Fahrleitner A, Dobnig H, Hermann J, Aglas F, Teichmann J, Neeck G, Leb G (2003) Vitamin D receptor initiation codon polymorphism, bone density and inflammatory activity of patients with ankylosing spondylitis. Osteoporos Int 14:995–1000

    Article  CAS  PubMed  Google Scholar 

  27. Uitterlinden AG, Burger H, Huang Q, Yue F, MC Guigan FE, Grant SF, Hofmann A, van Leeuwen JP, Pols HA, Ralston SH (1998) Relation of alleles of the collagen type I alpha 1 gene to bone density and the risk of osteoporotic fractures in postmenopausal women. N Engl J Med 338:1016–1021

    Article  CAS  PubMed  Google Scholar 

  28. Maxwell JP, Pi HT, Lin HAC, Kuo CC (1939) Further studies in adult rickets (osteomalacia) and foetal rickets. Proc R Soc Med 32:287–297

    CAS  PubMed Central  Google Scholar 

  29. Albright F, Reifenstein F (1948) The parathyreoid glands and metabolic bone disease: selected studies. The Williams and Wilkins Company, Baltimore

    Google Scholar 

  30. Preece MA, Mcintosh WB, Tomlinson S, Ford JA, Dunnigan MG, O’Riordan JLH (1973) Vitamin D deficiency among Asian immigrants to Britain. Lancet 301:907–910

    Article  Google Scholar 

  31. Holvik K, Meyer HE, Haug E, Brunvand L (2005) Prevalence and predictors of vitamin D deficiency in five immigrant groups living in Oslo, Norway: the Oslo Immigrant Health study. Eur J Clin Nutr 59:57–63

    Article  CAS  PubMed  Google Scholar 

  32. Offermann G, Manhold C (1978) Osteomalacia in Turkish guest-workers in Germany. Inn Med 5:103–111

    Google Scholar 

  33. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D3 and calcium to prevent hip fractures in olderly women. N Engl J Med 327:1637–1642

    Article  CAS  PubMed  Google Scholar 

  34. Wemeau JL (1995) Calcitriopic hormones and ageing. Horm Res 43:76–79

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work did not get any financial support.

We acknowledge the statistical support of MoReData GmbH, Kerkrader Strasse 11, 35394 Giessen, Germany.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Justus-Liebig-University Giessen, Klinikstrasse 33, 35392, Giessen, Germany

    Yasemin Tastan & Hans-Rudolf Tinneberg

  2. Department of Endocrinology and Diabetology, Philipps-University Marburg, Baldingerstrasse, 33043, Marburg, Germany

    Peter Herbert Kann

  3. Department of Bone Oncology, Endocrinology and Reproductive Medicine, Nordwest Hospital, Steinbacher Hohl 2-26, 60488, Frankfurt am Main, Germany

    Peyman Hadji

  4. Department of Internal Medicine and Rheumatology, Justus-Liebig-University, Giessen, Germany

    Ulf Müller-Ladner & Uwe Lange

  5. Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Kerckhoff-Klinik, Benekestrasse 2-8, 61231, Bad Nauheim, Germany

    Ulf Müller-Ladner & Uwe Lange

Authors
  1. Yasemin Tastan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Herbert Kann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hans-Rudolf Tinneberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peyman Hadji
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ulf Müller-Ladner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Uwe Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Uwe Lange.

Ethics declarations

Ethical approval

All voluntary study subjects gave written informed consent prior to the study which was approved by the local Ethics Committee of the Faculty of Medicine, Justus-Liebig-University Giessen, Germany.

Disclosures

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tastan, Y., Kann, P.H., Tinneberg, HR. et al. Low bone mineral density and vitamin d deficiency correlated with genetics and other bone markers in female Turkish immigrants in Germany. Clin Rheumatol 35, 2789–2795 (2016). https://doi.org/10.1007/s10067-016-3237-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3237-6

Keywords

Search

Navigation