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Exp Clin Endocrinol Diabetes 2012; 120(09): 517-523
DOI: 10.1055/s-0032-1321808
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Osteometabolic and Osteogenetic Pattern of Turkish Immigrants in Germany

I. H. Tarner   *
1   Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Kerckhoff-Klinik, Bad Nauheim, Germany
,
M. Z. Erkal   *
2   Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany
,
B. M. Obermayer-Pietsch
3   Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
,
L. C. Hofbauer
4   Division of Endocrinology, Diabetes and Metabolic Bone Disease, Department of Internal Medicine, University of Dresden, Dresden, Germany
,
S. Bergmann
5   Department of Clinical Chemistry and Laboratory Medicine, University of Dresden, Dresden, Germany
,
C. Goettsch
4   Division of Endocrinology, Diabetes and Metabolic Bone Disease, Department of Internal Medicine, University of Dresden, Dresden, Germany
,
K. Madlener
6   Department of Hemostasiology and Transfusion Medicine, Kerckhoff-Klinik, Bad Nauheim, Germany
,
U. Müller-Ladner
1   Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Kerckhoff-Klinik, Bad Nauheim, Germany
,
U. Lange
1   Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Kerckhoff-Klinik, Bad Nauheim, Germany
7   Professorship of Rheumatology, Osteology and Physical Medicine, Department of Internal Medicine, Justus-Liebig-University Giessen, Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Kerckhoff-Klinik, Bad Nauheim, Germany
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Publikationsverlauf

received 25. April 2012
first decision 25. April 2012

accepted 28. Juni 2012

Publikationsdatum:
06. September 2012 (online)

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Abstract

Introduction:

The etiology of osteoporosis comprises environmental and genetic factors. This study investigated vitamin D deficiency and specific genetic alterations of bone metabolism in a group of 183 Turkish immigrants in Germany in comparison with 46 age and sex matched healthy German controls (females in both groups were pre-menopausal).

Methods:

Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Serum levels of osteologic parameters were determined after overnight fasting. Polymorphisms of the vitamin D receptor (VDR) and lactase genes were genotyped using genomic DNA from peripheral leukocytes. Statistical analysis comprised student’s t-test, Mann-Whitney rank sum test, Chi-square analysis and Fisher’s exact test.

Results:

Severe 25-OH D3 hypovitaminosis (83.1%) and elevated parathyroid hormone (82%) were common among immigrants. Osteoporosis but not osteopenia was more prevalent in immigrants. Among immigrants with osteoporosis, TRAP5b was elevated in 26.7%, and β-crosslaps in 13.3%. Only the FokI FF VDR-gene-polymorphism was significantly more prevalent among immigrants. In contrast, Ff-genotyped Turkish women exhibited significantly decreased BMD. Lactase polymorphisms were significantly more common among immigrants (84.2% vs. 30.4%) and the CC genotype was commonly associated with reduced BMD (41.6%) but rarely osteoporosis (8.4%).

Conclusions:

Vitamin D deficiency, secondary hyperparathyroidism and osteoporosis are common among Turkish immigrants in Germany. Thus, in this population osteologic parameters and BMD should be analyzed and deficiencies be treated. Specifically, the VDR gene polymorphism FokI Ff is of clinical value in identifying females at risk of osteoporosis. In contrast, LCT polymorphisms, though common, do not appear to be a risk factor.

Key words

bone mineral density - osteoporosis - vitamin D deficiency - vitamin D receptor polymorphism - lactase polymorphism
*

*  I. H. Tarner and M. Z. Erkal contributed equally to this study.


 

  • References

  • 1 Bartley J. Prevalence of vitamin D deficiency among patients attending a multidisciplinary tertiary pain clinic. N Z Med J 2008; 28: 57-62
    PubMedGoogle Scholar
  • 2 Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 2007; 103: 620-625
    CrossrefPubMedGoogle Scholar
  • 3 Gugatschka M, Dobnig H, Fahrleitner-Pammer A et al. Molecularly-defined lactose malabsorption, milk consumption and anthropometric differences in adult males. Q J Med 2005; 98: 857-863
    CrossrefPubMedGoogle Scholar
  • 4 Erkal MZ, Wilde J, Bilgin Y et al. High prevalence of vitamin D deficiency, secondary hyperparathyreoidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int 2006; 17: 1133-1140
    CrossrefPubMedGoogle Scholar
  • 5 Hintzpeter B, Scheidt-Naeve C, Müller MJ et al. Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J Nutr 2008; 138: 1482-1490
    PubMedGoogle Scholar
  • 6 Holick MF. Vitamin D: A millenium perspective. J Cell Biochem 2003; 88: 296-307
    CrossrefPubMedGoogle Scholar
  • 7 Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004; 79: 362-371
    PubMedGoogle Scholar
  • 8 Meyer HE, Falch JA, Sogaard AJ et al. Vitamin D deficiency and secondary hyperparathyreoidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway. The Oslo Health Study. Bone 2004; 35: 412-417
    CrossrefPubMedGoogle Scholar
  • 9 Francis RM, Selby PL. Osteomalacia. Baillières Clin Endocrinol Metabol 1997; 11: 145-163
    PubMedGoogle Scholar
  • 10 Takeuchi Y. Pathophysiology in rickets/osteomalacia. Clin Calcium 2007; 17: 1508-1513
    PubMedGoogle Scholar
  • 11 Obermayer-Pietsch BM, Lange U, Tauber G et al. Vitamin D receptor initiation codon polymorphism, bone density and inflammatory activity of patients with ankylosing spondylitis. Osteoporos Int 2003; 14: 995-1000
    CrossrefPubMedGoogle Scholar
  • 12 Rizzoli R, Bonjour JP, Ferrari SL. Osteoporosis, genetics and hormones. J Mol Endocrinol 2001; 26: 79-94
    CrossrefPubMedGoogle Scholar
  • 13 Enattah N, Pekkarinen T, Välimäki MJ et al. Genetically defined adult-type hypolactasia and self-reported lactose intolerance as risk factors of osteoporosis in Finnish postmenopausal women. Eur J Clin Nutrition 2005; 59: 1105-1111
    CrossrefPubMedGoogle Scholar
  • 14 Enattah N, Pekkarinen T, Välimäki MJ et al. Calcium supply, bone mineral density and genetically defined lactose maldigestion in a cohort of elderly men. J Endocrinol Invest 2007; 30: 46-51
    PubMedGoogle Scholar
  • 15 Obermayer-Pietsch BM, Gugatschka M, Reitter S et al. Adult-type hypolactasia and calcium availability: decreased calcium intake or impaired calcium absorption?. Osteoporos Int 2007; 18: 445-451
    CrossrefPubMedGoogle Scholar
  • 16 Obermayer-Pietsch BM, Bonelli CM, Walter DE et al. Genetic predisposition for Adult Lactose Intolerance and Relation to Diet, Bone Density, and Bone Fractures. J Bone Miner Res 2004; 19: 42-47
    CrossrefPubMedGoogle Scholar
  • 17 Gross C, Eccleshall TR, Malloy PJ et al. 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 1996; 11: 1850-1855
    PubMedGoogle Scholar
  • 18 Obermayer-Pietsch BM, Frühauf GE, Chararas K et al. Association of the vitamin D receptor geneotype BB with low bone density in hyperthyroidism. J Bone Miner Res 2000; 15: 1950-1955
    CrossrefPubMedGoogle Scholar
  • 19 Maxwell JP, Pi HT, Liu HAC et al. Further studies in adult rickets (osteomalacia) and foetal rickets. Proc Roy Soc Med 1939; 32: 287-297
    PubMedGoogle Scholar
  • 20 Albright F, Reifenstein E. The parathyroid glands and metabolic bone disease: selected studies. Baltimore: Williams & Wilkins; 1948
    Google Scholar
  • 21 Offermann G, Manhold C. Osteomalacia in Turkish Guest-Workers in Germany. Inn Med 1978; 5: 103-111
    PubMedGoogle Scholar
  • 22 Chapuy MC, Arlot ME, Duboeuf F et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992; 327: 1637-1642
    CrossrefPubMedGoogle Scholar
  • 23 Wemeau JL. Calciotropic hormones and ageing. Horm Res 1995; 43: 76-79
    CrossrefPubMedGoogle Scholar
  • 24 Halleen JM. Tartrate-resistant acid phosphatase 5B is a specific and sensitive marker of bone resorption. Anticancer Res 2003; 23: 1027-1029
    PubMedGoogle Scholar
  • 25 Delmas PD. Treatment of osteoporosis. Lancet 2002; 359: 2018-2026
    CrossrefPubMedGoogle Scholar
  • 26 Enattah NS, Sahi T, Savilahti E et al. Identification of a variant associated with adult-type hypolactasia. Nat Genet 2002; 30: 233-237
    CrossrefPubMedGoogle Scholar
  • 27 Corazza GR, Benati G, Di Sario A et al. Lactose intolerance and bone mass in postmenopausal Italian women. Br J Nutr 1995; 73: 479-487
    CrossrefPubMedGoogle Scholar