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ABSTRACT: Context
The kindred described is the only known instance of a germ line loss of function mutation of estrogen receptor (ER)-alpha.Objective
Our objective was to assess the impact of a loss of function mutation in the ER-alpha gene on histomorphometry, bone volumetric density, bone geometry and skeletal growth, and ER-alpha heterozygosity on spine density and adult height in an extended pedigree.Design and participants
A longitudinal follow-up of the propositus with homozygous loss of function mutation of ER-alpha and single contact evaluation of the kindred were performed.Main outcome measures
Iliac crest bone biopsy and peripheral quantitative computed tomography of propositus with serial measures of areal spine bone mineral density (aBMD) by dual-energy x-ray absorptiometry and bone age were performed. Members of pedigree were evaluated for ER-alpha mutation carrier status and spine aBMD.Results
Bone biopsy revealed marked osteopenia (cortex: 641 microm), low trabecular volume (10.6%), decreased thickness (76.2 microm), normal trabecular number, and low activation frequency (0.099/yr). Radial periosteal circumference was similar, endosteal circumference larger, and trabecular and cortical volumetric bone mineral density markedly lower (158 and 1092 mg/cm(3), respectively) than controls. Spine aBMD at age 28.5 yr (0.745 g/cm(2)) decreased to 0.684 g/cm(2) (Z score -3.85) in 3.5 yr. Bone age advanced from 15-17.5 yr. Kindred analysis revealed that gene carriers had spine aBMD Z scores less than zero (P = 0.003), but carriers and nonmutant members were similar (-0.84 +/- 0.26 vs. -0.64 +/- 0.16).Conclusion
Homozygous ER-alpha disruption markedly affects bone growth, mineral content, and structure but not periosteal circumference. ER-alpha heterozygosity appears to not impair spine aBMD.
SUBMITTER: Smith EP
PROVIDER: S-EPMC2729204 | biostudies-literature | 2008 Aug
REPOSITORIES: biostudies-literature
Smith Eric P EP Specker Bonny B Bachrach Bert E BE Kimbro K S KS Li X J XJ Young Marian F MF Fedarko Neal S NS Abuzzahab M J MJ Frank Graeme R GR Cohen Robert M RM Lubahn Dennis B DB Korach Kenneth S KS
The Journal of clinical endocrinology and metabolism 20080527 8
<h4>Context</h4>The kindred described is the only known instance of a germ line loss of function mutation of estrogen receptor (ER)-alpha.<h4>Objective</h4>Our objective was to assess the impact of a loss of function mutation in the ER-alpha gene on histomorphometry, bone volumetric density, bone geometry and skeletal growth, and ER-alpha heterozygosity on spine density and adult height in an extended pedigree.<h4>Design and participants</h4>A longitudinal follow-up of the propositus with homozy ...[more]