Potential predictive marker of treatment effectiveness in patients with osteopenic syndrome after surgical menopause

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  • Authors: Zaydieva Y.Z.1, Kruchinina E.V.1, Gorenkova O.S.1, Polyakova E.Y.2, Kareva E.N.3, Kurguzova D.O.3, Kochina N.A.4, Krasnoshchok K.V.4, Serebrova S.Y.5
  • Affiliations:
    1. Moscow Regional Research Institute of Obstetrics and Gynecology
    2. Vladimirskiy Moscow Regional Research Clinical Institute
    3. Sechenov First Moscow State Medical University (Sechenov University)
    4. Pirogov Russian National Research Medical University
    5. Scientific Center for Expertise of Medical Products
  • Issue: Vol 22, No 4 (2020)
  • Pages: 39-42
  • Section: ORIGINAL ARTICLE
  • URL: https://gynecology.orscience.ru/2079-5831/article/view/43870
  • DOI: https://doi.org/10.26442/20795696.2020.4.200188
  • Cite item

Abstract


Introduction. Patients with surgical menopause have a risk for osteopenic syndrome (OS). Menopausal hormone therapy (MHT) in combination with calcium and vitamin D promotes increase in bone mineral density (BMD). The expression level of vitamin D receptor in mononuclear fraction cells (MNFC) of blood can be considered as a predictive marker of effectiveness of OS therapy.

Aim. To search a molecular predictive marker of the effectiveness of OS treatment.

Materials and methods. The study included 100 women aged 40–55 years with a duration of surgical menopause from 12 months to 6 years. The criterion for including patients in the study was the absence of contraindications to the use of MHT. The subject of the study was the determination of BMD by dual-energy X-ray absorptiometry, polymerase chain reaction diagnostics of the level of expression of vitamin D genes, estradiol and progesterone receptors, determination of 25-OH vitamin D in the blood.

Results. Analysis of 12-month OS therapy effectiveness evaluated with a surrogate marker BMD. The increase in BMD up to 3–4% per year was treated as absence of negative dynamics, more than 4% per year as positive one. Significant effect of combination therapy compared with MHT on BMD in patients with surgical menopause with a low baseline level of BMD (due to hypovitaminosis D) is associated with the anti-inflammatory, bone-protective effect of vitamin D. In both groups of patients not responding; to the prescribed therapy we were able to conduct a comparative analysis of expression level of the target molecules in the MNFC before the start of treatment. The efficacy of MHT and combination therapy for BMD disorders is positively associated with the expression level of vitamin D receptors in MNFC before treatment. Therefore, the vitDR mRNA level is a potential predictive marker of the effectiveness of OS treatment. The expression levels of nuclear estradiol beta receptor and membrane receptor for progesterone in MNFC before treatment showed an upward trend in women responding to therapy.

Conclusion. The expression level of the vitamin D receptor in MNFC of blood is significantly lower in the group of women with no/insufficient effect on 12-month combined therapy. This indicator can be considered as a predictive marker of the effectiveness of OS therapy.


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About the authors

Yansiiat Z. Zaydieva

Moscow Regional Research Institute of Obstetrics and Gynecology

Author for correspondence.
Email: 7726101@rambler.ru
ORCID iD: 0000-0003-4911-719X

Russian Federation, Moscow

D. Sci. (Med.), Prof., Moscow Regional Research Institute of Obstetrics and Gynecology

Elena V. Kruchinina

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: kruchinina.elena@mail.ru
ORCID iD: 0000-0002-3628-0863

Russian Federation, Moscow

Cand. Sci. (Med.), Moscow Regional Research Institute of Obstetrics and Gynecology

Olga S. Gorenkova

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: olga-gore@mail.ru
ORCID iD: 0000-0002-4448-5877

Russian Federation, Moscow

Cand. Sci. (Med.), Moscow Regional Research Institute of Obstetrics and Gynecology

Elena Yu. Polyakova

Vladimirskiy Moscow Regional Research Clinical Institute

Email: polyakova_eu@mail.ru
ORCID iD: 0000-0002-1389-0271

Russian Federation, Moscow

Cand. Sci. (Med.), Vladimirskiy Moscow Regional Research Clinical Institute

Elena N. Kareva

Sechenov First Moscow State Medical University (Sechenov University)

Email: elenakareva@mail.ru

Russian Federation, Moscow

D. Sci. (Med.), Prof., Sechenov First Moscow State Medical University (Sechenov University)

Daria O. Kurguzova

Sechenov First Moscow State Medical University (Sechenov University)

Email: kurguzova@mail.ru
ORCID iD: 0000-0003-1759-5592

Russian Federation, Moscow

Assistant, Sechenov First Moscow State Medical University (Sechenov University)

Natalya A. Kochina

Pirogov Russian National Research Medical University

Email: natalyakochina@yandex.ru
ORCID iD: 0000-0001-7748-0071

Russian Federation, Moscow

Senior Research Officer, Pirogov Russian National Research Medical University

Katherine V. Krasnoshchok

Pirogov Russian National Research Medical University

Email: katherinekamagina@gmail.com
ORCID iD: 0000-0003-3538-1977

Russian Federation, Moscow

biochemist, Pirogov Russian National Research Medical University

Svetlana Yu. Serebrova

Scientific Center for Expertise of Medical Products

Email: svetaserebrova@mail.ru
ORCID iD: 0000-0002-7163-7119

Russian Federation, Moscow

D. Sci. (Med.), Prof., Scientific Center for Expertise of Medical Products

References

  1. Francis RM. Non-response to osteoporosis treatment. J Br Menopause Soc 2004; 10 (2): 76–80.
  2. Cesareo R, Falchetti A, Attanasio R et al. Hypovitaminosis D: Is It Time to Consider the Use of Calcifediol? Nutrients 2019; 11: 1016. doi: 10.3390/nu11051016
  3. Клинические рекомендации Российского общества акушеров-гинекологов, утвержденные информационным письмом Минздрава России от 02.10.2015 №15-4/10/2-5804 «Менопаузальная гормонотерапия и сохранение здоровья женщин в зрелом возрасте». М., 2015. http://www.consultant.ru/document/cons_doc_LAW_320073/ [Klinicheskie rekomendatsii Rossiiskogo obshchestva akusherov-ginekologov, utverzhdennye informatsionnym pis’mom Minzdrava Rossii ot 02.10.2015 №15-4/10/2-5804 «Menopauzal’naia gormonoterapiia i sokhranenie zdorov’ia zhenshchin v zrelom vozraste». Moscow, 2015. http://www.consultant.ru/document/cons_doc_LAW_320073/ (in Russian).]
  4. Boyum A. Separation of leukocytes from blood and bone marrow. Scand J Lab Investig 1968; 21 (97): 1–9.
  5. Cesareo R, Iozzino M, D’Onofrio L et al. Effectiveness and safety of calcium and vitamin D treatment for postmenopausal osteoporosis. Minerva Еndocrinol 2015; 40: 231–7. https://www.researchgate.net/publication/280327589
  6. Kerschan-Schindl K. Prevention and rehabilitation of osteoporosis. Wien Med Wochenschr 2016; 166 (1–2): 22–7. doi: 10.1007/s10354-015-0417-y
  7. Paschalisa EP, Gamsjaegera S, Hasslera N et al. Vitamin D and calcium supplementation for three years in postmenopausal osteoporosis significantly alters bone mineral and organic matrix quality. Bone 2017; 95: 41–6. doi: 10.1016/j.bone.2016.11.002
  8. Siddique N, Fallon N, Steen G et al. Treatment of osteoporosis with recombinant parathyroid hormone, utilisation of total body DXA to observe treatment effects on total body composition and factors determining response to therapy. Ir J Med Sci 2019; 188 (2): 505–15. doi: 10.1007/s11845-018-1875-1

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