Role of the Sp1 polymorphism of the collagen I alpha 1 gene in osteoporosis
The Spl polymorphism of the Collagen I alpha 1 gene has previously been associated with low bone density and increased risk of fracture in a number of clinical studies. In chapter 3 the association with fracture was shown to be driven by the Spl polymorphism rather than other single nucleotide polymorphisms located in and around the collagen I alpha 1 gene. In chapter 4, the relationship between the Spl polymorphism and osteoporotic fracture was determined in a prospective population study of men and women. This study confirmed the association between "s" alleles and fracture and showed that COLIA1 genotyping interacted significantly with bone density measurements to enhance prediction of individuals at risk of osteoporotic fracture. In chapter 5, the "s" allele was found to be associated with body size in a population study of young adults. Although there was no association with BMD, individuals who carried the "s" allele were lighter at birth and this trend continued through adolescence and into young adulthood. This suggests that "s" individuals are at increased risk of osteoporosis from an early age, since body size is, in itself a risk factor for osteoporosis. In chapter 6, the effect of Spl alleles on quantitative ultrasound (QUS) was determined in a young post-menopausal population. It was found that there were no significant genotype related differences in broadband ultrasound attenuation (BUA). In chapter 7, family studies were conducted using the quantitative transmission disequilibrium test (qTDT). This showed evidence of a polygenic effect on BMD at the spine and hip and confirmed evidence of an association between Spl "s" alleles and BMD at the femoral neck. The data suggests that the previous associations of Spl alleles and BMD are genuine and not due to population admixture.