Abstract

PurposeGenome-wide association studies have identified numerous genetic variants that are associated with osteoporosis risk; however, most of them are present in the non-coding regions of the genome and the functional mechanisms are unknown. In this study, we aimed to investigate the potential variation in runt domain transcription factor 2 (RUNX2), which is an osteoblast-specific transcription factor that normally stimulates bone formation and osteoblast differentiation, regarding variants within RUNX2 binding sites and risk of osteoporosis in postmenopausal osteoporosis (PMOP).MethodsWe performed bioinformatics-based prediction by combining whole genome sequencing and chromatin immunoprecipitation sequencing to screen functional SNPs in the RUNX2 binding site using data from the database of Taiwan Biobank; Case-control studies with 651 postmenopausal women comprising 107 osteoporosis patients, 290 osteopenia patients, and 254 controls at Tri-Service General Hospital between 2015 and 2019 were included. The subjects were examined for bone mass density and classified into normal and those with osteopenia or osteoporosis by T-scoring with dual-energy X-ray absorptiometry. Furthermore, mRNA expression and luciferase reporter assay were used to provide additional evidence regarding the associations identified in the association analyses. Chi-square tests and logistic regression were mainly used for statistical assessment.ResultsThrough candidate gene approaches, 3 SNPs in the RUNX2 binding site were selected. A novel SNP rs6086746 in the PLCB4 promoter was identified to be associated with osteoporosis in Chinese populations. Patients with AA allele had higher risk of osteoporosis than those with GG+AG (adjusted OR = 6.89; 95% confidence intervals: 2.23–21.31, p = 0.001). Moreover, the AA genotype exhibited lower bone mass density (p < 0.05). Regarding mRNA expression, there were large differences in the correlation between PLCB4 and different RUNX2 alleles (Cohen’s q = 0.91). Functionally, the rs6086746 A allele reduces the RUNX2 binding affinity, thus enhancing the suppression of PLCB4 expression (p < 0.05).ConclusionsOur results provide further evidence to support the important role of the SNP rs6086746 in the etiology of osteopenia/osteoporosis, thereby enhancing the current understanding of the susceptibility to osteoporosis. We further studied the mechanism underlying osteoporosis regulation by PLCB4.

Highlights

  • Osteoporosis is a systemic bone disease and is characterized by significant decrease in bone mass density (BMD) and damage to bone microstructure [1]

  • RUNX2 contained 9,264,568 potential binding motifs in the human genome based on the sequence of the above binding sites

  • Our results showed that SNP rs6086746 had a significant association with osteoporosis risk according to genotype (p < 0.001; Table 2)

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Summary

Introduction

Osteoporosis is a systemic bone disease and is characterized by significant decrease in bone mass density (BMD) and damage to bone microstructure [1]. This is especially noted in postmenopausal women because the prevalence of osteopenia and osteoporosis increase with age [2]. To make the matter worse, the number of osteoporosis patients is expected to increase continuously owing to the effects of global population aging [5]. A Taiwanese survey showed that osteoporosis ranks 4th among chronic diseases in elderly people aged >65 years in Taiwan and its prevalence is increasing with population aging [6]. 8.6% and 15.5% of males and females, respectively, have one site with osteoporosis [7]

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