Professor (Emeritus) of Clinical Chemistry, Medical School, National and Kapodistrian University of Athens. f. Director of Hormones' Laboratory, "Aretaieio" Hospital
Intrauterine fetal development is characterized by increased rates of proliferation and apoptosis... more Intrauterine fetal development is characterized by increased rates of proliferation and apoptosis, while both these processes may be attenuated post-natally. Tissue polypeptide specific antigen and sFas serum concentrations were determined during pregnancy and post-natally, in order to evaluate their alterations during these crucial periods. Forty-seven healthy pregnant women, their full-term newborns and 35 healthy adults (controls) were included in the study. Markers were measured: (a) in maternal serum (MS), during the 1st, 2nd, 3rd trimester and at the 1st stage of labor; (b) in the umbilical cord (UC), during the 2nd stage of labor; (c) in neonatal serum in the 1st (IN) and 5th (5N) day after birth; and (d) in controls. The serum TPS concentrations in MS increased significantly with gestational age, being higher in the 3rd trimester and labor, than those in controls (p < 0.001). TPS values were significantly lower in the UC, compared to those in MS (p < 0.001), while they were markedly elevated in IN, compared to MS and UC (p < 0.001), and subsequently decreased in 5N (p < 0.001), remaining higher, than those in the controls (p < 0.001). Serum sFas concentrations in the MS depended significantly on gestational age (p < 0.001), being significantly lower in the first trimester, than those in the second (p < 0.003), the third (p < 0.03), in labor and controls (p < 0.005). sFas concentrations in the UC were significantly lower than in MS and controls (p < 0.001), while they increased significantly in 5N samples (p < 0.01). Our results demonstrate: (a) a higher apoptosis rate in the first trimester of pregnancy, possibly affecting maternal immuno-tolerance, followed by a down-regulation during the post-natal period; (b) a progressively increased proliferation from the first trimester to parturition, reflecting the fetal and placental growth and development, that seems to be thereafter moderated.
Journal of B.U.ON.: official journal of the Balkan Union of Oncology
Hepatic resection is the mainstay of the curative treatment of primary hepatic tumors, with const... more Hepatic resection is the mainstay of the curative treatment of primary hepatic tumors, with constantly improving short and long term results. Radiofrequency ablation (RFA)-assisted liver resection is a relatively new method of transection of the liver parenchyma with favorable intra- and perioperative results. The aim of this study was to investigate the oncological efficacy (long term overall survival/OS and disease free survival/DFS) and to confirm the favorable short term morbidity and mortality. Between May 2004 and January 2007, 28 patients underwent 32 resections with removal of 50 hepatocellular carcinoma (HCC) lesions. The technique of parenchymal transection has been described previously as RFA-assisted liver resection. Thirty-day morbidity and mortality were 42.8 and 0%, respectively. Blood transfusion was necessary for 28.5% of the patients. The median hospital stay was 16.5 days (range 5-34). The 1- and 3-year OS were 92.9 and 65.7%, respectively. The 1- and 3-year DFS were 62.3 and 54.6- respectively. No patient developed metastatic disease or local recurrence at the margin site. Twelve patients (42.9%) developed in-the-liver recurrence away from the resection area. RFA-assisted liver resection is a safe and oncologically efficacious method for the surgical treatment of HCC with results comparable to other surgical techniques.
Modulating effects of genetic and environmental risk factors on severity of human abdominal aorti... more Modulating effects of genetic and environmental risk factors on severity of human abdominal aortic aneurysm (AAA) tissue inflammation remain unclear. We investigated the influence of total plasma homocysteine (tHcy) and traditional atherosclerotic risk factors (ARF) on degree of AAA tissue inflammation. Aneurysm specimens were obtained from 89 male patients aged 52 to 83 years, underwent asymptomatic not ruptured AAA (mean diameter 5.5 cm) open repair and graded for degree of histologic inflammation. Multivariate analysis was used to determine the association of tHcy and ARF, with degree of inflammation. Current cigarette smoking, odds ratio (OR) 4.4, 95% confidence interval 1.3 to 15.2, P = .01 and no other ARF, neither tHcy levels OR 0.9 (0.9-1.02), P = .2 were associated with high-grade tissue inflammation. These results provide evidence against a major effect of tHcy levels on AAA tissue inflammation, while current cigarette smoking is a significant modulating factor.
An association between symptomatic carotid stenosis and recent infection with Chlamydia pneumonia... more An association between symptomatic carotid stenosis and recent infection with Chlamydia pneumoniae is reported. Thirty-five patients (20 symptomatic and 15 asymptomatic) with carotid stenosis of 70% to 90% underwent carotid endarterectomy. Endarterectomy was performed without patch and shunt; the average occlusion time of the internal carotid artery was 14 +/- 3 min. The atheromatic plaque and a portion of the thyroid artery were examined with polymerase chain reaction and peripheral vein blood was obtained for serologic detection of systematic infection, and IgG and IgM antibodies to C. pneumoniae by enzyme-linked immunosorbent assay. Twenty of 35 patients (57.1%) had increased titers of IgG antibodies to C. pneumoniae. Eight patients revealed IgG plus IgM antibodies; two of the eight had IgG, IgM, and positive findings on polymerase chain reaction. No C. pneumoniae was detected on the thyroid arteries. Sixty-five percent (13/20) of the patients with increased IgG antibodies to C. pneumoniae, 87.5% (7/8) with IgG + IgM, and 100% with IgG + IgM + positive polymerase chain reaction were symptomatic. Plaque morphology in association with symptoms did not reveal a significant correlation between soft plaques and symptoms, whereas the majority of the symptomatic patients had plaques of type III-V. Patients having recent contamination and positive polymerase chain reaction had a significant relationship between C. pneumoniae infection and symptomatic carotid disease. This supports the hypothesis that C. pneumoniae infection can produce a kind of instability of the carotid plaque. The results of this study demonstrate that patients with advanced atherosclerotic carotid disease have an increased incidence of C. pneumoniae infection. Recent infection could be responsible for instability of the carotid plaque, causing cerebral ischemic episodes.
Immunomediators seem to have a central role in the immune system of both human milk and newborn i... more Immunomediators seem to have a central role in the immune system of both human milk and newborn infants. CD31/PECAM-1 is an adhesion molecule, member of Ig gene superfamily, mediating cell-cell adhesion in both homophilic and heterophilic ways. Levels of the soluble form of PECAM-1 (sPECAM-1) were evaluated on the 2nd and 5th day postpartum in breast milk and serum paired samples from 20 lactating women as well as in time-matched serum from their single, term, healthy neonates. Concentrations of sPECAM-1 in breast milk (median, range) on both the 2nd (2.05 ng/ml, 0.0-7.2) and 5th day postpartum (0.89 ng/ml, 0.0-3.6) were about 10 and 20 times lower than those (mean +/- SD) in controls (healthy adults) (19.83 +/- 5.17, p<7 x 10(-8)), showing a significant fall from the 2nd to the 5th day postpartum (p<0.0005). Maternal serum sPECAM-1 values (mean +/- SD) were significantly lower on the 2nd day postpartum (14.21 +/- 5.15 ng/ml) than those in controls (p<0.002), but reached control values on the 5th day postpartum after a significant rise (p<0.0075). Neonatal serum sPECAM-1 values with no significant difference between the 2nd (14.4 +/- 4.11 ng/ml) and 5th day of life (14.54 +/- 4.99 ng/ml) were significantly lower than those in controls (p<0.002). Values of sPECAM-1 in milk and sera of lactating mothers and their neonates on the 2nd day postpartum depended on the mode of delivery, being significantly lower after caesarean section (p<0.034, p<0.0075 and p<0.035, respectively). In conclusion, our findings in the early postpartum period demonstrate that: (a) sPECAM-1 is present in human milk in low and decreasing concentrations; (b) the shedding of sPECAM-1 is an established component of the neonatal immune system from birth, though in lower concentrations than in adults, possibly reflecting its immaturity; and (c) the mode of delivery has a significant effect on sPECAM-1 values in milk and sera of lactating mothers and their neonates; the lower values after caesarean section may reveal a deranged endothelial homeostasis.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2002
To evaluate postpartum MCH changes in the early postpartum period, and to examine whether neonata... more To evaluate postpartum MCH changes in the early postpartum period, and to examine whether neonatal MCA is related to that in maternal serum (MS) or milk. MCA was measured by EIA on the second and fifth postpartum day in serum and BM from 30 lactating women and their single term neonates. Sera from 20 healthy women (controls), were also analyzed. All neonatal antigen concentrations were below the cut-off level for MCA (11 ng/ml). MS MCA was significantly increased compared with that in controls (P<0.00001), while antigen values in BM were highly elevated (P<0.00001), with a significant increase (P<0.0003) from the second to the fifth postpartum day. A strong correlation was found between the second and fifth day postpartum samples in MS, neonatal serum and BM MCA concentrations (r(s)=0.94, P<0.00001; r(s)=0.75, P<0.00001 and r(s)=0.69, P<0.0001, respectively). A significant correlation was also found in MCA values on the fifth postpartum day between neonatal serum and BM (r(s)=0.54, P<0.02). From these findings one may speculate on some ripening process in milk production and a possible transition of MCA from the neonatal gastro-intestinal tract into circulation.
The determinants of serum homocysteine in healthy postmenopausal women remain uncertain. The aim ... more The determinants of serum homocysteine in healthy postmenopausal women remain uncertain. The aim of this study was the assessment of the association of endogenous sex steroids with serum homocysteine levels in healthy postmenopausal women not on hormone therapy. 484 postmenopausal women aged 43-69 years were studied in a cross-sectional design. Parameters assessed were serum FSH, estradiol, total testosterone, SHBG, Free Androgen Index, delta4-Androstendione, Dehydroepiandrosterone sulphate, and homocysteine. Serum FSH correlated positively (r=0.23, p=0.01), while serum estradiol correlated negatively (r=-0.25, p=0.03) with circulating Hcy. This association remained statistically significant after adjustment for age, years since menopause, and BMI. Serum estradiol decreased, while FSH increased linearly with increasing homocysteine quartiles (p=0.04 and p=0.02, respectively). None of the serum androgens assessed correlated with circulating homocysteine. Endogenous estrogens and not androgens are related to serum homocysteine values in postmenopausal women. Whether this association has clinical implications remains to be clarified.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2001
To assess the usefulness of Mucin-like carcinoma-associated antigen (MCA) in monitoring pregnant ... more To assess the usefulness of Mucin-like carcinoma-associated antigen (MCA) in monitoring pregnant patients with breast cancer. Maternal serum (MS) and amniotic fluid (AF) antigen values were measured by an enzyme immunoassay in 30 pregnant women during the second trimester, in 28 during the third and in 26 at parturition. Sera only from 26 women in the first trimester and from 26 healthy, non-pregnant women (controls) were also analyzed. Maternal serum MCA concentrations increased significantly with gestational age (p<0.0001). The frequency of elevated serum values was 5% in the first, 35% in the second and 100% in the third trimester and at parturition. Antigen values in AF were markedly higher than those in MS (p<0.0001) and increased also significantly with advancing gestation (p<0.0001). A strong correlation was observed between MS and AF antigen values (r=0.77, p<0.0001). Maternal serum values at parturition were dependent on the mode of delivery, being higher in the cases who delivered vaginally, compared to those delivered by elective caesarean section (p<0.006). Our data suggest that pregnancy affects significantly maternal serum MCA. Consequently, MCA seems to be a non-reliable marker in monitoring pregnant patients.
Vitamin D receptor's (VDR) genotypes have been associated... more Vitamin D receptor's (VDR) genotypes have been associated both with the development of bone disease and the pathogenesis of multiple sclerosis (MS). We aimed to evaluate the association between the presence of Bsm1 restriction fragment length polymorphism of VDR and bone loss in ambulatory patients with MS. This cross-sectional study included 82 adult patients with relapsing-remitting MS. Fasting blood samples were obtained for biochemical-hormonal assessment and genotyping. Bone mineral density (BMD) was assessed at the lumbar spine (LS) and the femoral neck (FN), using dual energy X-ray absorptiometry. Possible associations between VDR's genotypes and BMD levels as well as biochemical and hormonal indices were evaluated. Among premenopausal women and men, carriers of the B allele exhibited higher BMD and Z score at the FN and a trend toward higher BMD at the LS, compared to patients with the bb genotype, after adjusting for age, BMI, sex, EDSS scoring, interferon administration, duration of MS and total steroids intake. Among postmenopausal women, the presence of the B allele was not associated with BMD or T score at any site, whereas carriers of the B allele exhibited higher levels of calcium (p value 0.008, univariate). No other significant differences were exhibited between levels of electrolytes, parathormone, 25-hydroxyvitamin D3 and the genotype of VDR, in any of the groups. VDR's Bsm1 polymorphism is associated with a mild effect on BMD in younger patients with MS. Larger studies are necessary to corroborate these findings.
Intrauterine fetal development is characterized by increased rates of proliferation and apoptosis... more Intrauterine fetal development is characterized by increased rates of proliferation and apoptosis, while both these processes may be attenuated post-natally. Tissue polypeptide specific antigen and sFas serum concentrations were determined during pregnancy and post-natally, in order to evaluate their alterations during these crucial periods. Forty-seven healthy pregnant women, their full-term newborns and 35 healthy adults (controls) were included in the study. Markers were measured: (a) in maternal serum (MS), during the 1st, 2nd, 3rd trimester and at the 1st stage of labor; (b) in the umbilical cord (UC), during the 2nd stage of labor; (c) in neonatal serum in the 1st (IN) and 5th (5N) day after birth; and (d) in controls. The serum TPS concentrations in MS increased significantly with gestational age, being higher in the 3rd trimester and labor, than those in controls (p < 0.001). TPS values were significantly lower in the UC, compared to those in MS (p < 0.001), while they were markedly elevated in IN, compared to MS and UC (p < 0.001), and subsequently decreased in 5N (p < 0.001), remaining higher, than those in the controls (p < 0.001). Serum sFas concentrations in the MS depended significantly on gestational age (p < 0.001), being significantly lower in the first trimester, than those in the second (p < 0.003), the third (p < 0.03), in labor and controls (p < 0.005). sFas concentrations in the UC were significantly lower than in MS and controls (p < 0.001), while they increased significantly in 5N samples (p < 0.01). Our results demonstrate: (a) a higher apoptosis rate in the first trimester of pregnancy, possibly affecting maternal immuno-tolerance, followed by a down-regulation during the post-natal period; (b) a progressively increased proliferation from the first trimester to parturition, reflecting the fetal and placental growth and development, that seems to be thereafter moderated.
Journal of B.U.ON.: official journal of the Balkan Union of Oncology
Hepatic resection is the mainstay of the curative treatment of primary hepatic tumors, with const... more Hepatic resection is the mainstay of the curative treatment of primary hepatic tumors, with constantly improving short and long term results. Radiofrequency ablation (RFA)-assisted liver resection is a relatively new method of transection of the liver parenchyma with favorable intra- and perioperative results. The aim of this study was to investigate the oncological efficacy (long term overall survival/OS and disease free survival/DFS) and to confirm the favorable short term morbidity and mortality. Between May 2004 and January 2007, 28 patients underwent 32 resections with removal of 50 hepatocellular carcinoma (HCC) lesions. The technique of parenchymal transection has been described previously as RFA-assisted liver resection. Thirty-day morbidity and mortality were 42.8 and 0%, respectively. Blood transfusion was necessary for 28.5% of the patients. The median hospital stay was 16.5 days (range 5-34). The 1- and 3-year OS were 92.9 and 65.7%, respectively. The 1- and 3-year DFS were 62.3 and 54.6- respectively. No patient developed metastatic disease or local recurrence at the margin site. Twelve patients (42.9%) developed in-the-liver recurrence away from the resection area. RFA-assisted liver resection is a safe and oncologically efficacious method for the surgical treatment of HCC with results comparable to other surgical techniques.
Modulating effects of genetic and environmental risk factors on severity of human abdominal aorti... more Modulating effects of genetic and environmental risk factors on severity of human abdominal aortic aneurysm (AAA) tissue inflammation remain unclear. We investigated the influence of total plasma homocysteine (tHcy) and traditional atherosclerotic risk factors (ARF) on degree of AAA tissue inflammation. Aneurysm specimens were obtained from 89 male patients aged 52 to 83 years, underwent asymptomatic not ruptured AAA (mean diameter 5.5 cm) open repair and graded for degree of histologic inflammation. Multivariate analysis was used to determine the association of tHcy and ARF, with degree of inflammation. Current cigarette smoking, odds ratio (OR) 4.4, 95% confidence interval 1.3 to 15.2, P = .01 and no other ARF, neither tHcy levels OR 0.9 (0.9-1.02), P = .2 were associated with high-grade tissue inflammation. These results provide evidence against a major effect of tHcy levels on AAA tissue inflammation, while current cigarette smoking is a significant modulating factor.
An association between symptomatic carotid stenosis and recent infection with Chlamydia pneumonia... more An association between symptomatic carotid stenosis and recent infection with Chlamydia pneumoniae is reported. Thirty-five patients (20 symptomatic and 15 asymptomatic) with carotid stenosis of 70% to 90% underwent carotid endarterectomy. Endarterectomy was performed without patch and shunt; the average occlusion time of the internal carotid artery was 14 +/- 3 min. The atheromatic plaque and a portion of the thyroid artery were examined with polymerase chain reaction and peripheral vein blood was obtained for serologic detection of systematic infection, and IgG and IgM antibodies to C. pneumoniae by enzyme-linked immunosorbent assay. Twenty of 35 patients (57.1%) had increased titers of IgG antibodies to C. pneumoniae. Eight patients revealed IgG plus IgM antibodies; two of the eight had IgG, IgM, and positive findings on polymerase chain reaction. No C. pneumoniae was detected on the thyroid arteries. Sixty-five percent (13/20) of the patients with increased IgG antibodies to C. pneumoniae, 87.5% (7/8) with IgG + IgM, and 100% with IgG + IgM + positive polymerase chain reaction were symptomatic. Plaque morphology in association with symptoms did not reveal a significant correlation between soft plaques and symptoms, whereas the majority of the symptomatic patients had plaques of type III-V. Patients having recent contamination and positive polymerase chain reaction had a significant relationship between C. pneumoniae infection and symptomatic carotid disease. This supports the hypothesis that C. pneumoniae infection can produce a kind of instability of the carotid plaque. The results of this study demonstrate that patients with advanced atherosclerotic carotid disease have an increased incidence of C. pneumoniae infection. Recent infection could be responsible for instability of the carotid plaque, causing cerebral ischemic episodes.
Immunomediators seem to have a central role in the immune system of both human milk and newborn i... more Immunomediators seem to have a central role in the immune system of both human milk and newborn infants. CD31/PECAM-1 is an adhesion molecule, member of Ig gene superfamily, mediating cell-cell adhesion in both homophilic and heterophilic ways. Levels of the soluble form of PECAM-1 (sPECAM-1) were evaluated on the 2nd and 5th day postpartum in breast milk and serum paired samples from 20 lactating women as well as in time-matched serum from their single, term, healthy neonates. Concentrations of sPECAM-1 in breast milk (median, range) on both the 2nd (2.05 ng/ml, 0.0-7.2) and 5th day postpartum (0.89 ng/ml, 0.0-3.6) were about 10 and 20 times lower than those (mean +/- SD) in controls (healthy adults) (19.83 +/- 5.17, p<7 x 10(-8)), showing a significant fall from the 2nd to the 5th day postpartum (p<0.0005). Maternal serum sPECAM-1 values (mean +/- SD) were significantly lower on the 2nd day postpartum (14.21 +/- 5.15 ng/ml) than those in controls (p<0.002), but reached control values on the 5th day postpartum after a significant rise (p<0.0075). Neonatal serum sPECAM-1 values with no significant difference between the 2nd (14.4 +/- 4.11 ng/ml) and 5th day of life (14.54 +/- 4.99 ng/ml) were significantly lower than those in controls (p<0.002). Values of sPECAM-1 in milk and sera of lactating mothers and their neonates on the 2nd day postpartum depended on the mode of delivery, being significantly lower after caesarean section (p<0.034, p<0.0075 and p<0.035, respectively). In conclusion, our findings in the early postpartum period demonstrate that: (a) sPECAM-1 is present in human milk in low and decreasing concentrations; (b) the shedding of sPECAM-1 is an established component of the neonatal immune system from birth, though in lower concentrations than in adults, possibly reflecting its immaturity; and (c) the mode of delivery has a significant effect on sPECAM-1 values in milk and sera of lactating mothers and their neonates; the lower values after caesarean section may reveal a deranged endothelial homeostasis.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2002
To evaluate postpartum MCH changes in the early postpartum period, and to examine whether neonata... more To evaluate postpartum MCH changes in the early postpartum period, and to examine whether neonatal MCA is related to that in maternal serum (MS) or milk. MCA was measured by EIA on the second and fifth postpartum day in serum and BM from 30 lactating women and their single term neonates. Sera from 20 healthy women (controls), were also analyzed. All neonatal antigen concentrations were below the cut-off level for MCA (11 ng/ml). MS MCA was significantly increased compared with that in controls (P<0.00001), while antigen values in BM were highly elevated (P<0.00001), with a significant increase (P<0.0003) from the second to the fifth postpartum day. A strong correlation was found between the second and fifth day postpartum samples in MS, neonatal serum and BM MCA concentrations (r(s)=0.94, P<0.00001; r(s)=0.75, P<0.00001 and r(s)=0.69, P<0.0001, respectively). A significant correlation was also found in MCA values on the fifth postpartum day between neonatal serum and BM (r(s)=0.54, P<0.02). From these findings one may speculate on some ripening process in milk production and a possible transition of MCA from the neonatal gastro-intestinal tract into circulation.
The determinants of serum homocysteine in healthy postmenopausal women remain uncertain. The aim ... more The determinants of serum homocysteine in healthy postmenopausal women remain uncertain. The aim of this study was the assessment of the association of endogenous sex steroids with serum homocysteine levels in healthy postmenopausal women not on hormone therapy. 484 postmenopausal women aged 43-69 years were studied in a cross-sectional design. Parameters assessed were serum FSH, estradiol, total testosterone, SHBG, Free Androgen Index, delta4-Androstendione, Dehydroepiandrosterone sulphate, and homocysteine. Serum FSH correlated positively (r=0.23, p=0.01), while serum estradiol correlated negatively (r=-0.25, p=0.03) with circulating Hcy. This association remained statistically significant after adjustment for age, years since menopause, and BMI. Serum estradiol decreased, while FSH increased linearly with increasing homocysteine quartiles (p=0.04 and p=0.02, respectively). None of the serum androgens assessed correlated with circulating homocysteine. Endogenous estrogens and not androgens are related to serum homocysteine values in postmenopausal women. Whether this association has clinical implications remains to be clarified.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2001
To assess the usefulness of Mucin-like carcinoma-associated antigen (MCA) in monitoring pregnant ... more To assess the usefulness of Mucin-like carcinoma-associated antigen (MCA) in monitoring pregnant patients with breast cancer. Maternal serum (MS) and amniotic fluid (AF) antigen values were measured by an enzyme immunoassay in 30 pregnant women during the second trimester, in 28 during the third and in 26 at parturition. Sera only from 26 women in the first trimester and from 26 healthy, non-pregnant women (controls) were also analyzed. Maternal serum MCA concentrations increased significantly with gestational age (p<0.0001). The frequency of elevated serum values was 5% in the first, 35% in the second and 100% in the third trimester and at parturition. Antigen values in AF were markedly higher than those in MS (p<0.0001) and increased also significantly with advancing gestation (p<0.0001). A strong correlation was observed between MS and AF antigen values (r=0.77, p<0.0001). Maternal serum values at parturition were dependent on the mode of delivery, being higher in the cases who delivered vaginally, compared to those delivered by elective caesarean section (p<0.006). Our data suggest that pregnancy affects significantly maternal serum MCA. Consequently, MCA seems to be a non-reliable marker in monitoring pregnant patients.
Vitamin D receptor's (VDR) genotypes have been associated... more Vitamin D receptor's (VDR) genotypes have been associated both with the development of bone disease and the pathogenesis of multiple sclerosis (MS). We aimed to evaluate the association between the presence of Bsm1 restriction fragment length polymorphism of VDR and bone loss in ambulatory patients with MS. This cross-sectional study included 82 adult patients with relapsing-remitting MS. Fasting blood samples were obtained for biochemical-hormonal assessment and genotyping. Bone mineral density (BMD) was assessed at the lumbar spine (LS) and the femoral neck (FN), using dual energy X-ray absorptiometry. Possible associations between VDR's genotypes and BMD levels as well as biochemical and hormonal indices were evaluated. Among premenopausal women and men, carriers of the B allele exhibited higher BMD and Z score at the FN and a trend toward higher BMD at the LS, compared to patients with the bb genotype, after adjusting for age, BMI, sex, EDSS scoring, interferon administration, duration of MS and total steroids intake. Among postmenopausal women, the presence of the B allele was not associated with BMD or T score at any site, whereas carriers of the B allele exhibited higher levels of calcium (p value 0.008, univariate). No other significant differences were exhibited between levels of electrolytes, parathormone, 25-hydroxyvitamin D3 and the genotype of VDR, in any of the groups. VDR's Bsm1 polymorphism is associated with a mild effect on BMD in younger patients with MS. Larger studies are necessary to corroborate these findings.
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