KUMJ | VOL. 16 | NO. 4 | ISSUE 64 | OCT.-DEC. 2018
Association of Serum Vitamin D Level with its Receptor Gene Polymorphism Bsml in Beta Thalassemia Major Patients from East India
Sinharay M, Roy S, Dasgupta A
Abstract: Background
Vitamin D deficiency is commonly identified in beta thalassemia major patients,
related to iron accumulation.Vitamin D mediates its action upon binding to vitamin
D receptor (VDR), a classical nuclear receptor. Several single nucleotide gene
polymorphisms has been identified in VDR gene among which Bsml is commonly
studied for its association with bone mineralisation and osteoporosis.
Objective
To explore the association between the Vitamin D Receptor Polymorphism (BsmI)
and serum levels of Vitamin D, ionised Calcium, alkaline phosphatase in patients with
beta thalassemia major.
Method
VDR gene was studied for Bsml polymorphisms from purified DNA in thirty six beta
thalassemic patients (cases) - fourteen male and twenty two females, and thirty three
controls after amplification by PCR followed by restriction digestion using appropriate
restriction enzymes. Allelic differences between two groups were assessed by chi
square and odds ratio test. Any potential link between the polymorphic variations
and vitamin D status were assessed by post hoc ANOVA with bonferroni correction
among the three genotypes.
Result
The distribution of BB genotype was significantly higher among the case groups
(thalassemic group, χ
2
= 9.77, p= 0.008). The odds ratio for the allele B was
significantly higher in thalassemia group for a range of 1.97 to 5.94 for 95 percent
cofidence interval (χ
2
=10.4, p=0.0013). Serum Vitamin D, ionised Calcium were
significantly low (p < 0.001) and Alkaline phosphatase (p < 0.001), was significantly
high in thalassemics (cases). The genotype BB group had significantly low Vitamin D
(p=0.001) and ionised Calcium (p < .001) compared to Bb and bb. The bb genotype
had the highest levels of Vitamin D and ionised Calcium among the three genotypes.
Conclusion
The thalassemic patients are prone to Vitamin D deficiency and the superimposed
predominance of BB genotype in them may be a risk factor for osteoporosis and
cardiac dysfunction. Moreover, the study indicated genotype bb to have a probable
protective role against Vitamin D deficiency in beta thalassemic patients
Keyword : Beta thalassemia, Vitamin D receptor , Vitamin D receptor gene