Objective: The 12/15-lipoxygenase gene ALOX15 is reported to be a negative regulator of BMD in knockout mice. Nonetheless results are controversial as over-expression of ALOX15 protects against inflammation-related bone loss. The aim of the present study is to systematically study the relation of ALOX15 polymorphisms in BMD variation in southern Chinese women. Methods: Ten tag single nucleotide polymorphisms (SNP) were genotyped in 942 subjects with either low BMD (defined by a BMD Z score ≤–1.28 at either the hip or spine) or high BMD (Z score ≧+1). Single locus and haplotype associations were performed using logistic regression with adjustment of age, height and weight. Results: The variant ‘G’ allele of rs2619112 was associated with a reduced risk of low BMD at the femoral neck in pre-menopausal women (OR = 0.442, p = 0.007) but an increased risk in post-menopausal women (OR = 1.727, p = 0.042). Haplotype analysis revealed findings similar to the single locus tests. Conclusion: The variant alleles of rs2619112 and rs916055 and their haplotypes of ALOX15 are associated with high BMD in pre-menopausal women but low BMD in post-menopausal women. This suggests that ALOX15 is a dual modulator of BMD variation with opposing effects in pre- and post-menopausal women.

Both thyrotoxicosis and hypothyroidism are associated with adverse pregnancy outcomes. There also is concern about the effect of overt maternal thyroid disease on fetal development. In addition, medications that affect the maternal thyroid gland can cross the placenta and affect the fetal thyroid gland. This document reviews the thyroid-related pathophysiologic changes that occur during pregnancy and the effects of overt and subclinical maternal thyroid disease on maternal and fetal outcomes. This Practice Bulletin has been updated with information on the diagnosis and the management of thyroid disease in pregnant women and includes a new clinical algorithm on management of thyroid disease in pregnancy.