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13 Taken together, these data strongly imply that APC might be involved in the regulation of bone mass by regulating the cytoplasmic http://www.selleckchem.com/products/azd9291.html levels of ��-catenin. FAP patients carry heterozygous APC mutations that result in a constitutively active transduction of ��-catenin. We hypothesized, therefore, that FAP may represent a valuable human model for the study of the role of the canonical Wnt signaling pathway in bone mass acquisition and maintenance. In this study we addressed the question of whether heterozygous mutations in the APC gene are associated with alterations in bone mass and/or bone turnover. Thirty consecutive FAP patients attending the Outpatient Clinic of the Department of Gastroenterology of the Leiden University Medical Centre (LUMC) for routine follow-up visits over a 6-month calendar period were invited to take part in the study. The inclusion http://www.selleck.cn/products/Everolimus(RAD001).html criteria were a clinically established, histologically documented, and genetically confirmed diagnosis of FAP and the willingness of the patient to participate in the study. The only exclusion criterion was the current or past use of any agent known to affect bone metabolism, such as bisphosphonates or parathyroid hormone (PTH). The study was approved by the Ethics Committee of the LUMC, and written informed consent was obtained from all patients. Demographic characteristics, including age, gender, ethnicity, body weight, height, body mass index (BMI), menopausal status, smoking habits, and alcohol use, were documented in all patients. Other data collected were family history of FAP, age at diagnosis, history of colectomy, age at colectomy, extracolonic manifestations, dental and fracture history, and use of medication. To allow for comparison between different ages and genders, http://www.selleckchem.com/products/ch5424802.html height was expressed as standard deviation score (SDS) corrected for shrinking and secular trend.14 BMD was measured in all patients at the lumbar spine (L1 to L4) and at different sites of both hips (total hip, femoral neck, and trochanter) using dual-energy X-ray absorptiometry (DXA; Hologic QDR-4500, Hologic Inc., Bedford, MA, USA). Mean BMD of the left and right hips was used for analysis. Data were expressed as T-scores (number of SDs from the mean value of the sex-matched reference population) and Z-scores (number of SDs from the mean value of the age- and sex-matched reference population) using the National Health and Nutrition Examination Survey (NHANES) reference values, which are compatible with those of Dutch control populations.15�C17 Standard World Health Organization (WHO) reference values established for BMD measurements were used to define osteopenia (?2.5?