*3.2.3 The relationship of genotypes of LRP5rs121908669 with lumbar bone mineral density*

The results of Odd ratio test, chi-square test, and Related-Samples McNemar Change Test which were applied to study the relationship between the genotypes of LRP5rs121908669 and lumbar BMD are shown in **Table 3**.

Osteopenia increases and osteoporosis decreases in lumbar bone (L1-L4) in carriers of the CC genotype. The appearance of normal BMD increases and osteoporosis decreases in lumbar bone in carriers of the GG genotype. The appearance of low lumbar bone mineral density (osteopenia) increases among carriers of the GC genotype.

It is noted that the genotypes of LRP5rs121908669 have an effect on the bone mineral density in the lumbar region, but the question could be "does it have an effect as important as the effect of hormonal factors on the bone mineral density in the lumbar region?"

In order to answer this question, a comparative study must be made between the statistical results in **Table 3** specially between the participants who carry the CC and GC genotypes and suffer from low bone mineral density in the lumbar region and the participants who carry the GG genotype and suffer from low of bone mineral density in the lumbar region. Genetic patterns have greater influence than hormonal factors, knowing that all participants are women per and after menopause. It is preferable to measure the estrogen hormone in the participants and compare its concentrations with the appearing of genotypes and study the effect on the bone mineral density in the lumbar region.

This study is the first of its kind in the world. There is only one Belgian study that revealed this mutation by chance and it has not studied afterward, but in that study



it was associated with an increase in bone mineral density without specifying the genotype, and this is contrary to the results of this research.
