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腰椎间盘疾病与维生素D受体基因多态性的关联。

The association of lumbar disc disease with vitamin-D receptor gene polymorphism.

作者信息

Kawaguchi Yoshiharu, Kanamori Masahiko, Ishihara Hirokazu, Ohmori Kazuo, Matsui Hisao, Kimura Tomoatsu

机构信息

Department of Orthopaedic Surgery, Toyama Medical and Pharmaecutical University, Faculty of Medicine, 2630 Sugitani, Toyama 930-0194, Japan.

出版信息

J Bone Joint Surg Am. 2002 Nov;84(11):2022-8. doi: 10.2106/00004623-200211000-00018.

Abstract

BACKGROUND

Although the etiology of lumbar disc disease is unknown, it has been suggested that a genetic factor contributes to its development. Recently, some genetic polymorphisms have been found to be related to clinical disorders. We investigated the association between vitamin-D receptor gene and estrogen receptor gene polymorphisms and lumbar disc disease in young adults.

METHODS

The participants included 205 young adults (166 women and thirty-nine men) with or without low-back problems. A magnetic resonance imaging scan of the lumbar spine was performed for all subjects, and the grade of disc degeneration was determined, according to the four-grade classification system of Schneiderman et al. The presence or absence of disc herniation was also evaluated. Genomic DNA was extracted from peripheral blood samples. The polymorphisms of the vitamin-D receptor and estrogen receptor genes were detected with use of a polymerase-chain-reaction assay. The restriction fragment length polymorphisms (RFLPs) for the vitamin-D receptor gene were analyzed by TaqI and ApaI restriction enzymes. XbaI and PvuII restriction enzymes were used for the estrogen receptor gene analysis. The distribution of polymorphism in subjects with disc degeneration and/or disc herniation was compared with that in the normal subjects.

RESULTS

The allelic frequencies of both vitamin-D receptor gene and estrogen receptor gene polymorphisms were similar to those in previous analyses of Japanese subjects. The allelic variation in the vitamin-D receptor gene was associated with multilevel and severe disc degeneration and disc herniation. The Tt allele was found to be more frequently associated with multilevel disc disease, severe disc degeneration, and disc herniation than was the TT allele. No additional associations were found.

CONCLUSIONS

This study revealed that the Tt allele of the vitamin-D receptor gene was more frequently associated with multilevel and severe disc degeneration and disc herniation than was the TT allele, pointing to an increased risk of disc disease at an early age in subjects with the Tt allele in the vitamin-D receptor gene.

摘要

背景

尽管腰椎间盘疾病的病因尚不清楚,但有研究表明遗传因素在其发病过程中起一定作用。近年来,一些基因多态性被发现与临床疾病相关。我们研究了维生素D受体基因和雌激素受体基因多态性与年轻成人腰椎间盘疾病之间的关联。

方法

研究对象包括205名有或无腰背痛问题的年轻成人(166名女性和39名男性)。对所有受试者进行腰椎磁共振成像扫描,并根据施奈德曼等人的四级分类系统确定椎间盘退变程度。同时评估是否存在椎间盘突出。从外周血样本中提取基因组DNA。采用聚合酶链反应检测维生素D受体和雌激素受体基因的多态性。用TaqI和ApaI限制性内切酶分析维生素D受体基因的限制性片段长度多态性(RFLP)。用XbaI和PvuII限制性内切酶分析雌激素受体基因。比较椎间盘退变和/或椎间盘突出患者与正常受试者的多态性分布。

结果

维生素D受体基因和雌激素受体基因多态性的等位基因频率与之前对日本受试者的分析结果相似。维生素D受体基因的等位基因变异与多节段和严重的椎间盘退变及椎间盘突出相关。发现Tt等位基因比TT等位基因更常与多节段椎间盘疾病、严重椎间盘退变和椎间盘突出相关。未发现其他关联。

结论

本研究表明,维生素D受体基因的Tt等位基因比TT等位基因更常与多节段和严重的椎间盘退变及椎间盘突出相关,提示维生素D受体基因携带Tt等位基因的个体在早年患椎间盘疾病的风险增加。

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