Koshizuka Yu, Ogata Naoshi, Shiraki Masataka, Hosoi Takayuki, Seichi Atsushi, Takeshita Katsushi, Nakamura Kozo, Kawaguchi Hiroshi
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, Hongo 7-3-1, Tokyo, Japan.
Eur Spine J. 2006 Oct;15(10):1521-8. doi: 10.1007/s00586-005-0005-8. Epub 2005 Dec 14.
Contribution of genetic backgrounds to the etiology of lumbar spondylosis has been suggested by epidemiological studies. This study was designed to determine the association of restriction fragment length polymorphisms (RFLPs) of estrogen receptor (ER), vitamin D receptor (VDR), parathyroid hormone (PTH) and interleukin-1beta (IL-1beta) genes with the radiological severity of lumbar spondylosis at the disk level from L1/2 to L5/S1 in Japanese post-menopausal women. ER and VDR RFLP haplotypes were associated with the severity of spondylosis in the upper levels (L1/2 and L2/3) more than in the lower levels. Association of ER genotype was more pronounced in the group younger than average than in the older group, while that of VDR genotype was more significant in the older group. Neither PTH nor IL1-beta RFLP was associated with the severity at any levels in either stratified group. We thus conclude that ER and VDR genes may contribute to lumbar spondylosis in a distinct manner: estrogen sensitivity influences the severity in the early phase after menopause while vitamin D plays an important role at older ages when the contribution of estrogen loss is weaker.
流行病学研究表明遗传背景对腰椎间盘退变病因有影响。本研究旨在确定雌激素受体（ER）、维生素D受体（VDR）、甲状旁腺激素（PTH）和白细胞介素-1β（IL-1β）基因的限制性片段长度多态性（RFLP）与日本绝经后女性从L1/2至L5/S1椎间盘水平腰椎间盘退变的放射学严重程度之间的关联。ER和VDR RFLP单倍型与上腰椎水平（L1/2和L2/3）的退变严重程度的相关性高于下腰椎水平。ER基因型的关联在低于平均年龄组中比在高于平均年龄组中更明显，而VDR基因型的关联在高于平均年龄组中更显著。在任何分层组中，PTH和IL-1β RFLP均与任何水平的严重程度无关。因此，我们得出结论，ER和VDR基因可能以不同方式导致腰椎间盘退变：雌激素敏感性影响绝经后早期的严重程度，而维生素D在雌激素丧失作用较弱的老年期起重要作用。
