Battié Michele C, Levalahti Esko, Videman Tapio, Burton Kim, Kaprio Jaakko
Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
J Appl Physiol (1985). 2008 Feb;104(2):379-85. doi: 10.1152/japplphysiol.01009.2007. Epub 2007 Nov 29.
Spinal range of motion is evaluated in assessing patients with back problems and monitoring outcomes, as well as in general fitness assessments. Yet, determinants of the substantial interindividual variation in spinal range of motion are not well understood. Substantial genetic effects on global measures of range of motion and hypermobility have been suggested from earlier studies, but genetic influences specifically on spinal range of motion have not been previously studied. The objectives of the present study were to investigate the relative role of genetic and environmental influences on lumbar range of motion in adult men and the pathways through which genes may influence range of motion. Thus we conducted a classic twin study of 300 monozygotic and dizygotic male twin pairs with consideration of covariates, using standard statistical methods. All subjects underwent a clinical examination, including general anthropometrics, lumbar range of motion, and lumbar MRI to assess disc degeneration, as well as an extensive interview on environmental and behavioral exposures and back pain history. We found the proportion of variance in lumbar range of motion attributable to genetic influences (heritability estimate) to be 47%. The extent of lumbar range of motion in flexion was predominantly determined by genetic influences (64%), while extension was influenced to a somewhat greater degree by environmental and behavioral factors. Statistically significant age-adjusted genetic correlations were found between lumbar extension and disc degeneration variables (r(a) = -0.38 to -0.43) and between flexion and body weight (r(a) = -0.33), suggesting two pathways through which genes influence lumbar range of motion.
在评估背部问题患者、监测治疗效果以及进行一般健康评估时，都会对脊柱活动范围进行评估。然而，对于个体间脊柱活动范围存在显著差异的决定因素，我们尚未完全了解。早期研究表明，基因对活动范围和关节过度活动的整体测量有显著影响，但此前尚未对基因对脊柱活动范围的具体影响进行研究。本研究的目的是调查基因和环境因素对成年男性腰椎活动范围的相对作用，以及基因可能影响活动范围的途径。因此，我们采用标准统计方法，对300对同卵和异卵男性双胞胎进行了一项经典的双胞胎研究，并考虑了协变量。所有受试者都接受了临床检查，包括一般人体测量、腰椎活动范围和腰椎MRI以评估椎间盘退变，以及关于环境和行为暴露及背痛病史的广泛访谈。我们发现，基因影响导致的腰椎活动范围变异比例（遗传度估计值）为47%。腰椎前屈活动范围的程度主要由基因影响决定（64%），而伸展则在一定程度上受环境和行为因素影响更大。在腰椎伸展与椎间盘退变变量之间（r(a)= -0.38至-0.43）以及前屈与体重之间（r(a)= -0.33）发现了具有统计学意义的年龄校正基因相关性，这表明基因影响腰椎活动范围的两条途径。
