Department of Clinical Motor System Medicine, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Osteoarthritis Cartilage. 2011 Nov;19(11):1301-6. doi: 10.1016/j.joca.2011.07.017. Epub 2011 Aug 16.
The objective of the present study was to explore the association of serum vitamin D concentration and polymorphism in the vitamin D receptor (VDR), with knee pain and radiographic knee osteoarthritis (OA) among men and women in a large population-based UK cohort study.
Seven hundred and eighty-seven participants in the Hertfordshire Cohort Study (399 men, 388 women; mean age 65.6±2.7 years) underwent a questionnaire on knee pain and radiographic knee examination. This study examined the association of Fok1, Cdx2 and Apa1 polymorphism in the gene for the VDR and serum 25(OH)D concentration with knee pain and radiographic knee OA by a generalized estimating equations population averaged logistic regression analysis in the Hertfordshire Cohort Study.
There were no associations of Fok1, Cdx2 and Apa1 polymorphisms of the VDR with knee OA except for Aa for Apa1 compared with AA [Odds ratio (OR) 0.59, 95% confidence interval (CI) 0.36-0.95, P=0.031]. While, ff for Fok1 (OR 1.60, 95% CI 1.07-2.39, P=0.022) and AA for Cdx2 polymorphism (OR 2.21, 95% CI 1.07-4.56, P=0.032) was significantly associated with higher prevalence of knee pain compared with FF for Fok1 and GG for Cdx2, respectively. None of these are statistically significant after adjusting for the three polymorphisms tested. 25(OH)D level was not significantly associated with radiographic knee OA, while, low tertile of 25(OH)D level tended to be associated with knee pain compared with high tertile of 25(OH)D level.
The present cross-sectional study using a large-scale population from the Hertfordshire Cohort study indicated that vitamin D may be associated with pain rather than radiographic change, but the evidence for an association between vitamin D genetic variation and pain in knee OA is very weak in the present study. Further replication of our results will be required to elucidate the association of vitamin D and knee OA.
本研究旨在探讨血清维生素 D 浓度和维生素 D 受体(VDR)多态性与英国大型人群队列研究中男性和女性膝关节疼痛和放射学膝关节骨关节炎(OA)之间的关系。
赫特福德郡队列研究(399 名男性,388 名女性;平均年龄 65.6±2.7 岁)的 787 名参与者接受了膝关节疼痛和放射学膝关节检查的问卷调查。本研究采用赫特福德郡队列研究的广义估计方程人群平均逻辑回归分析,检测了 VDR 基因的 Fok1、Cdx2 和 Apa1 多态性与血清 25(OH)D 浓度与膝关节疼痛和放射学膝关节 OA 的关系。
除 Apa1 的 Aa 与 AA 相比外(优势比(OR)0.59,95%置信区间(CI)0.36-0.95,P=0.031),VDR 的 Fok1、Cdx2 和 Apa1 多态性与膝关节 OA 无相关性。然而,Fok1 的 ff(OR 1.60,95%CI 1.07-2.39,P=0.022)和 Cdx2 多态性的 AA(OR 2.21,95%CI 1.07-4.56,P=0.032)与 Fok1 的 FF 和 Cdx2 的 GG 相比,膝关节疼痛的患病率显著更高。在调整了测试的三种多态性后,这些都没有统计学意义。25(OH)D 水平与放射学膝关节 OA 无显著相关性,而 25(OH)D 水平的低三分位与高三分位相比,膝关节疼痛的趋势更为明显。
本研究使用赫特福德郡队列研究的大型人群进行了横断面研究,结果表明维生素 D 可能与疼痛而不是放射学变化有关,但本研究中维生素 D 遗传变异与膝关节骨关节炎疼痛之间的关联证据非常薄弱。需要进一步复制我们的结果,以阐明维生素 D 和膝关节骨关节炎之间的关系。