Cong L, Tu G, Liang D
Department of Orthopaedic Surgery, The First Hospital of China Medical University, Shenyang, China.
Bone Joint Res. 2018 May 5;7(4):308-317. doi: 10.1302/2046-3758.74.BJR-2017-0207.R1. eCollection 2018 Apr.
Degenerative disc disease (DDD) and osteoarthritis (OA) are relatively frequent causes of disability amongst the elderly; they constitute serious socioeconomic costs and significantly impair quality of life. Previous studies to date have found that aggrecan variable number of tandem repeats (VNTR) contributes both to DDD and OA. However, current data are not consistent across studies. The purpose of this study was to evaluate systematically the relationship between aggrecan VNTR, and DDD and/or OA.
This study used a highly sensitive search strategy to identify all published studies related to the relationship between aggrecan VNTR and both DDD and OA in multiple databases from January 1996 to December 2016. All identified studies were systematically evaluated using specific inclusion and exclusion criteria. Cochrane methodology was also applied to the results of this study.
The final selection of seven studies was comprehensively evaluated and includes results for 2928 alleles. The most frequent allele among all the studies was allele 27. After comparing the distributions of each allele with others, statistically significant differences have been found in the distribution of the alleles by the two groups, with an over-representation of allele (A)21 (disease: 3.22%, control: 0.44%). Thus, carrying A21 increased the risk of DDD. Such an association was not found to be statistically significant when considering the risk of OA.
The findings suggest that VNTR A21 seems to be associated with higher risk to DDD, however, such an association may not be statistically significant regarding the risk of OA.: L. Cong, G. Tu, D. Liang. A systematic review of the relationship between the distributions of aggrecan gene VNTR polymorphism and degenerative disc disease/osteoarthritis. 2018;7:308-317. DOI: 10.1302/2046-3758.74.BJR-2017-0207.R1.
椎间盘退变疾病（DDD）和骨关节炎（OA）是老年人致残的常见原因；它们构成了严重的社会经济成本，并显著损害生活质量。既往研究发现，聚集蛋白聚糖可变数目串联重复序列（VNTR）与DDD和OA均有关。然而，目前各研究的数据并不一致。本研究的目的是系统评估聚集蛋白聚糖VNTR与DDD和/或OA之间的关系。
本研究采用高灵敏度检索策略，在多个数据库中识别1996年1月至2016年12月间所有发表的关于聚集蛋白聚糖VNTR与DDD和OA关系的研究。所有纳入研究均根据特定的纳入和排除标准进行系统评估。本研究结果也采用了Cochrane方法。
最终筛选出7项研究进行综合评估，共纳入2928个等位基因的结果。所有研究中最常见的等位基因是27号等位基因。在将每个等位基因的分布与其他等位基因进行比较后，发现两组等位基因分布存在统计学显著差异，（A）21号等位基因过度表达（疾病组：3.22%，对照组：0.44%）。因此，携带A21增加了DDD的风险。在考虑OA风险时，未发现这种关联具有统计学显著性。
研究结果表明，VNTR A21似乎与DDD的较高风险相关，然而，这种关联在OA风险方面可能无统计学显著性。：L. Cong，G. Tu，D. Liang。聚集蛋白聚糖基因VNTR多态性分布与椎间盘退变疾病/骨关节炎关系的系统评价。2018；7：308 - 317。DOI：10.1302/2046 - 3758.74.BJR - 2017 - 0207.R1。
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