Faculty of Medicine, Department of Orthopaedic and Traumatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Faculty of Medicine, Department of Biochemistry, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
J Orthop Surg Res. 2021 Jan 7;16(1):24. doi: 10.1186/s13018-020-02162-y.
Developmental dysplasia of the hip (DDH) is a common disorder and associated with significant morbidity of the hip joint. Several risk factors have been identified for DDH. The aim of this study is to investigate whether vitamin D and vitamin D receptor (VDR) levels differ in children with DDH and whether they have an effect on DDH development.
A total of 40 (17 males, 23 females; 9 right hips, 16 left hips, 15 bilateral hips) children who were treated for developmental dysplasia and 40 (23 males, 17 females) healthy children without any musculoskeletal system and metabolic disorders were included in this study between January and June 2019. Blood samples from the DDH and control groups of children were collected to measure the serum levels of vitamin D, VDR, calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP). The levels of Ca, P, and ALP were analyzed using the automated standard spectrophotometric laboratory method. The levels of vitamin D and VDR in the samples were analyzed using enzyme-linked immunoassay.
There were no significant differences in the serum levels of Ca, P, ALP, and vitamin D between the DDH and healthy groups (Ca 9.96 ± 0.47 vs. 9.92 ± 0.48 mg/dL, respectively, p = 0.721; P 5.3 ± 0.94 vs. 4.82 ± 0.88 mg/dL, respectively, p = 0.23; ALP 252.22 ± 170.15 vs. 245.3 ± 130.93 U/L, respectively, p = 0.839). However, serum VDR levels were significantly lower in children in the DDH group (5.77 ± 3.51 ng/mL) than in the healthy control group (9.25 ± 6.43 ng/mL) (p = 0.004).
In conclusion, we believe that low VDR levels can affect DDH regardless of the serum levels of Ca, P, ALP, and vitamin D. More comprehensive studies involving parents are needed to understand whether VDR levels mediate genetic transmission in DDH or not.
发育性髋关节发育不良(DDH)是一种常见疾病,与髋关节的显著发病率有关。已经确定了几个与 DDH 相关的危险因素。本研究的目的是研究 DDH 患儿的维生素 D 和维生素 D 受体(VDR)水平是否存在差异,以及它们是否对 DDH 的发展有影响。
本研究共纳入 2019 年 1 月至 6 月期间因发育性髋关节发育不良而接受治疗的 40 名儿童(男 17 名,女 23 名;右侧髋关节 9 个,左侧髋关节 16 个,双侧髋关节 15 个)和 40 名无肌肉骨骼系统和代谢疾病的健康儿童(男 23 名,女 17 名)作为对照组。采集 DDH 组和对照组儿童的血液样本,以测量血清中维生素 D、VDR、钙(Ca)、磷(P)和碱性磷酸酶(ALP)的水平。采用自动标准分光光度法对 Ca、P 和 ALP 水平进行分析。采用酶联免疫吸附试验分析样本中维生素 D 和 VDR 的水平。
DDH 组和健康组儿童的血清 Ca、P、ALP 和维生素 D 水平无显著差异(Ca 分别为 9.96 ± 0.47 和 9.92 ± 0.48mg/dL,p = 0.721;P 分别为 5.3 ± 0.94 和 4.82 ± 0.88mg/dL,p = 0.23;ALP 分别为 252.22 ± 170.15 和 245.3 ± 130.93U/L,p = 0.839)。然而,DDH 组儿童的血清 VDR 水平明显低于健康对照组(5.77 ± 3.51ng/mL 比 9.25 ± 6.43ng/mL,p = 0.004)。
综上所述,我们认为,无论血清 Ca、P、ALP 和维生素 D 水平如何,低 VDR 水平都可能影响 DDH。需要对父母进行更全面的研究,以了解 VDR 水平是否介导 DDH 的遗传传递。