Relationship Between Polymorphism Of Estrogen Receptor Gene And BMD, TCM Syndrome In Postmenopausal Women In Guangzhou

Section One Lirerature Study1 The cause and mechanisms of postmenopausal osteoporosis(PMOP) in Traditional Chinese Medicine(TCM)Deficiency of kidney is the fundamental cause of PMOP.The gradual decline of kidney essence causes the degradation of skeleton.Deficiency of spleen and stomach is related closely to PMOP.The kidney determines the conditions of congenital constitution and the spleen determines the required one.Blood stasis is an important pathological factor of senile patients.Activating blood circulation to dissipate blood stasis is an important method to treat PMOP.2 The research progress of polymorphism in bone rarefaction related genesOsteoporosis is a complex disease induced by all kings of agents,it intimately correlates with the peak value and the losing speed of bone mass,while,natural and environmental factors participate the achievement,the maintenance of peak value in bone mass,as well as the accommodation of bone mass losing.The investigation confirmed,genetic factor can explain the diversity of bone density in 60%～80%.In recent years,the research of related genes induced bone rarefaction became hot spot,VDR,ER,CTR,PTH play great roles in bone rarefaction.No matter twins or general crowd,the BMD of b allelomorphie gene individuals is higher than those of B allelomorphic gene.In youths,the BMD in BB genetype individuals is 2 standard deviation(S.D)lower than the individuals of same age and sexuality,it hints that the losing speed of BMD is fast in this category of crowd,detecting VDR polymorphism can estimate the BMD of different individuals in their different ages.ESG played a very important role in the BMD retaining and bone fracture preventing of climacteric females.After ER disenabling,bone mineralization obviously attenuate in femina or maleness rats.Likewise, the male whose estrogenic hormonal resistance or aromatizing enzyme is vicious due to ER genic mutation,the BMD also obviously degraded, however,after recruitment of estrogenic hormone,the low-grade bone mass can gradually increase.Masi have analyzed 307 post-menopause Italian femmes and discovered that TT and TC genetypes have higher frequency in occurrence,but the abdominal vertebra BMD of TT genetype individuals is obviously lower than those in CC genetype individuals.Kanzawa pointed, the abdominal vertebra BMD of PTH gene individuals in BB genetype is obviously higher than those of Bb and bb genetype,so he considered that the BstBI polymorphism of PTH gene has dependability with BMD while the DraⅡpolymorphism of PTH gene has no dependablity with BMD.3 The polymorphism of estrogen receptor(ER) gene and postmenopausal osteoporosis(PMOP)PMOP is a metabolic bone disease existing in post-menopause femmes, as a result of these femmes' hypofunction of ovary,ESG level drawdown and the disequilibrium of bone couple procedure,the bone resorption of osteoclast exceeds the bone formation of osteoblastic,osteopenia and bone fragility accrescence have developed,then induces fracture and so on.PMOP is the chief reason.Study has indicated:ER gene exists PvuⅡand XbaⅠpolymorphism enzyme cutting sites,enzyme cutting can create sequentiae genetype:PP,Pp,pp;XX,Xx,xx.According to compound genotypic allelomorph construction,there are nine kinds of haplotype allelomorph. Study has indicated:ER gene polymorphism is dependable with osteoporotic.Kobayashi had analyzed the relationship between genetype and BMD of 238 post-menopause healthy femmes at Nagano county in Japan,and pointed out:the abdominal vertebra the Z integral of BMD has correlation with PvuⅡsite,the corresponding BMD' s sequence of each genetype is: PP＜Pp＜pp,the Z integral of PP genetype in abdominal vertebra BMD is the lowest,but the corresponding BMD' s sequence of Xbal polymorphic site genetype is XX＞Xx＞xx,without statistical significance.Both of Mahonen' s study on finland femmes and Qi' s research of Australians concluded:the BMD of pp genetype abdominal vertebra is in low-grade. Huang Qi-ren considered,post-menopause healthy femme' s ER PvuⅡgenetype has significant correlation with the BMD in greater trochanter of femur,the BMD of PP genetype individuals is in low-grade.Section two The Clinical StudyObjectiveWith study on distributing regularity of post-menopause female' s ER gene polymorphism of long-term habitant in canton and the relationship with bone density,TCM differentiation of symptoms and signs for classification of syndrome about bone rarefaction,to offer theory evidence for filting relative high-risk group of bone rarefaction.MethodsChoosing 168 post-menopause femme(aged 45～70,averaged58)long-termly living in canton,making use of ambo-ability x-nema bone resorption meter,measuring the BMD of abdominal vertebra respectively(abdominal vertebra from the first segment to the fourth segment),measuring its contents of Ca,P,ALP,PTH,CT in blood serum with biochemical method, analyzing incision enzyme,PvuⅡ,XbaⅠRFLP with molecular biology method,observing the disposition of ER gene polymorphism at case of a particular disease group and control group(CG),as well as the relationship between it and bone rarefaction TCM pattern of syndrome.TCM differentiation of symptoms and signs for classification of syndrome contents insufficiency of kidney-yang,deficiency of kidney-yin, Qi-stagnancy and blood stasis and mixed pattern.ResultsThis research indicates:according to《primary osteoporosis diagnostic criteria of Chinese》,among the total 168 post-menopause femmes,108 are osteoporosis patients(CS group),60 are non-osteoporosis patients(CG group).The relationship between ER gene polymorphism and bone density in post-menopause femme at Canton region as follows:PP＜Pp＜pp,XX＞Xx＞xx. The bone density in compound genetypes of PPxx are lower than other genetypes.In demixing analysis,the distributed frequency of PP type and compound genetype of PPxx in osteoporosis group are higher than non-osteoporosis group,and the discrepancy is significance.According to differentiation of symptoms and signs for classification of syndrome about TCM,the primary appearance about post-menopause female osteoporosis pattern of syndrome in Canton is insufficiency of Kidney-Yang.Conclusions1 The relationship between ER gene polymorphism in post-menopause female at Canton region as follows:PP＜Pp＜pp,xx＜Xx＜XX.2 The distribution frequency of PP type in bone rarefaction group is higher than non-osteoporosis group,the discrepancy is significant(p＜0.01); then,the distribution of compound genetypes of PPxx is obviously higher than CG group(p＜0.01).Thus,we can think that the 2 kinds of gene carriers are osteoporosis susceptibility gene categories.3 The primary appearance about post-menopause female osteoporosis pattern of syndrome in Canton is insufficiency of Kidney-Yang.The specified genetype in ER acceptor gene polymorphism has intimate relation with differentiation of symptoms and signs for classification of syndrome, having guiding effect on practical determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs. Especially,taking genetic gene polymorphismas means of TCM medication, we can get the biology significance with polymorphism.