Study On Alcohol-induced Osteonecrosis Of The Femoral Head Related TCM Constitution With CYP2C8 Gene Polymorphism

Objective: Alcohol and hormone are the most common pathogenic factors of non-traumatic osteonecrosis of the femoral head(NONFH), with the pathogenesis research gradually thorough, A large number of studies suggests that alcohol and hormones can affect the enzyme cytochrome 450(CYP450) activity, and make important influence on the occurrence and development of NONFH.This study based on previous alcohol- induced osteonecrosis of the femoral head(AIONFH) related liver enzyme gene polymorphism research, and make more explore on AIONFH high-risk factors TCM constitution type relationship with CYP2C8 gene polymorphisms, and to understand the theoretical basis of TCM constitution type of AIONFH,provide theoretical guidance for early TCM constitution of AIONFH intervention,and make sure the traditional Chinese medicine can used to treatment of AIONFH by new ideas and methods.Methods:According to “Chinese medicine constitution classification and decision” standards,our team members under consultations and lay down the questionnaire(including general information and TCM constitution questionnaire), unified print bookbinding. collect the han nationality NONFH cases between September 02, 2014 ~ 2014 from gansu province hospital of TCM who came from outpatient and the inpatient hospital. total of 152 questionnaire cases and blood specimen, including 50 questionnaire cases and blood specimen of AIONFH as the disease group; At the same time collected 45 questionnaire cases and blood specimen of healthy volunteers with unrelated cases information as control group, in a timely manner to establish database of all NONFH patients and healthy volunteers,included questionnaire cases and blood specimen information(all questionnaire cases and blood collection after informed consent).According to database data determine the 50 patients with AIONFH TCM constitution type distribution, judge the high incidence of TCM constitution for patients with AIONFH was Phlegm damp constitution(PDC), and analysis of the above patient gender, age and other general information; and laboratory tests CYP2C8 genetic polymorphisms in the group of AIONFH of PDC, AIONFH of not PDC with control group, analysis of test results and come to a conclusion.Results:1 Study of clinical data1) 50 cases patients of disease group with AIONFH of traditional Chinese constitution results shows, PDC(frequency of 31, 62%), and constitution of yin-yang harmony(frequency of 12, 24%), constitution of yang asthenia(frequency of 7, 14%), constitution of damp-heat(frequency of 6, 12%), etc.2) Disease group with male 46 cases, female 4 cases, aged 20 to 70 years old, average age(43.3±11.2); control group with 35 cases of the men and 10 cases of women, ages 18 to65 years old, average age(39.8±10.6), two groups with gender distribution using c2 test,the average age of the t test, the results showed no statistically significant differences in gender and age in both groups, comparable(P >0.05);3) According to the results of disease group ARCO stage shows, the phase III is the most rare(52%, 50% of men and women 52%), followed by phase II(30%, 26% of men and women(4%), IV(16%, 14% of men and women 16%), phase I(2%, were men), found no0 patients;4) Disease group patients femoral head necrosis incidence side results shows left hip(18%,14% of men and women 4%), on the right side of the hip(26%, all men), bilateral hip(56%, 52% of men and women 4%)2 Studying of molecular biology1) Comparing CYP2C8 gene loci rs17110453 gene polymorphisms of disease group and control group, there was no statistically significant difference between two groups of different genotypes(c 2=0.253, P >0.05); Disease group compared with control group,there was no statistically significant difference allele(c2= 0.077, P > 0.05);Risk cases of CC genotype is AA genotype was 1.37 times(95%CI: 0.339~5.540), no significant difference(P >0.05).Prompt CYP2C8 gene loc rs17110453 gene polymorphismi had no obvious effect on the risk NONFH, rs17110453 CYP2C8 gene loci polymorphism and AIONFH of PDC has no direct relation.2) AIONFH of PDC with the control group there was no statistically significant difference genotype distribution(c2= 0.317, P>0.05), there was no statistically significant difference distribution of allele(c2=0.012, P >0.05);AIONFH of PDC risk group of CC genotype is AA genotype was 1.5 times(95%CI:0.321~7.008), there was no significant difference(P >0.05).3) AIONFH of PDC with AIONFH of not PDC two groups there was no statistically significant difference genotype and allele distribution(c2=3.475, P > 0.05) and c2= 0.000,P > 0.05).4) AIONFH of not PDC with the control group there was no statistically significant difference genotype and allele distribution(c2=0.056, P > 0.05) and c2=0.099, P > 0.05).Conclusion:1) AIONFH patients high incidence TCM constitution type is PDC;2) CYP2C8 gene loci rs17110453 gene polymorphism A > C mutation has no obvious relation with AIONFH risk, found no clear relationship between CYP2C8 gene loci rs17110453 gene polymorphism with AIONFH.