Correlation Of Vitamin D Receptor Single Nucleotide Polymorphisms And Lumbar Disc Degeneration

Background Lumbar disc degeneration is a degenerative disease and it is also very common disease in orthopedics especially happened in olds.It is featured in dehydration and herniation and cause symptoms such as low back pain and unilateral and bilateral lower limb pain.70%-80%patients will suffer from low back pain for their whole life and?20%patients need surgical treatments to get relief.Age,gender,smoking,occupation and injury are regarded as risk factors of lumbar disc degeneration,but they could not give explanation to all the situations,for example,why the young without above risk factors will have severe lumbar disc degeneration.Some epidemiological studies reveal that intervertebral disc degeneration is mainly influenced by genetic factors while environmental factors have less effect.Single-nucleotide polymorphism(SNP)is a kind of variation in genome which takes place in only one nucleotide.It is the most common type of heritable variations in human genome and makes up at least 90%polymorphisms.As a special type of gene mutation,SNP is always correlated with the increase of morbidity rate of many diseases.Many researches haves shown that SNPs in some structural genes,like collagen associated genes,and some metabolic genes,like vitamin D receptor gene and inflammation gene,could be related with lumbar disc degeneration.But the conclusions of different teams are not same,even opposite.So it is valuable and important to verify the conclusions and explore new SNPs correlated with lumbar disc degeneration.Objective This study explore the association between single nucleotide polymorphisms(SNP)rs731236,rs2228570,rs7975232 and rs1544410 and lumbar disc degeneration(LDD).Material and Methods This study is divided into two parts,meta-analysis and case-control study.For meta-analysis,search strategy was performed and the data was extracted.And then,in order to assess the association between above single nucleotide polymorphisms and LDD under allelic,dominant,recessive,heterozygous and homozygous genetic models,the pooled odds ratios and 95%confidence intervals were calculated.And then,heterogeneity test and sensitivity analysis were performed,and subgroup analysis was used to assess the association between above single nucleotide polymorphisms and LDD in different ethnicities.After meta-analysis,a case-control study was designed for verifying the conclusion of meta-analysis.Results 17 studies were included in this meta-analysis.The pooled results didn't show any association between VDR gene polymorphisms and LDD.But,interestingly,in subgroup analysis,rs2228570 polymophism is associated with LDD under the allelic(OR=0.70,95%CI 0.56-0.87,p=0.002),recessive(OR=60,95%CI 0.43-0.84,p=0.003)and homozygous(OR=0.47,95%CI 0.28-0.79,p=0.004)genetic models in Asian population.rs731236 and rs7975232 still didn't show obvious association.The results of meta-analysis were confirmed by follow-up case-control study.Conclusions rs2228570 polymorphism is associated with LDD predisposition in Asian population significantly.