title: Association between estrogen receptor gene polymorphisms and curve severity of idiopathic scoliosis.
abstract: METHODS
  Analysis of the estrogen receptor gene of girls with idiopathic scoliosis.
  
  
  OBJECTIVE
  To determine whether estrogen receptor gene polymorphisms correlate with curve severity of adolescent idiopathic scoliosis.
  
  
  BACKGROUND
  Studies suggest that idiopathic scoliosis is a familial condition and that curve progression is related to genetically determined factors, such as skeletal and sexual growth.
  
  
  METHODS
  A total of 304 girls with idiopathic scoliosis were followed until growth maturation. Height, arm span, menarcheal age, and age at growth maturation were recorded, and curve severity was measured using Cobb's method. The estrogen receptor gene, which contains polymorphic PvuII and XbaI sites, was amplified from lymphocyte deoxyribonucleic acid by polymerase chain reaction.
  
  
  RESULTS
  The mean maximum Cobb measurements for patients with genotypes XX and Xx were greater than for those with genotype xx (P = 0.002). The risk of curve progression, defined as progression of >5 degrees from initial evaluation, was higher with genotype Xx than with xx (P = 0.03). Patients with genotypes XX and Xx had a significantly higher risk for operative treatment than those with genotype xx (21.4%, 24.7% vs. 7.6%, P< 0.001). Growth examination around the time of the growth spurt revealed that the XbaI site polymorphism was also related to the age of growth maturation. The frequency of patients with growth maturation at >or=16 years was higher for genotypes XX and Xx than for genotype xx (33.3%, 29.9% vs. 16.8%, P= 0.013).
  
  
  CONCLUSIONS
  Our results suggest that the XbaI site polymorphism is associated with curve severity. DNA analysis may predict curve progression.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Chiba University, Chiba, Japan. inouema@chibae.hosp.go.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Shohei
authors.initials: S
authors.lastname: Minami
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitahara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Keijiro
authors.initials: K
authors.lastname: Isobe
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Makoto
authors.initials: M
authors.lastname: Tokunaga
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nishikawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Maruta
authors.forename: Hideshige
authors.initials: H
authors.lastname: Moriya
mesh_terms: D000293:Adolescent; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008572:Menarche; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D011859:Radiography; D011960:Receptors, Estrogen / Q000235:genetics*; D012307:Risk Factors; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000235:genetics* / Q000601:surgery; D012720:Severity of Illness Index; D013131:Spine / Q000000981:diagnostic imaging / Q000254:growth & development / Q000601:surgery
chemical_list: D011960:Receptors, Estrogen