Matrix metalloproteinase-3 and vitamin d receptor genetic polymorphisms, and their interactions with occupational exposure in lumbar disc degeneration.
OBJECTIVE
To investigate the occupational and genetic risk factors inducing lumbar disc degeneration in a Chinese population, and to explore their synergistic interactions.


METHODS
A case-control study involving 178 low back pain patients with lumbar disc degeneration and 284 controls was carried out. Five types of work-related factors were investigated using questionnaires. Polymerase chain reaction and restriction fragments length polymorphism was used to detect the polymorphisms of MMP-3 (matrix metalloproteinase-3)(rs731236), VDR-Taq (vitamin D receptor-Taq) and VDR-Apa (vitamin D receptor-Apa)(rs35068180). Rothman's synergy index was used to measure the synergistic interactions between gene polymorphisms and occupational risk factors.


RESULTS
Family history of lumbar disc diseases, back injury history, whole-body vibration, bending/twisting, heavy physical workload, age, mutation alleles 5A of MMP-3 and A of VDR-Apa were significantly associated with lumbar disc degeneration (OR=12.70, 11.79, 8.96, 5.46, 1.05, 1.96 and 1.70, respectively, p<0.05). Synergistic interactions existed between the mutation allele 5A of MMP-3 and whole-body vibration exposure, the mutation allele 5A of MMP-3 and bending/twisting, and the mutation allele A of VDR-Apa and bending/twisting (SI=13.27, 2.91, 2.35, respectively, p<0.05).


CONCLUSIONS
The results of this study suggest that gene-occupation interaction might play a certain role in exaggerating lumbar disc degeneration. There is a possibility that subjects who carry mutation alleles 5A of MMP-3 and/or A of VDR-Apa are more vulnerable to lumbar disc degeneration when they are exposed to whole-body vibration and/or bending/twisting under ergonomic loads.
Yuan
Han-Yan
HY
Department of Occupational Health, School of Public Health, Fudan University, Shanghai, China.
Tang
Ying
Y
Liang
You-Xin
YX
Lei
Ling
L
Xiao
Guo-Bing
GB
Wang
Sheng
S
Xia
Zhao-Lin
ZL
D000328:Adult; D001483:Base Sequence; D002681:China / Q000453:epidemiology; D005260:Female; D005838:Genotype; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000235:genetics*; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000235:genetics*; D008875:Middle Aged; D016273:Occupational Exposure; D011110:Polymorphism, Genetic; D018167:Receptors, Calcitriol / Q000235:genetics*; D013122:Spinal Diseases / Q000235:genetics; D011795:Surveys and Questionnaires
D018167:Receptors, Calcitriol; D019278:Matrix Metalloproteinase 3