title: Vascular endothelial growth factor polymorphisms in patients with steroid-induced femoral head osteonecrosis.
abstract: To investigate an association between steroid-induced femoral head osteonecrosis (FHON) and functional vascular endothelial growth factor (VEGF) gene (-2578A/C, -1154A/G, -634C/G, and +405C/G) polymorphisms polymerase chain reaction-restriction fragment length polymorphism genotyping was performed in 160 patients (86 idiopathic FHON and 74 steroid-induced FHON) and 160 gender- and age-matched controls. The steroid-induced subgroup had a significantly lower prevalence of -1154A allele (7.4% vs. 18.1%, odds ratio (OR) = 0.363) and genotype carrying -1154A (14.9% vs. 32.5%, OR = 0.333 in a recessive model) than controls. In a dominant model, the frequency of genotype carrying +405G (74.3% vs. 84.4%, OR = 0.492) was significantly lower in steroid-induced FHON than in controls. The distribution of haplotypes was significantly different between controls and FHON patients (p = 0.00011). Especially, when haplotypes were classified into high (CGCG and AAGG) or low (CGGC and AGGC) VEGF inducing haplotypes, patients with steroid-induced FHON had a significantly lower prevalence of high inducing haplotypes (7.4% vs. 15.9%, OR = 0.424) and a significantly higher prevalence of low inducing haplotypes (4.7% vs. 0.6%, OR = 7.894) than controls. Low inducing VEGF haplotypes may confer an increased risk and high inducing haplotypes have a protective effect for the development of steroid-induced FHON in Korea.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
authors.forename: Yun Jong
authors.initials: YJ
authors.lastname: Lee
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Eun Ha
authors.initials: EH
authors.lastname: Kang
authors.forename: Young-Kyun
authors.initials: YK
authors.lastname: Lee
authors.forename: Shin-Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Yeong Wook
authors.initials: YW
authors.lastname: Song
authors.forename: Kyung-Hoi
authors.initials: KH
authors.lastname: Koo
mesh_terms: D020121:5' Untranslated Regions / Q000235:genetics; D000328:Adult; D000368:Aged; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics*; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D005938:Glucocorticoids / Q000009:adverse effects*; D006239:Haplotypes; D006801:Humans; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D011401:Promoter Regions, Genetic / Q000235:genetics; D056910:Republic of Korea / Q000453:epidemiology; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics*; D055815:Young Adult
chemical_list: D020121:5' Untranslated Regions; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A