title: Endothelial nitric oxide synthase gene intron 4 polymorphism in non-traumatic osteonecrosis of the femoral head.
abstract: OBJECTIVE
  Nitric oxide (NO) synthesised by endothelial NO synthase (eNOS) is a potent regulator of internal haemodynamics. A polymorphism in intron 4 of the eNOS is associated with different vascular disorders. We investigated the potential involvement of this polymorphism in idiopathic and secondary osteonecrosis of the femoral head (ONFH) in Polish patients.
  
  
  METHODS
  We performed a study involving 68 patients with ONFH (45 idiopathic and 23 secondary) and 100 healthy controls. All subjects were genotyped for the eNOS4 polymorphism by the polymerase chain reaction followed by agarose gel electrophoresis.
  
  
  RESULTS
  The analysis revealed that the frequencies of eNOS4 genotypes were significantly different in ONFH patients (both idiopathic and secondary) than in controls. The frequencies of the 4a allele were significantly higher in the total group of patients versus controls [22.79 vs 9%, p = 0.00039, odds ratio (OR) 2.98]. In subgroup analysis the 4a allele increased significantly in both idiopathic (20 vs 9%, p = 0.0074, OR = 2.52) and secondary (28.26 vs 9%, p = 0.00047, OR = 3.98) ONFH patients compared to control subjects. The frequency of the 4a/b genotype in the total group of patients (36.76 vs 16%, p = 0.0011, OR = 3.24) as well as patients with idiopathic (35.56 vs 16%, p = 0.0069, OR = 2.96) and secondary (39.13 vs 16 %, p = 0.0073, OR = 3.89) ONFH was higher than in the control group.
  
  
  CONCLUSIONS
  There was a significantly higher frequency of eNOS 4a allele carriers among the total group of patients as well as in idiopathic and secondary ONFH. This suggests that the eNOS gene polymorphism may be associated with increased risk of ONFH.
authors.affiliation: Orthopaedic and Traumatology Department, Medical University of Lublin, ul. Dr K Jaczewskiego 8, 20-954, Lublin, Poland. jacekgagala@gmail.com
authors.forename: Jacek
authors.initials: J
authors.lastname: Gagala
authors.forename: Monika
authors.initials: M
authors.lastname: Buraczynska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mazurkiewicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ksiazek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005271:Femur Head Necrosis / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics; D005838:Genotype; D006801:Humans; D007438:Introns / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D011044:Poland; D011110:Polymorphism, Genetic / Q000235:genetics*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D052250:Nitric Oxide Synthase Type III