title: Matrix metalloproteinase-3, vitamin D receptor gene polymorphisms, and occupational risk factors in lumbar disc degeneration.
abstract: BACKGROUND
  Lumbar disc degeneration (LDD) is a process that begins early in life, contributing to the development of low back pain. LDD is a consequence of a variety of factors, and its etiology remains poorly understood. Objectives to investigate occupational and genetic risk factors inducing lumbar disc degeneration, and to evaluate the possible association of genetic polymorphisms of matrix metalloproteinase 3 (MMP-3) and vitamin D receptor (VDR) with the severity of LDD in an Egyptian population.
  
  
  METHODS
  A case control study involving 84 LDD and 60 controls was carried out. Five types of work related factors were investigated by questionnaire, complete neurological examination for all subjects and MRI for the cases. Polymerase chain reaction and restriction fragment length polymorphism methods were applied to detect polymorphisms in MMP-3 Promoter (-1,171 6A/5A) (rs 731236) and VDR-Apa (rs 35068180).
  
  
  RESULTS
  We found that family history, back injury, smoking, high level of sitting, bending/twisting, physical workload, lifting, whole body vibration, mutant allele 5A of MMP-3 and mutant allele T of VDR were significantly associated with LDD (OR = 2.9, 3.1, 2.1, 11.1, 15.9, 11.7, 8.2, 12.6, 2.5 and 3.1 respectively, p < 0.05). Cases that carry allele 5A and/or allele T were associated with LDD severity.
  
  
  CONCLUSIONS
  LDD is closely associated in occurrence and severity with occupational, environmental risk factors and susceptibility genes namely MMP-3, and VDR (ApaI). This study throws light on the importance of screening for early detection of susceptible individuals and disease prevention.
authors: Occupational and Environmental Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt, nerhamdy71@hotmail.com.
authors: N H
authors: NH
authors: Zawilla
authors: H
authors: H
authors: Darweesh
authors: N
authors: N
authors: Mansour
authors: S
authors: S
authors: Helal
authors: F M
authors: FM
authors: Taha
authors: M
authors: M
authors: Awadallah
authors: R
authors: R
authors: El Shazly
mesh_terms: D000328:Adult; D019567:Back Injuries / Q000150:complications; D016022:Case-Control Studies; D004534:Egypt; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000235:genetics*; D008875:Middle Aged; D009460:Neurologic Examination; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D005082:Physical Exertion; D012150:Polymorphism, Restriction Fragment Length; D011187:Posture; D011401:Promoter Regions, Genetic; D018167:Receptors, Calcitriol / Q000235:genetics*; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking; D011795:Surveys and Questionnaires; D014732:Vibration
chemical_list: D018167:Receptors, Calcitriol; D019278:Matrix Metalloproteinase 3
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