title: Polymorphisms in the Glucocorticoid Receptor Gene and Associations with Glucocorticoid-Induced Avascular Osteonecrosis of the Femoral Head.
abstract: OBJECTIVE
  Individual sensitivity to glucocorticoid (GC) therapy might play a pivotal role in the development of GC-induced avascular necrosis of the femoral head (GANFH). In a growing number of studies, common polymorphisms of the glucocorticoid receptor gene (nuclear receptor subfamily 3 group C member 1 [NR3C1]) have been associated with variability in the individual sensitivity to GCs. However, whether the NR3C1 gene polymorphisms actually influence the susceptibility of GANFH remains unknown.
  
  
  METHODS
  In this study, we report the findings of a case-control study to investigate the role of the NR3C1 gene single-nucleotide polymorphisms (SNPs) in GANFH susceptibility among 78 GANFH patients (GCs sensitive) and 115 GC-resistant controls.
  
  
  RESULTS
  Our results found no significant associations between the SNPs N363S, Tth111I, BclI, ER22/23EK, and A3669G with GANFH susceptibility. The G allele frequency, both homozygous and heterozygous, of SNP BclI was significantly different between control and GANFH combined with osteopenia subgroups (odds ratios [OR] = 1.81; 95% confidence intervals [CI] = 1.05-3.10; OR = 2.04; 95% CI = 1.03-4.07, respectively).
  
  
  CONCLUSIONS
  Most of these common SNPs in the NR3C1 gene likely do not play critical roles in the susceptibility of GANFH. However, the G allele at the SNP Bcll, irrespective of dosage, may increase risk for the development of GANFH combined with osteopenia in the Chinese population.
authors.affiliation: 1 Department of Orthopedics, Taizhou Hospital of Zhejiang Province , Taizhou, China .|2 College of Animal Science and Technology, Henan University of Science and Technology , Luoyang, China .
authors.forename: Zhanqin
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: 1 Department of Orthopedics, Taizhou Hospital of Zhejiang Province , Taizhou, China .|3 College of Medical Technology and Engineering, Henan University of Science and Technology , Luoyang, China .
authors.forename: Yun
authors.initials: Y
authors.lastname: Xue
authors.affiliation: 1 Department of Orthopedics, Taizhou Hospital of Zhejiang Province , Taizhou, China .
authors.forename: Dun
authors.initials: D
authors.lastname: Hong
authors.affiliation: 4 Department of Orthopedics, Bone-Setting Hospital of Luoyang , Luoyang, China .
authors.forename: Hongjun
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 3 College of Medical Technology and Engineering, Henan University of Science and Technology , Luoyang, China .
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Hu
authors.affiliation: 5 Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University , Hangzhou, China .
authors.forename: Shunwu
authors.initials: S
authors.lastname: Fan
authors.affiliation: 1 Department of Orthopedics, Taizhou Hospital of Zhejiang Province , Taizhou, China .
authors.forename: Haixiao
authors.initials: H
authors.lastname: Chen
mesh_terms: D000328:Adult; D000483:Alleles; D044466:Asian People / Q000235:genetics; D016022:Case-Control Studies; D002681:China; D005260:Female; D005270:Femur Head; D005271:Femur Head Necrosis / Q000235:genetics*; D005787:Gene Frequency / Q000235:genetics; D056726:Genetic Association Studies / Q000379:methods; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011965:Receptors, Glucocorticoid / Q000235:genetics*; D012307:Risk Factors
chemical_list: D005938:Glucocorticoids; C497713:NR3C1 protein, human; D011965:Receptors, Glucocorticoid
keywords: glucocorticoid-induced avascular osteonecrosis of the femoral head; nuclear receptor subfamily 3 group C member 1; single-nucleotide polymorphisms; susceptibility