金属蛋白酶组织抑制剂-2基因多态性与青少年特发性胸椎侧凸的相关研究

Association between tissue inhibitor of metalloproteinase-2 gene polymorphism and adolescent idiopathic thoracic scoliosis

目的探讨金属蛋白酶组织抑制N-2（TIMP-2）启动子区基因多态性与青少年特发性胸椎侧凸疾病易感性和严重程度的相关性。方法研究对象为2007年1月至2009年3月诊治的354例女性胸弯型青少年特发性脊柱侧凸（AIS）患者（AIS组）和2005年3月至2006年6月210名健康体检女性青少年（对照组）。选取TIMP-2基因启动子区-418G／C（rs8179090）单核苷酸多态性位点，采用聚合酶链反应一限制性片段长度多态性（PCR—RFLP）的方法对这该位点进行基因分型。比较不同基因型在AIS组与对照组之间的分布差异，并分析基因多态性与临床表型的相关性。结果rs8179090多态性位点的等位基因及基因型分布在两组中差异无统计学意义（P〉0．05）。AIS组中，体质量指数（BMI）〈17kg／m2或主弯Cobb角／〉40。的患者中C等位基因的比例分别显著高于BMI≥17kg／m2或主弯Cobb角〈40。者（P〈0．05）。已经达到骨骼成熟且自然史未受干扰的患者中，GC型和CC型患者的主弯Cobb角平均值显著大于GG型患者（P〈0．05）。结论TIMP-2基因启动子区-418G／C（rs8179090）多态性位点与女性胸弯型AIS患者青春期异常生长模式和侧凸进展有关，TIMP-2基因是胸弯型AIS的疾病修饰基因。

Objective To investigate the association between the tissue inhibitor of metalloproteinase-2（TIMP-2） gene polymorphisms with the predisposition and disease severity of thoracic adolescent idiopathic seoliosis （AIS）. Methods Three hundred and fifty-four female thoracic AIS patients treated from January 2007 to March 2009 and 210 healthy female who underwent health examination during March 2005 to June 2006 as normal controls were recruited in this study. One SNP-418G/C （rs8179090） in the promoter region were selected for TIMP-2 gene. PCR- RFLP was used for genotyping. Results No significant differences of genotype and allele frequency distribution were found between AIS patients and normal controls （P 〉 0. 05 ）. In AIS patients, the frequency of C allele of the patients with the body mass index （BMI） 〈 17 kg/m2 was significantly higher than those with the BMI ≥17 kg/m2 （P 〈 0. 05 ）, and the frequency of C allele of cases with the major Cobb angle ≥40°was significantly higher than that with Cobb angle 〈 40°（ P 〈 0.05 ）. Among the patients who reached skeletal maturity without any interference of natural history, significantly higher average maximum Cobb angle was found in patients with GC and CC genotype compare with those with GG genotype. Conclusions The SNP-418G/C （rs8179090） in the promoter region of TIMP-2 gene may be associated with abnormal growth pattern and curve progression of thoracic AIS. TIMP-2 gene is a disease-modifier gene of thoracic AIS.