Association of the Taq I Allele in Vitamin D Receptor With Degenerative Disc Disease and Disc Bulge in a Chinese Population

Cheung, Kenneth M.C.; Chan, Danny; Karppinen, Jaro; Chen, Yiquin; Jim, Jeffrey J.T.; Yip, Shea Ping; Ott, Jürg; Wong, Kelvin; Sham, Pak C.; Luk, Keith Dip Kei; Cheah, Kathryn S.E.; Leong, J. C. Y.; Song, You‐Qiang

doi:10.1097/01.brs.0000216530.41838.d3

Cited by 126 publications

(115 citation statements)

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“…T2-weighted sagittal magnetic resonance imaging (MRI) of the lumbar spine was performed for all subjects, and the images were evaluated by a physiatrist with expertise in radiographic assessment who was blinded to the clinical assessment. The technical imaging approach used has been previously described in greater detail (17,18). The presence and extent of disc degeneration as well as other radiographic parameters of interest, as noted below, were assessed in every subject.…”

Section: Methodsmentioning

confidence: 99%

“…Based on such criteria, a score of 0 was associated with no signal changes for the disc, a score of 1 was assigned when a slight decrease in signal intensity of the nucleus pulposus was present, a score of 2 was associated with the presence of hypointensity of the nucleus pulposus and normal disc height, and a score of 3 was reserved for a hypointense nucleus pulposus with disc space narrowing. The score for each disc level was then summed to create an overall degenerative disc disease (DDD) score (17,18). Because only subjects with Ն2 levels of disc degeneration were included in the study, the minimum DDD score was 2, and the potential range for the DDD score was 2-15.…”

Section: Methodsmentioning

confidence: 99%

“…variety of additional potential etiologic factors have been reported, suggesting that the impetus for disc degeneration may be a complex, multifactorial process (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Nonetheless, the effects of such degeneration, if progressive, may lead to the development of low back pain with or without sciatica.…”

mentioning

confidence: 99%

“…Although addressing genetic, developmental, or other potential etiologic factors (e.g., environmental, systematic diseases, hormonal) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) that have been suggested to be associated with disc degeneration goes beyond the nature of our study design, one should not dismiss the possibility that such factors may play a role in the manifestation of SLDD. Although a biomechanical component is suggested as contributing to disc degeneration in this context, the suggestion requires further investigation.…”

mentioning

confidence: 99%

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Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Cheung¹,

Samartzis²,

Karppinen³

et al. 2010

Arthritis & Rheumatism

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Objective. Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD).Methods. As part of a large genetics-based study in southern Chinese individuals (n ‫؍‬ 1,989), a crosssectional analysis was performed in subjects exhibiting disc degeneration in >2 levels (n ‫؍‬ 838) who were then categorized as having SLDD (n ‫؍‬ 174) or non-SLDD (contiguous, multilevel; n ‫؍‬ 664). Various radiographic parameters were assessed based on T2-weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed.Results. Overall, 8.7% of the whole population (n ‫؍‬ 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n ‫؍‬ 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04-2.10, P ‫؍‬ 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78-4.15, P < 0.001), which also presented in levels with no disc degeneration. A history of disc bulge/extrusion (P ‫؍‬ 0.004) and/or a history of back injury (P ‫؍‬ 0.010) was significantly associated with non-SLDD, and a greater degree of overall severity of disc degeneration was also associated with non-SLDD. Other demographic and MRI findings did not significantly differ between groups.Conclusion. To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Cheung¹,

Samartzis²,

Karppinen³

et al. 2010

Arthritis & Rheumatism

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show abstract

“…Whether the degeneration is the result of a loss of mechanical integrity in the disc or the mechanical loading itself being a precipitating factor of the degeneration, is still unresolved [1,82]. Recent evidence suggests that genetic factors are also important [5,11,28,68,80]. Nonetheless, degeneration of IVDs has been characterized extensively indicating that degeneration involves changes in disc morphology, composition of ECM, as well as loss of disc cells, proteoglycan and water content.…”

Section: Intervertebral Disc Degenerationmentioning

confidence: 99%

Regeneration of intervertebral disc by mesenchymal stem cells: potentials, limitations, and future direction

2006

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Over the past few years, substantial progress has been made in the field of stem cell regeneration of the intervertebral disc. Autogenic mesenchymal stem cells in animal models can arrest intervertebral disc degeneration or even partially regenerate it and the effect is suggested to be dependent on the severity of degeneration. Mesenchymal stem cells (MSCs) are able to escape alloantigen recognition which is an advantage for allogenic transplantation. A number of injectable scaffolds have been described and various methods to pre-modulate MSCs' activity have been tested. In future, work will need to address the use of mesenchymal stem cells in large animal models and the fate of the implanted mesenchymal stem cells, particularly in the long term, in animals. This review examines the state-of-the-art in the field of stem cell regeneration of the intervertebral disc, and critically discusses, with scientific support, the issues involved, before stem cells could be used in human subjects. [79,81]. In the development of organism, the single totipotent cell after fertilization divides and specializes into pluripotent cells, such as embryonic stem cells that are necessary for fetal development. The pluripotent cells then further specialize into multipotent cells that commit into lineages with tissue-specific functions. Cells have been successfully identified in or isolated from embryonic [70], fetal [34, 73], or adult tissues [45] and demonstrated to have stem cell-like properties in vitro and in vivo. The maintenance, survival and activity of these stem cells is suggested to be dependent on the special micro-environmental niche [45], such that uncommitted pluripotent stem cells can be induced to differentiate to form a particular cell type by the nature of the environment. Additionally, the pluripotency of stem cells depends on the source, the method of isolation, and conditions of ex-vivo cell processing.

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The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population‐based study

Samartzis

Karppinen

Chan

et al. 2012

Arthritis & Rheumatism

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241

178

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Objective. To investigate the association of being overweight or obese with the presence, extent, and severity of lumbar disc degeneration on magnetic resonance imaging (MRI) in adults.Methods. A population-based cross-sectional study of 2,599 southern Chinese volunteers was conducted. Subjects underwent radiographic and clinical assessment, and weight and height were measured. Sagittal T2-weighted MRIs of the lumbar spine were obtained. The presence, extent, and severity of disc degeneration and additional radiographic and clinical parameters were assessed. Asian-modified body mass index (BMI) (kg/m 2 ) categories were used. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.Results. The study included 1,040 men and 1,559 women (mean age 41.9 years). Disc degeneration was noted in 1,890 subjects (72.7%). BMI was significantly higher in subjects with disc degeneration (mean 23.3 kg/m 2 ) than in subjects without degeneration (mean 21.7 kg/m 2 ) (P < 0.001). A significant increase in the number of degenerated levels (P < 0.001), global severity of disc degeneration (P < 0.001), and end-stage disc degeneration with disc space narrowing (P < 0.001) was noted with elevated BMI, in particular in overweight and obese subjects. Conclusion. Our findings, in one of the largest studies to systematically assess lumbar disc degeneration on MRI, indicated a significant association between the presence, extent, and global severity of disc degeneration with weight in overweight and obese adults.Low back pain is a common debilitating condition worldwide with severe socioeconomic and health care consequences (1,2). Low back pain can cause functional impairment, diminished quality of life, loss of working ability, potential psychological distress, and increased health care costs (1-3). Although various factors have been implicated in low back pain, intervertebral disc degeneration that is evident radiologically or on advanced imaging (i.e., magnetic resonance imaging [MRI]) is a known cause of low back pain (4-13). In a Dr. Cheung has received consulting fees, speaking fees, and/or honoraria from Synthes, AOSpine, and Ellipse Technologies (less than $10,000 each) and holds patents on shape memory alloy reduction technologies, methods for antibacterial implants, and resorbable metallic materials.

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Association of the Taq I Allele in Vitamin D Receptor With Degenerative Disc Disease and Disc Bulge in a Chinese Population

Cited by 126 publications

References 33 publications

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Regeneration of intervertebral disc by mesenchymal stem cells: potentials, limitations, and future direction

The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population‐based study

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