Serum 25-hydroxyvitamin D, serum calcium and vitamin D receptor (VDR) polymorphisms in a selected population with lumbar disc herniation—A case control study

Abstract

BackgroundAssociation of Vitamin D receptor (VDR) polymorphisms with lumbar disc herniation (LDH) have been identified in several ethnic groups globally. Despite abundant sunlight, vitamin D deficiency is reported in many tropical countries. As vitamin D is a key modulator for intestinal calcium absorption, low vitamin D could contribute to low serum calcium leading to abnormalities of skeletal homeostasis. Therefore, present study was aimed to study the association of serum 25-hydroxyvitamin D (25(OH)D), serum calcium and VDR polymorphisms in a selected Sri Lankan population.Materials & methodsA case control study was conducted in 119 participants (cases = 51: controls = 68). Serum 25(OH)D levels were measured using ELISA. The VDR polymorphisms (Fok I and Taq I) were detected by polymerase chain reaction followed by restriction fragment length polymorphism.ResultsFindings indicated a significantly low (p = 0.000) 25(OH)D levels in cases (18.7±3.7 ng/mL) compared to controls(25.5±9.8 ng/mL) while 25(OH)D in both groups were below the reference range. Mean serum calcium levels in both groups were within normal reference range and was not significantly different among groups. Statistically significant association was not observed between VDR Fok I polymorphisms among cases and controls. Although Fok I polymorphism genotypes were in Hardy-Weinberg equilibrium (HWE), Taq I genotypes in controls violated HWE.ConclusionPresent study confirms that insufficient serum 25(OH)D levels in cases have major contribution to LDH. VDR Fok I polymorphisms did not have any significant association with LDH in Sri Lankan ethnicity.

Association Between FokI Polymorphism of Vitamin D Receptor Gene and Lumbar Spine Disc Degeneration

“…A total of 116 manuscripts were scanned by title and abstract and 29 articles were chosen for reading the full texts; however, most articles did not have detailed information to be considered in the statistical analysis. Finally, 11 studies were included in the qualitative synthesis (review) [9][10][11][12]19,[23][24][25][26][27][28] and 9 studies were included in the quantitative synthesis (meta-analysis) [9][10][11][12]19,[23][24][25][26] (Fig. 1), comprising a total of 1549 cases and 1672 controls to study the FokI polymorphism (rs2228570).…”

“…1), comprising a total of 1549 cases and 1672 controls to study the FokI polymorphism (rs2228570). The studies included in this meta-analysis were performed in the following regions: two studies in Latin-America, 9,10 two in the Middle-East, 11,23 two in Asia, 12,24 and three in Europe. 19,25,26 Initially, the analysis included the five genetic models previously proposed (allelic, homozygous, heterozygous, recessive, and dominant) with a general lumbar spine disorder diagnosis.…”

“…19,25,26 Initially, the analysis included the five genetic models previously proposed (allelic, homozygous, heterozygous, recessive, and dominant) with a general lumbar spine disorder diagnosis. [9][10][11][12]19,[23][24][25][26] A complementary analysis was performed to address probable bias in the analysis, excluding studies with a P value <0.05 for the HWE in the control group. However, no statistical differences were found (allelic: OR, 1.11; 95% CI, 0.98-1.…”

“…In a second analysis, the role of FokI VDR gene in individuals with lumbar disc herniation was explored. 19,24,25 Although in most of the genetic models, heterogeneity was not present (except the allelic model, with a Z test P value of 0.690), no associations were found in the allelic (OR, 1.87; 95% CI, 0.75-1.01; Z test P = 0.079), homozygous (OR, 0.92; 95% CI, 0.66-1.27; Z test P = 0.618), heterozygous (OR, 1.05; 95% CI, 0.80-1.38; Z test P = 0.698), recessive (OR, 1.01; 95% CI, 0.80-1.27; Z test P = 0.920), or dominant (OR, 1.00; 95% CI, 0.77-1.31; Z test P = 0.955) models (Table 2). The Egger test in the five genetic models obtained a P value >0.05.…”

The Impact of Vitamin D Deficiency to Treatment Success of Transforaminal Epidural Steroid Injection

“…Vitamin-D deficiency may lead to many skeletal pathologies and various chronic painful conditions, such as chronic low back pain (LBP). Furthermore, low concentration of serum 25-hydroxyvitamin D (25(OH)D) and polymorphisms in the VDR gene are shown to be related with lumbar disc disease, which is the main cause of chronic LBP (8)(9)(10). Although its predisposing effects in degenerative disc disease are investigated, the impact of deficient serum 25(OH)D to interventional treatment outcomes needs to be elucidated.…”