Research article - (2012)11, 147 - 155
Candidate Gene Analysis in Israeli Soldiers With Stress Fractures
Ran Yanovich1, Eitan Friedman2,4,, Roni Milgrom2, Bernice Oberman3, Laurence Freedman3, Daniel S. Moran1,5
1Heller Institute of Medical Research,
2Susanne Levy Gertner Oncogenetics Unit,
3Biostatistics Unit Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
4Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
5Ariel University Center of Samaria, Israel.

Eitan Friedman
✉ Head, the Susanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel
Email: eitan.friedman@sheba.health.gov.il
Received: 28-10-2011 -- Accepted: 27-01-2012
Published (online): 01-03-2012

ABSTRACT

To investigate the association of polymorphisms within candidate genes which we hypothesized may contribute to stress fracture predisposition, a case-control, cross- sectional study design was employed. Genotyping 268 Single Nucleotide Polymorphisms- SNPs within 17 genes in 385 Israeli young male and female recruits (182 with and 203 without stress fractures). Twenty-five polymorphisms within 9 genes (NR3C1, ANKH, VDR, ROR2, CALCR, IL6, COL1A2, CBG, and LRP4) showed statistically significant differences (p < 0.05) in the distribution between stress fracture cases and non stress fracture controls. Seventeen genetic variants were associated with an increased stress fracture risk, and eight variants with a decreased stress fracture risk. None of the SNP associations remained significant after correcting for multiple comparisons (false discovery rate- FDR). Our findings suggest that genes may be involved in stress fracture pathogenesis. Specifically, the CALCR and the VDR genes are intriguing candidates. The putative involvement of these genes in stress fracture predisposition requires analysis of more cases and controls and sequencing the relevant genomic regions, in order to define the specific gene mutations.

Key words: Stress fractures, Bone remodeling, genetic variance, SNPs, inherited predisposition.

Key Points
  • Understanding the possible contribution of genetic variants to stress fracture pathogenesis.
  • There is a paucity of data on the involvement of polymorphisms in specific genes in active military personnel/athletes which may contribute to stress fractures development.
  • The results from the current study should facilitate a more comprehensive look at the genetic component of stress fractures.








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