Vitamin D Receptor Genetic Variations May Associate with the Risk of Developing Late Fracture-Related Infection in the Chinese Han Population.

Xing-Qi Zhao,Kun Chen,Si-Ying He,Nan Jiang,Bin Yu,Han-Jun Qin,Hao-Yang Wan,Vlad Padureanu

doi:10.1155/2022/9025354

Xing-Qi Zhao, Kun Chen + Show 6 more

Open Access

https://doi.org/10.1155/2022/9025354

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Abstract

Variations in the vitamin D receptor (VDR) gene are related to several inflammatory disorders. However, the potential links between such alternations and the risk of developing late fracture-related infection (FRI) remain unclear. This study investigated associations between genetic variations in the VDR and susceptibility to late FRI in the Chinese Han population. Between January 2016 and December 2019, 336 patients with late FRI and 368 healthy controls were genotyped six VDR genetic variations, including ApaI (rs7975232), BsmI (rs1544410), FokI (rs2228570), TaqI (rs731236), GATA (rs4516035), and Cdx-2 (rs11568820). Significant associations were observed between rs7975232 and FRI susceptibility in the recessive (P = 0.019, OR = 0.530, 95% CI 0.310–0.906) model. Patients with AA genotype had a relatively higher level of serological vitamin D (20.6 vs. 20.3 vs. 17.9 ng/ml) (P = 0.021) than those of AC and CC genotypes. Although no statistical differences were observed, potential correlations may exist between rs1544410 (dominant model: P = 0.079, OR = 0.634), rs2228570 (dominant model: P = 0.055, OR = 0.699), and rs4516035 (dominant model: P = 0.065, OR = 1.768) and the risk of FRI development. In the Chinese cohort, ApaI was associated with a decreased risk of developing FRI, and patients with the AA genotype had a higher vitamin D level. Further studies are required to assess the role of genetic variations in BsmI, FokI, and GATA in the pathogenesis of late FRI.

Highlights

Fracture-related infection (FRI), one of the most frequent types of bone infection, refers to osseous infection with or without the surrounding soft tissue infection following trauma and/or orthopaedic surgery [1], with infections secondary to internal fixation and open fracture as the primary types
The results of the current case-control study, comprising 704 Chinese participants, demonstrated that the vitamin D receptor (VDR) gene sequence variant ApaI was associated with a decreased risk of late FRI development, and people with the AA genotype were less susceptible to FRI
We found that patients with AA genotype had a higher total vitamin D level than those with the AC and CC genotypes, implying vitamin D may have a protective effect against bone infection

Summary

Introduction

Fracture-related infection (FRI), one of the most frequent types of bone infection, refers to osseous infection with or without the surrounding soft tissue infection following trauma and/or orthopaedic surgery [1], with infections secondary to internal fixation and open fracture as the primary types. The average incidence of FRI was approximately 5%, with 1% to 2% after closed fractures, which exceeding 30% following open fractures [2]. The overall efficacy remains unsatisfactory, posing great pressures on the patients, physically and psychologically [3, 4] and economically [5, 6]. Reducing the incidence of FRI is of great personal and social significance and needs to be built on a comprehensive understanding of FRI pathogenesis

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