STUDY DESIGN: A prospective genetic association study. PURPOSE: The etiology of Modic changes (MCs) is unclear. Recently, the role of genetic factors in the etiology of MCs has been evaluated. However, studies with a larger patient subset are lacking, and candidate genes involved in other disc degeneration phenotypes have not been evaluated. We studied the prevalence of MCs and genetic association of 41 candidate genes in a large Indian cohort. OVERVIEW OF LITERATURE: MCs are vertebral endplate signal changes predominantly observed in the lumbar spine. A significant association between MCs and lumbar disc degeneration and nonspecific low back pain has been described, with the etiopathogenesis implicating various mechanical, infective, and biochemical factors. METHODS: We studied 809 patients using 1.5-T magnetic resonance imaging to determine the prevalence, patterns, distribution, and type of lumbar MCs. Genetic association analysis of 71 single nucleotide polymorphisms (SNPs) of 41 candidate genes was performed based on the presence or absence of MCs. SNPs were genotyped using the Sequenome platform, and an association test was performed using PLINK software. RESULTS: The mean age of the study population (n=809) was 36.7±10.8 years. Based on the presence of MCs, the cohort was divided into 702 controls and 107 cases (prevalence, 13%). MCs were more commonly present in the lower (149/251, 59.4%) than in the upper (102/251, 40.6%) endplates. L4–5 endplates were the most commonly affected levels (30.7%). Type 2 MCs were the most commonly observed pattern (n=206, 82%). The rs2228570 SNP of VDR (p=0.02) and rs17099008 SNP of MMP20 (p=0.03) were significantly associated with MCs. CONCLUSIONS: Genetic polymorphisms of SNPs of VDR and MMP20 were significantly associated with MCs. Understanding the etiopathogenetic mechanisms of MCs is important for planning preventive and therapeutic strategies.
Cohort Studies ; Genetic Association Studies ; Humans ; Intervertebral Disc Degeneration ; Low Back Pain ; Magnetic Resonance Imaging ; Phenotype ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prevalence* ; Prospective Studies ; Spine

OBJECTIVE: Measurement of kidney size by ultrasonography is an important parameter in the renal evaluation of patients. This study aims to establish the average size of kidneys of healthy adult Filipinos and examine the factors that influence it.
DESIGN: Cross-sectional, observational study
SETTING: Section of Nephrology, Department of Medicine and Department of Radiology, UP-PGH Medical Center, a tertiary government hospital
PARTICIPANTS: 264 healthy Filipino adults underwent kidney ultrasound after preliminary screening by history, physical examination, urinalysis, and serum creatinine
RESULTS: Renal sizes and volume were measured by ultrasound in 105 males and 159 females, with ages ranging from 18 to 75 years old. The left kidney was significantly larger than the right for mean length but not for width or thickness. Except for cortical thickness, renal length (L=98 mm, R=96mm vs. L=95mm, R=93mm), width (L=48mm, R=49mmvs. L=46mm,R=46mm), and thickness (L=43mm, R=42 mm vs. L=39 mm, R=39 mm) were significantly larger in males compared to females. While the gender differences persisted when corrected for age and body mass index, this disappeared when corrected for total body area. With advancing age, there was minimal shortening but significant increases in width and thickness (renal shape index)
CONCLUSION: Our study provides estimates of the average kidney size for normal adult Filipinos. The average kidney size of Filipinos is smaller than that of Caucasians for length (L=96mm vs. 112 mm, R=94mm vs. 109mm) and for width (L=47mm vs. 58mm, R=48mm vs. 57mm). Males have larger kidneys than females but the gender difference disappeared when corrected for total body area. Height but not weight has a significant influence on kidney size. With advancing age, kidneys tend to increase in width and thickness with no significant decrease in length or volume.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Kidney ; Radiology ; Adult ; Ultrasonography ; Patients

BACKGROUNDMorphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography.

METHODSThis cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis.

RESULTSBoth superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = -0.850 and 0.460, respectively) and deep (β = -0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness.

CONCLUSIONOur results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.

Adult ; Cross-Sectional Studies ; Eye ; blood supply ; Female ; Fluorescein Angiography ; Humans ; Macula Lutea ; pathology ; physiopathology ; Male ; Middle Aged ; Myopia ; pathology ; physiopathology ; Optic Disk ; pathology ; physiopathology ; Prospective Studies ; Retina ; pathology ; physiopathology ; Retinal Ganglion Cells ; pathology ; Tomography, Optical Coherence ; Young Adult