Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation

Seher POLAT, (Erzincan Binali Yıldırım Üniversitesi, Mengücek Gazi Eğitim ve Araştırma Hastanesi Tıp Fakültesi, Tıbbi Genetik Anabilim Dalı, Erzincan, Türkiye)
Barış ÖZÖNER, (Bahçeşehir Üniversitesi, Tıp Fakültesi, Beyin Cerrahisi Anabilim Dalı, İstanbul, Türkiye)
Yusuf Kemal ARSLAN, (Erzincan Binali Yıldırım Üniversitesi, Mengücek Gazi Eğitim ve Araştırma Hastanesi Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Erzincan, Türkiye)
Bilge EKİNCİ (Erzincan Binali Yıldırım Üniversitesi, Mengücek Gazi Eğitim ve Araştırma Hastanesi Tıp Fakültesi, Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, Erzincan, Türkiye)
Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi
2 1
Yıl: 2021 Cilt: 14 Sayı: 2 Sayfa Aralığı: 472 - 491 Metin Dili: İngilizce DOI: 10.18185/erzifbed.881338 İndeks Tarihi: 02-03-2022

Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation

Öz:
Lumbar disc herniation (LDH) defined in the early 1930s and has since been treated, is the most common disease group in which neurosurgeons have dealt with and performed operations. The pathogenesis of this disease is still unknown. The study aimed to evaluate any potential contribution of disease-associated single nucleotide gene polymorphisms (SNPs) in LDH etiology. Male and female volunteers with LDH participated in the study. All variants (SOD1 IVS3+35 A>C); SOD2 c.*3409T>A; c.*441A>G; MTHFR p.Ala222Val (c.677C>T), and PAI-1-844G>A) were analysed using polymerase chain reaction and restriction fragment length polymorphism (PCR–RFLP) method. In MTHFR 677C>T, “T” additive model and “T” dominant model, CC vs. CT (OR:5.69 Cl: 2.4-13.4 p<0.001) and CC vs. TC+TT(OR:5.69 Cl: 2.4-13.4 p<0.001) increased the risk of LDH almost 6-fold, “C” recessive model, CT+TT vs. CC (OR:5.68 Cl:2.4-13.5 p<0.001) reduced the risk of LDH almost 6-fold while others were not associated with LDH. In a paired analysis of MTHFRc.677C>T/PAI-1-844G>A genotypes, it was determined that AG genotype increased the protective effect of CC genotype (CC+AG vs others) of the MTHFR gene (OR: 8.4 Cl:2.2-3.1 P<0.001) while reducing the negative effect of the TC genotype of MTHFR gene(TC+AG vs others) in LDH risk(OR: 4.4 Cl: 1.5-12.1P=0.005). A similar result was not determined for the investigated SOD1 and SOD2 variants. For the first time, in our study groups, MTHFR677C>T polymorphism was found associated with an increased risk of LDH.
Anahtar Kelime:

Lomber Disk Hernisi Tanısı Alan Türk Hastalarda Genetik Polimorfizim

Öz:
1930'ların başından itibaren tanımlanan ve tedavi edilen bel fıtığı (LDH), beyin cerrahlarının ilgilendiği ve en yaygın ameliyat nedeni olan hastalıktır. LDH patogenezi hala bilinmemektedir. Bu çalışma kaspsamında hastalıkla ilişkili olduğu belirlenen beş adet tek nükleotid gen polimorfizmlerinin(SNPs) LDH etiyolojisine olan katkısının araştırılması amaçlanmıştır. Çalışmaya LDH tanısı alan erkek ve kadın gönüllüler dahil edimiştir. Polimorfizimlerin tamamı (SOD1 IVS3+35 A>C; SOD2 c.*3409T>A; c.*441A>G; MTHFR p.Ala222Val (c.677C>T) ve PAI-1-844 G>A polimeraz zincir reaksiyonu ve kesim parçası uzunluk polimorfizm (PCR– RFLP) yöntemi kullanılarak analiz edilmiştir. MTHFR677C> T polimorfizminde, “T” editif modelde CC’ye göre CT (OR: 5.69 Cl: 2.4-13.4 p<0.001) ve “T” baskın modelde CC’ye göre TC + TT (OR: 5.69 Cl: 2.4-13.4 p<0.001) genotiplerine sahip olmanın LDH riskini yaklaşık 6 kat artırdığı, “C” resesif modellde ise CT + TT'ye karşı CC genotipine sahip olmanın LDH riskini yaklaşık 6 kat (OR: 5.68 Cl: 2.4-13.5 p<0.001) azalttığı belirlenmiştir. MTHFR c.677C>T/PAI-1- 844G>A genotiplerinin ikili analizlerinde, CC genotipinin, koruyucu etkisinin AG genotipi ile birlikteliğinde arttırdığı (OR: 8.4 Cl:2.2-3.1 P<0.001), buna karşın TG genotipinin neden olduğu LDH riskini azalttığı (OR: 4.4 Cl: 1.5-12.1 P=0.005) belirlenmiştir. Benzer bir sonuç araştırılan SOD1 ve SOD2 varyantları için belirlenmemiştir. Çalışma grubumuzda MTHFR677C> T polimorfizmine bağlı olarak artan LDH riski ilk defa bu çalışma ile belirlenmiştir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Allan, D. B., and G. Waddell. 1989. 'An historical perspective on low back pain and disability', Acta Orthop Scand Suppl, 234: 1-23.
  • Anderson, M. T., F. J. Staal, C. Gitler, L. A. Herzenberg, and L. A. Herzenberg. 1994. 'Separation of oxidant-initiated and redox-regulated steps in the NF-kappa B signal transduction pathway', Proc Natl Acad Sci U S A, 91: 11527-31.
  • Andersson, G. B. 1999. 'Epidemiological features of chronic low-back pain', Lancet, 354: 581-5.
  • Anstee, D. J. 2010. 'The relationship between blood groups and disease', Blood, 115: 4635-43.
  • Apel, K., and H. Hirt. 2004. 'Reactive oxygen species: metabolism, oxidative stress, and signal transduction', Annu Rev Plant Biol, 55: 373-99.
  • Autio, R. A., J. Karppinen, J. Niinimaki, R. Ojala, M. Kurunlahti, M. Haapea, H. Vanharanta, and O.Tervonen. 2006. 'Determinants of spontaneous resorption of intervertebral disc herniations', Spine (Phila Pa 1976), 31: 1247-52.
  • Bakirezer, S. D., C. K. Yaltirik, A. H. Kaya, S. G. Yilmaz, S. Ozdogan, D. Billur, and T. Isbir. 2019. 'The Evaluation of Glutathione Reductase and Malondialdehyde Levels in Patients With Lumbar Disc Degeneration Disease', In Vivo, 33: 811-14.
  • Calder, P. C., R. Albers, J. M. Antoine, S. Blum, R. Bourdet-Sicard, G. A. Ferns, G. Folkerts, P. S. Friedmann, G. S. Frost, F. Guarner, M. Lovik, S. Macfarlane, P. D. Meyer, L. M'Rabet, M. Serafini, W. van Eden, J. van Loo, W. Vas Dias, S. Vidry, B. M. Winklhofer-Roob, and J. Zhao. 2009. 'Inflammatory disease processes and interactions with nutrition', Br J Nutr, 101 Suppl 1: S1-45.
  • Cooper, R. G., W. S. Mitchell, K. J. Illingworth, W. S. Forbes, J. E. Gillespie, and M. I. Jayson. 1991. 'The role of epidural fibrosis and defective fibrinolysis in the persistence of postlaminectomy back pain',Spine (Phila Pa 1976), 16: 1044-8.
  • Didion, S. P., M. J. Ryan, L. A. Didion, P. E. Fegan, C. D. Sigmund, and F. M. Faraci. 2002. 'Increased superoxide and vascular dysfunction in CuZnSOD-deficient mice', Circ Res, 91: 938-44.
  • Fagerberg, L., B. M. Hallstrom, P. Oksvold, C. Kampf, D. Djureinovic, J. Odeberg, M. Habuka, S.Tahmasebpoor, A. Danielsson, K. Edlund, A. Asplund, E. Sjostedt, E. Lundberg, C. A. Szigyarto, M. Skogs, J. O. Takanen, H. Berling, H. Tegel, J. Mulder, P. Nilsson, J. M. Schwenk, C. Lindskog, F.Danielsson, A. Mardinoglu, A. Sivertsson, K. von Feilitzen, M. Forsberg, M. Zwahlen, I. Olsson, S.Navani, M. Huss, J. Nielsen, F. Ponten, and M. Uhlen. 2014. 'Analysis of the human tissue-specific expression by genome-wide integration of transcriptomics and antibody-based proteomics', Mol Cell Proteomics, 13: 397-406.
  • Flohe, L., R. Brigelius-Flohe, C. Saliou, M. G. Traber, and L. Packer. 1997. 'Redox regulation of NF kappa B activation', Free Radic Biol Med, 22: 1115-26.
  • Franchini, M., and G. Lippi. 2015. 'The intriguing relationship between the ABO blood group, cardiovascular disease, and cancer', Bmc Medicine, 13.
  • Frosst, P., H. J. Blom, R. Milos, P. Goyette, C. A. Sheppard, R. G. Matthews, G. J. Boers, M. den Heijer, L. A. Kluijtmans, L. P. van den Heuvel, and et al. 1995. 'A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase', Nat Genet, 10: 111-3.
  • Fukai, T., M. R. Siegfried, M. Ushio-Fukai, Y. Cheng, G. Kojda, and D. G. Harrison. 2000. 'Regulation of the vascular extracellular superoxide dismutase by nitric oxide and exercise training', J Clin Invest, 105: 1631-9.
  • Garrido, E. 1993. 'Lumbar disc herniation in the pediatric patient', Neurosurg Clin N Am, 4: 149-52.
  • Ghosh, A. K., and D. E. Vaughan. 2012. 'PAI-1 in tissue fibrosis', J Cell Physiol, 227: 493- 507.
  • Gruber, H. E., G. L. Hoelscher, J. A. Ingram, S. Bethea, and E. N. Hanley. 2008. 'IGF-1 rescues human intervertebral annulus cells from in vitro stress-induced premature senescence', Growth Factors, 26: 220-5.
  • Grunhagen, T., G. Wilde, D. M. Soukane, S. A. Shirazi-Adl, and J. P. Urban. 2006. 'Nutrient supply and intervertebral disc metabolism', J Bone Joint Surg Am, 88 Suppl 2: 30-5.
  • Haaland, A. K., V. Graver, A. E. Ljunggren, M. Loeb, H. Lie, B. Magnaes, and H. C. Godal. 1992.'Fibrinolytic activity as a predictor of the outcome of prolapsed intervertebral lumbar disc surgery with reference to background variables: results of a prospective cohort study', Spine (Phila Pa 1976),17: 1022-7.
  • Halliwell, B. 1989. 'Tell me about free radicals, doctor: a review', J R Soc Med, 82: 747-52.
  • Hankey, G. J., and J. W. Eikelboom. 2000. 'Homocysteine and vascular disease', Indian Heart J, 52:S18-26.
  • Hold, G. L., and E. M. El-Omar. 2008. 'Genetic aspects of inflammation and cancer', Biochem J, 410:225-35.
  • Huang, W., Y. Qian, K. Zheng, L. Yu, and X. Yu. 2016. 'Is smoking a risk factor for lumbar disc herniation?', Eur Spine J, 25: 168-76.
  • Husemoen, L. L., U. Toft, M. Fenger, T. Jorgensen, N. Johansen, and A. Linneberg. 2006. 'The association between atopy and factors influencing folate metabolism: is low folate status causally related to the development of atopy?', Int J Epidemiol, 35: 954-61.
  • Iwaki, T., T. Urano, and K. Umemura. 2012. 'PAI-1, progress in understanding the clinical problem and its aetiology', Br J Haematol, 157: 291-8.
  • Janeczko, L., M. Janeczko, R. Chrzanowski, and G. Zielinski. 2014. 'The role o polymorphisms of genes encoding collagen IX and XI in lumbar disc disease', Neurol Neurochir Pol, 48: 60-2.
  • Jayson, M. I. 1989. 'Vascular damage, fibrosis, and chronic inflammation in mechanical back pain problems', Semin Arthritis Rheum, 18: 73-6.
  • Jukic, I., J. Bingulac-Popovic, V. Dogic, I. Babic, J. Culej, M. Tomicic, T. Vuk, D. Sarlija, and M. Balija. 2009. 'ABO blood groups and genetic risk factors for thrombosis in Croatian population', Croat Med J, 50: 550-8.
  • Kim, K. W., K. Y. Ha, J. S. Lee, K. W. Rhyu, H. S. An, and Y. K. Woo. 2007. 'The apoptotic effects of oxidative stress and antiapoptotic effects of caspase inhibitors on rat notochordal cells', Spine (Phila Pa 1976), 32: 2443-8.
  • Klinger, K. W., R. Winqvist, A. Riccio, P. A. Andreasen, R. Sartorio, L. S. Nielsen, N. Stuart, P. Stanislovitis, P. Watkins, R. Douglas, and et al. 1987. 'Plasminogen activator inhibitor type 1 gene is located at region q21.3-q22 of chromosome 7 and genetically linked with cystic fibrosis', Proc Natl Acad Sci U S A, 84: 8548-52.
  • Kousteni, S. 2011. 'FoxOs: Unifying links between oxidative stress and skeletal homeostasis', Curr Osteoporos Rep, 9: 60-6.
  • Leopold, J. A., and J. Loscalzo. 2009. 'Oxidative risk for atherothrombotic cardiovascular disease', Free Radic Biol Med, 47: 1673-706.
  • Liew, S. C., and E. D. Gupta. 2015. 'Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: epidemiology, metabolism and the associated diseases', Eur J Med Genet, 58: 1-10.
  • Long, D. M., M. BenDebba, W. S. Torgerson, R. J. Boyd, E. G. Dawson, R. W. Hardy, J. T. Robertson, G. W. Sypert, and C. Watts. 1996. 'Persistent back pain and sciatica in the United States: Patient characteristics', Journal of Spinal Disorders, 9: 40-58.
  • Loscalzo, J. 1996. 'The oxidant stress of hyperhomocyst(e)inemia', J Clin Invest, 98: 5-7.
  • Luo, M., Y. Ji, Y. Luo, R. Li, W. P. Fay, and J. Wu. 2017. 'Plasminogen activator inhibitor-1 regulates the vascular expression of vitronectin', J Thromb Haemost, 15: 2451-60.
  • Martin, B. I., R. A. Deyo, S. K. Mirza, J. A. Turner, B. A. Comstock, W. Hollingworth, and S. D. Sullivan. 2008. 'Expenditures and health status among adults with back and neck problems', JAMA, 299: 65664.
  • Martin, R. C., J. Ahn, S. A. Nowell, D. W. Hein, M. A. Doll, B. D. Martini, and C. B. Ambrosone. 2006. 'Association between manganese superoxide dismutase promoter gene polymorphism and breast cancer survival', Breast Cancer Res, 8: R45.
  • Martirosyan, N. L., A. A. Patel, A. Carotenuto, M. Y. Kalani, E. Belykh, C. T. Walker, M. C. Preul, and N.Theodore. 2016. 'Genetic Alterations in Intervertebral Disc Disease', Front Surg, 3: 59.
  • Matsui, H., M. Kanamori, H. Ishihara, K. Yudoh, Y. Naruse, and H. Tsuji. 1998. 'Familial predisposition for lumbar degenerative disc disease. A case-control study', Spine (Phila Pa 1976), 23: 1029-34.
  • Mayer, H. M., H. Mellerowicz, and S. W. Dihlmann. 1996. 'Endoscopic discectomy in pediatric and juvenile lumbar disc herniations', J Pediatr Orthop B, 5: 39-43.
  • Mio, F., K. Chiba, Y. Hirose, Y. Kawaguchi, Y. Mikami, T. Oya, M. Mori, M. Kamata, M. Matsumoto, K.Ozaki, T. Tanaka, A. Takahashi, T. Kubo, T. Kimura, Y. Toyama, and S. Ikegawa. 2007. 'A functional polymorphism in COL11A1, which encodes the alpha 1 chain of type XI collagen, is associated with susceptibility to lumbar disc herniation', Am J Hum Genet, 81: 1271-7.
  • Morange, P. E., N. Saut, M. C. Alessi, J. S. Yudkin, M. Margaglione, G. Di Minno, A. Hamsten, S. E. Humphries, D. A. Tregouet, and I. Juhan-Vague. 2007. 'Association of plasminogen activator inhibitor (PAI)-1 (SERPINE1) SNPs with myocardial infarction, plasma PAI-1, and metabolic parameters: the HIFMECH study', Arterioscler Thromb Vasc Biol, 27: 2250-7.
  • Motulsky, A. G. 1996. 'Nutritional ecogenetics: homocysteine-related arteriosclerotic vascular disease, neural tube defects, and folic acid', Am J Hum Genet, 58: 17-20.
  • Nerlich, A. G., B. E. Bachmeier, E. Schleicher, H. Rohrbach, G. Paesold, and N. Boos. 2007. 'Immunomorphological analysis of RAGE receptor expression and NF-kappaB activation in tissue samples from normal and degenerated intervertebral discs of various ages', Ann N Y Acad Sci, 1096: 239-48.
  • Nithya, K., T. Angeline, W. Isabel, and A. J. Asirvatham. 2016. 'SOD1 Gene +35A/C (exon3/intron3) Polymorphism in Type 2 Diabetes Mellitus among South Indian Population', Genet Res Int, 2016:3787268.
  • Obukhov, S. K., L. Hankenson, M. Manka, and J. R. Mawk. 1996. 'Multilevel lumbar disc herniation in 12-year-old twins', Childs Nerv Syst, 12: 169-71.
  • Panduru, N. M., D. Cimponeriu, M. Cruce, D. A. Ion, E. Mota, M. Mota, C. Serafinceanu, L. I. Chivu, M. Panduru, R. D. Chivu, and A. C. Covic. 2010. 'Association of +35A/C (intron3/exon3) polymorphism in SOD1-gene with diabetic nephropathy in type 1 diabetes', Rom J Morphol Embryol, 51: 37-41.
  • Parge, H. E., R. A. Hallewell, and J. A. Tainer. 1992. 'Atomic structures of wild-type and thermostable mutant recombinant human Cu,Zn superoxide dismutase', Proc Natl Acad Sci U S A, 89: 6109-13.
  • Pierdomenico, S. D., A. Bucci, D. Lapenna, F. M. Lattanzio, L. Talone, F. Cuccurullo, and A. Mezzetti. 2003. 'Circulating homocysteine levels in sustained and white coat hypertension', J Hum Hypertens, 17: 165-70.
  • Polat, S., and Y. Simsek. 2020. 'Five variants of the superoxide dismutase genes in Turkish women with polycystic ovary syndrome', Free Radic Res: 1-10.
  • Rodriguez, R., and R. Redman. 2005. 'Balancing the generation and elimination of reactive oxygen species', Proc Natl Acad Sci U S A, 102: 3175-6.
  • Sambrook, P. N., A. J. MacGregor, and T. D. Spector. 1999. 'Genetic influences on cervical and lumbar disc degeneration: a magnetic resonance imaging study in twins', Arthritis Rheum, 42: 366-72.
  • Schell, E., T. Theorell, D. Hasson, B. Arnetz, and H. Saraste. 2008. 'Stress biomarkers' associations to pain in the neck, shoulder and back in healthy media workers: 12-month prospective follow-up', European Spine Journal, 17: 393-405.
  • Skovron, M. L. 1992. 'Epidemiology of low back pain', Baillieres Clin Rheumatol, 6: 559-73.
  • Torres-Carrillo, N. M., N. Torres-Carrillo, M. Vazquez-Del Mercado, V. Delgado-Rizo, E. Oregon Romero, I. Parra-Rojas, and J. F. Munoz-Valle. 2008. 'The -844 G/A PAI-1 polymorphism is associated with mRNA expression in rheumatoid arthritis', Rheumatol Int, 28: 355-60.
  • Tran, P., D. Leclerc, M. Chan, A. Pai, F. Hiou-Tim, Q. Wu, P. Goyette, C. Artigas, R. Milos, and R. Rozen.2002. 'Multiple transcription start sites and alternative splicing in the methylenetetrahydrofolate reductase gene result in two enzyme isoforms', Mamm Genome, 13: 483-92.
  • van der Put, N. M., F. Gabreels, E. M. Stevens, J. A. Smeitink, F. J. Trijbels, T. K. Eskes, L. P. van den Heuvel, and H. J. Blom. 1998. 'A second common mutation in the methylenetetrahydrofolate reductase gene: an additional risk factor for neural-tube defects?', Am J Hum Genet, 62: 1044-51.
  • van Guldener, C., P. W. Nanayakkara, and C. D. Stehouwer. 2003. 'Homocysteine and blood pressure', Curr Hypertens Rep, 5: 26-31.
  • Wan, X. S., M. N. Devalaraja, and D. K. St Clair. 1994. 'Molecular structure and organization of the human manganese superoxide dismutase gene', DNA Cell Biol, 13: 1127-36.
  • Whincup, P. H., H. Refsum, I. J. Perry, R. Morris, M. Walker, L. Lennon, A. Thomson, P. M. Ueland, and S. B. J. Ebrahim. 1999. 'Serum total homocysteine and coronary heart disease: prospective study in middle aged men', Heart, 82: 448-54.
  • Zhang, Y. L., C. Z. Zhang, S. Y. Guan, L. Zhou, and Q. Li. 2017. 'Association between SOD2 rs6917589,rs2842980, rs5746136 and rs4880 polymorphisms and primary open angle glaucoma in a northern Chinese population', International Journal of Clinical and Experimental Pathology, 10: 3930-38
  • Ziskoven, C., M. Jager, J. Kircher, T. Patzer, W. Bloch, K. Brixius, and R. Krauspe. 2011. 'Physiology and pathophysiology of nitrosative and oxidative stress in osteoarthritic joint destruction', Can J Physiol Pharmacol, 89: 455-66.
APA Polat S, Özener B, ARSLAN Y, Ekinci B (2021). Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. , 472 - 491. 10.18185/erzifbed.881338
Chicago Polat Seher,Özener Barış,ARSLAN YUSUF KEMAL,Ekinci Bilge Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. (2021): 472 - 491. 10.18185/erzifbed.881338
MLA Polat Seher,Özener Barış,ARSLAN YUSUF KEMAL,Ekinci Bilge Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. , 2021, ss.472 - 491. 10.18185/erzifbed.881338
AMA Polat S,Özener B,ARSLAN Y,Ekinci B Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. . 2021; 472 - 491. 10.18185/erzifbed.881338
Vancouver Polat S,Özener B,ARSLAN Y,Ekinci B Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. . 2021; 472 - 491. 10.18185/erzifbed.881338
IEEE Polat S,Özener B,ARSLAN Y,Ekinci B "Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation." , ss.472 - 491, 2021. 10.18185/erzifbed.881338
ISNAD Polat, Seher vd. "Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation". (2021), 472-491. https://doi.org/10.18185/erzifbed.881338
APA Polat S, Özener B, ARSLAN Y, Ekinci B (2021). Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi, 14(2), 472 - 491. 10.18185/erzifbed.881338
Chicago Polat Seher,Özener Barış,ARSLAN YUSUF KEMAL,Ekinci Bilge Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi 14, no.2 (2021): 472 - 491. 10.18185/erzifbed.881338
MLA Polat Seher,Özener Barış,ARSLAN YUSUF KEMAL,Ekinci Bilge Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi, vol.14, no.2, 2021, ss.472 - 491. 10.18185/erzifbed.881338
AMA Polat S,Özener B,ARSLAN Y,Ekinci B Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi. 2021; 14(2): 472 - 491. 10.18185/erzifbed.881338
Vancouver Polat S,Özener B,ARSLAN Y,Ekinci B Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation. Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi. 2021; 14(2): 472 - 491. 10.18185/erzifbed.881338
IEEE Polat S,Özener B,ARSLAN Y,Ekinci B "Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation." Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi, 14, ss.472 - 491, 2021. 10.18185/erzifbed.881338
ISNAD Polat, Seher vd. "Genetic Polymorphisms in Turkish Patients with Lumbar Disk Herniation". Erzincan Üniversitesi Fen Bilimleri Enstitüsü Dergisi 14/2 (2021), 472-491. https://doi.org/10.18185/erzifbed.881338
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