Abstract

Abstract Objective To investigate the correlation between MTHFR C677T polymorphism and non-traumatic osteonecrosis of the femoral head. Methods Open published studies relevant to MTHFR C677T polymorphism and non-traumatic osteonecrosis of the femoral head were electronic systematic searched in the databases of cochrane central register of controlled trials, EMBSE and CNKI. The correlation between MTHFR C677T polymorphism and non-traumatic osteonecrosis of the femoral head was calculated by odds ratio (OR) and corresponding 95% confidence interval (95%CI). The publication bias for the included studies were assessed by Begg’s funnel plot and Egger’s line regression text. Results After systematic searching the electronic databases, 11 original studies were finally included the present work. The I2 test indicated significant statistical heterogeneity (I2=53.5%, P=0.018) across the included 11 publications. The polled results indicated that subjects of Caucasians with CC genotype had decreased risk of developing non-traumatic osteonecrosis of the femoral head (OR=0.65,95%CI: 0.44-0.96, P=0.031). However, there was no correlations between MTHFR C677T polymorphism and non-traumatic osteonecrosis of the femoral head in American Jewish and East Asian races(p>0.05). Sensitivity analysis indicated the pooled ORs were not sensitive to any included single study. The Begg’s funnel plot was generally left and right symmetrical which indicated no obviously publications. The Egger’s line regression test also demonstrated no statistical publication bias (t=1.57, P=0.15). Conclusion According to the present evidence, MTHFR C677T polymorphism was correlated with non-traumatic osteonecrosis of the femoral head especially for Caucasians race. Subjects of Caucasians race with CC genotype had decreased risk of developing non-traumatic osteonecrosis of the femoral head.

Highlights

  • Non-traumatic osteonecrosis of the femoral head is a disease characterized by acquired ischemic lesions of the femoral head

  • The polled results indicated that subjects of Caucasians with CC genotype had decreased risk of developing non-traumatic osteonecrosis of the femoral head (OR=0.65,95% confidence interval (95%CI): 0.44-0.96, P=0.031)

  • There was no correlations between MTHFR C677T polymorphism and non-traumatic osteonecrosis of the femoral head in American Jewish and East Asian races(p>0.05)

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Summary

Introduction

Non-traumatic osteonecrosis of the femoral head is a disease characterized by acquired ischemic lesions of the femoral head. As hip dysplasia and rapid progressive hip joint destruction, if the femoral head necrosis area reaches or exceeds 30% and remains untreated, nontraumatic osteonecrosis of the femoral head will develop into end-stage hip arthritis, which will lead to serious hip joint destruction, requiring surgical intervention. The etiology of non-traumatic osteonecrosis of the femoral head is not yet fully understood. Several studies have evaluated correlations between some MTHFR gene polymorphism and susceptibility for non-traumatic osteonecrosis of the femoral head [5, 6]. A meta-analysis included 8 trials published 7 years ago indicated the correlation between MTHFR C677T polymorphism and non-traumatic osteonecrosis of the femoral head [7].

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