Abstract
Background and objectiveThe neuropeptide vasoactive intestinal peptide is a 28-amino acid neuropeptide that has been shown to stimulate bone repair and angiogenesis. The purpose of this study was to explore the potential role of serum VIP concentration in osteonecrosis of femoral trauma (ONFH).MethodsOne hundred five patients diagnosed with non-traumatic ONFH and 103 healthy individuals were enrolled in our study. Serum VIP, tumor necrosis factor-α (TNF-α), interluekin-1 beta (IL-1β), and macrophage colony-stimulating factor (M-CSF) levels also were detected using the commercial ELISA kit. Radiographic progression was evaluated using FICAT classification. The clinical severity of ONFH was assessed by visual analog score (VAS) and Harris Hip Score (HHS). Receiver-operating characteristic (ROC) curve was performed to test the potential diagnostic value of VIP in radiographic progression.ResultsThe serum VIP level of patients with non-traumatic ONFH was significantly lower than that of healthy controls. There was no significant difference between the alcohol group, the steroid-induction group, and the idiopathic group. Serum VIP levels were significantly higher in ONFH patients with femoral head pre-collapse stage than collapse stage. Serum VIP levels were significantly lower. FICAT 4 non-traumatic ONFH patients had significantly lower serum concentrations of VIP when compared with FICAT 3 and FICAT 2. Moreover, serum VIP levels were significantly lower in ONFH patients with FICAT 3 than FICAT 2. Serum VIP levels were negatively related to FICAT stage. In addition, serum VIP levels were negatively associated with VAS score and positively associated with HHS score. Last, we found serum VIP levels were negatively associated with serum TNF-α and IL-1β levels. ROC curve analysis indicated that decreased serum VIP could serve as a decent biomarker with regard to the diagnosis of radiographic progression.ConclusionAttenuated serum VIP concentrations are correlated with disease severity of non-traumatic ONFH. Decreased serum VIP may serve as a potential indicator of non-traumatic ONFH.
Highlights
Non-traumatic femoral head necrosis (ONFH, known as avascular necrosis of the femoral head and aseptic femoral head necrosis) is a common but difficult-to-recover osteonecrosis disease, caused by abnormal blood supply to bone tissue, leading to bone tissue death, structural reconstruction, and collapse [1]
No significant differences in age and sex distribution and BMI were observed between ONFH patients and healthy controls
Serum Vasoactive intestinal peptide (VIP) levels were significantly lower in ONFH patients with FICAT 3 than FICAT 2 (204.0±33.0 pg/mL vs 230.2± 32.6 pg/mL, P=0.034)
Summary
Non-traumatic femoral head necrosis (ONFH, known as avascular necrosis of the femoral head and aseptic femoral head necrosis) is a common but difficult-to-recover osteonecrosis disease, caused by abnormal blood supply to bone tissue, leading to bone tissue death, structural reconstruction, and collapse [1]. Among non-traumatic ONFH patients, high-dose corticosteroid therapy for inflammatory diseases and alcohol-abuse were reported to be the two main risk factors for non-traumatic ONFH [4]. These factors may lead to some potential pathogenesis of ONFH, including intraosseous hypertension, fat metabolism disorder, intravascular coagulation, microvascular endothelial cell damage, and osteoblast and bone cell apoptosis [5], which may cause final necrosis of femoral head. Non-traumatic ONFH is usually asymptomatic in the early stages and difficult to diagnose. The purpose of this study was to explore the potential role of serum VIP concentration in osteonecrosis of femoral trauma (ONFH)
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