Abstract
BackgroundThe objective of this study was to evaluate whether apolipoprotein gene polymorphisms confer susceptibility to osteonecrosis of the femoral head (ONFH).MethodsThe relevant literature was screened from databases of Pubmed, Embase, Wanfang, Weipu and China National Knowledge Internet (CNKI) until May, 2017. In addition, odds ratio (OR) and its corresponding 95% confidence interval (CI) were used as a measure of effect size for calculating effect size.ResultsTotally, six case-control studies were included in this meta-analysis. It revealed that ApoB-C7623T polymorphism frequency was increased in ONFH group than in control group under three genetic models, including allele model (T vs. C, OR = 4.5149, 95% CI: 1.6968–12.0134); additive model (TC vs. CC, OR = 6.2515, 95% CI: 2.0939–18.6640); and dominant model (TT + TC vs. CC, OR = 5.4998, 95% CI: 1.9246–15.7163). In addition, the increased risk of ONFH were related to ApoA1-rs1799837 polymorphism under additive model (AA vs. GG, OR = 1.4175, 95% CI: 1.0522–1.9096) and recessive model (AA vs. GG + AG, OR = 1.7727, 95% CI: 1.3399–2.3452). However, four ApoB rs1042031, rs693, 3’-VNTR and G12619A polymorphisms under the all genetic models were not associated with susceptibility to ONFH.ConclusionThe T allele and TC genotype of ApoB-C7623T and AA genotype of ApoA1-rs1799837 may contribute to increase the risk of ONFH.
Highlights
The objective of this study was to evaluate whether apolipoprotein gene polymorphisms confer susceptibility to osteonecrosis of the femoral head (ONFH)
Osteonecrosis of the femoral head (ONFH) is an intractable disease characterized by the death of osteocytes that caused by obstructed circulation to a specific area, which leads to inadequate blood supply [1]
Several studies have demonstrated the genetic polymorphisms of endothelial nitric oxide synthase (NOS3) and vascular endothelial growth factor (VEGF) contribute to angiogenesis and bone turnover in ONFH patients [10, 11], revealing genetic factors may act as crucial role in the development of ONFH
Summary
The objective of this study was to evaluate whether apolipoprotein gene polymorphisms confer susceptibility to osteonecrosis of the femoral head (ONFH). Apolipoprotein (APO), a major blood plasma protein, mediates the transport of lipid by its interaction with cellular receptors [12], and lipid metabolism disorder is considered as one of the leading causes for ONFH development [13]. APOs are considered as sensitive markers for estimating lipid metabolic disorder in ONFH populations, whose plasma adiponectin levels are significantly lower than that in healthy controls [14]. The apolipoprotein A1 (ApoA1) level is associated with cholesterol homeostasis and lipid metabolism [15] It reveals that the Apo-A1 levels have significant positive correlation with HDL-cholesterol [16]. The polymorphisms of APOs genes may be associated with ONFH with altered lipid metabolism. Apolipoprotein B (ApoB) gene polymorphism is relevant with the tendon-vessel stagnation syndrome of steroid-induced ONFH [19]
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