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Imbalanced bone turnover markers and low bone mineral density in patients with osteonecrosis of the femoral head

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Abstract

Purpose

There have been few studies investigating the cumulative effect of individual factors related to bone metabolism on the systemic balance between bone formation and resorption in patients with osteonecrosis of the femoral head (ONFH). We investigated bone mineral density (BMD) of lumbar spine and bone turnover markers that reflect systemic bone metabolism.

Methods

Two-hundred twenty patients with ONFH were matched to 220 healthy subjects according to age, gender, and body mass index. ONFH patients were divided into steroid-induced (18%), alcoholic (21%), and idiopathic ONFH (61%) and subgroup analysis was performed to exclude the effect of steroid and malnutrition on bone metabolism. We compared lumbar spine bone mineral density (BMD) between groups and measured serum bone-specific alkaline phosphatase (BALP) and urinary deoxypyridinoline/creatinine (Dpd/Cr) ratio.

Results

Logistic regression analysis revealed low spine BMD was significantly associated with each subgroup of ONFH when compared with that of the control group (odds ratio of 2.27, 4.24, and 1.86 in alcoholic, steroid, and idiopathic ONFH, respectively). The mean value of serum BALP (27.02 U/L) was within the normal reference range while average urine Dpd/Cr ratio (6.24 nM/mM) increased in ONFH group when compared with respective reference range.

Conclusion

Spine BMD decreased and urinary Dpd/Cr ratio increased in patients with non-traumatic ONFH. Further studies will be necessary to identify whether non-traumatic ONFH is merely a regional disease confined to the femoral head or may affect systemic bone metabolism.

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Acknowledgements

We thank professor Won Kee Lee for statistical analysis.

Funding

We thank professor Won Kee Lee for statistical analysis. This work was supported by Institute for Information & communications, Technology Promotion (IITP) grant funded by the Korea government (MSIP) (B0101-18-1081).

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Authors and Affiliations

  1. Musculoskeletal Genome Research Center, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-Gu, Daegu, 700-721, South Korea

    Lulu Tian & Shin-Yoon Kim

  2. Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-Gu, Daegu, 700-721, South Korea

    Seung-Hoon Baek & Shin-Yoon Kim

  3. Department of Orthopedic Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-Gu, Daegu, 700-721, South Korea

    Seung-Hoon Baek, JinAn Jang & Shin-Yoon Kim

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  1. Lulu Tian
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Correspondence to Shin-Yoon Kim.

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Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Tian, L., Baek, SH., Jang, J. et al. Imbalanced bone turnover markers and low bone mineral density in patients with osteonecrosis of the femoral head. International Orthopaedics (SICOT) 42, 1545–1549 (2018). https://doi.org/10.1007/s00264-018-3902-2

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  • DOI: https://doi.org/10.1007/s00264-018-3902-2

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