The relationship between genetic polymorphisms in apolipoprotein E (ApoE) gene and osteonecrosis of the femoral head induced by steroid in Chinese Han population

Abstract

Previous studies suggested that apolipoprotein E (ApoE) genetic polymorphisms (SNPs) may result in abnormal lipid metabolism. Therefore, genetic polymorphisms in ApoE may be associated with the occurrence of osteonecrosis of the femoral head (ONFH). A case control study was designed to include 580 patients with steroid-induced ONFH and 560 age- and sex-matched non steroid-induced ONFH control subjects to analyze the association between ApoE polymorphisms and susceptibility of steroid-induced ONFH. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was utilized to differentiate two genotypes SNPs (rs7412 C/T and rs429358 T/C) in ApoE gene. Both rs7412 C/T and rs429358 T/C were found to be associated with the risk of steroid-induced ONFH. However, no significant association was observed between the haplotypes T-T, T-C and C-C in ONFH. Furthermore, T allele of rs7412 and C allele of rs429358 carriers were associated with higher levels of TG in steroid-induced ONFH patients (P < 0.05). The study suggested that ApoE genetic polymorphisms conferred susceptibility to steroid-induced ONFH in Chinese Han population. However, the results need further investigation with large sample size and various populations.

Steroid-induced osteonecrosis

“…Other SNPs with an impact on steroid-induced osteonecrosis have been demonstrated for cytochrome P450 and associated with lower risk [ 25 ], whereas different IL1B polymorphisms influence the risk for steroid-induced osteonecrosis [ 26 ]. Metalloproteinase 2, 8, and 10 polymorphisms contribute to susceptibility [ 27 , 28 ], as RETN (coding for resistin, an adipokine involved in metabolic disorders) and ApoA 5 and APOE (involved in lipid metabolism) SNP [ [29] , [30] , [31] ]. In contrast, metalloproteinase 9 SNPs appears to reduce the risk [ 32 ], similar to the gene for the tissue inhibitor of metalloprotease-4 [ 33 ], while the plasminogen activator inhibitor-1 (PAI-1) SNP has been demonstrated to be associated with an increased risk of steroid-induced osteonecrosis [ 34 ].…”

Association of MIR17HG and MIR155HG gene variants with steroid-induced osteonecrosis of the femoral head in the population of northern China

“…Osteonecrosis of the femoral head (ONFH), also known as avascularity necrosis of the femoral head, occurs mostly in young adults aged 30–50 and is a refractory disease in the Department of Orthopedics [ 23 ]. Due to hidden early symptoms, most patients with osteonecrosis develop to the middle and late stages when they are diagnosed with osteonecrosis, and there are varying degrees of femoral head collapse or loss of hip joint function, which seriously affect the quality of life of patients [ 30 , 32 , 36 ]. ONFH has different causes including steroids, alcohol, trauma, and idiopathic origins.…”

“…Clinical observations have found that not all patients treated with glucocorticoids have experienced femoral head necrosis, suggesting that there may be other risk factors or individual differences in the occurrence of glucocorticoid-induced ONFH. Some studies have shown that the difference between individuals may be related to gene polymorphism [ 18 , 32 ].…”

Association of MIR17HG&nbsp;and MIR155HG&nbsp;gene variants with steroid-induced osteonecrosis of the femoral head in the population of northern&nbsp;China

“…Osteonecrosis of the femoral head (ONFH), also known as avascularity necrosis of the femoral head, occurs mostly in young adults aged 30-50 and is a refractory disease in the Department of Orthopedics (Wang et al, 2017). Due to hidden early symptoms, most patients with osteonecrosis develop to the middle and late stages when they are diagnosed with osteonecrosis, and there are varying degrees of femoral head collapse or loss of hip joint function, which seriously affect the quality of life of patients (Xu et al, 2017;Zhang et al, 2017;Yuan et al, 2018). ONFH has different causes including steroids, alcohol, trauma, and idiopathic origins.…”

“…Clinical observations have found that not all patients treated with glucocorticoids have experienced femoral head necrosis, suggesting that there may be other risk factors or individual differences in the occurrence of glucocorticoid induced ONFH. Some studies have shown that the difference between individuals may be related to gene polymorphism (Yuan et al, 2018;Tian et al, 2019).…”