Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (20): 3117-3121.doi: 10.3969/j.issn.2095-4344.2572

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Serum Nesfatin-1 changes in osteonecrosis of the femoral head 

Shen Yingshan1, Chen Xiaojun1, Pang Fengxiang1, Huang Junyuan2, Chen Zhenqiu3, Zhou Yingchun2, He Wei3, 4, Wei Qiushi3, 4   

  1. 1First Clinical Medical College, Guangzhou University of Chinese Medicine; 2Clinical Laboratory, First Affiliated Hospital of Guangzhou University of Chinese Medicine; 3Hip Preserving Ward, No. 3 Orthopedic Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine; 4Institute of Hip Joint, Guangzhou University of Chinese Medicine

  • Received:2019-08-12 Revised:2019-08-14 Accepted:2019-09-17 Online:2020-07-18 Published:2020-04-10
  • Contact: Wei Qiushi, MD, Associate chief physician, Hip Preserving Ward, No. 3 Orthopedic Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; Institute of Hip Joint, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • About author:Shen Yingshan, Master candidate, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510407, Guangdong Province, China
  • Supported by:
    the National Natural Science Foundation of China (General Projects), No. 81473697 and 81573996; Guangdong Provincial Department of Science and Technology - Guangdong Provincial Academy of Traditional Chinese Medicine Joint Research Project, No. 2016A020226028; Guangdong Provincial Natural Science Foundation, No. 2017A030313698; Special Dominant Disease (Femoral Head Necrosis) Breakthrough Project of Guangdong Province for Traditional Chinese Medicine Province Construction, No. [2015]19; Guangdong Provincial Famous Chinese Medicine (He Wei) Heritage Studio Construction Project, No. [2017]17 

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Abstract:

BACKGROUND: Nesfatin-1, a novel feeding regulator, has been found to be closely linked to orthopedic diseases in recent years. The correlation between Nesfatin-1 and osteonecrosis of the femoral head (ONFH) remains unclear.

OBJECTIVE: To determine the changes in plasma Nesfatin-1 level in patients with ONFH and to study its correlation with the development of ONFH. 

METHODS: From May to December 2016, we enrolled 86 patients with ONFH who were hospitalized in the Hip Preserving Ward, No. 3 Orthopedic Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine (including 13 ARCO stage II, 26 ARCO stage III, and 47 ARCO stage IV) and 86 healthy controls. In the ONFH group, there were 26 cases of steroid-induced ONFH, 40 cases of alcoholic ONFH, 12 cases of traumatic ONFH, and 8 cases of idiopathic ONFH. The levels of Nesfatin-1 in peripheral venous blood were measured by enzyme-linked immunosorbent assay (ELISA). Comparison was performed between different ARCO stages, different etiologies as well as before and after collapse. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (No. 20140307), and each patient had signed an informed consent form prior to inclusion in the study.

RESULTS AND CONCLUSION: Plasma Nesfatin-1 level was significantly higher in ONFH patients than healthy controls (P=0.000). There were insignificant differences among different etiologies (P=0.956), but significant differences among different ARCO stages (P=0.011) as well as before and after collapse (P=0.003). There was a positive correlation between plasma Nesfatin-1 level and ARCO stages. Receiver operator characteristic curve analysis showed that Nesfatin-1 level had sensitivity (52.05%) and specificity (92.31%) in the diagnosis of ONFH. These findings indicate that Nesfatin-1 is closely related to the development of ONFH. It can reflect the degree of necrosis, which can provide reference for clinical diagnosis and treatment of ONFH.

Key words: osteonecrosis of the femoral head, Nesfatin-1, osteoblast differentiation, inflammatory reaction, collapse of the femoral head

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