gms | German Medical Science

Objectives: There have been conflicting reports regarding the osteogenic differentiation capacity and the gene expression of factors regulating bone formation and remodeling of bone marrow stromal cells (BMSCs) in patients with ONFH. The aim of this study was to investigate the effect of these osteogenic differentiation capacity and the gene expression on bone mineral density (BMD) and bone turnover markers in patients with ONFH.

Methods: Two-hundred and twenty patients with an average age of 53.52 years and mean BMI of 23.17±3.03 kg/m² were included in the ONFH group. Two-hundred and twenty subjects in the control group were matched according to age, gender and body mass index (BMI). The average age of control group was 53.10 years and the mean BMI of control group was 23.55±2.85 kg/m². There were 165 males and 55 females in each group. We compared lumbar spine BMD between two groups and measured bone turnover markers including serum bone specific alkaline phosphatase (BALP) and urinary deoxypyridinoline/creatinine (Dpd/Cr) ratio.

Results and Conclusion: The mean value of lumbar spine BMD in ONFH group (1.04±0.17 g/cm²) was significantly lower than that of control group (1.13±0.17 g/cm², p<0.0001). Compared with respective reference, the mean value of BALP in patients with ONFH (27.02±13.48 U/L) was in normal range while the mean value of Dpd/Cr ratio in these patients (6.24±2.87 nM/mM) exceeded the normal range. In conclusion, our results showed that lumbar spine BMD was decreased in ONFH patients and the balance between systemic bone formation and resorption was disrupted.