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.