Role of Thrombotic and Fibrinolytic Disorders in Osteonecrosis of the Femoral Head

Lee, Jong Suk; Koo, Kyung Hoi; Ha, Yong Chan; Koh, Kwang Kon; Kim, Seon Ju; Kim, Jang Rak; Song, Hae Ryong; Cho, Se Hyun

doi:10.1097/01.blo.0000092972.12414.a5

Cited by 22 publications

(3 citation statements)

References 13 publications

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“…Several mechanisms may have contributed to the negative association between adiponectin and nontraumatic ONFH. First, adiponectin produces vasculoprotective effects through direct actions on endothelial cells, platelets, smooth muscle cells, and inflammatory cells, thus modulating initiation and progression of certain risk factors for ischemic necrosis of the femoral head (such as platelet-derived and endothelium-derived microparticles 15 , or thrombotic/fibrinolytic factors 33 , which might contribute to hypercoagulability and microthrombosis in patients with ONFH). Second, adiponectin may also improve lipid metabolism.…”

Section: Discussionmentioning

confidence: 99%

Low Plasma Adiponectin as a Potential Biomarker for Osteonecrosis of the Femoral Head

Shuai¹,

Shen²,

Yang³

et al. 2010

J Rheumatol

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Section: Discussionmentioning

confidence: 99%

Low Plasma Adiponectin as a Potential Biomarker for Osteonecrosis of the Femoral Head

Shuai¹,

Shen²,

Yang³

et al. 2010

J Rheumatol

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“…Jones LC et al further reported 82.2% of their patient cohort was identified with coagulation abnormalities [ 9 ]. However, Lee et al argued that coagulopathy did not exist in East Asian patients because no differences were found in the thrombotic factors (protein C, protein S, antithrombin III, anticardiolipin antibody, and lupus antibody) and the fibrinolytic factors (tissue plasminogen activator, plasminogen activator inhibitor-1, lipoprotein (a), and plasminogen) in 24 ONFH patients and 24 matched controls [ 11 ]. In the current study, we recruited 155 ONFH patients and found 73.2% of them had abnormal coagulation profiles.…”

Section: Discussionmentioning

confidence: 99%

“…Zalavras et al found 22.2% of the 72 ONFH patients had either factor V Leiden or prothrombin mutation, while it was only 7.3% in the 300 control subjects [ 10 ]. On the contrary, Lee et al reported coagulopathy did not exist in Korean patients based on the results in 24 ONFH patients and 24 matched controls [ 11 ]. Furthermore, neither factor V Leiden nor prothrombin mutation was found in ONFH patients as well as in the control subjects in an Asian population [ 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Nitric Oxide Synthase Polymorphism and Coagulopathy in Patients with Osteonecrosis of the Femoral Head

Lin

Sung

et al. 2022

JCM

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Genetic polymorphism of nitric oxide synthase (NOS) can cause reduction of nitric oxide (NO) levels and may be associated with osteonecrosis of the femoral head (ONFH). However, the association of coagulopathy and NOS polymorphism in ONFH patients has not been confirmed. Between November 2005 and October 2013, 155 patients with ONFH were recruited in the study of serum coagulation profiles and NOS polymorphism. Another 43 patients who had dysplasia, osteoarthritis, or trauma of hip joints were included as controls. PCR genotyping for the analysis of NOS 27-bp polymorphism in intron 4 was performed. The analysis of coagulation profiles included fibrinogen, fibrinogen degradation product (FDP), protein S, protein C, and anti-thrombin III. The results showed that 27-bp repeat polymorphism was significantly associated with ONFH (OR 4.32). ONFH patients had significantly higher fibrinogen, FDP, protein S, and anti-thrombin III levels than that of the controls. The incidence of coagulopathy was significantly higher in ONFH patients (73.2%), and the odds ratio increased from 2.38 to 7.33 when they had 27-bp repeat polymorphism. Patients with hyperfibrinogenemia, elevated FDP levels, and with the risk factor of alcohol or steroid use had significantly higher risks of bilateral hip involvement. This study demonstrated the presence of NOS polymorphism, and a resultant reduction in NO production was associated with coagulopathy, which in turn might contribute to higher risks of bilateral ONFH. Our data suggests that checking NOS polymorphism and coagulopathy may provide a new avenue in managing ONFH.

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Endothelial nitric oxide synthase gene polymorphisms in patients with nontraumatic femoral head osteonecrosis

Koo

Lee

et al. 2006

Journal Orthopaedic Research

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As endothelial nitric oxide synthase (eNOS) has beneficial effects on skeletal, vascular, and thrombotic systems, the association between nontraumatic femoral head osteonecrosis (FHON) and eNOS gene polymorphisms was investigated in Korean patients with FHON. Genomic DNA from 103 patients with nontraumatic FHON (idiopathic in 50, steroid-induced in 29, and alcohol abuse in 24) and 103 control subjects matched for gender and age (3-year range) was analyzed for the 27-bp repeat polymorphism in intron 4 and Glu298Asp polymorphism in exon 7. The frequencies of alleles and genotypes were compared between patients and control subjects. The frequency of 4a allele was significantly higher in total patients than control subjects [6.8% vs. 2.4%, p ¼ 0.0345, odds ratio (OR) 2.931]. In subgroup analysis, the 4a allele significantly increased in patients with idiopathic FHON versus control subjects (9.0% vs. 2.4%, p ¼ 0.0297, OR 3.976). The frequency of the 4a/b genotype in total patients (13.6% vs. 4.9%, p ¼ 0.0302, OR 3.083) as well as patients with idiopathic FHON (18.0% vs. 4.9%, p ¼ 0.0246, OR 4.302) was higher than control subjects. The distribution of Glu298Asp polymorphisms was not significantly different between patients and control subjects. Microstellate polymorphism in intron 4 of eNOS polymorphism was significantly associated with idiopathic FHON in Korean patients. Because 4a allele is associated with lower synthesis of eNOS, these results suggest that carrier state of 4a allele in intron 4 might be a genetic risk factor of FHON and could provide insight into the protective role of nitric oxide in the pathogenesis of FHON. ß

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Role of Thrombotic and Fibrinolytic Disorders in Osteonecrosis of the Femoral Head

Cited by 22 publications

References 13 publications

Low Plasma Adiponectin as a Potential Biomarker for Osteonecrosis of the Femoral Head

Low Plasma Adiponectin as a Potential Biomarker for Osteonecrosis of the Femoral Head

Association of Nitric Oxide Synthase Polymorphism and Coagulopathy in Patients with Osteonecrosis of the Femoral Head

Endothelial nitric oxide synthase gene polymorphisms in patients with nontraumatic femoral head osteonecrosis

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