Clinical Study Of Lipid Metabolism-related Factors And Platelet Activating-related Factors On Patients With Non-traumatic Osteonecrosis Of The Femoral Head And Clinical Effect Of Traditional Chinese Medicine

Background:Both of circulatory impairment and metabolism abnormality of bone and lipid are involved in the complex pathogenesis regulation of nontraumatic osteonecrosis of femoral head (ONFH). The previous study confirmed that adiponectin predominantly exhibited significant anti-inflammatory and anti-atherosclerotic effects which indirectly prevented circulation vessel obstruction which lead to some ischemic diseases. Furthermore, adiponectin could regulate bone formation and remodel bone quality by suppressing osteoclast-genesis.Objectives:Therefore, we sought to assess whether plasma adiponectin levels correlated with the susceptibility of nontraumatic ONFH.Methods:The adiponectin levels were measured in nontraumatic ONFH (n=120), traumatic ONFH (n=45), osteoarthritis (n=35) and healthy control subjects (n=120), respectively. Other influence factors, such as plasma low-density lipoprotein, high density lipoprotein, apolipoprotein Al, apolipoprotein B, total cholesterol, triglycerides, and C-reactive protein were also measured by routine methods.Results:Nontraumatic ONFH patients had significantly lower plasma levels of adiponectin than those with control group (7.14±3.53 vs. 10.93±3.41μg/ml,p<0.001). Serum adiponectin levels were positively correlated with HDL-cholesterol (r=0.28, p＜0.001) and age (r=0.15, p=0.01), yet negatively correlated with body mass index (BMI) (r=-0.70, p<0.001), triglycerides (r=-0.55, p<0.001), and plasma C-reactive protein (r=-0.634, p<0.001). No correlation was seen with LDL-cholesterol (LDL-C) (r=-0.087, p=0.569). And there was a significant association between low plasma adiponectin levels and the presence of nontraumatic ONFH with bivariate correlate analysis (r=0.498, p＜0.001).Conclusions:Low adiponectin levels are significantly associated with the risk presence of nontraumatic ONFH. However, this biomarker may be useful to assessing the potential risk of nontraumatic ONFH. Objective:Objective one to detect the relationship of plasma platelet-derived microparticle (PMP), activation ratio of glycoproteinⅡb/Ⅲa(PAC-1) and P-selection (CD62P) in patients with ischemic osteonecrosis of the femoral head (INFH), and to investigate the function and clinical significance of the activation of PMP, PAC-1, and CD62P in patients of INFH.Objective two to detect the change of the number of PMP and the activation ratio of PAC-1 and CD62P in INFH before and after treatment with traditional chinese medicine, and to investigate the function and influence of traditional chinese medicine on platelet activation in INFH patientsMethods:The randomized, double-blind, and placebo-controlled study methods were used in 40 INFH patients, which divided into Huogu capsule treatment group (group A) and placebo-controlled treatment group (group B), 20 patients respectively. Twenty health volunteers were as group C. Flow cytometry were used to measure the quantity of PMP and activation ratio of PAC-1 and CD62P. Blood-lipid indicators (such as total cholesterol, triglycerides, high density lipoprotein, low-density lipoprotein, apolipoprotein B, and apolipoprotein A1), coagulation indicators (including prothrombin time, activated partial thromboplastin time, prothrombin international normalized ratio), hemorheology index, and plasma C-reactive protein concentration were measured by automatic-biochemical analyzer.Results:The quantity of PMP, activation ratio of PAC-1 and CD62P, and the index of hemorheology were on significant difference between group A and group B patients before treatment, but the parameters in the both two group were significant higher than group C (p<0.01). These parameters were significant decreased in group A, which obvious on difference in group B after 24 weeks treatment. Correlation analysis showed that there was a significant association between high plasma PMP quantity and the development of INFH (r=0.34,p＜0.01), and there was significantly positive correlation between the quantity of PMP and activation ratio of PAC-1 and CD62P, and level of CRP (r=0.28, p=0.03, r=0.61,p<0.01,and r=0.15, p=0.04 respectively).Conclusion:The levels of PMP, PAC-1 and CD62P can be taken as the specificity laboratory indices for clinical diagnosis of INFH. The quantity of PMP, activation ratio of PAC-1 and CD62P, and the index of hemorheology were marked improvement by using traditional Chinese medicine in INFH patients.