RT Journal Article
SR Electronic
T1 Low molecular weight phenotype of Apo(a) is a risk factor of corticosteroid-induced osteonecrosis of the femoral head after renal transplant.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 516
OP 522
VO 34
IS 3
A1 Tetsurou Hirata
A1 Mikihiro Fujioka
A1 Kenji A Takahashi
A1 Takeshi Asano
A1 Masashi Ishida
A1 Kiyokazu Akioka
A1 Masahiko Okamoto
A1 Norio Yoshimura
A1 Yoshiko Satomi
A1 Hoyoku Nishino
A1 Yoshio Hirota
A1 Shigeo Nakajima
A1 Shigeaki Kato
A1 Toshikazu Kubo
YR 2007
UL http://www.jrheum.org/content/34/3/516.abstract
AB OBJECTIVE: Osteonecrosis of the femoral head (ONF) is a necrosis due to disruption of the blood flow. The disease often occurs in association with corticosteroid treatment. The pathology of corticosteroid-induced ONF is unclear, although abnormalities in the coagulation and fibrinolytic systems or in the lipid metabolism have been reported to be involved. We examined the relationships between development of ONF and genetic variations and plasma level of lipoprotein(a) (Lp(a)), which is closely involved in the coagulation and fibrinolytic systems and lipid metabolism. METHODS: The study population consisted of 112 renal transplant patients undergoing corticosteroid treatment. Their apolipoprotein (a) [apo(a)] isoform was determined by Western blotting, and patients were classified into low molecular weight (LMW) or high molecular weight (HMW) groups. The plasma Lp(a) level was measured. Patients were also examined for 3 single-nucleotide polymorphisms (SNP), -773 (G/A), +93 (C/T), and +121 (G/A). Relationships between these 3 genetic factors of Lp(a) and ONF development were examined using statistical methods including multivariate analysis. RESULTS: A strong relationship was observed between the apo(a) molecular weight phenotype and ONF development, with an increased risk of ONF development for the LMW group (adjusted odds ratio 5.75, 95% CI 1.76-18.74, p = 0.0038). No significant relationships were observed between ONF and plasma Lp(a) level and SNP. CONCLUSION: Apo(a) molecular weight phenotype would be a useful predictor of ONF that develops after corticosteroid treatment.