The Journal of Hip Surgery 2017; 01(01): 061-066
DOI: 10.1055/s-0036-1597968
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Risks of Factor V rs6020 or Methylenetetrahydrofolate Reductase rs12121543 Polymorphism with Hyperhomocysteinemia in the Development of Osteonecrosis of the Femoral Head

Meng-Ling Lu
1   Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
2   Department of Medicine, Chang Gung University, College of Medicine, Taoyuan, Taiwan
,
Pei-Hsun Sung
3   Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
,
Tsan-Wen Huang
4   Department of Orthopaedic Surgery, Chiayi Chang Gung Memorial Hospital, Puzi City, Taiwan
,
Su-Chin Chen
1   Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
2   Department of Medicine, Chang Gung University, College of Medicine, Taoyuan, Taiwan
,
Rio Lin
1   Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
2   Department of Medicine, Chang Gung University, College of Medicine, Taoyuan, Taiwan
,
Hon-Kan Yip
3   Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
,
Mel S. Lee
1   Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
2   Department of Medicine, Chang Gung University, College of Medicine, Taoyuan, Taiwan
› Author Affiliations
Further Information

Publication History

Publication Date:
31 March 2017 (online)

Abstract

The presence of single nucleotide polymorphisms (SNPs) associated with thrombophilia or hypofibrinolysis in Caucasian patients with osteonecrosis of the femoral head (ONFH) were reported to be irrelevant in the Asian populations. The purpose of this study was to explore the relationship between factor V rs6020 and methylenetetrahydrofolate reductase (MTHFR) rs12121543 by SNP assessment and serum homocysteine levels with the risk of ONFH development in Chinese population. From 2006 to 2013, 136 ONFH patients and 123 healthy controls were recruited. Serum homocysteine levels were measured in patients after a 12-hour fast. Genomic DNA from whole blood was used for genotyping of rs6020 and rs12121543 by MALDI-TOF (Matrix-Assisted Laser Desorption Inoization–Time of Flight Mass Spectrometry) on Brucker SNP Genotyping System (Bruker, Bremen, Germany). The odds ratio of the genotype between the ONFH patients and the control patients was analyzed using SPSS 13.0 for Windows (SPSS Inc.). A p < 0.05 was considered statistically significantly different. The G-to-A polymorphism in rs6020 had a higher risk (odds ratio: 6.91; 95% CI 3.68–12.99) than those without the polymorphism (wild type). The risk of ONFH was increased with MTHFR rs12121543 C-to-A polymorphism (odds ratio: 1.65; 95% CI 0.99–2.75). The presence of SNP in either factor V rs6020 or MTHFR rs12121543 was associated with increased risk of ONFH as compared with wild genotype patients (odds ratio 8.89; 95% CI 4.36–18.12). Patients with rs6020 polymorphism and concomitant hyperhomocysteinemia (> 12 μM) had significantly increased the risk of ONFH from 6.36- to 9.83-fold. The results of the study demonstrated that factor V rs6020 G-to-A polymorphism and MTHFR rs12121543 C-to-A polymorphism were significantly associated with the increased risk of ONFH development. Concomitant hyperhomocysteinemia and factor V rs6020 G-to-A polymorphism significantly increased the risk for the ONFH development in Chinese patients.

 
  • References

  • 1 Lee MS, Chang YH, Chao EK, Shih CH. Conditions before collapse of the contralateral hip in osteonecrosis of the femoral head. Chang Gung Med J 2002; 25 (4) 228-237
  • 2 Mont MA, Jones LC, Hungerford DS. Nontraumatic osteonecrosis of the femoral head: ten years later. J Bone Joint Surg Am 2006; 88 (5) 1117-1132
  • 3 Chen WM, Liu YF, Lin MW , et al. Autosomal dominant avascular necrosis of femoral head in two Taiwanese pedigrees and linkage to chromosome 12q13. Am J Hum Genet 2004; 75 (2) 310-317
  • 4 Margaglione M, D'Andrea G, d'Addedda M , et al. The methylenetetrahydrofolate reductase TT677 genotype is associated with venous thrombosis independently of the coexistence of the FV Leiden and the prothrombin A20210 mutation. Thromb Haemost 1998; 79 (5) 907-911
  • 5 Poort SR, Rosendaal FR, Reitsma PH, Bertina RM. A common genetic variation in the 3′-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 1996; 88 (10) 3698-3703
  • 6 Björkman A, Svensson PJ, Hillarp A, Burtscher IM, Rünow A, Benoni G. Factor V Leiden and prothrombin gene mutation: risk factors for osteonecrosis of the femoral head in adults. Clin Orthop Relat Res 2004; (425) 168-172
  • 7 Zalavras CG, Vartholomatos G, Dokou E, Malizos KN. Genetic background of osteonecrosis: associated with thrombophilic mutations?. Clin Orthop Relat Res 2004; (422) 251-255
  • 8 Chang JD, Hur M, Lee SS, Yoo JH, Lee KM. Genetic background of nontraumatic osteonecrosis of the femoral head in the Korean population. Clin Orthop Relat Res 2008; 466 (5) 1041-1046
  • 9 Peng KT, Huang KC, Huang TW , et al. Single nucleotide polymorphisms other than factor V Leiden are associated with coagulopathy and osteonecrosis of the femoral head in Chinese patients. PLoS One 2014; 9 (8) e104461
  • 10 Kim YW, Yoon KY, Park S, Shim YS, Cho HI, Park SS. Absence of factor V Leiden mutation in Koreans. Thromb Res 1997; 86 (2) 181-182
  • 11 Jun ZJ, Ping T, Lei Y, Li L, Ming SY, Jing W. Prevalence of factor V Leiden and prothrombin G20210A mutations in Chinese patients with deep venous thrombosis and pulmonary embolism. Clin Lab Haematol 2006; 28 (2) 111-116
  • 12 Kim TH, Hong JM, Kim HJ, Park EK, Kim SY. Lack of association of MTHFR gene polymorphisms with the risk of osteonecrosis of the femoral head in a Korean population. Mol Cells 2010; 29 (4) 343-348
  • 13 Chen J, Guo Y, Jin T , et al. Association of MMPs/TIMPs polymorphism with alcohol-induced osteonecrosis of femoral head in the Chinese Han population. Int J Clin Exp Pathol 2016; 9 (8) 8231-8238
  • 14 Koo KH, Lee JS, Lee YJ, Kim KJ, Yoo JJ, Kim HJ. Endothelial nitric oxide synthase gene polymorphisms in patients with nontraumatic femoral head osteonecrosis. J Orthop Res 2006; 24 (8) 1722-1728
  • 15 Van Veldhuizen PJ, Neff J, Murphey MD, Bodensteiner D, Skikne BS. Decreased fibrinolytic potential in patients with idiopathic avascular necrosis and transient osteoporosis of the hip. Am J Hematol 1993; 44 (4) 243-248
  • 16 Glueck CJ, Glueck HI, Tracy T, Speirs J, McCray C, Stroop D. Relationships between lipoprotein(a), lipids, apolipoproteins, basal and stimulated fibrinolytic regulators, and D-dimer. Metabolism 1993; 42 (2) 236-246
  • 17 Yoo JL, Park CH, Ha YC, Lee YK, Koo KH. Ischemic diseases of the hip; osteonecrosis, borderline necrosis and bone marrow edema syndrome. Formosan J Musculoskeletal Disord 2016; 7 (3) 145-152
  • 18 Bertina RM, Koeleman BP, Koster T , et al. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994; 369 (6475): 64-67
  • 19 Greengard JS, Sun X, Xu X , et al. Activated protein C resistance caused by Arg506Gln mutation in factor Va. Lancet 1994; 343 (8909): 1361-1362
  • 20 Le W, Yu JD, Lu L , et al. Association of the R485K polymorphism of the factor V gene with poor response to activated protein C and increased risk of coronary artery disease in the Chinese population. Clin Genet 2000; 57 (4) 296-303
  • 21 Hiyoshi M, Arnutti P, Prayoonwiwat W , et al. A polymorphism nt 1628G-->A (R485K) in exon 10 of the coagulation factor V gene may be a risk factor for thrombosis in the indigenous Thai population. Thromb Haemost 1998; 80 (4) 705-706
  • 22 Watanabe H, Hamada H, Yamakawa-Kobayashi K, Yoshikawa H, Arinami T. Evidence for an association of the R485K polymorphism in the coagulation factor V gene with severe preeclampsia from screening 35 polymorphisms in 27 candidate genes. Thromb Haemost 2001; 86 (6) 1594-1595
  • 23 Wernimont SM, Clark AG, Stover PJ , et al. Folate network genetic variation predicts cardiovascular disease risk in non-Hispanic white males. J Nutr 2012; 142 (7) 1272-1279
  • 24 Wernimont SM, Clark AG, Stover PJ , et al. Folate network genetic variation, plasma homocysteine, and global genomic methylation content: a genetic association study. BMC Med Genet 2011; 12: 150-159
  • 25 Gardeniers JWM. ARCO committee on terminology and staging (report on the committee meeting at Santiago De Compostela). ARCO Newsletter 1993; 5: 79-82
  • 26 Lee MS, Hsieh PH, Shih CH, Wang CJ. Non-traumatic osteonecrosis of the femoral head—from clinical to bench. Chang Gung Med J 2010; 33 (4) 351-360
  • 27 Botstein D, Risch N. Discovering genotypes underlying human phenotypes: past successes for mendelian disease, future approaches for complex disease. Nat Genet 2003; 33 (Suppl): 228-237
  • 28 Carlson CS, Eberle MA, Kruglyak L, Nickerson DA. Mapping complex disease loci in whole-genome association studies. Nature 2004; 429 (6990): 446-452
  • 29 Lentz SR, Piegors DJ, Fernández JA , et al. Effect of hyperhomocysteinemia on protein C activation and activity. Blood 2002; 100 (6) 2108-2112