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Genetic polymorphisms in plasminogen activator inhibitor-1 predict susceptibility to steroid-induced osteonecrosis of the femoral head in Chinese population

Yanqiong Zhang1, Rongtian Wang2, Shangzhu Li3, Xiangying Kong1, Zhiyao Wang2, Weiheng Chen12* and Na Lin1*

Author affiliations

1 Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing 100700, China

2 Wang Jing Hospital (Hospital of Orthopedics and Traumatology), China Academy of Chinese Medical Sciences, Beijing 100102, China

3 Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300041, China

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Citation and License

Diagnostic Pathology 2013, 8:169  doi:10.1186/1746-1596-8-169

Published: 17 October 2013



Steroid usage has been considered as a leading cause of non-traumatic osteonecrosis of the femoral head (ONFH), which is involved in hypo-fibrinolysis and blood supply interruption. Genetic polymorphisms in plasminogen activator inhibitor-1 (PAI-1) have been demonstrated to be associated with ONFH risk in several populations. However, this relationship has not been established in Chinese population. The aim of this study was to investigate the association of PAI-1 gene polymorphisms with steroid-induced ONFH in a large cohort of Chinese population.


A case–control study was conducted, which included 94 and 106 unrelated patients after steroid administration recruited from 14 provinces in China, respectively. Two SNPs (rs11178 and rs2227631) within PAI-1 were genotyped using Sequenom MassARRAY system.


rs2227631 SNP was significantly associated with steroid-induced ONFH group in codominant (P = 0.04) and recessive (P = 0.02) models. However, there were no differences found in genotype frequencies of rs11178 SNP between controls and patients with steroid-induced ONFH (all P > 0.05).


Our data offer the convincing evidence for the first time that rs2227631 SNP of PAI-1 may be associated with the risk of steroid-induced ONFH, suggesting that the genetic variations of this gene may play an important role in the disease development.

Virtual slides

The virtual slide(s) for this article can be found here: webcite.

Steroid-induced osteonecrosis of the femoral head; Plasminogen activator inhibitor-1; Single nucleotide polymorphism