To investigate serum pituitary adenylate cyclase activating polypeptide (PACAP) levels in relation to disease progression in patients diagnosed with non-traumatic osteonecrosis of femoral head (ONFH). A total of 102 non-traumatic ONFH patients and 95 healthy controls were enrolled in this study. Serum PACAP levels were examined using enzyme-linked immunosorbent assay (ELISA). Radiographic progression of ONFH was detected using the Association Research Circulation Osseous (ARCO) classification system. Harris hip score (HSS) and visual analogue scale (VAS) were analyzed to understand clinical severity. Serum levels of the ONFH marker IL-33 and β‐CTX were also detected. ROC curve analysis was performed to investigate the potential diagnostic value of serum PACAP in the radiographic progression of ONFH. Serum PACAP levels were significantly decreased in non-traumatic ONFH patients when compared to healthy controls. ARCO stage 4 showed markedly lower serum PACAP levels than stage 3. ARCO stage 3 had significantly decreased serum PACAP levels compared to stage 1/2. Serum PACAP levels were negatively correlated with the ARCO classification. In addition, serum PACAP levels were positively associated with HSS score and negatively related to VAS score. Last, PACAP levels were negatively correlated with serum IL-33 and positively associated with β-CTX. ROC curve analysis indicated that PACAP may serve as an early indicator for the radiographic progression of ONFH. Reduced serum PACAP levels may reflect disease severity in non-traumatic ONFH patients.

研究血清垂体腺苷酸环化酶激活多肽（诊断为非创伤性股骨头坏死（ONFH）的患者中与疾病进展相关的PACAP水平。本研究共纳入102位非创伤性ONFH患者和95位健康对照。使用酶联免疫吸附测定（ELISA）检测血清PACAP水平。使用联合研究循环骨（ARCO）分类系统检测ONFH的放射学进展。哈里斯髋关节评分（HSS）和视觉模拟量表（VAS）进行了分析，以了解临床严重程度。还检测了ONFH标志物IL-33和β-CTX的血清水平。进行了ROC曲线分析以研究血清PACAP对ONFH影像学进展的潜在诊断价值。与健康对照组相比，非创伤性ONFH患者的血清PACAP水平显着降低。与第3阶段相比，第4阶段的ARCO显示血清PACAP水平明显降低。与第1/2阶段相比，第3阶段的ARCO血清PACAP水平明显降低。血清PACAP水平与ARCO分类呈负相关。另外，血清PACAP水平与HSS评分呈正相关，与VAS评分呈负相关。最后，PACAP水平与血清​​IL-33呈负相关，与β-CTX呈正相关。ROC曲线分析表明PACAP可以作为ONFH影像学进展的早期指标。降低的血清PACAP水平可能反映出非创伤性ONFH患者的疾病严重程度。另外，血清PACAP水平与HSS评分呈正相关，与VAS评分呈负相关。最后，PACAP水平与血清​​IL-33呈负相关，与β-CTX呈正相关。ROC曲线分析表明PACAP可以作为ONFH影像学进展的早期指标。降低的血清PACAP水平可能反映出非创伤性ONFH患者的疾病严重程度。另外，血清PACAP水平与HSS评分呈正相关，与VAS评分呈负相关。最后，PACAP水平与血清​​IL-33呈负相关，与β-CTX呈正相关。ROC曲线分析表明PACAP可以作为ONFH影像学进展的早期指标。降低的血清PACAP水平可能反映出非创伤性ONFH患者的疾病严重程度。