This study is focussed on evaluating and comparing two mediators of osteoclast, osteoprotegerin (OPG) and nuclear factor-κB ligand (RANKL), in plasma and tissue levels in patients with steroid-induced osteonecrosis of femoral head (SIONFH). Subjects were included in this cross-sectional case-control study in 2016. Bone histomorphology, immunohistochemistry, Western blotting, OPG and RANKL plasma levels, post-hoc statistical power and receiver-operating characteristic (ROC) curves were evaluated. Eighty-six patients diagnosed with SIONFH and 51 healthy subjects were included. OPG expression levels in bone samples increased with ARCO stage, and RANKL expression levels decreased with ARCO stages. Plasma OPG and RANKL levels were significantly higher in the SIONFH group compared with the healthy control group. The plasma OPG level and ratio of OPG and RANKL were positively associated with ARCO stages and significantly higher in stages III and IV. Plasma RANKL levels were negatively associated with ARCO stage and were significantly higher in ARCO stages II and III. Plasma OPG and RANKL may represent potential biomarkers during SIONFH at different stages. Higher plasma OPG levels indicated late-stage SIONFH, and higher plasma RANKL levels indicated early stage. Our findings may provide a clue for the development of diagnostic tools and therapies for SIONFH.

中文翻译：

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破骨细胞活性与类固醇诱导的股骨头坏死的发展有关。

这项研究的重点是评估和比较类固醇诱导的股骨头坏死（SIONFH）患者血浆和组织中破骨细胞的两种介体，骨保护素（OPG）和核因子-κB配体（RANKL）。2016年将受试者纳入该横断面病例对照研究。评估了骨组织形态学，免疫组织化学，蛋白质印迹，OPG和RANKL血浆水平，事后统计功效和受体工作特征（ROC）曲线。包括86位被诊断为SIONFH的患者和51位健康受试者。骨样品中OPG表达水平随ARCO分期而增加，而RANKL表达水平随ARCO分期而降低。与健康对照组相比，SIONFH组的血浆OPG和RANKL水平明显更高。血浆OPG水平以及OPG和RANKL的比例与ARCO阶段呈正相关，在III和IV阶段显着更高。血浆RANKL水平与ARCO分期呈负相关，在ARCO II期和III期显着更高。血浆OPG和RANKL可能代表SIONFH在不同阶段的潜在生物标志物。血浆OPG较高表明SIONFH处于晚期，血浆RANKL较高表明处于早期。我们的发现可能为SIONFH的诊断工具和疗法的开发提供线索。血浆OPG和RANKL可能代表SIONFH在不同阶段的潜在生物标志物。血浆OPG较高表明SIONFH处于晚期，血浆RANKL较高表明处于早期。我们的发现可能为SIONFH的诊断工具和疗法的开发提供线索。血浆OPG和RANKL可能代表SIONFH在不同阶段的潜在生物标志物。血浆OPG较高表明SIONFH处于晚期，血浆RANKL较高表明处于早期。我们的发现可能为SIONFH的诊断工具和疗法的开发提供线索。