Association of ABCB1/MDR1 polymorphisms in patients with glucocorticoid-induced osteonecrosis of the femoral head: Evidence for a meta-analysis

Purpose: Glucocorticoid-induced osteonecrosis of the femoral head (GC-induced ONFH) is a rebarbative disease affecting people from all ages, especially young adults, and often leads to severe joint pain and limitations on physical activity. Numerous studies have reported that ABCB1 polymorphisms are associated with GC-induced ONFH, but the results are inconclusive, partially because the sample size of published studies is relatively small. Therefore, we performed a meta-analysis including seven case-control studies to estimate such association.

Methods: Published literature from Medline, Embase, and CNKI were searched for eligible publications. Pooled odds ratio (OR) together with their 95% confidence (CI) was calculated using a fixed effect model or random effect model. The meta-analysis was performed in accordance to PRISMA Statement Criteria.

Results: The ABCB1 3435T allele reduces the GC-induced ONFH risk based on the evidence from the co-dominant model (CT vs. CC, OR=0.73, 95% CI: 0.53-1.00; TT vs. CC, OR=0.43, 95% CI: 0.26-0.69), dominant model (CT+TT vs. CC, OR=0.64, 95% CI: 0.48-0.87), allele contract model, (T vs. C, OR=0.68, 95% CI: 0.54-0.84), and recessive model (TT vs. CC+CT, OR=0.52, 95% CI: 0.34-0.81). Similarly, the ABCB1 2677T/A allele reduce the GC-induced ONFH risk based on the evidence from the co-dominant model (GT/A vs. GG, OR=0.66, 95% CI: 0.45-0.96; T/AT/A vs. GG, OR=0.52, 95% CI: 0.34-0.82), dominant model (GT/A+T/AT/A vs. GG, OR=0.61, 95% CI: 0.43-0.87), and allele contract model (T/A vs. G, OR=0.73, 95% CI: 0.58-0.90).

Conclusions: The meta-analysis revealed that 3435T allele and ABCB1 2677T/A allele may decrease the risks of GC-induced ONFH.