Research Papers:

A metabolomic study on early detection of steroid-induced avascular necrosis of the femoral head

Xiangnan Ren, Wu Fan, Zixing Shao, Kaiyun Chen, Xuefeng Yu and Qionglin Liang _

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Oncotarget. 2018; 9:7984-7995. https://doi.org/10.18632/oncotarget.24150

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Xiangnan Ren1, Wu Fan2, Zixing Shao1, Kaiyun Chen2, Xuefeng Yu2 and Qionglin Liang1

1Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing 100084, China

2The Fourth Affiliated Hospital, Nanchang University, Nanchang 330003, China

Correspondence to:

Qionglin Liang, email: [email protected]

Xuefeng Yu, email: [email protected]

Keywords: metabolomics; lipid metabolism; femoral head necrosis; steroid-induced; early diagnosis

Received: October 16, 2017     Accepted: January 04, 2018     Published: January 10, 2018


The early and accurate diagnosis of steroid-induced avascular necrosis of the femoral head (SANFH) is appealing considering its irreversible progression and serious consequence for the patients. The purpose of this study was to investigate the metabolic change of SANFH for its early detection. Two stages were designed in this study, namely discovery and verification. Except the biochemical index anomaly and the accidental death, 30 adult healthy adult Japanese white rabbits were used for screening out the potential metabolites in discovery experiment and 13 rabbits were used in verification experiment. The femoral heads were assessed with magnetic resonance imaging and transmission electron microscopy. The metabolomic profiling of serum samples were analysis by UHPLC-MS/MS. Metabolomic cluster analysis enable us to differentiate the rabbits without and with injection of the glucocorticoid in 1 week even when there is no obvious abnormal symptom in behaviors or imaging diagnosis. The majority of differential metabolites were identified as phospholipids which were observed significant change after injection of glucocorticoid in 1, 2, 3 weeks. And the results obtained in verification experiment of 6 weeks showed that these differential metabolites exhibited consistent trends in late progression with that in early-stage. At the end of 6 weeks the damage of SANFH could be verified by pathological imaging. Therefore the finding of serum metabolite profile links to the progression of SANFH and provides the potential of early detection of SANFH.

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