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

• Single nucleotide polymorphisms are genetic risk factors for GC-induced ONFH.
• The ABCB1 3435T carrier and/or 2677T/A carrier were significantly associated with lower occurrence of GC-induced ONFH.
• The ABCB1 3435T and/or 2677T/A could potentially be used to predict the development of GC-induced ONFH.

PurposeGlucocorticoid-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.MethodsPublished 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.ResultsThe 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).ConclusionsThe meta-analysis revealed that 3435T allele and ABCB1 2677T/A allele may decrease the risks of GC-induced ONFH.