title: Association of ABCB1/MDR1 polymorphisms in patients with glucocorticoid-induced osteonecrosis of the femoral head: Evidence for a meta-analysis.
abstract: OBJECTIVE
  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.
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
authors: Zifei
authors: Z
authors: Zhou
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China. Electronic address: hua_yingqi@163.com.
authors: Yingqi
authors: Y
authors: Hua
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
authors: Junjian
authors: J
authors: Liu
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
authors: Dongqing
authors: D
authors: Zuo
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
authors: Hongsheng
authors: H
authors: Wang
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
authors: Quanchi
authors: Q
authors: Chen
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
authors: Longpo
authors: L
authors: Zheng
authors: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China. Electronic address: czd856@vip.sohu.com.
authors: Zhengdong
authors: Z
authors: Cai
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics; D000483:Alleles; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D005838:Genotype; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D010020:Osteonecrosis / Q000139:chemically induced / Q000235:genetics* / Q000473:pathology; D020641:Polymorphism, Single Nucleotide; D012307:Risk Factors
chemical_list: C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D005938:Glucocorticoids
keywords: ATP-binding cassette sub-family B; Glucocorticoid; Meta-analysis; Osteonecrosis; Polymorphism