Plasma ghrelin and von Willebrand Factor levels in patients with non-traumatic osteonecrosis of the femoral head

Objective: Increased evidence indicating ghrelin's direct influence on bone has been reported, but previous studies did not investigate its relationship with osteonecrosis of the femoral head (ONFH) in vivo. Coagulation disorders are considered to play important roles in ONFH. The aim of this study was to investigate the relationship of ghrelin, von Willebrand Factor (vWF) and other potentially relevant indicators with non-traumatic osteonecrosis of the femoral head. Methods: Patients with non-traumatic ONFH (including steroid-induced, alcohol-induced, and idiopathic ONFH) and healthy controls were recruited for the study. We evaluated levels of plasma ghrelin and vWF. Other potentially relevant indicators, von Willebrand Factor cleaving protease (vWF-cp), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (tPA), leptin, C-reactive protein (CRP), and lipid parameters were also assayed. Correlation coefficients and logistic regression models were used to assess the associations. Results: Patients with non-traumatic ONFH had significantly lower ghrelin levels, higher vWF, PAI-1, CRP levels than those in healthy controls. Ghrelin level was negatively correlated with vWF after adjustment for other variables. Logistic regression model revealed that non-traumatic ONFH was independently associated with plasma ghrelin and vWF. Conclusions: This study indicates that plasma ghrelin, vWF and PAI-1 levels were changed in patients with non-traumatic ONFH. Ghrelin in combination with vWF may prove to be involved in the pathogenesis of non-traumatic ONFH.