Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head

Abstract Objective To investigate the role of serum β C-terminal telopeptide of type 1 collagen (β-CTx) and N-terminal mid-fragment of osteocalcin (N-MID) concentration in non-traumatic osteonecrosis of the femoral head (NONFH). Materials and methods In this retrospective case-control study, serum β...

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Main Authors: Baoxiang Zhao, Xin Sun, Zhiqun Wang, Zhi Feng, Shiying Wang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05897-8
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author Baoxiang Zhao
Xin Sun
Zhiqun Wang
Zhi Feng
Shiying Wang
author_facet Baoxiang Zhao
Xin Sun
Zhiqun Wang
Zhi Feng
Shiying Wang
author_sort Baoxiang Zhao
collection DOAJ
description Abstract Objective To investigate the role of serum β C-terminal telopeptide of type 1 collagen (β-CTx) and N-terminal mid-fragment of osteocalcin (N-MID) concentration in non-traumatic osteonecrosis of the femoral head (NONFH). Materials and methods In this retrospective case-control study, serum β-CTx and N-MID levels were measured in 64 NONFH patients and 64 healthy controls. Propensity score matching (PSM) was used to balance the baseline characteristics of the two groups. The study was conducted at Linyi People’s Hospital between January 2023 and February 2024. The primary outcomes included the differences in serum β-CTx and N-MID levels between the two groups, their correlations with clinical parameters, and their diagnostic performance for NONFH. Results The serum concentration of β-CTx and N-MID was significantly higher in NONFH patients compared to healthy controls (β-CTx: 0.70 ± 0.30 ng/ml vs. 0.36 ± 0.16 ng/ml, P < 0.001; N-MID: 21.35 ± 8.24 ng/ml vs. 13.27 ± 3.87 ng/ml, P < 0.001). No significant differences were observed in serum β-CTx and N-MID levels among different etiological subgroups or ARCO stages. Pearson analysis revealed a positive correlation between serum β-CTx and N-MID levels, as well as β-CTx and pain duration. The ROC curve analysis showed that β-CTx had an AUC of 0.876 (95% CI 0.815–0.938) with a cut-off value of 0.505 ng/ml, sensitivity of 90.63%, and specificity of 76.56%. N-MID had an AUC of 0.860 (95% CI 0.797–0.924) with a cut-off value of 17.050 ng/ml, sensitivity of 84.38%, and specificity of 78.13%. Conclusion Serum β-CTx and N-MID levels are significantly elevated in patients with NONFH and may serve as potential biomarkers for the diagnosis of NONFH. Further studies with larger sample sizes are needed to validate these findings and explore their clinical applications.
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spelling doaj-art-25ef60ccd5da4e7e902beae530e68e332025-08-20T02:39:24ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-05-012011710.1186/s13018-025-05897-8Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral headBaoxiang Zhao0Xin Sun1Zhiqun Wang2Zhi Feng3Shiying Wang4Department of Orthopedics, Linyi People’s Hospital, Shandong Second Medical UniversityDepartment of Orthopedics, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Medical Group)Department of Laboratory Medicine, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Medical Group)Department of Orthopedics, Linyi People’s Hospital, Shandong Second Medical UniversityDepartment of Orthopedics, Linyi People’s Hospital, Shandong Second Medical UniversityAbstract Objective To investigate the role of serum β C-terminal telopeptide of type 1 collagen (β-CTx) and N-terminal mid-fragment of osteocalcin (N-MID) concentration in non-traumatic osteonecrosis of the femoral head (NONFH). Materials and methods In this retrospective case-control study, serum β-CTx and N-MID levels were measured in 64 NONFH patients and 64 healthy controls. Propensity score matching (PSM) was used to balance the baseline characteristics of the two groups. The study was conducted at Linyi People’s Hospital between January 2023 and February 2024. The primary outcomes included the differences in serum β-CTx and N-MID levels between the two groups, their correlations with clinical parameters, and their diagnostic performance for NONFH. Results The serum concentration of β-CTx and N-MID was significantly higher in NONFH patients compared to healthy controls (β-CTx: 0.70 ± 0.30 ng/ml vs. 0.36 ± 0.16 ng/ml, P < 0.001; N-MID: 21.35 ± 8.24 ng/ml vs. 13.27 ± 3.87 ng/ml, P < 0.001). No significant differences were observed in serum β-CTx and N-MID levels among different etiological subgroups or ARCO stages. Pearson analysis revealed a positive correlation between serum β-CTx and N-MID levels, as well as β-CTx and pain duration. The ROC curve analysis showed that β-CTx had an AUC of 0.876 (95% CI 0.815–0.938) with a cut-off value of 0.505 ng/ml, sensitivity of 90.63%, and specificity of 76.56%. N-MID had an AUC of 0.860 (95% CI 0.797–0.924) with a cut-off value of 17.050 ng/ml, sensitivity of 84.38%, and specificity of 78.13%. Conclusion Serum β-CTx and N-MID levels are significantly elevated in patients with NONFH and may serve as potential biomarkers for the diagnosis of NONFH. Further studies with larger sample sizes are needed to validate these findings and explore their clinical applications.https://doi.org/10.1186/s13018-025-05897-8Non-traumatic osteonecrosis of the femoral headBone turnoverBiomarkerβ C-terminal telopeptide of type 1 collagenN-terminal mid-fragment of osteocalcin
spellingShingle Baoxiang Zhao
Xin Sun
Zhiqun Wang
Zhi Feng
Shiying Wang
Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head
Journal of Orthopaedic Surgery and Research
Non-traumatic osteonecrosis of the femoral head
Bone turnover
Biomarker
β C-terminal telopeptide of type 1 collagen
N-terminal mid-fragment of osteocalcin
title Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head
title_full Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head
title_fullStr Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head
title_full_unstemmed Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head
title_short Elevated levels of β C-terminal telopeptide of type 1 collagen and N-terminal mid-fragment of osteocalcin in patients with non-traumatic osteonecrosis of the femoral head
title_sort elevated levels of β c terminal telopeptide of type 1 collagen and n terminal mid fragment of osteocalcin in patients with non traumatic osteonecrosis of the femoral head
topic Non-traumatic osteonecrosis of the femoral head
Bone turnover
Biomarker
β C-terminal telopeptide of type 1 collagen
N-terminal mid-fragment of osteocalcin
url https://doi.org/10.1186/s13018-025-05897-8
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