Serum malondialdehyde and superoxide dismutase levels in patients with non-traumatic osteonecrosis of femoral head: a cross-sectional study

The present study was aimed to analyze the serum levels of malondialdehyde (MDA) as well as superoxide dismutase (SOD) among patients with non-traumatic (NT) osteonecrosis of the femoral head (ONFH).

Patients with NT-ONFH as well as healthy individuals were selected for this study. MDA and SOD levels in the serum were measured utilizing an enzyme-linked immunosorbent assay (ELISA). Besides, the severity of ONFH was evaluated radiographically utilizing the Ficat classification system. In addition, clinical severity was assessed based on the Harris hip score (HSS)/visual analogue scale (VAS).The clinical methodology for diagnostic use of MDA and SOD with regard to NT-ONFH was determined by decision tree method through R language.

A total of 124 patients with NT-ONFH and 118 healthy individuals were included. NT-ONFH patients exhibited higher MDA levels but lower SOD levels in the serum when compared to healthy controls (HCs) with statistical significance. Among the Ficat stages, stage IV had notably higher MDA levels and lower SOD levels in the serum in contrast with stage III. Additionally, stage III showed increased serum MDA levels and decreased SOD levels in contrast with stage II. MDA levels in the serum in a positive relationship with the Ficat classification, while SOD levels were negatively related to it. Moreover, MDA levels in the serum were in a positive relationship with clinical severity, whereas SOD levels were negatively associated with it. Further analysis using ROC curves indicated that elevated serum MDA levels and reduced SOD levels may serve as favorable markers for assessing Ficat stage.Serum MDA > 0.57 nmol/mL along with SOD ≤ 91.15 U/mL seems to be decent for diagnosis use of NT-ONFH.

Patients diagnosed with NT-ONFH displayed elevated MDA levels and reduced SOD levels in the serum, indicating the involvement of increased oxidative stress and declining antioxidant activity in the progression of this condition.