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This study aims to understand the degree of methylation of the <jats:italic>OPG<\/jats:italic>, <jats:italic>RANK<\/jats:italic>, and <jats:italic>RANKL<\/jats:italic> genes in steroid-related ONFH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A case-control study was designed, including 50 patients (25 males and 25 females) and 50 matched controls. The European Molecular Biology Open Software Suite (EMBOSS) was used to predict the existence and location of CpG islands in the <jats:italic>OPG<\/jats:italic>, <jats:italic>RANK<\/jats:italic>, and <jats:italic>RANKL<\/jats:italic> genes. The Agena MassARRAY platform was used to detect the methylation status of the above genes in the blood of subjects. The relationship between the methylation level of CpG sites in each gene and steroid-related ONFH was analysed by the chi-square test, logistic regression analysis, and other statistical methods.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In the CpG islands of the <jats:italic>OPG<\/jats:italic>, <jats:italic>RANK<\/jats:italic>, and <jats:italic>RANKL<\/jats:italic> genes in patients with steroid-related ONFH, several CpG sites with high methylation rates and high methylation levels were found. Some hypermethylated CpG sites increase the risk of steroid-related ONFH. In addition, a few hypermethylated CpG sites have predictive value for the early diagnosis of steroid-related ONFH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Methylation of certain sites in the <jats:italic>OPG<\/jats:italic>\/<jats:italic>RANK<\/jats:italic>\/<jats:italic>RANKL<\/jats:italic> signalling pathway increases the risk of steroid-related ONFH. Some hypermethylated CpG sites may be used as early prediction and diagnostic targets for steroid-related ONFH.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-021-04472-6","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T07:02:50Z","timestamp":1624950170000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["DNA methylation in the OPG\/RANK\/RANKL pathway is associated with steroid-induced osteonecrosis of the femoral head"],"prefix":"10.1186","volume":"22","author":[{"given":"Menghu","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuju","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feimeng","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqiang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-3665","authenticated-orcid":false,"given":"Jianzhong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"4472_CR1","doi-asserted-by":"publisher","first-page":"102460","DOI":"10.1016\/j.jaut.2020.102460","volume":"110","author":"C Chang","year":"2020","unstructured":"Chang C, Greenspan A, Gershwin ME. 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The study was approved by the Ethics Committee of Inner Mongolia Medical University (Approval number: YKD2018073). All participants gave written informed consent for the use of personal data for research aims.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"599"}}