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This study aimed to investigate the possible correlation between <jats:italic>ESR1<\/jats:italic> and <jats:italic>APOE<\/jats:italic> gene polymorphisms and the risk of ONFH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this case\u2013control study, the potential association between three genetic variants (rs2982573 C\u2009&lt;\u2009T, rs10872678 C\u2009&lt;\u2009T, and rs9322332 A\u2009&lt;\u2009C) of the <jats:italic>ESR1<\/jats:italic> gene and two genetic variants (rs7259620 A\u2009&lt;\u2009G and rs769446 C\u2009&lt;\u2009T) of the <jats:italic>APOE<\/jats:italic> gene with the risk of ONFH was investigated. Correlations between gene polymorphisms and ONFH risk were assessed using logistic regression analysis, with calculation of odds ratios (ORs) and 95% confidence intervals (CIs).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The overall analysis demonstrated that rs9322332 in the <jats:italic>ESR1<\/jats:italic> gene exhibited a correlation with a decreased risk of ONFH under the homozygous (AA vs.CC: OR\u2009=\u20090.69, 95% CI [0.53\u20130.90], <jats:italic>p<\/jats:italic>\u2009=\u20090.006), dominant (CA\u2009+\u2009AA vs. CC: OR\u2009=\u20090.70, 95% CI [0.54\u20130.90], <jats:italic>p<\/jats:italic>\u2009=\u20090.006), and additive (OR\u2009=\u20090.79, 95% CI [0.66\u20130.95], <jats:italic>p<\/jats:italic>\u2009=\u20090.013) models. The stratification analysis revealed that rs9322332 was linked to a lower risk of ONFH in subgroups characterized by individuals aged over 51\u00a0years and non-smokers. Nevertheless, there were no notable correlations found between <jats:italic>ESR1<\/jats:italic> rs2982573 and rs10872678, as well as <jats:italic>APOE<\/jats:italic> rs7259620 and rs769446, with the risk of ONFH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p><jats:italic>ESR1<\/jats:italic>-rs9322332 is closely linked to a decreased risk of ONFH, thereby enhancing our understanding of the relationship between gene polymorphisms and ONFH.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13018-023-04447-4","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T12:02:57Z","timestamp":1702641777000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Correlation between ESR1 and APOE gene polymorphisms and risk of osteonecrosis of the femoral head: a case\u2013control study"],"prefix":"10.1186","volume":"18","author":[{"given":"Yuan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoya","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinping","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyan","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"4447_CR1","doi-asserted-by":"publisher","first-page":"1037190","DOI":"10.3389\/fgene.2022.1037190","volume":"13","author":"Z Che","year":"2022","unstructured":"Che Z, Song Y, Zhu L, Liu T, Li X, Huang L. 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