Purpose: Oxidative stress is closely associated with the pathogenesis of nontraumatic osteonecrosis of the femoral head (ONFH). This study aimed to determine whether the serum levels of antioxidant nutrients were decreased in patients with ONFH. Methods: We analyzed the serum levels of antioxidant nutrients in 39 patients with ONFH (ONFH group) and 78 age-and gender-matched healthy people (control group) who voluntarily participated in the Yakumo study, which is a comprehensive health examination program. We measured and compared the serum levels of α-tocopherol (vitamin E) and total carotenoids, including zeaxanthin/lutein, β-cryptoxanthin, lycopene, α-carotene, and β-carotene, in the ONFH and control groups using high-performance liquid chromatography. Results: The mean serum levels of total carotenoids were significantly lower in the ONFH group than in the control group (2.36 ± 1.26 and 3.79 ± 2.36 mmol/l, respectively, p < 0.001). However, no significant difference was found in a-tocopherol between the two groups (26.37 + 6.90 mmol/l in the ONFH group and 26.24 ± 6.28 mmol/l in the control group, p =0.920). Among each carotenoid, the serum levels of zeaxanthin/lutein, lycopene, and β-carotene were significantly lower in the ONFH group than in the control group (p < 0.001). Conclusions: The serum levels of carotenoids were lower in patients with ONFH than in healthy, community-living people. This result suggests that carotenoids may be related to the pathogenesis of ONFH.
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