Figure 3.

Differences in bone and angiogenesis biomarkers in Gaucher disease patients according to their osteonecrosis status. Analysis of differences between groups indicated that patients with Gaucher disease who experienced either historical or incidental osteonecrosis had greater levels of (a) osteopontin (Kruskal–Wallis one-way ANOVA on ranks test: p-value = 0.010) and (b) MMP-2 (Kruskal–Wallis one-way ANOVA on ranks test: p-value = 0.017) and lower levels of (d) VEGF-C (Kruskal–Wallis one-way ANOVA on ranks test: p-value = 0.036) compared with those osteonecrosis-free. Patients with incident osteonecrosis had lower levels of (c) MMP-9 (Kruskal–Wallis one-way ANOVA on ranks test: p-value = 0.001) compared with those free from osteonecrosis and those with historical events. Boxes include the data between first and third quartiles, the central bar indicates the median, and the whiskers show minimum and maximum values. The dots represent all patients. In patients with Gaucher disease type 1, osteopontin was positively correlated to (e) bone disease (r = 0.28, p-value = 0.001) and (i) disease severity (r = 0.37, p-value < 0.001), while MMP-2 was positively correlated to (j) disease severity (r = 0.20, p-value = 0.022) but not with (f) bone disease. MMP-9 and VEGF-C were negatively correlated to (g,h) bone disease (r = −0.23, p-value = 0.008 and r = −0.37, p-value < 0.001, respectively) and (k,l) disease severity (r = −0.26, p-value = 0.003 and r = −0.37, p < 0.001). The correlation between continuous variables was assessed with Spearman’s rank correlation coefficient. GD-DS3 = Gaucher disease type 1 disease severity scoring system; MMP = matrix metalloproteinase; ON = osteonecrosis; VEGF-C = vascular endothelial growth factor C. (●) Osteonecrosis-free; (●) historical osteonecrosis; (●) incident osteonecrosis.