Aller et al. (2017) reported the association of TIMP4 rs3755724 with predictors of ≥5% weight loss. Furthermore, in a study of obesity, TIMP4 was associated with high fat diet-induced obesity and may act through the regulation of lipid absorption (Sakamuri et al., 2017). There is a growing awareness that steroid hormones may cause ONFH through disruptions to lipid metabolism. Long-term high doses of steroid hormones intake induced hyperlipidemia and also caused hypertrophy and proliferation of fat cells in the bone marrow cavity of the femoral head, resulting in ONFH (Ding & Zhou, 2009). The gene discussed is TIMP4; the disease is obesity due to melanocortin 4 receptor deficiency.