On the other hand, 3 cytokines showed a negative causal effect on osteonecrosis, suggesting a decreased risk: MCP-4 (IVW OR = 0.81, 95% CI = 0.67–0.99, P = .038), IL-10RB (IVW OR = 0.84, 95% CI = 0.699–0.999, P = .049), and CSF1 (IVW OR = 0.72, 95% CI = 0.54–0.96, P = .026). Here, CCL13 is linked to osteonecrosis.