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Evaluating the Risk of a Fifth Metatarsal Stress Fracture by Measuring the Serum 25-Hydroxyvitamin D Levels
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- Yu Shimasaki
- School of Health and Sports Science, Juntendo University, Chiba, Japan
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- Masashi Nagao
- Department of Orthopedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
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- Takayuki Miyamori
- Department of Nursing and Rehabilitation Science, School of Physical Therapy at Odawara, International University of Health and Sports Science, Kanagawa, Japan
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- Yukihiro Aoba
- School of Health and Sports Science, Juntendo University, Chiba, Japan
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- Norifumi Fukushi
- Institute of Physical Education, Keio University, Kanagawa, Japan
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- Yoshitomo Saita
- Department of Orthopedic Surgery, Juntendo University Hospital, Tokyo, Japan
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- Hiroshi Ikeda
- Department of Orthopedic Surgery, Juntendo University Hospital, Tokyo, Japan
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- Sung-Gon Kim
- Department of Orthopedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
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- Masahiko Nozawa
- Department of Orthopedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
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- Kazuo Kaneko
- Department of Orthopedic Surgery, Juntendo University Hospital, Tokyo, Japan
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- Masafumi Yoshimura
- School of Health and Sports Science, Juntendo University, Chiba, Japan
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Description
<jats:sec><jats:title>Background:</jats:title><jats:p> The fifth metatarsal bone is a common site of stress fractures in soccer athletes. Although several endocrine risk factors for stress fractures have been proposed, the endocrine risks for fifth metatarsal (5-MT) stress fractures have not been evaluated. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> To evaluate the endocrine risks of fifth metatarsal stress fractures, we conducted a cumulative case-control study. The present study included 37 athletes, of which 18 had a history of a zone 2 or zone 3 fifth metatarsal stress fracture and 19 controls. We analyzed serum 25-hydroxyvitamin D (25-OHD), serum parathyroid hormone (PTH), as well as biochemical markers of bone turnover by univariate or multivariate analyses. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Logistic regression analyses adjusted for multiple confounders revealed that insufficient serum 25-OHD levels less than 30 ng/mL (odds ratio [OR], 23.3), higher serum PTH levels (OR, 1.01), or higher serum bone-specific isoform of alkaline phosphatase levels (OR, 1.10) rather than serum tartrate-resistant acid phosphatase 5b were associated with statistically significantly increased odds of 5-MT stress fractures. A postestimation calculation demonstrated that 25-OHD levels of 10 and 20 ng/mL were associated with 5.1 and 2.9 times greater odds for 5-MT stress fractures, respectively. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> 25-OHD insufficiency was associated with an increased incidence of 5-MT stress fractures. This insight may be useful for intervening to prevent 5-MT stress fractures. </jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p> Level III, case-control study. </jats:p></jats:sec>
Journal
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- Foot & Ankle International
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Foot & Ankle International 37 (3), 307-311, 2015-11-23
SAGE Publications