Evaluating the risk of a fifth metatarsal stress fracture by measuring the serum 25-hydroxyvitamin D levels

Yu Shimasaki, Masashi Nagao, Takayuki Miyamori, Yukihiro Aoba, Norifumi Fukushi, Yoshitomo Saita, Hiroshi Ikeda, Sung Gon Kim, Masahiko Nozawa, Kazuo Kaneko, Masafumi Yoshimura

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)307-311
Number of pages5
JournalFoot and Ankle International
Volume37
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

Fingerprint

Stress Fractures
Metatarsal Bones
Serum
Odds Ratio
Parathyroid Hormone
Athletes
25-hydroxyvitamin D
Soccer
Bone Remodeling
Alkaline Phosphatase
Case-Control Studies
Protein Isoforms
Multivariate Analysis
Biomarkers
Logistic Models
Regression Analysis
Bone and Bones
Incidence

Keywords

  • fifth metatarsal stress fracture
  • soccer athletes
  • Vitamin D

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Evaluating the risk of a fifth metatarsal stress fracture by measuring the serum 25-hydroxyvitamin D levels. / Shimasaki, Yu; Nagao, Masashi; Miyamori, Takayuki; Aoba, Yukihiro; Fukushi, Norifumi; Saita, Yoshitomo; Ikeda, Hiroshi; Kim, Sung Gon; Nozawa, Masahiko; Kaneko, Kazuo; Yoshimura, Masafumi.

In: Foot and Ankle International, Vol. 37, No. 3, 01.03.2016, p. 307-311.

Research output: Contribution to journalArticle

Shimasaki, Y, Nagao, M, Miyamori, T, Aoba, Y, Fukushi, N, Saita, Y, Ikeda, H, Kim, SG, Nozawa, M, Kaneko, K & Yoshimura, M 2016, 'Evaluating the risk of a fifth metatarsal stress fracture by measuring the serum 25-hydroxyvitamin D levels', Foot and Ankle International, vol. 37, no. 3, pp. 307-311. https://doi.org/10.1177/1071100715617042
Shimasaki, Yu ; Nagao, Masashi ; Miyamori, Takayuki ; Aoba, Yukihiro ; Fukushi, Norifumi ; Saita, Yoshitomo ; Ikeda, Hiroshi ; Kim, Sung Gon ; Nozawa, Masahiko ; Kaneko, Kazuo ; Yoshimura, Masafumi. / Evaluating the risk of a fifth metatarsal stress fracture by measuring the serum 25-hydroxyvitamin D levels. In: Foot and Ankle International. 2016 ; Vol. 37, No. 3. pp. 307-311.
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