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

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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

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Keywords

  • fifth metatarsal stress fracture
  • soccer athletes
  • Vitamin D

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Shimasaki, Y., Nagao, M., Miyamori, T., Aoba, Y., Fukushi, N., Saita, Y., Ikeda, H., Kim, S. G., 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, 37(3), 307-311. https://doi.org/10.1177/1071100715617042