title: Factors associated with hallux valgus in a population-based study of older women and men: the MOBILIZE Boston Study.
abstract: OBJECTIVE
  To examine potential risk factors for hallux valgus in community-dwelling elders.
  
  
  METHODS
  Data from 600 MOBILIZE Boston Study participants (386 women and 214 men) were analyzed. Hallux valgus was defined as >15 degrees angular deviation of the hallux with respect to the first metatarsal bone toward the lesser toes. Associations of hallux valgus with age, body mass index (BMI), race, education, pes planus, foot pain, and in women, history of high heel shoe use, were assessed using sex-specific Poisson regression with robust variance estimation for risk ratios (RR) and 95% confidence intervals (CI).
  
  
  RESULTS
  Hallux valgus was present in 58% of women and 25% of men. Higher BMI was inversely associated with presence of hallux valgus in women (P trend=0.001), with the strongest inverse association observed in those with BMI of 30.0 or more compared to those with normal BMI (RR=0.7, 95% CI: 0.5, 0.9). Women, who usually wore high-heeled shoes during ages 20-64 years compared to those who did not, had increased likelihood of hallux valgus (RR=1.2, 95% CI: 1.0, 1.5). Among men, those with BMI between 25.0 and 29.9 had increased likelihood of hallux valgus compared to those with normal BMI (RR=1.9, 95% CI: 1.0, 3.5). Men with pes planus were more likely to have hallux valgus (RR=2.1, 95% CI: 1.3, 3.3) compared to men without pes planus.
  
  
  CONCLUSIONS
  In women, hallux valgus was associated with lower BMI and high heel use during ages 20-64, while in men, associations were observed with higher BMI and pes planus. Our results suggest that the etiologic mechanisms for hallux valgus may differ between men and women.
authors.affiliation: Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131-1097, USA. uyen-sanguyen@hrca.harvard.edu
authors.forename: U-S D T
authors.initials: US
authors.lastname: Nguyen
authors.forename: H J
authors.initials: HJ
authors.lastname: Hillstrom
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: A B
authors.initials: AB
authors.lastname: Dufour
authors.forename: D P
authors.initials: DP
authors.lastname: Kiel
authors.forename: E
authors.initials: E
authors.lastname: Procter-Gray
authors.forename: M M
authors.initials: MM
authors.lastname: Gagnon
authors.forename: M T
authors.initials: MT
authors.lastname: Hannan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005413:Flatfoot / Q000150:complications; D006215:Hallux Valgus / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012775:Shoes / Q000009:adverse effects