title: Factors related to curved femur in elderly Japanese women.
abstract: BACKGROUND
  Multiple factors are involved in the development of atypical femoral fractures, and excessive curvature of the femur is thought to be one of them. However, the pathogenesis of femoral curvature is unknown. We evaluated the influence of factors related to bone metabolism and posture on the development of femoral curvature.
  
  
  METHODS
  A total of 139 women participated in the present study. Curvatures were measured using antero-posterior and lateral radiography of the femur. We evaluated some bone and vitamin D metabolism markers in serum, the bone mineral density (BMD), lumbar spine alignment, and pelvic tilt.
  
  
  RESULTS
  We divided the women into two groups, curved and non-curved groups, based on the average plus standard deviation as the cut-off between the groups. When univariate logistic regression analysis was performed to detect factors affecting femoral curvature, the following were identified as indices significantly affecting the curvature: age of the patients, serum concentrations of calcium, intact parathyroid hormone, pentosidine, homocysteine and 25-hydroxyvitamin D (25(OH)D), and BMD of the proximal femur (P < 0.05) both in the lateral and anterior curvatures. When we used multivariate analyses to assess these factors, only 25(OH)D and age (lateral and anterior standardized odds ratio: 0.776 and 0.385, and 2.312 and 4.472, respectively) affected the femoral curvature (P < 0.05).
  
  
  CONCLUSIONS
  Femoral curvature is strongly influenced by age and serum vitamin D.
authors.affiliation: a Department of Orthopedic Surgery , Akita University Graduate School of Medicine , 1-1-1 Hondo , Akita 010-8543 , Japan ;
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchie
authors.affiliation: a Department of Orthopedic Surgery , Akita University Graduate School of Medicine , 1-1-1 Hondo , Akita 010-8543 , Japan ;
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.affiliation: a Department of Orthopedic Surgery , Akita University Graduate School of Medicine , 1-1-1 Hondo , Akita 010-8543 , Japan ;
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasukawa
authors.affiliation: b Division of Orthopedic Surgery , Nakadori General Hospital , 3-15, Misono-cho, Minami-dori , Akita 010-8577 , Japan.
authors.forename: Seietsu
authors.initials: S
authors.lastname: Senma
authors.affiliation: b Division of Orthopedic Surgery , Nakadori General Hospital , 3-15, Misono-cho, Minami-dori , Akita 010-8577 , Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Narita
authors.affiliation: b Division of Orthopedic Surgery , Nakadori General Hospital , 3-15, Misono-cho, Minami-dori , Akita 010-8577 , Japan.
authors.forename: Seiya
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: b Division of Orthopedic Surgery , Nakadori General Hospital , 3-15, Misono-cho, Minami-dori , Akita 010-8577 , Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hatakeyama
authors.affiliation: b Division of Orthopedic Surgery , Nakadori General Hospital , 3-15, Misono-cho, Minami-dori , Akita 010-8577 , Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: a Department of Orthopedic Surgery , Akita University Graduate School of Medicine , 1-1-1 Hondo , Akita 010-8543 , Japan ;
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015519:Bone Density; D002118:Calcium / Q000097:blood; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000208:ethnology / Q000209:etiology*; D005269:Femur / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007564:Japan; D008159:Lumbar Vertebrae; D008239:Lysine / Q000031:analogs & derivatives / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010281:Parathyroid Hormone / Q000097:blood; D012044:Regression Analysis; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications
chemical_list: D010281:Parathyroid Hormone; D006710:Homocysteine; D014807:Vitamin D; D001120:Arginine; C104450:25-hydroxyvitamin D; C062187:pentosidine; D008239:Lysine; D002118:Calcium
keywords: 25-Hydroxyvitamin D; atypical femoral fracture; curved femur; osteomalacia; women