Objective: Excessive curvature of the femur has been considered to be one of\nthe factors associated with atypical femoral fracture (AFF). Although we clarified\nthat femoral curvature was markedly influenced by a low vitamin D\nlevel, very few studies have been conducted on the direct relationship between\nAFF and a serum low level of vitamin D. Therefore, we compared the\nserum vitamin D level between AFF and osteoporosis patients. Methods: A\ntotal of 48 consecutive AFFs in 36 Japanese patients were retrospectively reviewed\nusing the medical records, and 12 consecutive AFFs in 9 patients (AFF\ngroup) whose 25-hydroxyvitamin D (25(OH)D) levels were examined were\nincluded in this study. As a non-AFF control group, 45 consecutive\nage-matched female patients with osteoporosis (Osteoporosis group) were\nenrolled. We compared some laboratory examination items, the bone mineral\ndensity, and curvature of the femur. Results: When univariate logistic regression\nanalysis was performed to compare the 2 groups, Ca levels and lateral\nand anterior curvatures in the AFF group were significantly greater than in\nthe Osteoporosis group (P < 0.05, P < 0.01, and P < 0.01, respectively), and\nthe 25(OH)D level in the AFF group was significantly lower than in the Osteoporosis\ngroup (P < 0.01). We used discriminant analysis of these extracted\nitems to exclude the mutual influence of factors and identify factors closely\nassociated with AFF, and 25(OH)D, Ca and anterior curvature were identified\nas significant items to differentiate these diseases (P < 0.05, P < 0.01, and P <\n0.01, respectively). Conclusion: AFF patients showed low vitamin D levels\nand marked femoral curvatures.
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