More Prevalent and Severe Low Bone-Mineral Density in Boys with Severe Adolescent Idiopathic Scoliosis Than Girls: A Retrospective Study of 798 Surgical Patients
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摘要Introduction: A total of 0.1–0.8% of AIS patients progress to severe stages without clear mechanisms, and AIS girls are more prone to curve progression than boys. Recent studies suggest that AIS girls have systemic and persistent low bone-mineral density (BMD), which has been shown to be a significant prognostic factor of curve progression in AIS. The present study aimed to (a) investigate the prevalence of low BMD in patients with severe AIS and (b) assess the sexual dimorphism and independent risk factors of low BMD in severe AIS patients. Materials and Methods: A total of 798 patients (140 boys vs. 658 girls) with AIS who reached surgical threshold (Cobb ≥ 40°) were recruited. BMD were assessed using BMD Z-scores from dual-energy X-ray absorptiometry (DXA). Demographic, clinical, and laboratory values of the subjects were collected from their medical records. Logistic regression analysis was performed to identify independent risk factors of low BMD. Results: The overall prevalence of BMD Z-score ≤ −2 and ≤ −1 were 8.1% and 37.5%, respectively. AIS boys had significantly lower BMD Z-scores (−1.2 ± 0.96 vs. −0.57 ± 0.92) and higher prevalence of low BMD (Z-score ≤ −2: 22.1% vs. 5.2%, p < 0.001; Z-score ≤ −1: 59.3% vs. 32.8%, p < 0.001) than girls. Sex, BMI, serum alkaline phosphatase, and potassium were independent factors of low BMD in the severe AIS patients. Conclusions: The present large cohort of surgical AIS patients revealed that low BMD is more prevalent and severe in boys than in girls with severe curves. Low BMD may serve as a more valuable predictive factor for curve progression to the surgical threshold in boys than girls with AIS.
出版社接受日期09.03.2023
著者Zhichong Wu, Xiufen Zhu, Leilei Xu, Zhen Liu, Zhenhua Feng, Vivian Wing Yin Hung, Jack Chun Yiu Cheng, Yong Qiu, Wayne Y. W. Lee, Tsz Ping Lam, Zezhang Zhu
期刊名稱Journal of Clinical Medicine
出版年份2023
月份4
卷號12
期次8
文章號碼2991
國際標準期刊號2077-0383
語言英式英語

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