Does scoliosis causes low bone mass? A comparative study between siblings

Abstract

The aim of this study is to assess the prevalence low bone mass among girls with adolescent idiopathic scoliosis (AIS) and their siblings. The subjects of this study were Saudi Arabian girls with AIS. Patients had their weight and height measured to calculate their body mass index (BMI). Clinical examination and investigations were done to rule out any other cause of scoliosis. All had bone mineral density (BMD) measurement of hip area and the spine using DEXA scan, Hologic Inc. Patients with a BMD of \ -2.6 was taken as osteoporotic and those between \ -1 and -2.5 was taken as osteopenic for analysis. As control subjects, siblings of the patients with normal spine had their BMI calculated and BMD measurement done. We were able to analyze the data of 32 girls with an average age of 18.42 ± 5.71 (14-26) years with mean BMI of 17.7 ± 0.69 (16.5-18.5) kg/M 2 . Analysis of the scans of the hip revealed that 62.5% of the patients were osteoporotic with BMD of 0.837 (0.697-0.936) ± 0.04, T-score -3.8 ± 0.56 (-2.6 to -3.9) and Z-score. Nine (28.1%) were osteopenic with BMD of 0.768 ± 0.15 (0.638-0.878), mean T-score of -1.6 (-1.1 to 2.5) and Z-score -3.5 ± 0.63 (-2.9 to -3.9). Analysis of BMD of the spine showed similar results. In comparison to the scoliotics, girls with normal spine had higher BMI and BMD which was statistically significant at P \ 0.001. T-and Z-score was also lower in scoliotic girls in comparison with girls with normal spine significant at P \ 0.001 (CI 95%). Our study indicates that the scoliosis causes osteopenia and osteoporosis among girls while their siblings with normal spine remain with normal bone mass.

Body composition in adolescent idiopathic scoliosis

“…This relationship has also been described in AIS [5,[27][28][29][30]. Studies of AN demonstrate that BMI and disease duration is a strong predictor of an alteration in bone turnover.…”

“…Studies of AN demonstrate that BMI and disease duration is a strong predictor of an alteration in bone turnover. Bone turnover has been shown to be markedly disturbed when the BMI falls below 15 kg/m 2 [5,[27][28][29]. Values of BMI in AIS could be also a predictor of osteoporosis.…”

“…There is controversy as to whether there are real anthropometric alterations in patients with adolescent idiopathic scoliosis (AIS) [1][2][3][4][5][6]. Numerous growth studies have reported that AIS patients are taller than healthy controls [7][8][9].…”

“…A similar controversy exists with respect to weight or the body mass index (BMI). Such being that some studies find differences and others do not detect them [1,[4][5][6][12][13][14] Anorexia nervosa (AN) and AIS make their debut during adolescence and both may be associated with an alteration of subjective physical perception. This aspect combined with the demonstration, in some studies, of a lower BMI in patients with AIS [1,4,14] has led certain authors to propose a possible link between AIS and AN [4,15].…”

Fasting total ghrelin levels are increased in patients with adolescent idiopathic scoliosis

“…Incidence of AIS patients below undernourishment degree 1 or even within the margins of anorexia nervosa (AN) is above the general population [6][7][8].…”