Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China

Abstract

ObjectivesTo determine the influence of ethnic disparities, socioeconomic status (SES) and hukou on the incidence of scoliosis.MethodsWe enrolled 2,445 junior high school students (Han: 1,153; ethnic minorities: 1,292) aged 12–16 years from two schools in Tianzhu Tibetan Autonomous County, Gansu Province from November 2020 to February 2021. We measured the angle of trunk rotation (ATR) using a scoliometer. Two-factor analysis of variance was used to comparatively analyze differences in the ATR according to ethnicity, age, sex, body mass index (BMI), and SES between the groups. Associations between risk factors and scoliosis were estimated using odds ratios and 95% confidence intervals with an unconditional multivariate logistic regression model for the two groups.ResultsAdolescents with Han ethnicity were more likely to have scoliosis than their ethnic minority counterparts (10.8% vs. 7.1%, P < 0.05). The ATR value in the Han group decreased with age whereas the minority group showed an upward trend (P < 0.05). The difference between ethnic groups was not significant, only at level 3. In particular, the ATR values among Han girls were significantly higher than those of ethnic minority girls (P < 0.05). Compared with Han adolescents, the BMI of ethnic minorities had a greater impact on the ATR. A statistically significant difference in SES was found between the two ethnic groups (P < 0.05). Hukou and parents' occupation had an important influence on the onset of scoliosis.ConclusionsHan adolescents had higher ATR values and were more likely to have scoliosis than ethnic minority adolescents in our study. Growth and development indicators (height and BMI) and differences in SES between the two groups played an important role.

Prevalence and plasma exosome-derive microRNA diagnostic biomarker screening of adolescent idiopathic scoliosis in Yunnan Province, China

“…Nevertheless, there was no statistically significant difference in the proportion of individuals with a Cobb angle ≥40° between the two sex. The prevalence of IS in Yunnan Province was found to be lower than that in certain regions, such as the Qinghai-Tibet Plateau, which is characterized by a high-altitude environment and a predominantly Tibetan population; However, the prevalence of IS in Yunnan Province showed a similar trend to previous studies in other ethnic groups and regions in China ( 6 , 34 , 35 ). Furthermore, it was observed that the incidence of IS exhibited a gradual rise in correlation with advancing age, peaking in the 13–14 years age range, followed by a subsequent gradual decline.…”

“…However, it falls within the range of prevalence rates observed in different provinces in China (ranging from 0.11% to 2.64%) ( 9 , 10 , 34 , 35 ). Research indicates that the prevalence of AIS is associated with various factors, such as ethnicity, altitude of residence, and socioeconomic status ( 6 , 35 ). The prevalence of AIS varies among countries, including the United States (0.52%) ( 8 ), Japan (0.87%) ( 36 ), Saudi Arabia (0.78%) ( 37 ), India (0.61%) ( 33 ), Korea (0.497%) ( 38 ), and Iran (0.62%) ( 39 ).…”

“…First, students underwent the Adam Forwards Bend Test to observe whether they exhibited any signs of chest asymmetry, shoulder blade asymmetry, waist asymmetry, pelvic tilt, or deviation of the spinous process line from the midline ( 20 ). Students who were positive for one of these were further examined for angle of trunk rotation (ATR) ( 6 ). Following the guidelines established by the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment ( 21 ) and the Screening Criteria for Scoliosis in China (GB/T 16133–2014) ( 6 ), students with an ATR ≥ 5° were considered to have suspected positive results in the scoliosis screening.…”

“…Students who were positive for one of these were further examined for angle of trunk rotation (ATR) ( 6 ). Following the guidelines established by the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment ( 21 ) and the Screening Criteria for Scoliosis in China (GB/T 16133–2014) ( 6 ), students with an ATR ≥ 5° were considered to have suspected positive results in the scoliosis screening. They were subsequently referred to a hospital for confirmation of the condition through full-length spinal x-ray examinations.…”

“…The influence of factors such as region, ethnicity, and lifestyle, as well as differences in research methods and inclusion criteria, has led to significant variations in the prevalence of AIS ( 6 ). Globally, the prevalence of AIS ranges from approximately 0.47% to 5.2%.…”