Abstract
The link between scoliotic deformity and bone metabolism in adolescent idiopathic scoliosis (AIS) has not been well researched. Moreover, the data concerning the cross-talk between fat tissue content/hormonal activity and bone markers in this group of patients are lacking. The aim of the study was to assess whether there exists a significant relationship between the severity of AIS and bone turnover markers and leptin levels. The study group was consisted of 77 AIS girls, aged 14.7 ± 2.17 years. Scoliotic curve severity assessed by Cobb’s angle was categorized as mild (10–19°), moderate (20–39°), or severe (≥40°). Corrected height, weight, and waist and hip circumferences were measured and body mass index (BMI), corrected height Z-score, BMI Z-score, and waist/height ratio (WHtR) were calculated for the entire group. Body composition parameters: fat mass (FAT), fat-free mass (FFM), and predicted muscle mass (PMM) were determined using a bioelectrical impedance analyzer. Bone turnover markers (osteocalcin (OC) and amino terminal of collagen cross-links (NTx) and leptin levels were assessed in serum. Multiple regression analysis showed that, OC, NTx (negatively with p < 0.05), and leptin (positively with p < 0.01) were significantly associated with curve severity in AIS girls. Moreover, Cobb’s angle was positively correlated with W/HtR (p < 0.01) and FAT (p < 0.05). One-way analysis of variance (ANOVA) revealed significant differences in leptin (p < 0.05 vs. mild only), OC (p < 0.05 vs. mild and moderate), and W/HtR (p < 0.01 and p < 0.05 vs. mild and moderate, respectively) between the three AIS severity subgroups. OC was significantly lower in the severe AIS subgroup, while leptin and W/HtR were significantly higher. Significant correlations between leptin and anthropometrical parameters as BMI z-score and W/HtR were shown. Leptin level correlated also significantly with BMI z score (p < 0.001), W/HtR (p < 0.0001), and body composition parameters (p < 0.000001). Moreover, there was a significant negative correlation between NTx and leptin level (p < 0.05). Bone metabolism in AIS girls seems to be altered and significantly related to the scoliotic curve severity. Leptin may be a crucial link in the cross-talk between bone turnover and body composition in this group of patients. Further studies concerning interrelationship between nutritional status and bone metabolism in patients with AIS are warranted.
Highlights
Adolescent idiopathic scoliosis (AIS) is the most prevalent form of spinal deformity during the period of growth spurt and pubertal development
Presented cross-sectional study revealed the significant correlation between scoliotic curve magnitude and bone turnover markers and leptin level in AIS girls
Data coming from the present study confirmed our previous findings [30], that the degree of spinal deformity was independently connected with type of the adipose tissue distribution and body composition (W/HtR and fat mass (FAT)) after age and Tanner stage adjustment
Summary
Adolescent idiopathic scoliosis (AIS) is the most prevalent form of spinal deformity during the period of growth spurt and pubertal development. The most important clinical issue in the patients with AIS is the deformity progression. Pathogenesis of AIS probably has a multifactorial background [1,2,3,4,5,6] and is still the matter of discussion [7,8]. Abnormal growth pattern during puberty was considered as one of the possible etiological models of AIS pathogenesis. In the study conducted by Nicolopoulos et al, adolescent girls with AIS had longer lower extremities with taller both total and sedentary heights and these silhouette components were significantly different than in girls from the control group [5]. Similar findings were described in the group of 598 Chinese girls with IS [9]
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