Low Body Mass Index Levels and Idiopathic Scoliosis in Korean Children: A Cross-Sectional Study

Abstract

Background: The prevalence of idiopathic scoliosis is rapidly increasing in Korean children, but research on the disorder is limited compared to that in other countries. Accordingly, in the present study, we aimed to investigate the relationship between idiopathic scoliosis and body mass index (BMI) levels in Korean children. Methods: This cross-sectional study enrolled elementary school students and middle school first graders in the Capital Area in Korea. The participants underwent body composition measurements and screening for idiopathic scoliosis. Idiopathic scoliosis was defined as a Cobb angle of ≥10°. The students were classified into three groups—the severely underweight (SUW: BMI < 16 kg/m2) group, the underweight group (UW: 16 ≤ BMI < 18.5 kg/m2), and the normal weight group (NW: 18.5 ≤ BMI < 25 kg/m2) to compare the risk of idiopathic scoliosis across BMI levels. Results: The final cohort comprised 1375 participants. The odds ratio (OR) of idiopathic scoliosis was 0.69 (95% confidence interval (CI): 0.50–0.94) and 0.66 (95% CI: 0.49–0.89) for the UW and the NW groups, respectively, with the SUW group as the reference. This shows that the risk decreased significantly by 31% and 34% in the UW and the NW groups, respectively. After controlling for age and sex, the corresponding ORs were 0.72 (95% CI: 0.52–0.98) and 0.70 (95% CI: 0.51–0.96), and the risk significantly decreased by 28% and 30% in the UW and the NW groups, respectively. Conclusions: Low body weight is closely associated with spinal deformity and idiopathic scoliosis.

Is There a Relationship between Idiopathic Scoliosis and Body Mass? A Scoping Review

“…The body measurements taken into consideration as a parameter of comparison between the different studies were the BMI and the degree of scoliosis assessed by the Cobb angle. Except for the study of Kyoung-kyu Jeon et al [ 19 ], where scoliosis was assessed using a stadiometer (Seca, Hamburg, Germany) and a body composition analyzer (Inbody 720, Biospace, Seoul, Korea), and the studies of M. Clark et al [ 20 ] and Weijun Wang et al [ 21 ], that used a method of measuring scoliosis from DXA images (the DXA Scoliosis Method, DSM), to reduce the exposition of children to X-radiation, all other studies evaluated the presence and degree of scoliosis using radiographs and Cobb angle measurements (common reference value for diagnosing scoliosis was a Cobb angle ≥10°). There were 3 BMI criteria used in the studies, always calculated with the kg/m 2 formula, they included: the criteria of the WHO, the International Obesity Task Force and the Korean Centers for Disease Control (KCDC).…”

“…Weight and BMI are important indices to reflect a child’s health condition. Maintaining adequate body weight during childhood could help reduce the risk of worsening scoliosis, especially given the growth spurts and development of secondary sexual characteristics that occur during puberty [ 19 ]. The assessment and monitoring of body weight could be of great help in the process of screening children at risk of scoliosis, to implementing targeted preventive interventions.…”

Association between lean mass and adolescent idiopathic scoliosis: A meta- analysis

“…Considering the prevalence of AIS is higher in female than male and men's lean mass is higher than women's in both AIS patients and healthy people [31,32], we assumed sex as one source of the heterogeneity. And the result of female subgroup meta analysis showed the mean difference of lean mass between AIS patients and control group in this subgroup analysis was greater than the meta analysis, and the heterogeneity decreased in this subgroup.…”

Exploring the association between specific genes and the onset of idiopathic scoliosis: a systematic review

“…More specifically, this gene promotes leptin signalling by stimulating Janus kinases 1 and 2 [ 36 ]. A specific study reported the risk of scoliosis as 1.5 times higher in the underweight group compared to both healthy and overweight groups [ 7 , 37 ]. A study also reported that IS patients had lower leptin levels in serum compared to the control group, a parameter often found in severely underweight patients [ 37 ].…”

“…A specific study reported the risk of scoliosis as 1.5 times higher in the underweight group compared to both healthy and overweight groups [ 7 , 37 ]. A study also reported that IS patients had lower leptin levels in serum compared to the control group, a parameter often found in severely underweight patients [ 37 ]. This data suggests that there may be involvement of the SH2B1 gene in IS onset thanks to its involvement in leptin signalling, and perhaps its polymorphic effects on weight regulation [ 7 , 36 ].…”