Prevalence of 25-OH-Vitamin D and Calcium Deficiency in Adolescent Idiopathic Scoliosis

Abstract

Several etiologies have been proposed as a basis and evolution theory for the development of adolescent idiopathic scoliosis, but limited data were published until now that link vitamin D and calcium deficiency to this condition. The present study aims to evaluate the relationship between 25-OH-Vitamin D, total calcium, and the following data: Cobb angle, age, and patient sex. The seasonal variation for vitamin D will also be taken into consideration. A total of 101 patients with a mean age of 11.61 ± 2.33 years had vitamin D and calcium levels tested. The mean Cobb angle was 26.21o ± 12.37. The level of vitamin D was, on average, 24 ng/mL ± 9.64. Calcium values were within the normal range, with an average of 9.82 mg/dL ± 0.42. The male group showed lower levels of vitamin D compared to the female group (19.6 vs. 25.45 ng/mL) (p = 0.02). Seasonal variations showed significant differences for vitamin D (p=.0001). Vitamin D level was positively correlated with the calcium level (p=0.01, r=0.973), but also with the patient�s age (p <0.001, r=0.158). The Cobb angle was negatively correlated with serum vitamin D levels (p<0.01, r=-0.472). Patients included in this study had low vitamin D levels, significant differences being observed between boys and girls, boys being more affected. The positive correlation between vitamin D and calcium, together with the negative correlation with the Cobb angle, is yet another proof that patients with idiopathic scoliosis should be investigated regularly for these pathologies.

Do Adolescent Idiopathic Scoliosis Patients With Vitamin D Deficiency Have Worse Spine Fusion Outcomes?

“…23 Furthermore, lower levels of vitamin D have been correlated with a higher major curve angle in 2 studies of AIS. 9,24 This is in line with a prospective study that showed vitamin D deficiency predicted greater progression of major curve angle over a 2 year time span, with patients who received vitamin D supplementation compared with placebo having significantly less curve progression. 11 When interpreted in conjunction with our findings, it is possible that patients with vitamin D deficiency develop a curve in the surgical range more quickly.…”

“…AIS patients are noted to have significantly lower 25-hydroxyvitamin D levels when compared with age-matched controls presenting after orthopaedic trauma,10 sports injury,9 or healthy adolescents recruited from the community 23. Furthermore, lower levels of vitamin D have been correlated with a higher major curve angle in 2 studies of AIS 9,24. This is in line with a prospective study that showed vitamin D deficiency predicted greater progression of major curve angle over a 2 year time span, with patients who received vitamin D supplementation compared with placebo having significantly less curve progression 11.…”

What Is New in Pediatric Bone Health

“…Adolescent idiopathic scoliosis (AIS) has been linked to vitamin D deficiency, which may be due to its regulatory effect in calcium-phosphorus metabolism. [69][70][71][72] Low serum vitamin 25(OH)D and calcium levels are negatively correlated with Cobb measurements. 66,[70][71][72][73][74] Development of AIS has been correlated to abnormal bone metabolism, defective bone qualities including regulation of fibrosis, and poor posture control.…”

“…[69][70][71][72] Low serum vitamin 25(OH)D and calcium levels are negatively correlated with Cobb measurements. 66,[70][71][72][73][74] Development of AIS has been correlated to abnormal bone metabolism, defective bone qualities including regulation of fibrosis, and poor posture control. 66,69,72 There is a negative correlation between serum turnover markers including alkaline phosphate, osteocalcin, C-terminal telopeptide of type I collagen, and P1NP and adolescent lumbar BMD in those with AIS.…”

Vitamin D—A Risk Factor for Bone Fractures in Children: A Population-Based Prospective Case–Control Randomized Cross-Sectional Study

“…Pathological conditions such as nonspecific symmetrical non-radiating muscle pain, pathological bone fractures, slipped capital femoral epiphysis, back pain, muscle cramps, and pain during running may suggest insufficient or low vitamin D levels [ 17 ]. Vitamin D was also seen as a risk factor for curvature progression among children with scoliosis [ 18 , 19 ]. According to Perez-Rossello, bone demineralization is associated with a median value of 25-OH-vitamin D of 7 ng/mL [ 20 ].…”