Xue Li1, Vivian Wing Yin Hung2, Fiona Wai Ping Yu2, Alec Lik Hang Hung2, Bobby Kin Wah Ng2, Jack Chun Yiu Cheng2, Tsz Ping Lam3, Benjamin Hon Kei Yip4. 1. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region. 2. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong Special Administrative Region. 3. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Hong Kong Special Administrative Region. Electronic address: tplam@cuhk.edu.hk. 4. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region. Electronic address: benyip@cuhk.edu.hk.
Abstract
OBJECTIVES: Low bone mineral status has been reported in patients first presented with adolescent idiopathic scoliosis (AIS). We aimed to study whether low-normal bone mineral density (BMD) is persistent among AIS girls during puberty and at peak bone mass, and whether if such persistence is associated with curve severity and differed from healthy controls. METHOD: This prospective longitudinal study comprised 550 AIS girls and 194 healthy control subjects followed from 1997 till 2016. Low-normal BMD was defined as z-standardized bone mineral density (z-BMD) of bilateral femoral neck ≤ -1. Markov Chain 2-stages analysis was conducted to investigate the low-normal BMD transition rate. Linear mixed-effects model and Bland-Altman plot were used to investigate whether low-normal BMD is persistent among a subgroup of AIS patients that reached peak bone mass. RESULTS: The average z-BMD were comparable between AIS cohort and controls at 11 years old (-0.532 vs -0.602), but at 19 years old z-BMD worsened among AIS subjects (-0.860) while controls z-BMD improved (-0.455). During growth period until skeletal maturity, persistence of low-normal BMD was high in both cohorts (>80%) and the AIS group with severe curve presented 100% persistence. Subgroup analysis revealed that z-BMD of AIS patients at skeletal maturity and peak bone mass were highly correlated (r2 = 0.905) and with good agreement. CONCLUSION: AIS patients had poorer BMD that is associated with curve severity and more likely to persist beyond peripubertal period and at peak bone mass when compared to controls.
OBJECTIVES: Low bone mineral status has been reported in patients first presented with adolescent idiopathic scoliosis (AIS). We aimed to study whether low-normal bone mineral density (BMD) is persistent among AISgirls during puberty and at peak bone mass, and whether if such persistence is associated with curve severity and differed from healthy controls. METHOD: This prospective longitudinal study comprised 550 AISgirls and 194 healthy control subjects followed from 1997 till 2016. Low-normal BMD was defined as z-standardized bone mineral density (z-BMD) of bilateral femoral neck ≤ -1. Markov Chain 2-stages analysis was conducted to investigate the low-normal BMD transition rate. Linear mixed-effects model and Bland-Altman plot were used to investigate whether low-normal BMD is persistent among a subgroup of AISpatients that reached peak bone mass. RESULTS: The average z-BMD were comparable between AIS cohort and controls at 11 years old (-0.532 vs -0.602), but at 19 years old z-BMD worsened among AIS subjects (-0.860) while controls z-BMD improved (-0.455). During growth period until skeletal maturity, persistence of low-normal BMD was high in both cohorts (>80%) and the AIS group with severe curve presented 100% persistence. Subgroup analysis revealed that z-BMD of AISpatients at skeletal maturity and peak bone mass were highly correlated (r2 = 0.905) and with good agreement. CONCLUSION:AISpatients had poorer BMD that is associated with curve severity and more likely to persist beyond peripubertal period and at peak bone mass when compared to controls.
Authors: K G Yang; W Y W Lee; A L H Hung; V W Y Hung; M F Tang; T F Leung; A P S Kong; J C Y Cheng; T P Lam Journal: Osteoporos Int Date: 2021-10-13 Impact factor: 4.507
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