与青少年特发性脊柱侧弯相关的体育活动和生活方式因素

Physical Activities and Lifestyle Factors Related to Adolescent Idiopathic Scoliosis.

作者信息

Watanabe Kota, Michikawa Takehiro, Yonezawa Ikuho, Takaso Masashi, Minami Shohei, Soshi Shigeru, Tsuji Takashi, Okada Eijiro, Abe Katsumi, Takahashi Masamichi, Asakura Keiko, Nishiwaki Yuji, Matsumoto Morio

机构信息

1Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan 2National Institute for Environmental Studies, Ibaraki, Japan 3Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan 4Department of Orthopedic Surgery, Kitasato University, Kanagawa, Japan 5Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan 6Department of Orthopedic Surgery, Zikei University, Tokyo, Japan 7Department of Orthopedic Surgery, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan 8Department of Orthopedic Surgery, Saiseikai Chuo Hospital, Tokyo, Japan 9Tokyo Health Service Association, Tokyo, Japan 10Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan 11Division of Environmental and Occupational Health, Toho University, Tokyo, Japan.

出版信息

J Bone Joint Surg Am. 2017 Feb 15;99(4):284-294. doi: 10.2106/JBJS.16.00459.

DOI:10.2106/JBJS.16.00459

PMID:28196030

Abstract

BACKGROUND

In addition to genetic factors, environmental and lifestyle factors are thought to play an important role in the onset of adolescent idiopathic scoliosis (AIS). This cross-sectional study was conducted to explore lifestyle factors related to AIS.

METHODS

This study included 2,759 Japanese female junior high school students who planned a secondary screening after an initial moiré topography screening indicated possible scoliosis. The students and their mothers, or guardians, were asked to fill out a questionnaire consisting of 38 questions about demographic factors, lifestyle-related factors, social factors, household environment, participation in sports, health status, and factors related to the mother's pregnancy and delivery. The questionnaire was completed by 2,747 students (a 99.6% response rate). After excluding students with heart disease, neurological disease, or a congenital vertebral anomaly, 2,600 students were eligible for assessment. After undergoing a secondary screening with standing radiographs of the spine, students were assigned to the normal (control) group if radiographs showed a curve of <15° or to the scoliosis group if they had a curve of ≥15°. The odds ratios (ORs) for AIS in relation to the possible risk or preventive factors were estimated by logistic regression analyses.

RESULTS

No lifestyle-related factor was significantly associated with AIS. However, AIS was associated with classical ballet training (OR, 1.38; 95% confidence interval [CI], 1.09 to 1.75); the odds of AIS developing increased as the child's frequency of training, number of years of experience, and duration of training in ballet increased. The OR for AIS was 1.5 times higher for participants whose mothers had scoliosis. AIS was also associated with a low body mass index (BMI). These associations remained even after mutual adjustment was performed.

CONCLUSIONS

No association was found between AIS and lifestyle-related factors. However, classical ballet training, a family history of scoliosis, and low BMI may be associated with AIS.

LEVEL OF EVIDENCE

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

除遗传因素外，环境和生活方式因素被认为在青少年特发性脊柱侧凸（AIS）的发病中起重要作用。本横断面研究旨在探讨与AIS相关的生活方式因素。

方法

本研究纳入了2759名日本初中女生，她们在初次莫尔条纹地形筛查显示可能患有脊柱侧凸后计划进行二次筛查。学生及其母亲或监护人被要求填写一份包含38个问题的问卷，这些问题涉及人口统计学因素、生活方式相关因素、社会因素、家庭环境、体育活动参与情况、健康状况以及与母亲怀孕和分娩相关的因素。2747名学生完成了问卷（应答率为99.6%）。在排除患有心脏病、神经系统疾病或先天性椎体异常的学生后，2600名学生符合评估条件。在接受脊柱站立位X线片二次筛查后，若X线片显示侧弯角度<15°，学生被分配至正常（对照）组；若侧弯角度≥15°，则被分配至脊柱侧凸组。通过逻辑回归分析估计与可能的风险或预防因素相关的AIS的比值比（OR）。

结果

没有生活方式相关因素与AIS显著相关。然而，AIS与古典芭蕾训练相关（OR，1.38；95%置信区间[CI]，1.09至1.75）；随着儿童芭蕾训练频率、训练年限和训练时长的增加，发生AIS的几率增加。母亲患有脊柱侧凸的参与者发生AIS的OR高出1.5倍。AIS还与低体重指数（BMI）相关。即使进行了相互调整，这些关联仍然存在。