Department of Spine Surgery, Xiangya Hospital, Central South University, China.
Biomed Res Int. 2018 Jul 16;2018:9784083. doi: 10.1155/2018/9784083. eCollection 2018.
Adolescent idiopathic scoliosis (AIS) is common deformity with unknown cause. Previous studies have suggested the abnormal serum leptin and ghrelin level in AIS girls. The aim of present study was to evaluate whether the serum leptin and ghrelin level could serve as risk factor in predicting the curve progression in AIS girls. The associations between them and the physical characteristics were also investigated.
Circulating leptin and ghrelin levels from 105 AIS girls and 40 age-matched non-AIS girls were examined by enzyme-linked immunosorbent assay. The correlations between ghrelin and leptin levels and growth-related parameters (age, weight, corrected height, corrected BMI, main Cobb angle, and Risser sign) were analyzed in AIS group. Multivariate logistic regression was used to investigate factors predicting curve progression in AIS girls.
A significantly lower leptin level (6.55 ± 2.88 vs. 8.01 ± 3.12 ng/ml, < 0.05) and a higher ghrelin level (6.33 ± 2.46 vs. 4.46 ± 2.02 ng/ml, < 0.05) were found in all AIS patients, as compared with normal controls. Curve progression patients had a higher ghrelin level than stable curve patients (7.61 ± 2.48 vs. 5.54 ± 2.11 ng/ml, < 0.01); for leptin level, there was no significant difference between progression and stable group. The results of multivariate logistic stepwise regression showed that premenarche status, initial main Cobb magnitude that was more than or equal to 23°, high ghrelin level (≥7.30 ng/ml), and lower Risser grade (grades 0 to 2) were identified as risk factors in predicting curve progression. Ghrelin levels of >6.48 ng/ml were predictive for curve progression with 70.00 % sensitivity and 72.31 % specificity, and the area under the curve (AUC) was 0.741 (95 % confidence interval 0.646-0.821).
High ghrelin level may serve as a new quantitative indicator for predicting curve progression in AIS girls.
青少年特发性脊柱侧凸（AIS）是一种常见的畸形，其病因不明。先前的研究表明，AIS 女孩的血清瘦素和 ghrelin 水平异常。本研究旨在评估血清瘦素和 ghrelin 水平是否可作为预测 AIS 女孩脊柱侧凸进展的危险因素，并探讨它们与体格特征的关系。
采用酶联免疫吸附试验检测 105 例 AIS 女孩和 40 例年龄匹配的非 AIS 女孩的循环瘦素和 ghrelin 水平。分析 AIS 组中 ghrelin 和 leptin 水平与生长相关参数（年龄、体重、校正身高、校正 BMI、主 Cobb 角和 Risser 征）之间的相关性。采用多元 logistic 回归分析预测 AIS 女孩曲线进展的因素。
与正常对照组相比，所有 AIS 患者的瘦素水平（6.55±2.88 vs. 8.01±3.12ng/ml， < 0.05）显著降低，ghrelin 水平（6.33±2.46 vs. 4.46±2.02ng/ml， < 0.05）升高。曲线进展患者的 ghrelin 水平高于稳定曲线患者（7.61±2.48 vs. 5.54±2.11ng/ml， < 0.01）；瘦素水平在进展组和稳定组之间无显著差异。多元逐步 logistic 回归分析结果表明，初潮前状态、初始主 Cobb 角≥23°、高 ghrelin 水平（≥7.30ng/ml）和较低的 Risser 分级（0 至 2 级）是预测曲线进展的危险因素。ghrelin 水平>6.48ng/ml 对曲线进展具有 70.00%的灵敏度和 72.31%的特异性，曲线下面积（AUC）为 0.741（95%置信区间 0.646-0.821）。
高 ghrelin 水平可能成为预测 AIS 女孩曲线进展的新定量指标。
