SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Osteoporos Int. 2022 Mar;33(3):725-735. doi: 10.1007/s00198-021-06200-1. Epub 2021 Oct 13.
Decreased cortical bone density and bone strength at peak height velocity (PHV) were noted in girls with adolescent idiopathic scoliosis (AIS). These findings could provide the link to the previously reported observation that low bone mineral density (BMD) could contribute as one of the prognostic factors for curve progression that mostly occurs during PHV in AIS.
As part of the studies related to aetiopathogenesis of AIS, we assessed bone qualities, bone mechanical strength and bone turnover markers (BTMs) focusing at the peri-pubertal period and PHV in AIS girls.
396 AIS girls in two separate cohorts were studied. Skeletal maturity was assessed using the validated thumb ossification composite index (TOCI). Bone qualities and strength were evaluated with high-resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA).
Cohort-A included 179 girls (11.95 ± 0.95 years old). Girls at TOCI-4 had numerically the highest height velocity (0.71 ± 0.24 cm/month) corresponding to the PHV. Subjects at TOCI-4 had lower cortical volumetric BMD (672.36 ± 39.07 mg/mm), cortical thickness (0.68 ± 0.08 mm) and apparent modulus (1601.54 ± 243.75 N/mm) than: (a) those at TOCI-1-3 (724.99 ± 32.09 mg/mm (p < 0.001), 0.79 ± 0.11 mm (p < 0.001) and 1910.88 ± 374.75 N/mm (p < 0.001), respectively) and (b) those at TOCI-8 (732.28 ± 53.75 mg/mm (p < 0.001), 0.84 ± 0.14 mm (p < 0.001), 1889.11 ± 419.37 N/mm (p < 0.001), respectively). Cohort-B included 217 girls (12.22 ± 0.89 years old). Subjects at TOCI-4 had higher levels of C-terminal telopeptide of type 1 collagen (1524.70 ± 271.10 pg/L) and procollagen type 1 N-terminal propeptide (941.12 ± 161.39 µg/L) than those at TOCI-8 (845.71 ± 478.55 pg/L (p < 0.001) and 370.08 ± 197.04 µg/L (p < 0.001), respectively).
AIS girls had decreased cortical bone density and bone mechanical strength with elevated BTMs at PHV. Coupling of PHV with decreased cortical and FEA parameters could provide the link to the previously reported observation that low BMD could contribute as one of the prognostic factors for curve progression that mostly occurs during PHV in AIS.
在青少年特发性脊柱侧凸（AIS）患者中，研究峰值骨量（PHV）时皮质骨密度和骨强度降低的情况。这些发现可能为之前的观察结果提供了联系，即低骨密度可能是 AIS 患者 PHV 期间曲线进展的预测因素之一。
研究了两个独立队列中的 396 名 AIS 女孩。使用经过验证的拇指骨化复合指数（TOCI）评估骨骼成熟度。使用高分辨率外周定量计算机断层扫描（HR-pQCT）和有限元分析（FEA）评估骨质量和强度。
队列 A 包括 179 名女孩（11.95±0.95 岁）。TOCI-4 的女孩身高增长速度最快（0.71±0.24cm/月），相当于 PHV。TOCI-4 的女孩皮质体积骨密度（672.36±39.07mg/mm）、皮质厚度（0.68±0.08mm）和表观弹性模量（1601.54±243.75N/mm）均低于 TOCI-1-3（724.99±32.09mg/mm，p<0.001；0.79±0.11mm，p<0.001；1910.88±374.75N/mm，p<0.001）和 TOCI-8（732.28±53.75mg/mm，p<0.001；0.84±0.14mm，p<0.001；1889.11±419.37N/mm，p<0.001）。队列 B 包括 217 名女孩（12.22±0.89 岁）。TOCI-4 的女孩 C 端肽 1 型胶原（CTX-1）（1524.70±271.10pg/L）和 1 型前胶原 N 端前肽（P1NP）（941.12±161.39µg/L）水平均高于 TOCI-8（CTX-1：845.71±478.55pg/L，p<0.001；P1NP：370.08±197.04µg/L，p<0.001）。
在 PHV 时，AIS 女孩的皮质骨密度和骨机械强度降低，骨转换标志物升高。PHV 时皮质和 FEA 参数降低与之前的观察结果相吻合，即低骨密度可能是 AIS 患者 PHV 期间曲线进展的预测因素之一。
