Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University.
Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University.
Environ Health Prev Med. 2023;28:55. doi: 10.1265/ehpm.23-00004.
Adolescent idiopathic scoliosis (AIS) is the most common type of idiopathic scoliosis, affecting approximately 0.61%-6.15% adolescents worldwide. To date, the results on the relationship between moderate-to-vigorous physical activity (MVPA) and AIS were inconsistent, and the association between screen time (ST) and AIS remained unclear. This study aimed to describe MVPA and ST among adolescents, and to explore the independent and joint associations between PA, ST, and AIS.
A frequency-matched case-control study based on the 2021 Chinese School-based Scoliosis Screening Program in Shenzhen city, south China, was conducted. The research involved 494 AIS patients (aged 9-17 years) and 994 sex- and age-matched healthy controls. MVPA and ST were measured using a self-administered questionnaire. Logistic regression models estimated associations between PA, ST, and AIS.
Compared to subjects meeting the recommended 60-min daily of MVPA, adolescents reporting daily MVPA time less than 60 min had 1.76 times higher odds of experiencing AIS (95% CI: 1.32-2.35) and adolescents reporting daily MVPA in inactive status had 2.14 times higher odds of experiencing AIS (95% CI: 1.51-3.03). Moreover, participants reporting ST for 2 hours or more had 3.40 times higher odds of AIS compared with those reporting ST less than 2 hours (95% CI: 2.35-4.93). When compared with the adolescents reporting both ST and MVPA meeting the guidelines recommended times (ST < 2 h and MVPA ≥ 60 min/day), those reporting both ST ≥ 2 h and MVPA in inactive status are 8.84 times more likely to develop AIS (95% CI: 3.99-19.61).
This study reported that the insufficient MVPA, especially MVPA in inactive status, and excessive ST were risk factors for AIS. Additionally, the joint effects of insufficient MVPA and excessive ST probably increase the risk of AIS.
青少年特发性脊柱侧凸（AIS）是最常见的特发性脊柱侧凸类型，影响全球约 0.61%-6.15%的青少年。迄今为止，关于中高强度体力活动（MVPA）与 AIS 之间的关系的结果并不一致，而屏幕时间（ST）与 AIS 之间的关联尚不清楚。本研究旨在描述青少年的 MVPA 和 ST，并探讨 PA、ST 与 AIS 之间的独立和联合关联。
本研究基于中国深圳市 2021 年学校脊柱侧凸筛查计划，采用频数匹配的病例对照研究。研究涉及 494 例 AIS 患者（年龄 9-17 岁）和 994 名性别和年龄匹配的健康对照。MVPA 和 ST 通过自我管理问卷进行测量。使用逻辑回归模型估计 PA、ST 和 AIS 之间的关联。
与每天达到推荐 60 分钟 MVPA 的受试者相比，报告每天 MVPA 时间少于 60 分钟的青少年患 AIS 的几率高 1.76 倍（95%CI：1.32-2.35），报告每天 MVPA 处于不活跃状态的青少年患 AIS 的几率高 2.14 倍（95%CI：1.51-3.03）。此外，报告 ST 时间在 2 小时或以上的参与者患 AIS 的几率是报告 ST 时间少于 2 小时的参与者的 3.40 倍（95%CI：2.35-4.93）。与报告同时满足 ST 时间少于 2 小时和 MVPA 时间每天≥60 分钟推荐时间的青少年相比，报告同时满足 ST 时间≥2 小时和 MVPA 时间不活跃的青少年患 AIS 的几率高 8.84 倍（95%CI：3.99-19.61）。
本研究报告称，MVPA 不足，尤其是不活跃状态下的 MVPA，以及 ST 时间过长是 AIS 的危险因素。此外，MVPA 不足和 ST 时间过长的联合作用可能会增加 AIS 的风险。
