Zhao Lijuan, Jiang Xiujun, Zhang Wenhui, Hao Li, Wu Shangxi, Zhang Yuting, Xu Hong, Zhu Bing
Department of Health Hazard Surveillance, Hangzhou Center For Disease Control and Prevention (Hangzhou Health Supervision Institution), No. 568 Mingshi Road, Hangzhou, 310021, Zhejiang, China.
Department of Automotive and Architectural Landscape Architecture, Fuyang College, Zhejiang Open University, Hangzhou, Zhejiang, China.
BMC Public Health. 2025 May 13;25(1):1741. doi: 10.1186/s12889-025-22883-1.
Spinal Curvature Abnormality (SCA) is a general term for abnormal curvature of the spine that can have long-term negative consequences in adolescents. Research into its aetiology is important for identifying high-risk populations and formulating tailored prevention strategies. This study aimed to evaluate the association between school-related factors and daily lifestyle habits and SCA.
In this population-based cross-sectional study, 5652 primary and secondary school students were recruited in Hangzhou, eastern China. All selected students underwent spinal health screenings, as well as height and weight assessments. The influencing factors were gathered through self-report questionnaires completed by the students themselves. We used logistic regression models to estimate the relative risk of SCA prevalence for each variable in the analysis.
The overall prevalence of SCA was found to be 2.23% (126/5652), with the SCA rates observed among students in primary school, junior high school, and senior high school, at 0.06%, 1.88%, and 4.61%, respectively. After adjustment for potential confounders, multivariable logistic regression models showed that live on campus was significantly increased the risk of SCA in children and adolescents (OR = 2.68, 95% CI:183 - 3.92; P < 0.001). However, attending a suburban school (OR = 0.18, 95% CI:0.11-0.31; P < 0.001), spending ≥ 2 h per day outdoors (OR = 0.56, 95% CI:0.34-0.93; P = 0.026), being overweight (OR = 0.54, 95% CI:0.31-0.95; P = 0.032) and maintaining correct sitting and standing postures (OR = 0.60, 95% CI:0.37-0.97; P = 0.036) were protective factors for SCA in children and adolescents.
In conclusion, academic-related factors, outdoor activity time, weight status and daily lifestyle habits were significantly associated with SCA in Chinese children and adolescents. It is recommended that schools, families, hospitals and society should jointly take measures to encourage adolescent students to cultivate good academic-related behaviours and healthy lifestyles to maintain and promote spinal health.
脊柱曲率异常（SCA）是脊柱异常弯曲的统称，对青少年可能产生长期负面影响。对其病因的研究对于识别高危人群和制定针对性的预防策略很重要。本研究旨在评估与学校相关的因素、日常生活习惯与SCA之间的关联。
在这项基于人群的横断面研究中，在中国东部的杭州招募了5652名中小学生。所有入选学生均接受了脊柱健康筛查以及身高和体重评估。影响因素通过学生自己填写的自我报告问卷收集。我们在分析中使用逻辑回归模型来估计每个变量的SCA患病率的相对风险。
发现SCA的总体患病率为2.23%（126/5652），小学、初中和高中学生的SCA发生率分别为0.06%、1.88%和4.61%。在对潜在混杂因素进行调整后，多变量逻辑回归模型显示，住校会显著增加儿童和青少年患SCA的风险（OR = 2.68，95%CI：1.83 - 3.92；P < 0.001）。然而，就读于郊区学校（OR = 0.18，95%CI：0.11 - 0.31；P < 0.001）、每天户外活动≥2小时（OR = 0.56，95%CI：0.34 - 0.93；P = 0.026）、超重（OR = 0.54，95%CI：0.31 - 0.95；P = 0.032）以及保持正确的坐姿和站姿（OR = 0.60，95%CI：0.37 - 0.97；P = 0.036）是儿童和青少年SCA的保护因素。
总之，学业相关因素、户外活动时间、体重状况和日常生活习惯与中国儿童和青少年的SCA显著相关。建议学校、家庭、医院和社会应共同采取措施，鼓励青少年学生养成良好的学业相关行为和健康的生活方式以维持和促进脊柱健康。
