Vitamin D and adolescent idiopathic scoliosis, should we stop the hype?

Vitamin D and adolescent idiopathic scoliosis, should we stop the hype?

• Author
• José María González Ruiz
• Co-authors
• Maria Isabel Pérez Núñez , María Dolores García Alfaro , Carlos Aurelio Palancar
• Abstract

• Introduction: Adolescent idiopathic scoliosis (AIS) can be considered as the result of a phenomenon of developmental instability, due to the presence of fluctuating asymmetry (FA) in the torso. On the other hand, in recent years studies have been published that relate vitamin D deficiency to a greater Cobb angle, although causality has not yet been demonstrated.

  Objectives: Our objective was to study the relationship between vitamin D and the characteristic asymmetric phenotype of AIS in a cohort, evaluating the shape of the torso through fluctuating asymmetry and the magnitude of the Cobb angle.

  Methods: We conducted a prospective cross-sectional observational study of a cohort of 53 AIS patients recruited from two national centers between October 2021 and March 2022 (ethical statement: 2021.183 dated May 28, 2021). Inclusion criteria were age 10-16 years, Cobb>20º, and Tanner stage <4. We excluded patients with endocrine disorders, supplementary treatment, or previous fractures. We used a torso surface scanner (ArtecTM MHT-3D) to map the deformity in 360° and calculated FA using morphogeometric methods. We performed a PA tele-radiograph to calculate the Cobb, Mehta, rotation, and conducted a blood test measuring serum levels of calcium, phosphate, magnesium, albumin, vitamin D, and PTH. We conducted a multivariable multiple regression analysis between surface topography and serum variables and a correlation analysis between vitamin D and FA and Cobb angle variables.

  Results: No correlation was found between vitamin D and FA, although differences in torso shape were observed between patients with vitamin D deficiency and insufficiency, with respect to torso width in the frontal and sagittal planes. We found an inverse correlation between vitamin D and Cobb angle, but only in premenarchal patients (n=7, r=-0.92).

  Conclusion: Our results do not support mass screening for vitamin D in AIS patients. The differences in torso shape were more related to lower robustness in patients with deficiency than with the characteristic asymmetric phenotype (rotation-hump or lateral deviation). The correlation found between vitamin D and Cobb angle in premenarchal patients warrants further studies with a larger sample.

  Acknowledgments: We want to thank all patients and their families for their enthusiasm and predisposition to participate in the study. Also, we want to express our professional and personal gratitude to Dr. Joan Bagó, Dr. Paco Pérez-Grueso and Dr. Enrique Izquierdo for the initial discussion that was the starting line for this project.

   

  Funding: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Research was funded by grant number PID2020-115854GB-I00 to Markus Bastir, José María González Ruiz, and Carlos A. Palancar, by MCIN/AEI/10.13039/501100011033 of the Spanish Ministry of Science and Innovation and the European Union. Funding source did not have involvement in the design, the research or the writing of this original article

• Keywords
• Adolescent Idiopathic Scoliosis; Vitamin D; Surface Topography
• Modality
• Comunicação oral
• Subject Area
• Instrumentos de avaliação