Association between vitamin D deficiency and adolescent idiopathic scoliosis.

Abstract

Adolescent idiopathic scoliosis (AIS), characterized by an abnormal curvature of the spine, is a prevalent condition among adolescents with a multifactorial etiology involving genetic, hormonal, and environmental influences. Recent studies have proposed the potential involvement of vitamin D in scoliosis pathogenesis; this study aimed to explore that possible association. A case-control analysis was conducted involving 177 adolescents aged 10-18 years, comprising 73 patients diagnosed with AIS and 104 controls. Anthropometric data (age, gender, height, weight, BMI, and Cobb angle) and biochemical markers [25-hydroxyvitamin D, calcium, phosphorus, parathyroid hormone (PTH), blood urea nitrogen, creatinine, and alkaline phosphatase] were collected and compared. While the mean serum vitamin D level was lower in AIS cases (26.4 ng/ml) than in controls (28.8 ng/ml), this difference did not reach statistical significance ( P  = 0.096). However, categorical analysis revealed a significantly higher proportion of vitamin D deficiency among AIS cases (21.9%) than among controls (10.6%), with an unadjusted odds ratio of 2.37 (95% confidence interval: 1.03-5.47; P  = 0.043). This association lost statistical significance after adjustment for confounders, including gender, BMI, and PTH levels, in a multivariate logistic regression model. These findings suggest that vitamin D deficiency alone may not be a direct causative factor in AIS. The results also underscore the importance of accounting for confounding factors such as hormonal markers, body composition, and gender. Further research, especially in diverse populations, is needed to clarify the role of vitamin D in the pathogenesis and clinical management of AIS.

Level of evidence: Level III.