Relationship between bone density and bone metabolism in adolescent idiopathic scoliosis
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RESEARCH
Open Access
Relationship between bone density and bone metabolism in adolescent idiopathic scoliosis Ko Ishida1*, Yoichi Aota2, Naoto Mitsugi1, Motonori Kono2, Takayuki Higashi3, Takuya Kawai2, Katsutaka Yamada3, Takanori Niimura2, Kanichiro Kaneko3, Hironori Tanabe3, Yohei Ito1, Tomoyuki Katsuhata1 and Tomoyuki Saito3
Abstract Several authors have confirmed that 27 to 38% of AIS patients had osteopenia. But few studies have assessed bone metabolism in AIS. This study assessed bone mineral density and bone metabolism in AIS patients using the bone metabolism markers, BAP and TRAP5b. The subjects were 49 consecutive adolescent AIS patients seen at our institutes between March 2012 and September 2013. Sixty-five percent of AIS patients had osteopenia or osteoporosis and 59% of AIS patients had high values for TRAP5b. The AIS patients with high values of TRAP5b had lower Z scores than those with normal values of TRAP5b. Higher rates of bone resorption are associated with low bone density in AIS patients. The features of adolescent idiopathic scoliosis (AIS) have been researched. Since first reported by Burner et al. in 1982 [1], several authors have confirmed that 27 to 38% of AIS patients had osteopenia [2-6]. Furthermore osteopenia or osteoporosis had been reported to be one of causes of scoliosis curvature aggravation [6]. But few studies have assessed bone metabolism in AIS. Cheung et al. reported that the serum concentration of bone alkaline phosphatase (BAP, bone formation marker) in AIS patients was higher than that of controls, while urinary concentrations of deoxypyridinoline (bone resorption marker) in patients with AIS were lower [7]. Urinary deoxypyridinoline has been found to be more affected by renal function, fasting, and hourly variations than tartrate-resistant acid phosphatase serum band 5 (TRAP5b) [8]. The aim of this study was to clarify the bone metabolism in AIS and the relationship between bone metabolism and bone density in AIS. This study characterizes bone metabolism in AIS patients by assessing serum levels of TRAP5b.
September 2013. Inclusion criteria for this study were those patients: (i) ages were from ten to twenty years old; (ii) females; and (iii) no scoliosis operation. The average age at the time of bone density measurement was 15.2 ± 2.0 years-old (range: 10–19). Eighteen subjects were evaluated before treatment, 31 had been treated by brace. The number of subjects scored using the Risser sign as a parameter of bone growth were Grade 0: 1, Grade 1: 4, Grade 2: 1, Grade 3: 6, Grade 4: 24, and Grade 5: 13. The average age of menarche was 12.3 ± 1.1 years-old and two subjects had not had menarche yet. Height and weight measured on the date closest to the bone density test and calculated BMI were used in the analysis. The degree of scoliosis was evaluated as the Cobb angle of major curvature from long antero-posterior standing radiographs. The mean ± SD of the Cobb angle was 39 ± 13 degrees. Using the Lenke classification, 29 cases were type1, 3 cases were type2, 1 case wa
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