Asssociation Between Leptin And Etiology Of Adolescent Idiopathic Scoliosis And Clinical Radiographic Evaluation Of Normal Juveniles And Adolescents

Chapter 1 A critical role of abnormal leptin bioavailability in the etiology of adolescent idiopathic scoliosisObjective To validate the differences of the level of leptin, sOB-R, adiponectin and leptin-adiponectin index between AIS patients and healthy controls with an enlarged sample size.Methods 324 AIS patients and 286 healthy adolescent volunteers were recruited in this study. Anthropometric parameters including age, body height, arm span, body weight, BMI were measured and biochemical parameters including level of leptin, sOB-R, adiponectin and leptin-adiponectin index were assayed by ELISA in both AIS group and controls. Then Cobb angle was only investigated in AIS group. The anthropometric data and level of biochemical parameters were compared between the AIS group and the controls. The correlation between the biochemical parameters and the age, body weight. height, BMI were analyzed in AIS patients and healthy volunteers, together with the relationship between the curve magnitude and biochemical parameters above. Results The AIS group was older than the controls. Meanwhile, the AIS patients had heavier body weight, taller height and higher BMI than the healthy volunteers. With the use of independent T test combined with multivariate regression analysis, the level of sOB-R was proven to be significantly higher than that in normal controls (31.6±7.5 ng/ml Vs.20.6±6.8μg/mL, P<0.001) and the level of leptin, adiponectin and lepint-adiponectin index between the two cohorts did not show significant differences. In addition. the severity of curve was not observed to correlate with the level of the assayed biochemical parameters.Conclusion This validation-aiming study could confirm the previous findings that level of soluble leptin receptor is higher in AIS patients than controls, while concentration of leptin and adiponectin remains unchanged in AIS patients. With the powerful evidence supported by such conclusion, a further study for in-depth mechanism on such leptin bioavailability in AIS patients is supposed be warranted.Chapter 2 The prevalence and distribution of thoracic and lumbar vertebral numerical variation of the juveniles and adolescents without spinal deformities in Jiangsu.Objective. To detect the prevalence and distribution of thoracic and lumbar vertebral numerical variation in the juveniles and adolescents without spinal deformities in Jiangsu and thus to increase awareness of vertebral numerical variation among the spine surgeons.Methods. A retrospective review of radiographs of 358 juveniles and adolescents without spinal deformities aged between 3 and 18 in Jiangsu was performed. The study included 176 males and 182 females with standing full-spine radiography was reviewed to assess the number of thoracic and lumbar vertebrae. The prevalence and the distribution of the variation were recorded.Results.9.2% of the subjects (thirty-three) had an atypical number of vertebrae in the thoracic and/or lumbar spine. Nineteen subjects (5.3%) had an atypical number of thoracic vertebrae, with eighteen having eleven thoracic vertebrae and only subject having thirteen. Eighteen subjects (5.0%) had an atypical number of lumbar vertebrae, with one having four lumbar vertebrae and seventeen having six. Multilevel vertebral anomalies were present in 1.1% of the subjects (four of 358). The prevalence of variation of 11 thoracic vertebrae and 6 lumbar vertebrae were higher than the 13 thoracic vertebrae and 4 lumbar vertebrae respectively (P< 0.05).Conclusions. The variation of the number of thoracic or lumbar vertebrae was found in 9.2% juveniles and adolescents without spinal deformities, following a higher possibility of variable 11 thoracic or 6 lumbar vertebrae in Jiangsu.