Low oxygen content as a potential risk factor for scoliosis
A school-based cross-sectional study
Bibliographic Data
Background Scoliosis is a complex three-dimensional spinal deformity. While its clinical and imaging features are well established, the exact etiology and pathogenesis remain unclear. Previous studies have identified altitude as a significant environmental factor associated with scoliosis development. High-altitude regions are characterized by lower oxygen levels, raising the question of whether hypoxia contributes to the higher prevalence of scoliosis observed in these areas. Methods This cross-sectional study used school-based scoliosis screening data. Individuals with an angle of trunk rotation (ATR) ≥ 5° were recorded as positive cases. Demographic information and regional environmental data were collected. Statistical analyses were conducted to identify risk factors associated with scoliosis. Results The positive screening rate was 1.9%. Females and adolescents aged 10–18 years had significantly higher positivity rates than males and younger children (both p < 0.001). Han students showed slightly lower positivity compared with Bai and other minority groups ( p = 0.001). Participants living above 2000 m and those in regions with oxygen content <235 g/m 3 demonstrated higher positivity rates (both p < 0.001). Across all demographic subgroups, positivity increased with higher altitude and lower oxygen content. Further LASSO regression analysis showed that higher altitude and oxygen density below 235 g/m3 were positively associated with positive screening results, suggesting that individuals living in high-altitude, low-oxygen environments were more likely to screen positive(Coefficient=0.3527). In contrast, age 6–10 years was strongly negatively associated with positive screening results, indicating a relatively lower risk compared with other age groups(Coefficient = −1.3370). Correlation analysis further confirmed a significant negative association between environmental oxygen concentration and scoliosis detection rate (r = −0.784, P < 0.001). Conclusion Lower ambient oxygen content is associated with higher scoliosis screening positivity
Correlation · Etiology · Oxygen · Risk factor · Scoliosis · Trunk · High Altitude and Hypoxia · Hip disorders and treatments · Scoliosis diagnosis and treatment
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