A cross-sectional study on prevalence of scoliosis among primary and middle school students in Jiaxing City
JIA Juanjuan1, LIN Yun1, ZHU Guoying1, HONG Xia1, SUN Yangming1, HE Haitao2, CHEN Liyan3, LI Yun4
1. Department of School Health, Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang 314050, China; 2. Xiuzhou Center for Disease Control and Prevention, Jiaxing, Zhejiang 314000, China; 3. Jiashan Center for Disease Control and Prevention, Jiaxing, Zhejiang 314100, China; 4. Pinghu Center for Disease Control and Prevention, Jiaxing, Zhejiang 314200, China
Abstract:Objective To investigate the prevalence of scoliosis among primary and middle school students in Jiaxing City, Zhejiang Province, so as to provide insights into scoliosis control among children and adolescents. Methods Grade 4 to 6 primary school students and grade 1 to 3 junior high school students were recruited using a stratified cluster sampling method in Jiaxing City in 2019. Participants' demographic characteristics, dietary habits and nutritional status, physical activity, learning environments, reading and writing habits were collected using questionnaires. Scoliosis was screened through general examinations, forward bend test and scoliometer, and scoliosis was diagnosed with whole-spine X-ray scans in an erect position. The prevalence of scoliosis was descriptively analyzed among primary and middle school students. Results A total of 8 026 primary and middle school students were included, 7 304 valid questionnaires were recovered, with an effective recovery rate of 91.00%. The respondents included 3 667 primary school students (50.21%) and 3 637 junior high school students (49.79%), and included 3 776 boys (51.70%) and 3 528 girls (48.30%). There were 659 participants with initial screening positive for scoliosis (9.02%), and the percentages of positive initial screening of thoracic, thoracolumbar and lumbar scoliosis were 2.93%, 4.56% and 4.56%, respectively. A higher percentage of positive initial screening of scoliosis was diagnosed among participants living in Pinghu City (10.45%), junior high school students (11.74%), girls (11.96%), students with a medical history of anemia (22.44%), students with less than 3 days of moderate-intensity physical activity in the past week (9.46%), students with less than 3 days of walking duration of over 10 minutes in the past week (10.18%), students with daily sitting duration of 5 hours and more in the past week (10.74%), students with their class seats exchanged every semester or month (10.28%), students with daily reading and writing duration of 3 hours and more after school (10.93%) and students with less than 10 cm distance from the chest at reading or writing to the edge of the table (9.67%) (all P<0.05). A total of 218 students received whole-spine X-ray scans in an erect position, 132 participants were definitively diagnosed as scoliosis (60.55%), and the estimated prevalence of scoliosis was 5.46%. Conclusion The percentage of positive initial screening of scoliosis was 9.02% among primary and middle school students in Jiaxing City. Gender, stage of learning, nutritional status, exercise frequency and habits of reading and writing may be factors affecting the development of scoliosis.
贾娟娟, 林云, 朱国英, 洪霞, 孙炀明, 何海涛, 陈丽艳, 李赟. 嘉兴市中小学生脊柱侧弯调查[J]. 预防医学, 2022, 34(8): 782-787.
JIA Juanjuan, LIN Yun, ZHU Guoying, HONG Xia, SUN Yangming, HE Haitao, CHEN Liyan, LI Yun. A cross-sectional study on prevalence of scoliosis among primary and middle school students in Jiaxing City. Preventive Medicine, 2022, 34(8): 782-787.
[1] 张银昌,沙士甫,姜恩泽,等.青少年Chiari畸形伴脊柱侧弯与特发性脊柱侧弯患者肺功能损害的特征[J].中华医学杂志,2018,98(6):418-421. ZHANG Y C,SHA S F,JIANG E Z,et al.Comparison of the pulmonary function between adolescent patients with Chiari malformation associated scoliosis and idiopathic scoliosis[J].Natl Med J China,2018,98(6):418-421. [2] 张丽芳,邓淑珍,刘春艳,等.云南某高中特发性脊柱侧弯疑似症状检出现状及影响因素分析[J].中国校医,2021,35(9):654-656,670. ZHANG L F,DENG S Z,LIU C Y,et al.Detection status and influencing factors of suspected symptoms of idio-pathic scoliosis in students in a senior high school in Yunnan Province[J].Chin J Sch Doct,2021,35(9):654-656,670. [3] 吴春丽,李东方,张晓辉.郑州市儿童青少年脊柱侧弯现状及影响因素[J].华南预防医学,2021,47(5):673-675. WU C L,LI D F,ZHANG X H.Status and influencing factors of scoliosis in children and adolescents in Zhengzhou[J].South China J Prev Med,2021,47(5):673-675. [4] CAI Z,WU R,ZHENG S,et al.Morphology and epidemiological study of idiopathic scoliosis among primary school students in Chaozhou,China[J/OL].Environ Health Prev,2021,26(1)[2022-05-31].https://doi.org/10.1186/s12199-021-00989-3. [5] 耿贯一.流行病学(第一卷)[M].北京:人民卫生出版社,1995:161-169. GENG G Y.Epidemiology(Volume One)[M].Beijing:People's Medical Publishing House,1995:161-169. [6] 中华人民共和国国家卫生和计划生育委员会,国家标准化管理委员会.儿童青少年脊柱弯曲异常的筛查:GB/T 16133—2014[S].2014. National Health and Family Planning Commission of the People's Republic of China,Standardization Administration of the People's Republic of China.Screening of spinal curvature abnormality of children and adolescents:GB/T 16133-2014[S].2014. [7] 中华人民共和国国家卫生和计划生育委员会.学龄儿童青少年营养不良筛查:WS/T 456—2014[S].2014. National Health and Family Planning Commission of the People's Republic of China.Screening standard for malnutrition of school-age children and adolescents:WS/T 456-2014[S].2014. [8] 龙凤,魏海亮,梁宇霆,等.2015年海淀区青少年脊柱侧弯发生率及其危险因素分析[J].中国公共卫生,2020,36(10):1496-1498. LONG F,WEI H L,LIANG Y T,et al.Prevalence and risk factors of scoliosis among senior high school graduates in Haidian district of Beijing,2015[J].Chin J Public Health,2020,36(10):1496-1498. [9] 施冬冬,陈前芬.青少年特发性脊柱侧凸病因学的研究进展[J].中国学校卫生,2021,42(2):316-320. SHI D D,CHEN Q F.Current insights into the aetiology of adolescent idiopathic scoliosis[J]. Chin J Sch Health,2021,42(2):316-320. [10] ZHENG S H,ZHOU H,GAO B,et al.Estrogen promotes the onset and development of idiopathic scoliosis via disproportionate endochondral ossification of the anterior and posterior column in a bipedal rat model[J/OL].Exp Mol Med,2018,50(11)[2022-05-31].https://doi.org/10.1038/s12276-018-0161-7. [11] 季成叶. 儿童青少年卫生学[M].7版.北京:人民卫生出版社,2012:149. JI C Y.Child and adolescent hygiene[M].7th.Beijing:People's Medical Publishing House,2012:149. [12] HAIDAR R,MHAIDLI H,MUSALLAM K M,et al.The spine in β-thalassemia syndromes[J].Spine,2012,37(4):334-339. [13] UNAL S,GUMRUK F.Fanconi anemia patient with bilaterally hypoplastic scapula and unilateral winging associated with scoliosis and rib abnormality[J].J Pediatr Hematol Oncol,2006,28(9):616-617. [14] JEON K,KIM D I.The association between low body weight and scoliosis among korean elementary school students[J/OL].Int J Environ Res Public Health,2018,15(12)[2022-05-31].https://doi.org/10.3390/ijerph15122613. [15] CLARK E M,TAYLOR H J,HARDING I,et al.Association between components of body composition and scoliosis:a prospective cohort study reporting differences identifiable before the onset of scoliosis[J].J Bone Miner Res,2014,29(8):1729-1736. [16] TAM E M,LIU Z,LAM T P,et al.Lower muscle mass and body fat in adolescent idiopathic scoliosis are associated with abnormal leptin bioavailability[J].Spine,41(11):940-946. [17] 海波,沈蕙,刘萌萌,等.苏州市中小学生脊柱侧弯调查[J].预防医学,2021,33(9):940-943. HAI B,SHEN H,LIU M M,et al.Investigation of postural scoliosis among primary and middle school students in Suzhou[J].Prev Med,2021,33(9):940-943. [18] DE ASSIS S J C,SANCHIS G J B,DE SOUZA C G,et al.Influence of physical activity and postural habits in schoolchildren with scoliosis[J/OL].Arch Public Health,2021,79(1)[2022-05-31].https://doi.org/10.1186/s13690-021-00584-6. [19] TOBIAS J H,FAIRBANK J,HARDING I,et al.Association between physical activity and scoliosis:a prospective cohort study[J].Int J Epidemiol,2019,48(4):1152-1160. [20] 邹艳,林云,何海涛,等.儿童青少年脊柱侧弯的影响因素研究[J].预防医学,2022,34(4):395-399. ZOU Y,LIN Y,HE H T,et al.Factors affecting scoliosis among children and adolescents[J].Prev Med,2022,34(4):395-399. [21] MINGHELLI B,OLIVEIRA R,NUNES C.Postural habits and weight of backpacks of Portuguese adolescents:are they associated with scoliosis and low back pain?[J].Work,2016,54(1):197-208.