Screening Scoliosis In ShenZhen Schools And Gene Expression Profile Of Adolescent Idiopathic Scoliosis

Adolescent Idiopathic Scoliosis(AIS) is a vertebral deformity and usually onsets at prepuberty. Screening on incidence rate of AIS was 1.04% in Beijing in 1989, 1.33% in Sian in 2004 and 4% in Hongkong in 2004 respectively. Behind abnormal vision,obesity, phimosis and social retardation, AIS is the 5th common diseases. AIS was studied extensively in all over worlds in latest decades and huge mounts of papers involving pathogenesis, clinic, surgery, etiology and so on was published. However, it semms that breakthrough research has not reached yet.The aim of the present studies was to set screening approach for AIS, to screen spinal deformity in primary and middle schools in Shenzhen, to detect primarily hormones levels and to study gene expression peripheral blood leucocyte in AIS with different severity.One examiner independently assessed 56 patients presenting to a scoliosis clinic for trunk asymmetry with Adam's forward bend test and axial trunk rotation with the Scoliometer. The forward bend test, Scoliometer and Cobb's angle were scaled as negative, positive and significantly positive respectively. For the Scoliometer, less than 5 degree is negative, 5 to 7 is positive and more than 7 is most positive. For forward bend test, if no asymmetry was found, the test was negative; if the asymmetry was significant, the test was most positive; if the asymmetry was found, the test is positive. For Cobb's angle, the negative was less than 10 degree, positive was 10 to 20 degree, significant positive was more than 20 degree. The Cobb method was taken as the gold standard. The accuracy of Adam's forward bend test and Scoliometer were tested by Cobb's angle. Scoliometer and Cobb's angle were compared for their efficiency.Adams bending test and Scoliometer were used to screen vertebral malformation. Examiners were trained to match the same standard sceen methods by forward bending test and scoliometers. The students with suspicious malformation were informed to go to Shenzhen children hospital for further professional assessment at outpatient clinics. Serum level of estradiol(E2), growth hormone(GH) and DHS (dehydroepiandrosterone sulfate) were detected in female AIS By solid phase,compet chemoluminescence enzyme immunodetection (IMMULITE analysator).Gene chip was used to test their gene expression of peripheral blood leucocyte.By Adams bending test and Scoliometer were used to perform survey, 40579 students in 29 schools in FuTian District were screened in 2004 Eight hundreds and fifty on students were screened with suspicious spinal malformation. The incedence rate of suspicious spinal deformity in current study was 2.136%. One thousand six hundrens and seventy five middle school students were screened and 47 suspicious spinal malformation was found (2.806%) . Fifteen thousands and two hundrens and twenty two unior high school students were screened and 329 suspicious spinal malformation was found (2.1613%) . Twenty three thousands six hundrens and eighty two lementary school students were screened and 475 suspicious spinal malformation was found (2.006%) . Forward bending test and scoliometer were compared with Cobb's angle. It show that Adams bending test and Scoliometer were simple and effective approach for vertebral malformation screen. Normal control group and female AIS were test for serum hormone level. Serum hormone level is normal in control group. Serum GH was higher in 4 adolescents and DHS was lower (<50μg/dl) in 4 AIS. E2 was under normal limit in 1 normal control and 1 AIS. Gene expression by gene chip show 42 gene in 17 chromosome were found to be associate with severity of AIS.Vertebral deformity is a common abnormity in callan. Adams bending test and scoliometer is simple and shortcut approach for school spine screening. It is effective and reliable in large-scale screening. Altough, serum hormones is no significant difference between two group, the premarily test showed that serum GH of AIS was higher than normal control and serum DHS is in lower limit. Gene expression in peripheral blood leucocyte show AIS is polygenetic disease. Gene expression assayed by gene chip is a method studying pathogenesis and pathologic change.