Subject characteristics
A total of 45547 students aged 6-17 were investigated and screened with scoliosis, including 23706 males and 21841 females. The overall prevalence of scoliosis screening positive among students were 3.9%. The prevalence of low weight, overweight and obesity among the participants were 6.6%, 14.3% and 12.4%, respectively.
Prevalence by age and living area
Urban areas can include town and cities while rural areas include villages. The prevalence of scoliosis screening positive among children and adolescents in urban area was 4.1%, which was higher than that in rural area(p<0.05)(Table1). Especially, the difference existed among children and adolescents aged 7,11,15,16 and 17years old(p <0.05).
In urban area, the prevalence of scoliosis screening positive was 6.8% among children and adolescents aged 17, while in rural area, the prevalence was 5.4% among children and adolescents aged 12, both higher than that of other ages, respectively(p <0.05) (Figure 1).
Prevalence by age and gender
The prevalence of scoliosis screening positive among female children and adolescents was 4.1%, which was higher than that of males(p <0.05)(Table 2). Especially, the difference existed among children and adolescents aged 8,10,11 and 16 years old(p <0.05).
The prevalence of scoliosis screening positive increased with age both in males and females(p <0.05)(Figure 2). When we divided age into two groups (6-10 years old & 11-17 years old), we found that the prevalence of scoliosis screening positive of students aged 11-17 were higher than that aged 6-10(c2=305.261, p <0.001).
Prevalence by age and nutritional status
We classified the nutritional status as low weight, eutrophic, overweight, obese. According to “Screening for overweight and obesity among school-age children and adolescents”, we judged overweight and obesity. According to “Screening standard for malnutrition of school-age children and adolescents”, we judged low weight. The prevalence of scoliosis screening positive among children and adolescents with low weight was 5.3%, which was higher than that without low weight(p <0.05)(Table 3). Especially, the difference existed among children and adolescents aged 9,10,11,12,13,14,15,16 and 17 years old(p <0.05).
The prevalence of scoliosis screening positive was 12.8% among children and adolescents aged 13 with low weight, while that was 4.0% among children and adolescents aged 14 with obesity, both higher than that of other ages, respectively (Figure 3) (p <0.05).
Influencing factors for the prevalence
In multi factor regression analysis, we found age (OR=1.145, 95%CI: 1.128,1.162), gender (OR=1.118, 95%CI:1.016, 1.230) and low weight (OR=1.480, 95%CI:1.250, 1.751) were the influencing factors for prevalence of scoliosis screening positive (p < 0.05) (Table4) .
Table 1
The prevalence of scoliosis screening positive among students stratified by living area
Age
|
|
Urban area
|
|
|
Rural area
|
|
Chi square
|
p
|
N
|
Scoliosis screening positive
|
Positive rate
|
N
|
Scoliosis screening positive
|
Positive rate
|
6
|
1672
|
16
|
1.0%
|
1669
|
24
|
1.4%
|
1.634
|
>0.05
|
7
|
1911
|
16
|
0.8%
|
1934
|
55
|
2.8%
|
21.354
|
<0.001
|
8
|
1948
|
29
|
1.5%
|
1867
|
42
|
2.2%
|
3.022
|
>0.05
|
9
|
1842
|
36
|
2.0%
|
1808
|
53
|
2.9%
|
3.661
|
>0.05
|
10
|
1984
|
41
|
2.1%
|
2036
|
58
|
2.8%
|
2.559
|
>0.05
|
11
|
1930
|
50
|
2.6%
|
1999
|
85
|
4.3%
|
8.17
|
<0.01
|
12
|
1901
|
85
|
4.5%
|
1950
|
106
|
5.4%
|
1.9
|
>0.05
|
13
|
1906
|
122
|
6.4%
|
1998
|
100
|
5.0%
|
3.544
|
>0.05
|
14
|
1992
|
116
|
5.8%
|
1996
|
103
|
5.2%
|
0.844
|
>0.05
|
15
|
2734
|
167
|
6.1%
|
1171
|
51
|
4.4%
|
4.78
|
<0.05
|
16
|
2785
|
168
|
6.0%
|
905
|
24
|
2.7%
|
15.824
|
<0.001
|
17
|
2712
|
184
|
6.8%
|
897
|
35
|
3.9%
|
9.828
|
<0.01
|
Total
|
25317
|
1030
|
4.1%
|
20230
|
736
|
3.6%
|
9.394
|
<0.01
|
Table 2
The prevalence of scoliosis screening positive among students stratified by gender
Age
|
|
Male
|
|
|
Female
|
|
Chi square
|
p
|
N
|
Scoliosis screening positive
|
Positive rate
|
N
|
Scoliosis screening positive
|
Positive rate
|
6
|
1718
|
22
|
1.3%
|
1648
|
18
|
1.1%
|
0.208
|
>0.05
|
7
|
2020
|
39
|
1.9%
|
1825
|
32
|
1.8%
|
0.166
|
>0.05
|
8
|
2019
|
27
|
1.3%
|
1796
|
44
|
2.4%
|
6.442
|
<0.05
|
9
|
1951
|
45
|
2.3%
|
1674
|
44
|
2.6%
|
0.306
|
>0.05
|
10
|
2071
|
34
|
1.6%
|
1949
|
65
|
3.3%
|
11.986
|
<0.01
|
11
|
2051
|
48
|
2.3%
|
1878
|
87
|
4.6%
|
15.525
|
<0.001
|
12
|
1957
|
94
|
4.8%
|
1894
|
97
|
5.1%
|
0.207
|
>0.05
|
13
|
2027
|
127
|
6.3%
|
1877
|
95
|
5.1%
|
2.635
|
>0.05
|
14
|
2005
|
99
|
4.9%
|
1983
|
120
|
6.1%
|
0.383
|
>0.05
|
15
|
2050
|
106
|
5.2%
|
1855
|
112
|
6.0%
|
1.389
|
>0.05
|
16
|
1932
|
114
|
5.9%
|
1758
|
78
|
4.4%
|
3.998
|
<0.05
|
17
|
1905
|
121
|
6.4%
|
1704
|
98
|
5.8%
|
0.569
|
>0.05
|
Total
|
23706
|
876
|
3.7%
|
21841
|
890
|
4.1%
|
5.38
|
<0.05
|
Table 3
The prevalence of scoliosis screening positive among students stratified by nutritional status
|
|
Low weight
|
|
|
Eutrophic
|
|
|
Overweight
|
|
|
Obesity
|
|
Chi square
|
p
|
|
N
|
Scoliosis screening positive
|
Positive rate
|
N
|
Scoliosis screening positive
|
Positive rate
|
N
|
Scoliosis screening positive
|
Positive rate
|
N
|
Scoliosis screening positive
|
Positive rate
|
6
|
192
|
2
|
1.0%
|
2161
|
27
|
1.2%
|
476
|
8
|
1.7%
|
512
|
3
|
0.6%
|
2.918
|
>0.05
|
7
|
327
|
2
|
0.6%
|
2480
|
53
|
2.1%
|
529
|
9
|
1.7%
|
509
|
7
|
1.4%
|
4.592
|
>0.05
|
8
|
354
|
6
|
1.7%
|
2480
|
54
|
2.2%
|
450
|
7
|
1.6%
|
531
|
4
|
0.8%
|
6.183
|
>0.05
|
9
|
252
|
13
|
5.2%
|
2333
|
55
|
2.4%
|
503
|
9
|
1.8%
|
562
|
12
|
2.1%
|
9.011
|
<0.05
|
10
|
242
|
6
|
2.5%
|
2589
|
75
|
2.9%
|
446
|
10
|
2.2%
|
743
|
8
|
1.1%
|
8.064
|
<0.05
|
11
|
253
|
11
|
4.3%
|
2480
|
96
|
3.9%
|
655
|
20
|
3.1%
|
541
|
8
|
1.5%
|
8.583
|
<0.05
|
12
|
226
|
16
|
7.1%
|
2567
|
139
|
5.4%
|
585
|
24
|
4.1%
|
473
|
12
|
2.5%
|
11.085
|
<0.05
|
13
|
195
|
25
|
12.8%
|
2634
|
159
|
6.0%
|
624
|
24
|
3.8%
|
451
|
14
|
3.1%
|
28.654
|
<0.001
|
14
|
211
|
19
|
9.0%
|
2746
|
162
|
5.9%
|
606
|
21
|
3.5%
|
425
|
17
|
4.0%
|
12.514
|
<0.01
|
15
|
228
|
11
|
4.8%
|
2730
|
176
|
6.4%
|
594
|
21
|
3.5%
|
353
|
10
|
2.8%
|
13.904
|
<0.01
|
16
|
241
|
22
|
9.1%
|
2600
|
137
|
5.3%
|
542
|
25
|
4.6%
|
307
|
8
|
2.6%
|
12.134
|
<0.01
|
17
|
277
|
26
|
9.4%
|
2561
|
157
|
6.1%
|
490
|
30
|
6.1%
|
281
|
6
|
2.1%
|
12.996
|
<0.01
|
Total
|
2998
|
159
|
5.3%
|
30361
|
1290
|
4.2%
|
6500
|
208
|
3.2%
|
5688
|
109
|
1.9%
|
7.739
|
<0.05
|
Table 4
Logistic analysis of influencing factors for prevalence of scoliosis screening positive among students
Variables
|
Wald
|
p
|
OR
|
95% C.I.for EXP(B)
|
Lower
|
Upper
|
Age
|
306.651
|
<0.001
|
1.145
|
1.128
|
1.162
|
Gender (Male/Female)
|
5.203
|
<0.05
|
1.118
|
1.016
|
1.230
|
Living area (Urban area/Rural area)
|
0.606
|
>0.05
|
1.040
|
0.942
|
1.148
|
Low weight (Yes/No)
|
20.784
|
<0.001
|
1.480
|
1.250
|
1.751
|