{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:54:17Z","timestamp":1792439657508,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072518"],"award-info":[{"award-number":["82072518"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Low bone mineral density is the major prognostic factor for adolescent idiopathic scoliosis (AIS), but the underlying mechanisms remain unclear. Accumulating evidence suggests that gut microbiota (GM) have the potential to affect bone development, and the GM signatures are altered in AIS patients. However, the effect of GM alterations on aberrant bone homeostasis in AIS remains unclear. This study aims to investigate the GM profile in AIS patients with different bone mineral density (BMD) and explore the association between GM, osteopenia, and aberrant bone turnover.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 126 patients with AIS who received surgical treatment were retrospectively included in this study. We analyzed the composition of the GM by 16S rRNA sequencing and BMD by dual X\u2010ray absorptiometry. Based on the BMD of the femur neck, the patients were divided into the osteopenia group (OPN) if the Z score\u2009&lt;\u2009\u22121, and the normal (NOR) group if the Z score\u2009\u2265\u2009\u22121 SD compared to the healthy control. For the 16S rRNA sequencing, the raw reads were filtered to remove low\u2010quality reads, and operational taxonomic units were identified with the Uparse program. Weighted UniFrac distance matrix for the beta\u2010diversity metrics and principal coordinate analysis (PCoA) was performed, and the statistical comparisons were made with permutational multivariate analysis of variance (PERMANOVA) and analysis of similarity (ANONISM). Linear discriminant analysis effect size (LEfSe) was used to identify the enriched species in two groups. The \u201cRandom forest\u201d was applied to determine the optimal biomarker for OPN according to the mean decrease in Gini value. The metabolic function was predicted by the Tax4Fun analysis. The Pearson correlation coefficient was used to evaluate the associations between GM species, bone turnover markers, and BMD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The serum \u03b2\u2010CTX was increased in the OPN group (n\u2009=\u200967) compared to the NOR group (n\u2009=\u200959). Patients in OPN groups showed significantly decreased \u03b1 diversity indicated by the Shannon index. Principal coordinate analysis (PCoA) analysis showed significant clustering of GM between OPN and NOR groups. At genus level, the <jats:italic>Escherichia\u2010Shigella<\/jats:italic> and <jats:italic>Faecalibacterium<\/jats:italic> were significantly enriched in the OPN group compared to that in the NOR group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), whereas the abundance of <jats:italic>Prevotella<\/jats:italic> was significantly decreased (<jats:italic>p<\/jats:italic>\u2009=\u20090.0012). The relative abundance of <jats:italic>Megamonas and Prevotella<\/jats:italic> was positively correlated with the femur BMD. The abundance of <jats:italic>Escherichia\u2010Shigella<\/jats:italic> was negatively correlated with femur BMD and positively correlated with serum <jats:italic>\u03b2<\/jats:italic>\u2010CTX levels. Functional analysis revealed significant differences in starch and sucrose metabolism, pyruvate and cysteine, and methionine metabolism between NOR and OPN groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The alterations of GM in AIS patients are correlated with osteopenia. The association between enriched species, BMD, and bone turnover markers provides novel diagnostic and therapeutic targets for the clinical management of AIS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14019","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T05:41:24Z","timestamp":1708666884000},"page":"965-975","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Gut Microbiota Alterations in Adolescent Idiopathic Scoliosis Are Associated with Aberrant Bone Homeostasis"],"prefix":"10.1111","volume":"16","author":[{"given":"Jie","family":"Li","sequence":"first","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjie","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Ling","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University  Nanjing 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