{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:11:48Z","timestamp":1778739108888,"version":"3.51.4"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study used school-based scoliosis screening data. Individuals with an angle of trunk rotation (ATR)\u202f\u2265\u202f5\u00b0 were recorded as positive cases. Demographic information and regional environmental data were collected. Statistical analyses were conducted to identify risk factors associated with scoliosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The positive screening rate was 1.9%. Females and adolescents aged 10\u201318\u202fyears had significantly higher positivity rates than males and younger children (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Han students showed slightly lower positivity compared with Bai and other minority groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). Participants living above 2000\u202fm and those in regions with oxygen content &amp;lt;235\u202fg\/m\n                      <jats:sup>3<\/jats:sup>\n                      demonstrated higher positivity rates (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). 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\/m\u00b3 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\u201310 years was strongly negatively associated with positive screening results, indicating a relatively lower risk compared with other age groups(Coefficient =\u202f\u22121.3370). Correlation analysis further confirmed a significant negative association between environmental oxygen concentration and scoliosis detection rate (r = \u22120.784,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower ambient oxygen content is associated with higher scoliosis screening positivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1804995","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:33:12Z","timestamp":1778736792000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Low oxygen content as a potential risk factor for scoliosis: a school-based cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Jiahao","family":"Hao","sequence":"first","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingsong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shangjia","family":"Zhe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyue","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1016\/j.spinee.2020.01.008","article-title":"Prevalence of adolescent idiopathic scoliosis in Turkey: an epidemiological study","volume":"20","author":"Y\u0131lmaz","year":"2020","journal-title":"Spine J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"171","DOI":"10.4103\/ajps.AJPS_62_21","article-title":"Epidemiological and diagnostic characteristics of scoliosis in children in a single tertiary Centre in Abidjan","volume":"19","author":"Yaokreh","year":"2022","journal-title":"Afr J Paediatr Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1265\/ehpm.22-00243","article-title":"Academic-related factors and daily lifestyle habits associated with adolescent idiopathic scoliosis: a case-control 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