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. 2024 Dec 6;103(49):e40916.
doi: 10.1097/MD.0000000000040916.

Causal relationship between physical activity and scoliosis: A Mendelian randomization study

Cong Wang  1 , Gang Liu, Qi Lu, Zhengmei Ning, Junfei Chen
Affiliations

Causal relationship between physical activity and scoliosis: A Mendelian randomization study

Cong Wang et al. Medicine (Baltimore). .

Abstract

Scoliosis, marked by abnormal spinal curvature, is common in adolescents and can lead to chronic pain and reduced quality of life. The relationship between physical activity and scoliosis is debated. In this study, we aim to investigate the causal relationship between physical activity levels and idiopathic scoliosis risk using the Mendelian randomization (MR) approach. Two-sample MR analyses evaluated low-intensity (low-intensity physical activity [LIPA]), moderate-to-vigorous (MVPA), and total physical activity (TLA) as exposures, selecting genetic instruments based on their associations. Total physical activity significantly associated with idiopathic scoliosis (OR = 1.72; 95% CI = 1.11-2.68; P = .015), whereas LIPA and MVPA showed no significant associations. Reverse MR found no idiopathic scoliosis impact on activity levels. Multivariable MR showed no significant activity-scoliosis links. Total physical activity emerges as an idiopathic scoliosis risk factor, warranting mechanistic exploration. LIPA and MVPA do not causally link to scoliosis. Idiopathic scoliosis does not influence activity levels.

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Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1.
Figure 1.
Schematic overview of the study design. (A) Univariate bidirectional Mendelian randomization (MR) analysis between low-intensity physical activity (LIPA), moderate-to-vigorous physical activity (MVPA), total physical activity (TLA), and scoliosis. (B) Multivariable Mendelian randomization analysis with LIPA, MVPA, and TLA as exposures and scoliosis as the outcome.
Figure 2.
Figure 2.
Scatterplot of SNP effects on exposure vs outcome in the forward Mendelian randomization analysis. (A) LIPA versus scoliosis, (B) MVPA versus scoliosis, and (C) TLA vs scoliosis. LIPA = low-intensity physical activity, MVPA = moderate-to-vigorous physical activity, SNPs = single nucleotide polymorphisms, TLA = total physical activity.
Figure 3.
Figure 3.
Scatterplot of SNP effects on exposure vs outcome in the reverse Mendelian randomization analysis. (A) scoliosis versus LIPA, (B) scoliosis versus MVPA, and (C) scoliosis versus TLA. LIPA = low-intensity physical activity, MVPA = moderate-to-vigorous physical activity, SNPs = single nucleotide polymorphisms, TLA = total physical activity.
Figure 4.
Figure 4.
Leave-one-out analysis employing the inverse variance weighted method in the forward Mendelian randomization analysis. (A) LIPA as exposure and scoliosis as outcome, (B) MVPA as exposure and scoliosis as outcome, and (C) TLA as exposure and scoliosis as outcome. LIPA = low-intensity physical activity, MVPA = moderate-to-vigorous physical activity, TLA = total physical activity.
Figure 5.
Figure 5.
Leave-one-out analysis employing the inverse variance weighted method in the reverse Mendelian randomization analysis. (A) scoliosis as exposure and LIPA as outcome, (B) scoliosis as exposure and MVPA as outcome, and (C) scoliosis as exposure and TLA as outcome. LIPA = low-intensity physical activity, MVPA = moderate-to-vigorous physical activity, TLA = total physical activity.
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