Blood Biomarker Profiles in Adolescent Idiopathic Scoliosis: A Literature Review of Pathophysiological Insights and Clinical Implications.

Zhang, Yuheng; Deng, Yaolong; Sui, Wenyuan; Zhang, Tianyuan; Yang, Junlin · Global Spine J · 2026

review · Level V

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Abstract

Study DesignLiterature review.ObjectiveTo systematically review blood biomarker profiles in adolescent idiopathic scoliosis (AIS) and evaluate their pathophysiological implications and clinical potential for diagnosis, prognosis, and therapeutic monitoring.MethodsA comprehensive literature search was conducted to identify studies examining blood-based biomarkers in AIS patients, including alterations in vitamin D, calcium, trace elements, sex hormones, leptin, melatonin, growth hormone, ghrelin, bone metabolism factors, microRNAs, proteomic and metabolomic profiles. Relevant findings were synthesized to elucidate systemic biological alterations associated with AIS.ResultsConsistent vitamin D and calcium deficiencies, hormonal dysregulation (leptin, estrogen, ghrelin), altered trace element levels (selenium), and distinct changes in bone metabolism markers (osteocalcin, P1NP, RANKL) were observed in AIS patients. Emerging evidence supports the involvement of specific microRNAs and proteomic/metabolomic profiles in AIS pathogenesis and curve progression. These blood biomarkers exhibit potential for early diagnosis, risk stratification, and individualized treatment approaches.ConclusionsBlood biomarkers offer valuable insights into the systemic pathophysiology of AIS and may serve as accessible tools for improving early detection, progression monitoring, and personalized management of AIS. Further longitudinal and multi-omics studies are warranted to validate their clinical utility.