| Summary: | <i>Background:</i> The prevalence of scoliosis in Korean elementary school students is increasing, leading to various physical and psychological problems. This study aimed to investigate the association between low body weight and scoliosis among Korean elementary school students. <i>Methods:</i> This was a cross-sectional analysis. Participants were 1062 elementary school students in the metropolitan areas of Korea. Participants were evaluated for scoliosis based on body composition, including weight and height, and with spine structure analysis equipment. Scoliosis diagnosis was defined as having a Cobb’s angle greater than 10°. <i>Results:</i> Participants were divided into Normal Weight (NW), Underweight (UW), and Severely Underweight (SUW) groups. Results show that the UW and SUW groups had significantly higher risks of developing scoliosis (odds ratio (OR): 1.43, 95% CI (confidence interval): 1.07⁻1.90; OR: 1.45, 95% CI: 1.02⁻2.05) compared to the NW group; after controlling for age and gender, the OR were 1.44 (95% CI: 1.08⁻1.92) and 1.46 (95% CI: 1.01⁻2.09), respectively. <i>Conclusions:</i> Low weight and the risk of developing scoliosis are very closely associated. Maintenance of appropriate and normal weight in Korean elementary school students appears to be a very effective method for preventing and reducing the risk of scoliosis.
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