In addition, most AIS patients have abnormal changes in estrogen and estrogen receptors, including increased serum estrogen concentrations, abnormal cellular responses to estrogen, older menarche age, and estrogen receptor gene polymorphisms, which are closely related to the susceptibility of AIS, the severity of the curve, and the progression of scoliosis [10, 11]. This evidence concerns the gene ESR1 and androgen insensitivity syndrome.