Association between calcium-phosphorus balance and adolescent idiopathic scoliosis: A meta-analysis

STUDY DESIGN: A systematic review and meta-analysis. OBJECTIVE: The objective of this meta-analysis was to evaluate the association between calcium-phosphorus balance and adolescent idiopathic scoliosis (AIS). METHODS: Databases, including PubMed, OVID database, Web of Science, CBM database and CNKI database were searched for the relevant case control studies and cross-sectional studies. Two authors selected studies and extracted data independently. Data analysis was performed by Review Manager Software 5.0. Subgroup analysis was performed on the serum level of vitamin D according to gender and menstruation. RESULTS: Five studies were included, with a total of 646 cases of AIS and 791 controls. AIS group had a lower serum level of vitamin D compared to control group [MD = -6.74, 95% CI (-9.47, -4.00)]. Gender and menstruation condition were thought to have no effect on the primary outcome of vitamin D level by subgroup analysis [MD = -5.97, 95% CI (7.61, -4.34)]. The AIS group had a lower calcium level [SMD= -0.77, 95% CI (-1.51, -0.02)] and calcitonin level compared to control group. There was no statistical difference in phosphorus level [SMD=0.5, 95% CI (-0.46, 0.57)] and parathyroid hormone level [SMD = -0.11, 95% CI (-0.54, -0.31)]. Meanwhile, the observational indexes, including serum levels of calcium, phosphorus, parathyroid hormone and calcitonin were within normal limits. CONCLUSION: Vitamin D deficiency may be involved in the pathogenesis of AIS by influencing the regulation of calcium-phosphors metabolism on human bone. Therefore, we suggest to screen vitamin D level in AIS patients. LEVEL OF EVIDENCE: Level III, Therapeutic Study.