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

Abstract 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