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Study design: A systematic review and meta-analysis.
Objective: The objective of this meta-analysis was to evaluate the association between calciumphosphorus 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 ¼ 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 ¼ 5.97, 95% CI (7.61, 4.34)]. The AIS group had a lower calcium level [SMD¼ 0.77, 95% CI (1.51, 0.02)] and calcitonin level compared to control group. There was no statistical difference in phosphorus level [SMD¼0.5, 95% CI (0.46, 0.57)] and parathyroid hormone level [SMD ¼ 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