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Cited by 28Thyroid Disorders and TreatmentsBone health and osteoporosis researchThyroid and Parathyroid Surgery

Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies

Zhu, Hongling, Zhang, Jichen, Wang, Jingnan, Zhao, Xuemei, Gu, Mingjun·2020·Endocrine
DOI 10.1007/s12020-019-02110-9
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Abstract

Purpose To comprehensively investigate the associations of subclinical thyroid dysfunction with BMD and fractures at various sites. Methods Comprehensive electronic and manual searches of databases were systematically conducted to identify prospective cohort studies from the inception of the databases to May 2019. The summary results for fractures and BMDs at various sites were calculated by relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) using the random-effects model. Results Seventeen prospective cohorts from 24 studies were identified and 313,557 individuals were recruited in a final analysis. The summary RR indicated that subclinical hyperthyroidism was associated with an increased risk of any fracture (RR, 1.17; 95% CI, 1.08-1.26; P Conclusion Subclinical hyperthyroidism could induce additional risk on fractures at any, hip, spine, and non-spine, whereas subclinical hypothyroidism did not have any impact on fractures. Moreover, BMD at the lower distal and ultradistal forearms might be affected by subclinical hyperthyroidism, and higher femur neck BMD could be affected by subclinical hypothyroidism.

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Crossref · 10.1007/s12020-019-02110-9

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17 of 17 references verified0 citation errors · 0 not checkable

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  • A recent meta-analysis of 17 prospective cohort studies found that subclinical hypothyroidism did not increase fracture risk but increased femoral neck bone mineral density in women, whereas subclinical hyperthyroidism increased the risk of spine and hip fractures.

    “According to a recently published meta-analysis of the associations of subclinical thyroid dysfunction with bone fractures in 17 prospective cohort studies, subclinical hypothyroidism did not increase the risk of fracture but instead showed an increase in the femoral neck (FN) BMD in women.In contrast, subclinical hyperthyroidism increased the risk of fractures in the spine and hip (14).”

    From Effect of TSH Suppression Therapy on Bone Mineral Density in Differentiated Thyroid Cancer: A Systematic Review and Meta-analysis (2021) · cites this paper as [14]

  • There is much convincing evidence that asymptomatic endogenous hyperthyroidism adversely affects bones.

    “Large-scale cohort studies and meta-analyses have reported an increased risk of osteoporosis and osteoporotic fractures, so there is much convincing evidence that asymptomatic endogenous hyperthyroidism adversely affects bones (14,39).”

    From Effect of TSH Suppression Therapy on Bone Mineral Density in Differentiated Thyroid Cancer: A Systematic Review and Meta-analysis (2021) · cites this paper as [14]

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Authors
Zhu, H., Zhang, J., Wang, J., Zhao, X., & Gu, M.
Affiliations
Second Military Medical University (CN)
Corresponding author
Gu, Mingjun
ORCID
Venue
Endocrine
Publisher
Springer Science and Business Media LLC
Published
2019-11-13
Volume
67
Issue
3
Pages
685-698
ISSN
  • 0969-711X (ISSN-L)
  • 1355-008X
  • 1559-0100
DOI
10.1007/s12020-019-02110-9
OpenAlex
W2987895006
Cited by
28
References
17
Citations by year
2026: 5 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 6
FWCI
0.65
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Endocrine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
subclinical thyroid dysfunction, subclinical hyperthyroidism, subclinical hypothyroidism, bone mineral density, fracture, hip fracture, spinal fractures, femoral neck bone mineral density, osteoporosis risk
MeSH terms
Female, Hip Fractures, Humans, Hyperthyroidism, Male, Prospective Studies, Thyroid Diseases, Bone Density

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