Does thyroid function influence fracture risk? Prospective data from the HUNT2 study, Norway
Abstract
Objective: To prospectively study the relation between TSH and risk of hip and forearm fractures. Design: A population-based cohort study. Methods: In a substudy of the second survey of the Nord Trøndelag Health Study, Norway (HUNT2, 1995–97), linked with a hospital-based fracture registry, we investigated the relation between baseline TSH and risk of hip and/or forearm fractures. Population: A total of 16 610 women and 8595 men aged 40 years or more, without previous self-reported thyroid disease and hip or forearm fractures. Results: During 12.5 years follow-up, a total of 1870 women and 342 men experienced hip or forearm fractures. Overall, there was no relation between baseline TSH and fracture risk. However, there was weak evidence that women with TSH <0.5 and >3.5 mU/l had a slightly increased risk of hip fractures (hazard ratio (HR) 1.30, 95% CI 0.97–1.94 and HR 1.19, 95% CI 0.93–1.52) compared with the reference group with TSH of 1.5–2.4 mU/l. Supplementary analyses showed higher hip fracture risk in women with TSH >4.0 mU/l and negative thyroid peroxidase antibodies (TPOAb) compared with the reference group (HR 1.75, 95% CI 1.24–2.46). Conclusion: We found no statistically significant relation between baseline TSH and subsequent fracture risk, but the data suggest a weak positive association with hip fracture risk among women with both low and high TSH. The latter association was confined to women with negative TPOAb status.
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Variation in thyroid status within the reference range in post-menopausal women is associated with altered bone mineral density and fracture risk.
“Population studies have also shown that variation in thyroid status within the reference range in post-menopausal women is associated with altered BMD and fracture risk.”
From Thyroid diseases and bone health (2018) · cites this paper as [49]
Other studies have not found increased fracture rates in SH subjects.
“Other studies have not found increased fracture rates in SH subjects (410-412).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [410]
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- Authors
- Svare, A., Nilsen, T. I. L., Åsvold, B. O., Forsmo, S., Schei, B., Bjøro, T., & Langhammer, A.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Oslo University Hospital (NO)
- Corresponding author
- Svare, Anders
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-12
- Volume
- 169
- Issue
- 6
- Pages
- 845-852
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2119065252
- Cited by
- 52
- References
- 36
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 9 · 2016: 5 · 2015: 5 · 2014: 4
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (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 › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- thyroid-stimulating hormone, fracture risk, hip fracture, forearm fractures, thyroid function, thyroid peroxidase antibodies, sex differences
- MeSH terms
- Adult, Aged, Female, Follow-Up Studies, Hip Fractures, Humans, Male, Middle Aged, Norway, Prospective Studies, Radius Fractures, Registries, Risk, Thyroid Function Tests, Thyroid Gland, Thyrotropin, Ulna Fractures, Bone Density, Incidence, Odds Ratio, Fractures, Bone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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