Subclinical hyperthyroidism is linked to bone loss, hip fracture: meta-analysis

  • Xu N & al.
  • Endocrine
  • 23 mar. 2020

  • de Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A meta-analysis finds that subclinical hyperthyroidism (SH) vs no SH is associated with bone loss in women and increased hip fracture in both sexes.

Why this matters

  • More than 200 million worldwide have osteoporosis, and rates are increasing.
  • Findings suggest evaluation of bone mineral density (BMD) in patients with SH.

Study design

  • Meta-analysis of 12 cohort studies involving 275,086 participants followed for 3 months-13 years.
  • SH was defined by low or suppressed levels of thyroid-stimulating hormone with normal concentrations of free T4 and free T3.
  • Funding: Science and Technology Planning Project of Guangdong Province, China; National Natural Science Foundation of China.

Key results

  • SH vs no SH had no effect on lumbar spine BMD.
  • SH vs no SH was associated with a reduction in femoral neck BMD in females (risk difference, −0.03; P=.03), but not males.
  • SH vs no SH was associated with an increase in hip fracture in all patients (mean difference, 0.02; P=.004), and an increase in female (mean difference, 0.03; P=.008) and male subgroups (mean difference, 0.01; P<.0001>

Limitations

  • High heterogeneity across studies.
  • Studies were observational.