Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies
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 databas...
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| Veröffentlicht in: | Endocrine 2020-03, Vol.67 (3), p.685-698 |
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| container_title | Endocrine |
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| creator | Zhu, Hongling Zhang, Jichen Wang, Jingnan Zhao, Xuemei Gu, Mingjun |
| description | 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
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| doi_str_mv | 10.1007/s12020-019-02110-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2314256942</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2314256942</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-e3635e89648ca3232e64a57ec522db9bfb50cb2187e19c7241e461a98b3d33563</originalsourceid><addsrcrecordid>eNp9kc1u1TAQRi1ERUvbF2CBLLHpJsU_cZywq6oClSqxaaXuLMeZ9LpK7IvHAWXPg-Pb24LEgpVtzZkzHn2EvOPsnDOmPyIXTLCK8a5ignNWda_IEVeqPEv9dblLpSrG2vtD8hbxkTEhRKPfkEPJteCsbY_IrwvE6LzNPgYaR4pL7yYfvLMTzZs1RT_QYcVxCe4J-enzhvYxAJ19gFSoAQL6vFIbBjom6_KS4BO1dIZsKxvstKLHnXqbIm6haH4AdXETU6aYl8EDnpCD0U4Ip8_nMbn7fHV7-bW6-fbl-vLipnJSq1yBbKSCtmvq1lkppICmtkqDU0IMfdePvWKuF7zVwDunRc2hbrjt2l4OUqpGHpOzvbd85fsCmM3s0cE02QBxQSMkr4VquloU9MM_6GNcUtlmR2mmGib1Tij2lCu7YYLRbJOfbVoNZ2aXkdlnZEpG5ikj05Wm98_qpZ9h-NPyEkoB5B7AUgoPkP7O_o_2N8_UngQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2370560376</pqid></control><display><type>article</type><title>Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies</title><source>SpringerNature Journals</source><creator>Zhu, Hongling ; Zhang, Jichen ; Wang, Jingnan ; Zhao, Xuemei ; Gu, Mingjun</creator><creatorcontrib>Zhu, Hongling ; Zhang, Jichen ; Wang, Jingnan ; Zhao, Xuemei ; Gu, Mingjun</creatorcontrib><description>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
< 0.001), hip fracture (RR, 1.27; 95% CI, 1.09–1.48;
P
= 0.003), spine fracture (RR, 1.97; 95% CI, 1.31–2.97;
P
= 0.001), and non-spine fracture (RR, 1.19; 95% CI, 1.04–1.37;
P
= 0.014). However, there were no significant associations of subclinical hypothyroidism with the risk of any fractures (
P
= 0.166), hip fracture (
P
= 0.068), spine fracture (
P
= 0.818), and non-spine fracture (
P
= 0.277). Finally, subclinical hyperthyroidism was associated with lower distal forearm BMD in women, and ultradistal forearm BMD in both men and women, whereas subclinical hypothyroidism was associated with higher femur neck BMD in women.
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.</description><identifier>ISSN: 1355-008X</identifier><identifier>EISSN: 1559-0100</identifier><identifier>DOI: 10.1007/s12020-019-02110-9</identifier><identifier>PMID: 31721088</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bone mineral density ; Cohort analysis ; Diabetes ; Endocrinology ; Femur ; Forearm ; Fractures ; Health risk assessment ; Hip ; Humanities and Social Sciences ; Hyperthyroidism ; Hypothyroidism ; Internal Medicine ; Medicine ; Medicine & Public Health ; Meta-analysis ; multidisciplinary ; Original Article ; Risk assessment ; Science ; Thyroid ; Thyroid diseases ; Thyroid gland ; Women</subject><ispartof>Endocrine, 2020-03, Vol.67 (3), p.685-698</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>2019© Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-e3635e89648ca3232e64a57ec522db9bfb50cb2187e19c7241e461a98b3d33563</citedby><cites>FETCH-LOGICAL-c375t-e3635e89648ca3232e64a57ec522db9bfb50cb2187e19c7241e461a98b3d33563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12020-019-02110-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12020-019-02110-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31721088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Hongling</creatorcontrib><creatorcontrib>Zhang, Jichen</creatorcontrib><creatorcontrib>Wang, Jingnan</creatorcontrib><creatorcontrib>Zhao, Xuemei</creatorcontrib><creatorcontrib>Gu, Mingjun</creatorcontrib><title>Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies</title><title>Endocrine</title><addtitle>Endocrine</addtitle><addtitle>Endocrine</addtitle><description>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
< 0.001), hip fracture (RR, 1.27; 95% CI, 1.09–1.48;
P
= 0.003), spine fracture (RR, 1.97; 95% CI, 1.31–2.97;
P
= 0.001), and non-spine fracture (RR, 1.19; 95% CI, 1.04–1.37;
P
= 0.014). However, there were no significant associations of subclinical hypothyroidism with the risk of any fractures (
P
= 0.166), hip fracture (
P
= 0.068), spine fracture (
P
= 0.818), and non-spine fracture (
P
= 0.277). Finally, subclinical hyperthyroidism was associated with lower distal forearm BMD in women, and ultradistal forearm BMD in both men and women, whereas subclinical hypothyroidism was associated with higher femur neck BMD in women.
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.</description><subject>Bone mineral density</subject><subject>Cohort analysis</subject><subject>Diabetes</subject><subject>Endocrinology</subject><subject>Femur</subject><subject>Forearm</subject><subject>Fractures</subject><subject>Health risk assessment</subject><subject>Hip</subject><subject>Humanities and Social Sciences</subject><subject>Hyperthyroidism</subject><subject>Hypothyroidism</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>multidisciplinary</subject><subject>Original Article</subject><subject>Risk assessment</subject><subject>Science</subject><subject>Thyroid</subject><subject>Thyroid diseases</subject><subject>Thyroid gland</subject><subject>Women</subject><issn>1355-008X</issn><issn>1559-0100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQRi1ERUvbF2CBLLHpJsU_cZywq6oClSqxaaXuLMeZ9LpK7IvHAWXPg-Pb24LEgpVtzZkzHn2EvOPsnDOmPyIXTLCK8a5ignNWda_IEVeqPEv9dblLpSrG2vtD8hbxkTEhRKPfkEPJteCsbY_IrwvE6LzNPgYaR4pL7yYfvLMTzZs1RT_QYcVxCe4J-enzhvYxAJ19gFSoAQL6vFIbBjom6_KS4BO1dIZsKxvstKLHnXqbIm6haH4AdXETU6aYl8EDnpCD0U4Ip8_nMbn7fHV7-bW6-fbl-vLipnJSq1yBbKSCtmvq1lkppICmtkqDU0IMfdePvWKuF7zVwDunRc2hbrjt2l4OUqpGHpOzvbd85fsCmM3s0cE02QBxQSMkr4VquloU9MM_6GNcUtlmR2mmGib1Tij2lCu7YYLRbJOfbVoNZ2aXkdlnZEpG5ikj05Wm98_qpZ9h-NPyEkoB5B7AUgoPkP7O_o_2N8_UngQ</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Zhu, Hongling</creator><creator>Zhang, Jichen</creator><creator>Wang, Jingnan</creator><creator>Zhao, Xuemei</creator><creator>Gu, Mingjun</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200301</creationdate><title>Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies</title><author>Zhu, Hongling ; Zhang, Jichen ; Wang, Jingnan ; Zhao, Xuemei ; Gu, Mingjun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-e3635e89648ca3232e64a57ec522db9bfb50cb2187e19c7241e461a98b3d33563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bone mineral density</topic><topic>Cohort analysis</topic><topic>Diabetes</topic><topic>Endocrinology</topic><topic>Femur</topic><topic>Forearm</topic><topic>Fractures</topic><topic>Health risk assessment</topic><topic>Hip</topic><topic>Humanities and Social Sciences</topic><topic>Hyperthyroidism</topic><topic>Hypothyroidism</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>multidisciplinary</topic><topic>Original Article</topic><topic>Risk assessment</topic><topic>Science</topic><topic>Thyroid</topic><topic>Thyroid diseases</topic><topic>Thyroid gland</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Hongling</creatorcontrib><creatorcontrib>Zhang, Jichen</creatorcontrib><creatorcontrib>Wang, Jingnan</creatorcontrib><creatorcontrib>Zhao, Xuemei</creatorcontrib><creatorcontrib>Gu, Mingjun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Hongling</au><au>Zhang, Jichen</au><au>Wang, Jingnan</au><au>Zhao, Xuemei</au><au>Gu, Mingjun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies</atitle><jtitle>Endocrine</jtitle><stitle>Endocrine</stitle><addtitle>Endocrine</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>67</volume><issue>3</issue><spage>685</spage><epage>698</epage><pages>685-698</pages><issn>1355-008X</issn><eissn>1559-0100</eissn><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
< 0.001), hip fracture (RR, 1.27; 95% CI, 1.09–1.48;
P
= 0.003), spine fracture (RR, 1.97; 95% CI, 1.31–2.97;
P
= 0.001), and non-spine fracture (RR, 1.19; 95% CI, 1.04–1.37;
P
= 0.014). However, there were no significant associations of subclinical hypothyroidism with the risk of any fractures (
P
= 0.166), hip fracture (
P
= 0.068), spine fracture (
P
= 0.818), and non-spine fracture (
P
= 0.277). Finally, subclinical hyperthyroidism was associated with lower distal forearm BMD in women, and ultradistal forearm BMD in both men and women, whereas subclinical hypothyroidism was associated with higher femur neck BMD in women.
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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31721088</pmid><doi>10.1007/s12020-019-02110-9</doi><tpages>14</tpages></addata></record> |
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| subjects | Bone mineral density Cohort analysis Diabetes Endocrinology Femur Forearm Fractures Health risk assessment Hip Humanities and Social Sciences Hyperthyroidism Hypothyroidism Internal Medicine Medicine Medicine & Public Health Meta-analysis multidisciplinary Original Article Risk assessment Science Thyroid Thyroid diseases Thyroid gland Women |
| title | Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies |
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