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01-03-2020 | Hyperthyroidism | Original Article

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

Authors: Hongling Zhu, Jichen Zhang, Jingnan Wang, Xuemei Zhao, Mingjun Gu

Published in: Endocrine | Issue 3/2020

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.

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O. Johnell, J.A. Kanis, A. Oden, I. Sernbo, I. Redlund-Johnell, C. Petterson, C. De Laet, B. Jonsson, Mortality after osteoporotic fractures. Osteoporos. Int 15(1), 38–42 (2004). https://doi.org/10.1007/s00198-003-1490-4 CrossRefPubMed

A.N. Tosteson, S.E. Gabriel, M.R. Grove, M.M. Moncur, T.S. Kneeland, L.J. Melton, 3rd: Impact of hip and vertebral fractures on quality-adjusted life years. Osteoporos. Int 12(12), 1042–1049 (2001)CrossRefPubMed

H.X. Jiang, S.R. Majumdar, D.A. Dick, M. Moreau, J. Raso, D.D. Otto, D.W. Johnston, Development and initial validation of a risk score for predicting in-hospital and 1-year mortality in patients with hip fractures. J. Bone Min. Res 20(3), 494–500 (2005). https://doi.org/10.1359/jbmr.041133 CrossRef

N.O. Foundation. America’s Bone Health: the State of Osteoporosis and Low Bone Mass in Our Nation. (National Osteoporosis Foundation, Washington, DC, 2002) pp. 1–55

P. Vestergaard, L. Mosekilde, Hyperthyroidism, bone mineral, and fracture risk–a meta-analysis. Thyroid 13(6), 585–593 (2003). https://doi.org/10.1089/105072503322238854 CrossRefPubMed

J.G. Hollowell, N.W. Staehling, W.D. Flanders, W.H. Hannon, E.W. Gunter, C.A. Spencer, L.E. Braverman, Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87(2), 489–499 (2002). https://doi.org/10.1210/jcem.87.2.8182 CrossRefPubMed

K. Takeda, M. Mishiba, H. Sugiura, A. Nakajima, M. Kohama, S. Hiramatsu, Evaluated reference intervals for serum free thyroxine and thyrotropin using the conventional outliner rejection test without regard to presence of thyroid antibodies and prevalence of thyroid dysfunction in Japanese subjects. Endocr. J. 56(9), 1059–1066 (2009)CrossRefPubMed

G. Mazziotti, T. Porcelli, I. Patelli, P.P. Vescovi, A. Giustina, T.S.H. Serum, values and risk of vertebral fractures in euthyroid post-menopausal women with low bone mineral density. Bone 46(3), 747–751 (2010). https://doi.org/10.1016/j.bone.2009.10.031 CrossRefPubMed

Z. Yan, H. Huang, J. Li, J. Wang, Relationship between subclinical thyroid dysfunction and the risk of fracture: a meta-analysis of prospective cohort studies. Osteoporos. Int 27(1), 115–125 (2016). https://doi.org/10.1007/s00198-015-3221-z CrossRefPubMed

10.

C.E. Aubert, C. Floriani, D.C. Bauer, B.R. da Costa, D. Segna, M.R. Blum, T.H. Collet, H.A. Fink, A.R. Cappola, L. Syrogiannouli, R.P. Peeters, B.O. Asvold, W.P.J. den Elzen, R.N. Luben, A.P. Bremner, A. Gogakos, R. Eastell, P.M. Kearney, M. Hoff, E. Le Blanc, G. Ceresini, F. Rivadeneira, A.G. Uitterlinden, K.T. Khaw, A. Langhammer, D.J. Stott, R.G.J. Westendorp, L. Ferrucci, G.R. Williams, J. Gussekloo, J.P. Walsh, D. Aujesky, N. Rodondi, Thyroid function tests in the reference range and fracture: individual participant analysis of prospective cohorts. J. Clin. Endocrinol. Metab. 102(8), 2719–2728 (2017). https://doi.org/10.1210/jc.2017-00294 CrossRefPubMedPubMedCentral

11.

M.R. Blum, D.C. Bauer, T.H. Collet, H.A. Fink, A.R. Cappola, B.R. da Costa, C.D. Wirth, R.P. Peeters, B.O. Asvold, W.P. den Elzen, R.N. Luben, M. Imaizumi, A.P. Bremner, A. Gogakos, R. Eastell, P.M. Kearney, E.S. Strotmeyer, E.R. Wallace, M. Hoff, G. Ceresini, F. Rivadeneira, A.G. Uitterlinden, D.J. Stott, R.G. Westendorp, K.T. Khaw, A. Langhammer, L. Ferrucci, J. Gussekloo, G.R. Williams, J.P. Walsh, P. Juni, D. Aujesky, N. Rodondi, Subclinical thyroid dysfunction and fracture risk: a meta-analysis. JAMA 313(20), 2055–2065 (2015). https://doi.org/10.1001/jama.2015.5161 CrossRefPubMedPubMedCentral

12.

D. Segna, D.C. Bauer, M. Feller, C. Schneider, H.A. Fink, C.E. Aubert, T.H. Collet, B.R. da Costa, K. Fischer, R.P. Peeters, A.R. Cappola, M.R. Blum, H.A. van Dorland, J. Robbins, K. Naylor, R. Eastell, A.G. Uitterlinden, F. Rivadeneira Ramirez, A. Gogakos, J. Gussekloo, G.R. Williams, A. Schwartz, J.A. Cauley, D.A. Aujesky, H.A. Bischoff-Ferrari, N. Rodondi, Association between subclinical thyroid dysfunction and change in bone mineral density in prospective cohorts. J. Intern. Med. 283(1), 56–72 (2018). https://doi.org/10.1111/joim.12688 CrossRefPubMed

13.

C.D. Wirth, M.R. Blum, B.R. da Costa, C. Baumgartner, T.H. Collet, M. Medici, R.P. Peeters, D. Aujesky, D.C. Bauer, N. Rodondi, Subclinical thyroid dysfunction and the risk for fractures: a systematic review and meta-analysis. Ann. Intern. Med. 161(3), 189–199 (2014). https://doi.org/10.7326/m14-0125 CrossRefPubMedPubMedCentral

14.

R. Yang, L. Yao, Y. Fang, J. Sun, T. Guo, K. Yang, L. Tian, The relationship between subclinical thyroid dysfunction and the risk of fracture or low bone mineral density: a systematic review and meta-analysis of cohort studies. J. Bone Min. Metab. 36(2), 209–220 (2018). https://doi.org/10.1007/s00774-017-0828-5 CrossRef

15.

D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(7), e1000097 (2009). https://doi.org/10.1371/journal.pmed.1000097 CrossRefPubMedPubMedCentral

16.

G. Wells, B. Shea, D. O’Connell, The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-analyses. Ottawa (ON). http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm (2009)

17.

R. DerSimonian, N. Laird, Meta-analysis in clinical trials. Controlled Clin. trials 7(3), 177–188 (1986)CrossRefPubMed

18.

A.E. Ades, G. Lu, J.P. Higgins, The interpretation of random-effects meta-analysis in decision models. Medical decision making: an international journal of the Society for. Med. Decis. Mak. 25(6), 646–654 (2005). https://doi.org/10.1177/0272989x05282643 CrossRef

19.

J.J. Deeks, J.P. Higgins, D.G. Altman, Analysing data and undertaking meta‐analyses. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series, 243–296 (2008)

20.

J.P. Higgins, S.G. Thompson, J.J. Deeks, D.G. Altman, Measuring inconsistency in meta-analyses. BMJ (Clin. Res. ed.) 327(7414), 557–560 (2003). https://doi.org/10.1136/bmj.327.7414.557 CrossRef

21.

A. Tobias, Assessing the influence of a single study in the meta-analysis estimate. Stata Tech. Bull. 47, 15–17 (1999)

22.

D.G. Altman, J.M. Bland, Interaction revisited: the difference between two estimates. BMJ (Clin. Res. ed.) 326(7382), 219 (2003). https://doi.org/10.1136/bmj.326.7382.219 CrossRef

23.

M. Egger, G. Davey Smith, M. Schneider, C. Minder, Bias in meta-analysis detected by a simple, graphical test. BMJ (Clin. Res. ed.) 315(7109), 629–634 (1997). https://doi.org/10.1136/bmj.315.7109.629 CrossRef

24.

C.B. Begg, M. Mazumdar, Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4), 1088–1101 (1994)CrossRefPubMed

25.

D.C. Bauer, B. Ettinger, M.C. Nevitt, K.L. Stone, Risk for fracture in women with low serum levels of thyroid-stimulating hormone. Ann. Intern. Med. 134(7), 561–568 (2001). https://doi.org/10.7326/0003-4819-134-7-200104030-00009 CrossRefPubMed

26.

M. Imaizumi, M. Akahoshi, S. Ichimaru, E. Nakashima, A. Hida, M. Soda, T. Usa, K. Ashizawa, N. Yokoyama, R. Maeda, S. Nagataki, K. Eguchi, Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 89(7), 3365–3370 (2004). https://doi.org/10.1210/jc.2003-031089 CrossRefPubMed

27.

J. Gussekloo, E. van Exel, A.J. de Craen, A.E. Meinders, M. Frolich, R.G. Westendorp, Thyroid status, disability and cognitive function, and survival in old age. JAMA 292(21), 2591–2599 (2004). https://doi.org/10.1001/jama.292.21.2591 CrossRefPubMed

28.

N. Rodondi, A.B. Newman, E. Vittinghoff, N. de Rekeneire, S. Satterfield, T.B. Harris, D.C. Bauer, Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death. Arch. Intern. Med. 165(21), 2460–2466 (2005). https://doi.org/10.1001/archinte.165.21.2460 CrossRefPubMed

29.

K.E. Barbour, J.M. Zmuda, R. Boudreau, E.S. Strotmeyer, M.J. Horwitz, R.W. Evans, A.M. Kanaya, T.B. Harris, J.A. Cauley, The effects of adiponectin and leptin on changes in bone mineral density. Osteoporos. Int 23(6), 1699–1710 (2012). https://doi.org/10.1007/s00198-011-1768-x CrossRefPubMed

30.

J.P. Walsh, A.P. Bremner, M.K. Bulsara, P. O’Leary, P.J. Leedman, P. Feddema, V. Michelangeli, Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch. Intern. Med. 165(21), 2467–2472 (2005). https://doi.org/10.1001/archinte.165.21.2467 CrossRefPubMed

31.

W.M. van der Deure, A.G. Uitterlinden, A. Hofman, F. Rivadeneira, H.A. Pols, R.P. Peeters, T.J. Visser, Effects of serum TSH and FT4 levels and the TSHR-Asp727Glu polymorphism on bone: the Rotterdam Study. Clin. Endocrinol. (Oxf.) 68(2), 175–181 (2008). https://doi.org/10.1111/j.1365-2265.2007.03016.x CrossRef

32.

A. Hofman, S. Darwish Murad, C.M. van Duijn, O.H. Franco, A. Goedegebure, M.A. Ikram, C.C. Klaver, T.E. Nijsten, R.P. Peeters, B.H. Stricker, H.W. Tiemeier, A.G. Uitterlinden, M.W. Vernooij, The Rotterdam Study: 2014 objectives and design update. Eur. J. Epidemiol. 28(11), 889–926 (2013). https://doi.org/10.1007/s10654-013-9866-z CrossRefPubMed

33.

A. Hofman, G.G. Brusselle, S. Darwish Murad, C.M. van Duijn, O.H. Franco, A. Goedegebure, M.A. Ikram, C.C. Klaver, T.E. Nijsten, R.P. Peeters, B.H. Stricker, H.W. Tiemeier, A.G. Uitterlinden, M.W. Vernooij, The Rotterdam Study: 2016 objectives and design update. Eur. J. Epidemiol. 30(8), 661–708 (2015). https://doi.org/10.1007/s10654-015-0082-x CrossRefPubMedPubMedCentral

34.

G. Grimnes, N. Emaus, R.M. Joakimsen, Y. Figenschau, R. Jorde, The relationship between serum TSH and bone mineral density in men and postmenopausal women: the Tromso study. Thyroid 18(11), 1147–1155 (2008). https://doi.org/10.1089/thy.2008.0158 CrossRefPubMed

35.

J. Finigan, D.M. Greenfield, A. Blumsohn, R.A. Hannon, N.F. Peel, G. Jiang, R. Eastell, Risk factors for vertebral and nonvertebral fracture over 10 years: a population-based study in women. J. Bone Min. Res 23(1), 75–85 (2008). https://doi.org/10.1359/jbmr.070814 CrossRef

36.

R.W. Flynn, S.R. Bonellie, R.T. Jung, T.M. MacDonald, A.D. Morris, G.P. Leese, Serum thyroid-stimulating hormone concentration and morbidity from cardiovascular disease and fractures in patients on long-term thyroxine therapy. J. Clin. Endocrinol. Metab. 95(1), 186–193 (2010). https://doi.org/10.1210/jc.2009-1625 CrossRefPubMed

37.

T. Vadiveloo, P.T. Donnan, L. Cochrane, G.P. Leese, The Thyroid Epidemiology, Audit, and Research Study (TEARS): morbidity in patients with endogenous subclinical hyperthyroidism. J. Clin. Endocrinol. Metab. 96(5), 1344–1351 (2011). https://doi.org/10.1210/jc.2010-2693 CrossRefPubMed

38.

J.S. Lee, P. Buzkova, H.A. Fink, J. Vu, L. Carbone, Z. Chen, J. Cauley, D.C. Bauer, A.R. Cappola, J. Robbins, Subclinical thyroid dysfunction and incident hip fracture in older adults. Arch. Intern. Med. 170(21), 1876–1883 (2010). https://doi.org/10.1001/archinternmed.2010.424 CrossRefPubMedPubMedCentral

39.

M.C. Garin, A.M. Arnold, J.S. Lee, J. Robbins, A.R. Cappola, Subclinical thyroid dysfunction and hip fracture and bone mineral density in older adults: the cardiovascular health study. J. Clin. Endocrinol. Metab. 99(8), 2657–2664 (2014). https://doi.org/10.1210/jc.2014-1051 CrossRefPubMedPubMedCentral

40.

S.M. Boekholdt, S.M. Titan, W.M. Wiersinga, K. Chatterjee, D.C. Basart, R. Luben, N.J. Wareham, K.T. Khaw, Initial thyroid status and cardiovascular risk factors: the EPIC-Norfolk prospective population study. Clin. Endocrinol. (Oxf.) 72(3), 404–410 (2010). https://doi.org/10.1111/j.1365-2265.2009.03640.x CrossRef

41.

E. Murphy, C.C. Gluer, D.M. Reid, D. Felsenberg, C. Roux, R. Eastell, G.R. Williams, Thyroid function within the upper normal range is associated with reduced bone mineral density and an increased risk of nonvertebral fractures in healthy euthyroid postmenopausal women. J. Clin. Endocrinol. Metab. 95(7), 3173–3181 (2010). https://doi.org/10.1210/jc.2009-2630 CrossRefPubMed

42.

D. Nanchen, J. Gussekloo, R.G. Westendorp, D.J. Stott, J.W. Jukema, S. Trompet, I. Ford, P. Welsh, N. Sattar, P.W. Macfarlane, S.P. Mooijaart, N. Rodondi, A.J. de Craen, Subclinical thyroid dysfunction and the risk of heart failure in older persons at high cardiovascular risk. J. Clin. Endocrinol. Metab. 97(3), 852–861 (2012). https://doi.org/10.1210/jc.2011-1978 CrossRefPubMed

43.

A. Svare, T.I. Nilsen, B.O. Asvold, S. Forsmo, B. Schei, T. Bjoro, A. Langhammer, Does thyroid function influence fracture risk? Prospective data from the HUNT2 study, Norway. Eur. J. Endocrinol. 169(6), 845–852 (2013). https://doi.org/10.1530/eje-13-0546 CrossRefPubMed

44.

A.C. Waring, S. Harrison, H.A. Fink, M.H. Samuels, P.M. Cawthon, J.M. Zmuda, E.S. Orwoll, D.C. Bauer, A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study. J. Bone Min. Res 28(3), 472–479 (2013). https://doi.org/10.1002/jbmr.1774 CrossRef

45.

J.A. Cauley, P.M. Cawthon, K.E. Peters, S.R. Cummings, K.E. Ensrud, D.C. Bauer, B.C. Taylor, J.M. Shikany, A.R. Hoffman, N.E. Lane, D.M. Kado, M.L. Stefanick, E.S. Orwoll, Risk factors for hip fracture in older men: the osteoporotic fractures in men study (MrOS). J. Bone Min. Res 31(10), 1810–1819 (2016). https://doi.org/10.1002/jbmr.2836 CrossRef

46.

G. Ceresini, G.P. Ceda, F. Lauretani, M. Maggio, E. Usberti, M. Marina, S. Bandinelli, J.M. Guralnik, G. Valenti, L. Ferrucci, Thyroid status and 6-year mortality in elderly people living in a mildly iodine-deficient area: the aging in the Chianti Area Study. J. Am. Geriatr. Soc. 61(6), 868–874 (2013). https://doi.org/10.1111/jgs.12267 CrossRefPubMedPubMedCentral

47.

B. Abrahamsen, H.L. Jorgensen, A.S. Laulund, M. Nybo, T.H. Brix, L. Hegedus, Low serum thyrotropin level and duration of suppression as a predictor of major osteoporotic fractures-the OPENTHYRO register cohort. J. Bone Min. Res 29(9), 2040–2050 (2014). https://doi.org/10.1002/jbmr.2244 CrossRef

48.

B. Abrahamsen, H.L. Jorgensen, A.S. Laulund, M. Nybo, D.C. Bauer, T.H. Brix, L. Hegedus, The excess risk of major osteoporotic fractures in hypothyroidism is driven by cumulative hyperthyroid as opposed to hypothyroid time: an observational register-based time-resolved cohort analysis. J. Bone Min. Res 30(5), 898–905 (2015). https://doi.org/10.1002/jbmr.2416 CrossRef

49.

D.S. Cooper, B. Biondi, Subclinical thyroid disease. Lancet (Lond., Engl.) 379(9821), 1142–1154 (2012). https://doi.org/10.1016/s0140-6736(11)60276-6 CrossRef

50.

R. Baliram, L. Sun, J. Cao, J. Li, R. Latif, A.K. Huber, T. Yuen, H.C. Blair, M. Zaidi, T.F. Davies, Hyperthyroid-associated osteoporosis is exacerbated by the loss of TSH signaling. J. Clin. Investig. 122(10), 3737–3741 (2012). https://doi.org/10.1172/jci63948 CrossRefPubMedPubMedCentral

51.

M.D. Brennan, C. Powell, K.R. Kaufman, P.C. Sun, R.S. Bahn, K.S. Nair, The impact of overt and subclinical hyperthyroidism on skeletal muscle. Thyroid 16(4), 375–380 (2006). https://doi.org/10.1089/thy.2006.16.375 CrossRefPubMed

52.

A.D. Toft, Clinical practice. Subclinical hyperthyroidism. New Engl. J. Med. 345(7), 512–516 (2001). https://doi.org/10.1056/NEJMcp010145 CrossRefPubMed

53.

B. Biondi, E.A. Palmieri, M. Klain, M. Schlumberger, S. Filetti, G. Lombardi, Subclinical hyperthyroidism: clinical features and treatment options. Eur. J. Endocrinol. 152(1), 1–9 (2005)CrossRefPubMed

54.

A. Bertoli, A. Fusco, A. Andreoli, A. Magnani, A. Tulli, D. Lauro, A. De Lorenzo, Effect of subclinical hypothyroidism and obesity on whole-body and regional bone mineral content. Horm. Res 57(3-4), 79–84 (2002). https://doi.org/10.1159/000057956 CrossRefPubMed

55.

B. Biondi, Natural history, diagnosis and management of subclinical thyroid dysfunction. Best. Pr. Res Clin. Endocrinol. Metab. 26(4), 431–446 (2012). https://doi.org/10.1016/j.beem.2011.12.004 CrossRef

Title: Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies
Authors: Hongling Zhu
Jichen Zhang
Jingnan Wang
Xuemei Zhao
Mingjun Gu
Publication date: 01-03-2020
Publisher: Springer US
Keywords: Hyperthyroidism
Hypothyroidism
Published in: Endocrine / Issue 3/2020
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-019-02110-9

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