Lee Youjin, Yoon Byung-Ho, Lee Seeyoun, Chung Youn Kyung, Lee Young-Kyun
Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
J Bone Metab. 2019 Feb;26(1):45-50. doi: 10.11005/jbm.2019.26.1.45. Epub 2019 Feb 28.
The effects of subclinical hyperthyroidism on fracture risk induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with thyroid cancer still remains controversial. We performed a meta-analysis and systematic review to evaluate the effects of TSH suppression therapy on osteoporotic fracture in patients with thyroid cancer.
We performed a systematic search to identify studies which included osteoporotic fractures (hip fracture and vertebral fracture) in patients on TSH suppression therapy for thyroid cancer. Main outcome measures were occurrence and risk of osteoporotic fractures including hip and vertebral fractures between patients and controls.
A systematic search yielded a total of 8 studies appropriate for review which included osteoporotic fracture outcome in patients on TSH suppression therapy for thyroid cancer. Studies with larger number of subjects showed the higher risk of osteoporotic fracture in group with TSH suppression therapy, although studies with smaller sample size presented a similar risk of fracture with control group.
Although studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the increased risk of osteoporotic fractures in patients with thyroid cancer.
亚临床甲状腺功能亢进对甲状腺癌患者因促甲状腺激素（TSH）抑制治疗所致骨折风险的影响仍存在争议。我们进行了一项荟萃分析和系统评价，以评估TSH抑制治疗对甲状腺癌患者骨质疏松性骨折的影响。
我们进行了系统检索，以识别纳入接受甲状腺癌TSH抑制治疗患者骨质疏松性骨折（髋部骨折和椎体骨折）的研究。主要结局指标是患者与对照组之间骨质疏松性骨折（包括髋部和椎体骨折）的发生率和风险。
系统检索共获得8项适合综述的研究，这些研究纳入了接受甲状腺癌TSH抑制治疗患者的骨质疏松性骨折结局。受试者数量较多的研究显示TSH抑制治疗组骨质疏松性骨折风险较高，尽管样本量较小的研究显示与对照组骨折风险相似。
尽管研究因数量有限而受到限制，但结果提示慢性TSH抑制治疗与甲状腺癌患者骨质疏松性骨折风险增加之间可能存在关联。
