Department of Health Statistics, College of Public Health, Tianjin Medical University, Tianjin, China.
Eur Rev Med Pharmacol Sci. 2020 Jan;24(2):922-929. doi: 10.26355/eurrev_202001_20077.
To evaluate the effect of TSH-suppressive therapy on the bone mineral density in patients with differentiated thyroid carcinoma (DTC).
The cross-sectional, cohort, prospective controlled, and case-control studies on the bone mineral density change in patients with DTC after TSH-suppressive therapy from databases were searched, including PubMed, Embase, and Cochrane library databases. The effect of TSH-suppressive therapy on bone mineral density of lumbar, femoral neck, femoral greater trochanter, and Ward triangle was analyzed. Data from the database establishment to January 2019 were all reviewed. Meta-analysis was performed with RevMan 5.3 software after two reviewers independently screened the date. The categorical variables were expressed as odds ratios, while the numerical variables were expressed as mean differences. Based on the heterogeneity of the study, a comprehensive analysis was performed by using fixed or random effect models.
A total of 11 studies involving 434 patients with differentiated thyroid cancer were included. No significant difference in the bone mineral density of lumbar indications between the experimental and control groups was observed (MD=0.00, 95% CI=-0.03-0.03, p=0.96). The bone mineral density of the femoral neck indications (MD=-0.01, 95% CI=-0.04-0.03, p=0.70). A significant difference between experimental and control groups in the bone mineral density of femoral trochanter indications was observed (MD=-0.11, 95% CI=-0.14-0.07, p<0.00001). The bone mineral density of Ward's triangle indications (MD=-0.06, 95% CI=-0.11-0.01, p=0.02).
TSH-suppressive therapy in patients with DTC mainly reduces the proximal femur bone mineral density.
评估甲状腺刺激素（TSH）抑制治疗对分化型甲状腺癌（DTC）患者骨密度的影响。
从PubMed、Embase 和 Cochrane 图书馆数据库中检索关于 DTC 患者接受 TSH 抑制治疗后骨密度变化的横断面、队列、前瞻性对照和病例对照研究。分析 TSH 抑制治疗对腰椎、股骨颈、股骨大转子和 Ward 三角区骨密度的影响。所有数据均来自数据库建立至 2019 年 1 月。两名审阅者独立筛选数据后，采用 RevMan 5.3 软件进行荟萃分析。分类变量表示为比值比，数值变量表示为均数差值。根据研究的异质性，采用固定或随机效应模型进行综合分析。
共纳入 11 项涉及 434 例分化型甲状腺癌患者的研究。实验组和对照组腰椎部位骨密度无显著差异（MD=0.00，95%CI=-0.03-0.03，p=0.96）。实验组和对照组股骨颈部位骨密度无显著差异（MD=-0.01，95%CI=-0.04-0.03，p=0.70）。实验组和对照组股骨转子间部位骨密度有显著差异（MD=-0.11，95%CI=-0.14-0.07，p<0.00001）。实验组和对照组 Ward 三角部位骨密度有显著差异（MD=-0.06，95%CI=-0.11-0.01，p=0.02）。
DTC 患者的 TSH 抑制治疗主要降低了近端股骨的骨密度。
