Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul-Jensen Boulevard, 8200, Aarhus, Denmark.
Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Osteoporos Int. 2021 Jun;32(6):1053-1060. doi: 10.1007/s00198-021-05822-9. Epub 2021 Feb 1.
An increased risk of fractures in primary hyperparathyroidism (PHPT) has been reported in a number of relatively small studies. Performing a systematic literature search, we identified available studies and calculated common estimates by pooling results from the individual studies in a meta-analysis. Searching EMBASE and PubMed, we identified published studies reporting the risk of fractures in PHPT compared to a control group. We calculated odds ratio (OR) with 95% confidence interval (CI). A total of 804 studies were identified of which 12 studies were included. Risk of any fracture was increased compared to controls (OR 2.01; 95% CI, 1.61-2.50; I 46%, 5 studies). Analysis of fracture risk at specific sites showed an increased risk of fracture at the forearm (OR 2.36; 95% CI, 1.64-3.38; I 0%, 4 studies) and spine (OR 3.00; 95% CI, 1.41, 6.37, I 88%, 9 studies). Risk estimate for hip fractures was non-significantly increased (OR 1.27; 95% CI, 0.97-1.66; I 0%, 3 studies). Risk of vertebral fractures (VFx) was also increased if analyses were restricted to only studies with a healthy control group (OR 5.76; 95% CI, 3.86-8.60; I 29%, 6 studies), studies including patients with mild PHPT (OR 4.22; 95% CI, 2.20-8.12; I 57%, 4 studies) or studies including postmenopausal women (OR 8.07; 95% CI, 4.79-13.59; I 0%, 3 studies). PHPT is associated with an increased risk of fractures. Although a number of studies are limited-it seems that the risk is increased across different skeletal sites including patients with mild PHPT and postmenopausal women.
原发性甲状旁腺功能亢进症（PHPT）患者骨折风险增加已在一些相对较小的研究中报道。通过系统文献检索，我们确定了现有研究，并通过荟萃分析将个体研究的结果汇总计算常见估计值。通过搜索 EMBASE 和 PubMed，我们确定了报告 PHPT 患者与对照组相比骨折风险的已发表研究。我们计算了比值比（OR）及其 95％置信区间（CI）。共确定了 804 项研究，其中纳入了 12 项研究。与对照组相比，任何部位骨折的风险均增加（OR 2.01；95％CI，1.61-2.50；I 46％，5 项研究）。对特定部位骨折风险的分析显示，前臂（OR 2.36；95％CI，1.64-3.38；I 0％，4 项研究）和脊柱（OR 3.00；95％CI，1.41-6.37，I 88％，9 项研究）骨折风险增加。髋部骨折风险估计值增加不显著（OR 1.27；95％CI，0.97-1.66；I 0％，3 项研究）。如果仅分析纳入健康对照组的研究（OR 5.76；95％CI，3.86-8.60；I 29％，6 项研究）、纳入轻度 PHPT 患者的研究（OR 4.22；95％CI，2.20-8.12；I 57％，4 项研究）或纳入绝经后妇女的研究（OR 8.07；95％CI，4.79-13.59；I 0％，3 项研究），则椎体骨折（VFx）风险也增加。PHPT 与骨折风险增加相关。尽管一些研究存在局限性，但似乎风险在不同的骨骼部位均增加，包括轻度 PHPT 患者和绝经后妇女。
