Zhu Junyu, Zhang Liang, Shao Mingjie, Wang Haochen
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Departmrnt of Orthopaedic Trauma, Chenzhou No 1 People's Hospital, Chenzhou, China.
J Orthop Surg Res. 2025 Nov 3;20(1):950. doi: 10.1186/s13018-025-06405-8.
Parathyroid hormone plays a key role in muscle metabolism and function, yet its precise association with sarcopenia remains controversial. This meta-analysis evaluated the relationship between serum parathyroid hormone levels and the risk of sarcopenia.
We systematically searched PubMed, Embase, and Web of Science until April 2025 for observational studies on the link between parathyroid hormone levels and sarcopenia. Using random-effects models, we derived pooled odds ratios with 95% confidence intervals and conducted subgroup analyses. Sensitivity analyses were performed to ensure robustness by excluding small or low-quality studies. Study quality was assessed with modified Newcastle-Ottawa scales, and publication bias was checked using funnel plot symmetry.
This meta-analysis included 11 studies involving 4,759 participants, with mean ages ranging from 57.5 to 76.4 years and 50.37% of participants being female. Our meta-analysis showed a positive association between serum parathyroid hormone levels and the risk of sarcopenia (odds ratios = 1.10, 95% confidence intervals 1.03-1.17, P < 0.001). Subgroup analyses indicated a consistently positive association across diagnostic definitions and study settings, although the effect size was greater in studies using alternative diagnostic criteria (OR = 1.94, 95% confidence intervals 1.21-3.13) and in hospital-based populations (OR = 2.19, 95% confidence intervals 1.27-3.77). Sensitivity analysis confirmed the stability of these findings, with no publication bias detected.
This meta-analysis suggests a potential positive association between elevated parathyroid hormone levels and sarcopenia risk. However, given the substantial heterogeneity and the observational nature of the included studies, these findings should be interpreted with caution. Further large-scale, prospective investigations are warranted to clarify the causal relationship and to explore whether targeting parathyroid hormone could contribute to sarcopenia prevention or management.
甲状旁腺激素在肌肉代谢和功能中起关键作用，但其与肌肉减少症的确切关联仍存在争议。本荟萃分析评估了血清甲状旁腺激素水平与肌肉减少症风险之间的关系。
我们系统检索了截至2025年4月的PubMed、Embase和Web of Science，以查找关于甲状旁腺激素水平与肌肉减少症之间联系的观察性研究。使用随机效应模型，我们得出了合并优势比及95%置信区间，并进行了亚组分析。通过排除小型或低质量研究进行敏感性分析，以确保结果的稳健性。使用改良的纽卡斯尔-渥太华量表评估研究质量，并使用漏斗图对称性检查发表偏倚。
本荟萃分析纳入了11项研究，涉及4759名参与者，平均年龄在57.5至76.4岁之间，50.37%的参与者为女性。我们的荟萃分析显示，血清甲状旁腺激素水平与肌肉减少症风险之间存在正相关（优势比=1.10，95%置信区间1.03-1.17，P<0.001）。亚组分析表明，在不同的诊断定义和研究环境中，这种关联始终为正，尽管在使用替代诊断标准的研究（优势比=1.94，95%置信区间1.21-3.13）和基于医院的人群中（优势比=2.19，95%置信区间1.27-3.77）效应量更大。敏感性分析证实了这些结果的稳定性，未检测到发表偏倚。
本荟萃分析表明，甲状旁腺激素水平升高与肌肉减少症风险之间可能存在正相关。然而，鉴于纳入研究存在显著异质性且为观察性研究，这些结果应谨慎解读。需要进一步进行大规模的前瞻性研究，以阐明因果关系，并探索针对甲状旁腺激素是否有助于预防或管理肌肉减少症。
