Skeletal Effect of Parathyroidectomy on Patients With Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis
Pooled result · Fractures at any siteResult — go to the resultRelative risk 0.80 95% CI 0.74–0.86Authors' conclusion
PTX significantly reduced overall and hip fracture risks in PHPT patients. Despite minimal BMD increase, the substantial decrease in fracture risk suggests additional benefits of PTX beyond mineral content enhancement.
Study context
- Population
- Patients with primary hyperparathyroidism (PHPT); PubMed, Embase and Cochrane Library searched until September 202235 studies (5 randomized controlled trials (RCTs)
- Participants
- 238,188 patients
- Comparison
- PTX vs observation
- PTXn = 73,778
- Observation (OBS)n = 164,410reference
- Outcome
- Fracture at any site
Methodological detailsPRISMA, 2 independent reviewers
- PRISMA
- 2 independent reviewers
Pooled result
Fractures at any site
Relative risk
0.80
95% CI 0.74–0.86
PTXvs OBS
RR 0.80 (95% CI 0.74–0.86)
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Hip fractures (237 217 patients; PTX 73 458 vs OBS 163 759) | 0.63 (0.52–0.76) | |
| 0.512Relative risk (log scale) |
Forearm and vertebral fractures
- No reduction in forearm (3574 patients) and vertebral (3795 patients) fractures
Annual percentage bone mineral density (BMD) change from baseline, higher with PTX
- Femoral neck
- 1.91% (95% CI, 1.14-2.68)
- Hip
- 1.75% (95% CI, 0.58-2.92)
- Radius
- 1.75% (95% CI, 0.31-3.18)
- Spine
- 2.13% (95% CI, 1.16-3.10)
Original publication
Skeletal Effect of Parathyroidectomy on Patients With Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. Published 13 May 2024. doi:10.
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