Abstract
Introduction: Primary hyperparathyroidism, a prevalent endocrine disorder, is known to cause osteoporosis. This study aims to examine the association between primary hyperparathyroidism and the risk of bone fracture.
Materials and Methods: A systematic review and meta-analysis approach was employed in this article. The databases ProQuest, PubMed, Web of Science, Cochrane, and the search engine Google Scholar were searched up to June 20, 2023. Data analysis was conducted applying STATA 14 software.
Results: Primary hyperparathyroidism increased the risk of any fractures overall (OR: 1.45, 95% CI: 1.26–1.67) in patients aged 50-59 years (OR: 1.37, 95% CI: 1.18–1.60) and in those aged 60-69 years (OR: 1.60, 95% CI: 1.25–2.05). Moreover, primary hyperparathyroidism led to an increased risk of vertebral fracture (OR: 1.90, 95% CI: 1.12–3.22), foot fracture (OR: 1.55, 95% CI: 1.09–2.20), femur fracture (OR: 1.51, 95% CI: 1.16–1.96), and osteoporotic fracture (OR: 1.42, 95% CI: 1.24–1.64). However, no statistically significant association was reported between primary hyperparathyroidism and the risk of hip fracture (OR: 1.11, 95% CI: 0.90–1.38), hand fracture (OR: 1.55, 95% CI: 0.88–2.75), forearm fracture (OR: 1.51, 95% CI: 0.52–4.39), femoral neck fracture (OR: 1.12, 95% CI: 0.56–2.25), and cervical fracture (OR: 1.40, 95% CI: 0.63–3.13).
Conclusion: The risk of any fractures in patients with primary hyperparathyroidism was 45% higher than in healthy individuals and increased with advancing age. Furthermore, primary hyperparathyroidism elevated the risk of vertebral fracture by 90%, foot fracture by 55%, femur fracture by 51%, and osteoporotic fracture by 42%.
Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024563393) and Research Registry (UIN: reviewregistry1851) websites.