SynthesisAnnals of internal medicine2014
Subclinical thyroid dysfunction and the risk for fractures: a systematic review and meta-analysis.
Synthesis in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 11 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Association of subclinical thyroid dysfunction with the risk of vertebral fracture: a meta-analysis of prospective cohort studies.Annals of medicine · 2025Pooled it
- The relationship of hip fracture and thyroid disorders: a systematic review.Frontiers in endocrinology · 2023Pooled it
- Pooled it
- Effect of subclinical hyperthyroidism on osteoporosis: A meta-analysis of cohort studies.Endocrine · 2020Pooled it
- Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies.Endocrine · 2020Pooled it
- Hypothyroidism and related diseases: a methodological quality assessment of meta-analysis.BMJ open · 2019Pooled it
- The association between serum uric acid level and the risk of fractures: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Pooled it
- Subclinical Thyroid Dysfunction and the Risk of Cognitive Decline: a Meta-Analysis of Prospective Cohort Studies.The Journal of clinical endocrinology and metabolism · 2016Pooled it
- Relationship between subclinical thyroid dysfunction and the risk of fracture: a meta-analysis of prospective cohort studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Pooled it
- Type 1 diabetes and risk of fracture: meta-analysis and review of the literature.Diabetic medicine : a journal of the British Diabetic Association · 2015Pooled it
- Pooled it
- Bone mineral density assessment by DXA in disease-associated osteoporosis: the limitations.Frontiers in endocrinology · 2026Review
- Exploring the mediating role of thyroid function in the effect of celiac disease on osteoporosis: A Mendelian randomization study.Medicine · 2025Article
- Evaluation and Management of Bone Health in Patients with Thyroid Diseases: A Position Statement of the Korean Thyroid Association.Endocrinology and metabolism (Seoul, Korea) · 2023Review
- CD11cFrontiers in immunology · 2022Article
- Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- DNA methylation at a nutritionally sensitive region of theScience advances · 2021Article
- Decision Making in Subclinical Thyroid Disease.The Medical clinics of North America · 2021Review
- Skeletal health in patients with differentiated thyroid carcinoma.Journal of endocrinological investigation · 2021Review
- Low TSH Levels Within Euthyroid Range Could Play a Negative Role on Bone Mineral Density in Postmenopausal Women with Type 2 Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundData on the association between subclinical thyroid dysfunction and fractures conflict. PURPOSE: To assess the risk for hip and nonspine fractures associated with subclinical thyroid dysfunction among prospective cohorts. DATA SOURCES: Search of MEDLINE and EMBASE (1946 to 16 March 2014) and reference lists of retrieved articles without language restriction. STUDY SELECTION: Two physicians screened and identified prospective cohorts that measured thyroid function and followed participants to assess fracture outcomes. DATA EXTRACTION: One reviewer extracted data using a standardized protocol, and another verified data. Both reviewers independently assessed methodological quality of the studies. DATA SYNTHESIS: The 7 population-based cohorts of heterogeneous quality included 50,245 participants with 1966 hip and 3281 nonspine fractures. In random-effects models that included the 5 higher-quality studies, the pooled adjusted hazard ratios (HRs) of participants with subclinical hyperthyroidism versus euthyrodism were 1.38 (95% CI, 0.92 to 2.07) for hip fractures and 1.20 (CI, 0.83 to 1.72) for nonspine fractures without statistical heterogeneity (P = 0.82 and 0.52, respectively; I2= 0%). Pooled estimates for the 7 cohorts were 1.26 (CI, 0.96 to 1.65) for hip fractures and 1.16 (CI, 0.95 to 1.42) for nonspine fractures. When thyroxine recipients were excluded, the HRs for participants with subclinical hyperthyroidism were 2.16 (CI, 0.87 to 5.37) for hip fractures and 1.43 (CI, 0.73 to 2.78) for nonspine fractures. For participants with subclinical hypothyroidism, HRs from higher-quality studies were 1.12 (CI, 0.83 to 1.51) for hip fractures and 1.04 (CI, 0.76 to 1.42) for nonspine fractures (P for heterogeneity = 0.69 and 0.88, respectively; I2 = 0%). LIMITATIONS: Selective reporting cannot be excluded. Adjustment for potential common confounders varied and was not adequately done across all studies.
conclusionSubclinical hyperthyroidism might be associated with an increased risk for hip and nonspine fractures, but additional large, high-quality studies are needed. PRIMARY FUNDING SOURCE: Swiss National Science Foundation.
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Registered trials
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