SynthesisThe Journal of clinical endocrinology and metabolism2017
Thyroid Function Tests in the Reference Range and Fracture: Individual Participant Analysis of Prospective Cohorts.
Synthesis in The Journal of clinical endocrinology and metabolism, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
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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
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Hip Fragility Fractures: One Or Two Pathologies? A Systematic Review and Meta-Analysis of Demographic, Diagnostic and Therapeutic Aspects.Aging and disease · 2025Pooled it
- The optimal healthy ranges of thyroid function defined by the risk of cardiovascular disease and mortality: systematic review and individual participant data meta-analysis.The lancet. Diabetes & endocrinology · 2023Pooled it
- Association of subclinical thyroid dysfunction with bone mineral density and fracture: a meta-analysis of prospective cohort studies.Endocrine · 2020Pooled it
- Association of impaired sensitivity to thyroid hormone with low bone mineral density and bone mineral content.Frontiers in endocrinology · 2026Review
- Thyroid dysfunction in ageing populations.Endocrine connections · 2025Review
- Thyroid dysfunction and osteoporosis: A two-sample bidirectional Mendelian randomization study.Medicine · 2025Article
- Higher Serum Free T4 Is Associated With Increased Risk of Mortality and Cerebrovascular Events in Elderly Men.Journal of the Endocrine Society · 2025Article
- Associations of Free and Reverse Triiodothyronine with Long-Term All-Cause Mortality After Acute Ischemic Stroke and Acute Myocardial Infarction.Journal of clinical medicine · 2025Article
- The mediating role of thyroid-related hormones between thyroid dysfunction diseases and osteoporosis: a mediation mendelian randomization study.Scientific reports · 2025Article
- Association between sensitivity to thyroid hormones and trabecular bone score in euthyroid individuals: a population-based cross-sectional study.BMC musculoskeletal disorders · 2024Article
- Testing for a causal role of thyroid hormone measurements within the normal range on human metabolism and diseases: a systematic Mendelian randomization.EBioMedicine · 2024Article
- Association of serum thyroid-stimulating hormone and bone mineral density in Chinese adults with normal thyroid function.Nutrition & metabolism · 2024Article
- Higher serum free thyroxine levels are associated with increased risk of hip fractures in older men.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- The ageing thyroid: implications for longevity and patient care.Nature reviews. Endocrinology · 2024Review
- Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals.Journal of endocrinological investigation · 2023Article
- Article
- Recent advances in the identification of related factors and preventive strategies of hip fracture.Frontiers in public health · 2023Review
- Independent Skeletal Actions of Pituitary Hormones.Endocrinology and metabolism (Seoul, Korea) · 2022Article
- The Effects of Common Genetic Variation in 96 Genes Involved in Thyroid Hormone Regulation on TSH and FT4 Concentrations.The Journal of clinical endocrinology and metabolism · 2022Article
- Free thyroxine but not TSH levels are associated with decline in functional status in a cohort of geriatric outpatients.European geriatric medicine · 2022Article
Corrections and comments
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Authors and funding
34 authors at 20 institutions in 9 countries.
Funding
Abstract
Context: Hyperthyroidism is associated with increased fracture risk, but it is not clear if lower thyroid-stimulating hormone (TSH) and higher free thyroxine (FT4) in euthyroid individuals are associated with fracture risk. Objective: To evaluate the association of TSH and FT4 with incident fractures in euthyroid individuals. Design: Individual participant data analysis. Setting: Thirteen prospective cohort studies with baseline examinations between 1981 and 2002. Participants: Adults with baseline TSH 0.45 to 4.49 mIU/L. Main Outcome Measures: Primary outcome was incident hip fracture. Secondary outcomes were any, nonvertebral, and vertebral fractures. Results were presented as hazard ratios (HRs) with 95% confidence interval (CI) adjusted for age and sex. For clinical relevance, we studied TSH according to five categories: 0.45 to 0.99 mIU/L; 1.00 to 1.49 mIU/L; 1.50 to 2.49 mIU/L; 2.50 to 3.49 mIU/L; and 3.50 to 4.49 mIU/L (reference). FT4 was assessed as study-specific standard deviation increase, because assays varied between cohorts. Results: During 659,059 person-years, 2,565 out of 56,835 participants had hip fracture (4.5%; 12 studies with data on hip fracture). The pooled adjusted HR (95% CI) for hip fracture was 1.25 (1.05 to 1.49) for TSH 0.45 to 0.99 mIU/L, 1.19 (1.01 to 1.41) for TSH 1.00 to 1.49 mIU/L, 1.09 (0.93 to 1.28) for TSH 1.50 to 2.49 mIU/L, and 1.12 (0.94 to 1.33) for TSH 2.50 to 3.49 mIU/L (P for trend = 0.004). Hip fracture was also associated with FT4 [HR (95% CI) 1.22 (1.11 to 1.35) per one standard deviation increase in FT4]. FT4 only was associated with any and nonvertebral fractures. Results remained similar in sensitivity analyses. Conclusions: Among euthyroid adults, lower TSH and higher FT4 are associated with an increased risk of hip fracture. These findings may help refine the definition of optimal ranges of thyroid function tests.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.