Objective Considering the fact that the relationship between serum thyroid-stimulating hormone and bone mineral density in postmenopausal women is still controversial, this study adopts meta-analysis in evaluating the correlation between TSH and BMD, as well as osteoporosis in the postmenopausal women with normal thyroid function.
Methods Cochrane Library, PubMed, VIP, Web of Science, Wan Fang Data, and CNKI databases were searched for articles concerning correlation between TSH and BMD in postmenopausal women. The retrieval time was set from the date of database establishment to November 30, 2020. Revman5.3 and Stata12.0 software were used for meta-analysis.
Results A total of 19 articles were incorporated, including 9 articles describing the correlation coefficient (r) between TSH and BMD covering 2,573 subjects; 10 articles reflecting the risk of OP and TSH with 21,387 subjects in total; 4 articles that included in the study reflecting the mean BMD with 1,310 individuals. The Summary Fisher’ Z of the correlation between TSH and BMD was 0.16, 95% CI (0.00, 0.32), and the correlation coefficient of Summary Fisher’ Z conversion was 0.158. Study on the relationship between TSH and osteoporosis based on OR demonstrated that the combined OR was 1.76, 95% CI (1.27, 2.45), P<0.05. The BMD of group with low TSH was lower than that of the control group, SMD at -0.31, 95% CI (-0.44, -0.18), P<0.001. The BMD of group with high TSH was higher than that of the control group, SMD at 0.22, 95% CI (0.08, 0.35), P=0.001. The subgroup analyzing results displayed that the risk of osteoporosis of the subjects from community with low TSH was 1.89, 95% CI (1.43, 2.49), P<0.01. The risk of osteoporosis for subjects with low TSH and from hospitals was 1.36, 95% CI (0.46, 3.99), P=0.58; 1.84 for subjects with low TSH and anti-osteoporosis drugs, 95% CI (1.05, 3.22), P=0.03; and 1.74 for those with low TSH but not taking anti-osteoporosis drugs, 95% CI (1.08, 2.82), P=0.02. The dose-response relationship showed that the risk of osteoporosis tended to decrease when TSH was more than 2.5mIu/L.
Conclusion The serum TSH is positively related with BMD in postmenopausal women, and high TSH (>2.5 mIu/L) within the normal range is possibly helpful to decrease the risk of osteoporosis in postmenopausal women.