Association Between Parathyroidectomy and Bone Fracture Risk in Patients With Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis Publisher



Farhadi M¹ ; Vahdati SS² ; Mesbahi H³ ; Samadizadeh S⁴ ; Naderi M⁵ ; Noktehsanj R⁶ ; Norouzbeygi A⁷ ; Emamieh S⁸ ; Forghan M⁶ Show Affiliations
Source: Journal of Parathyroid Disease Published:2025

Abstract

Introduction: Parathyroidectomy is the definitive treatment for primary hyperparathyroidism and enhances bone density; thus, this study aimed to investigate the association between parathyroidectomy and fracture risk in individuals with primary hyperparathyroidism. Materials and Methods: This meta-analysis and systematic review were conducted through simple and advanced searches in PubMed, Cochrane, Web of Science, ProQuest, and Google Scholar. The search was updated until June 25, 2023. Data were collected using SPSS version 19 and analyzed with STATA software version 14. Results: Eleven cohort studies totaling 97,388 patients with primary hyperparathyroidism who had parathyroidectomy were included in the meta-analysis. In individuals with primary hyperparathyroidism, parathyroidectomy decreased the fracture risk by 15% (odds ratio [OR]: 0.85; 95% confidence interval [CI]: 0.74, 0.99) overall and by 22% (OR: 0.78; 95% CI: 0.76, 0.80) in patients aged 70 to 79 years; however, no notable association was found between parathyroidectomy and the fracture risk in patients aged 50 to 59 years (OR: 0.99; 95% CI: 0.55, 1.76) and 60 to 69 years (OR: 0.84; 95% CI: 0.69, 1.02); additionally, parathyroidectomy resulted in a 29% reduction in the fracture risk in the USA (OR: 0.71; 95% CI: 0.61, 0.81) and a 23% reduction in the hip fracture risk (OR: 0.77; 95% CI: 0.60, 0.97); however, no statistically notable correlation was found between parathyroidectomy and the risk of hand, foot, vertebral, femur, forearm, spine, upper extremity, femoral neck, and osteoporotic fractures. Conclusion: Parathyroidectomy reduced fracture risk by 15%, notably preventing bone and hip fractures in people over 70. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024564707) and Research Registry (UIN: reviewregistry1854 websites. © 2025 The Author(s);.