Graves' disease and bone mineral density: a meta-analysis and UK Biobank
Abstract
Objective: To investigate the association between Graves' disease (GD) and bone mineral density by integrating a meta-analysis with a large-scale cross-sectional analysis in the UK Biobank.
Methods: We systematically searched PubMed, Web of Science, and Cochrane Library for cohort and cross-sectional studies. The pooled findings were then examined in the UK Biobank using multivariable linear regression models with adjustment for age, BMI, lifestyle factors, vitamin D, calcium, and sex.
Results: The meta-analysis (14 studies, 3,643 participants) showed that GD patients had significantly lower bone mineral density than controls (Mean Difference = -0.09, 95% CI [-0.10, -0.07], P P = 0.023). However, substantial between-study heterogeneity was observed (I2 = 92.1%), indicating considerable variation across studies. Meta-regression and subgroup analyses identified postmenopausal women, older age (>50 years), and lower BMI as key factors amplifying the association. In the UK Biobank (n = 42374), after rigorous adjustment for all covariates, the association was substantially attenuated and remained statistically significant only at the ribs (P < 0.05), while other skeletal sites, including the lumbar spine and femoral neck, showed no significant differences.
Conclusion: This dual-evidence approach provides suggestive, rather than definitive, evidence that GD is associated with reduced BMD. The meta-analysis suggested widespread BMD reductions in GD patients. However, due to the…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 42,374 participants or records.
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