Characteristics of the studies included in the analysis
| Study (location) | Study population | Methods | Outcomes | ||||
| Age, mean (SD), years | Aetiology | Extent of thyroidectomy | No. of postmenopausal participants, n (total=1127) | Assessment tool of bone density (measurement site included in the meta-analysis) | Outcomes included in the meta-analysis (unit) | Assessment time after thyroidectomy, mean, year | |
| Recker and Shapiro (USA)31 | 50.2 | DTC | Total | Patients, 18 Controls, 16 | DPA (lumbar spine and femoral regions) | BMD (g/m2) | 9.6 |
| Diamond et al (Australia)16 | 59 (2.8) | DTC | Total | Patients, 10 Controls, 10 | DPA (lumbar spine, femoral neck) | BMD (g/m2) | 5.9 |
| Franklyn et al (UK)32 | 63.4 (8.1) | DTC | Subtotal* | Patients, 26 Controls, 26 | DEXA (lumbar spine and femoral regions) | BMD (g/m2) | NR |
| Abugassa et al (Sweden)33 | 58 (2) | Thyroid cancer | Total | Patients, 13 Controls, 12 | DPA (lumbar spine and femoral regions) | BMD (g/cm2) | 13.0 |
| Kung et al (China)15 | 62 (8) | Thyroid cancer | Total | Patient, 34 Control, 34 | DEXA (lumbar spine, femoral regions) | BMD (g/cm2) | 12.2 |
| Giannini et al (Italy)34 | Patients, 57.6 (1.7) Control, 56 (0.4) | Non-medullary thyroid carcinoma† | Total | Patients, 13 Controls, 11 | DEXA (lumbar spine, femoral regions) | BMD (g/cm2) | 7.6 |
| Hawkins et al (Spain)35 | Patients, 59.6 (7.5) Control, 49.3 (5.2) | Thyroid cancer | Near-total | Patients, 21 Controls, 53 | DEXA (lumbar spine) | BMD (g/cm2) | 6.2 |
| Frusciante et al (Italy)11 | Patients, 55.3 (1.7) Controls, 53.3 (2.5) | DTC | Near-total | Patients, 6 Controls, 7 | DEXA (lumbar spine, femoral neck) | BMD (g/cm2) | 5.7 |
| Toivonen et al (Finland)12 | Patients, 45 (range 27–71) Controls, 43 (range 26–65)‡ | DTC | Near-total | Patients, 10 Controls, 12 | DEXA (lumbar spine, femoral neck) | BMD (g/cm2) | 10 |
| Goerres et al (Switzerland)14 | Patients, 61.6 (12.0) Controls, 562.7 (8.1) | Thyroid cancer | Total | Patients, 23 Controls, 42 | DEXA (lumbar spine, femoral neck) | BMD (g/cm2) | 8.8 |
| Chen et al (China)36 | 57.7 (6.9) | DTC | Near-total | Patients, 25 Controls, 25 | DEXA (lumbar spine, femoral neck) | BMD (g/cm2) | 7.8 |
| Reverter et al (Spain)13 | 58 (9) | DTC | Near-total | Patients, 44 Controls, 44 | DEXA (lumbar spine, femoral neck) | BMD (g/cm2) | 12.0 |
| Eftekhari et al (Iran)37 | Patients, 51.7 (7.3) Controls, 51.2 (7.8)‡ | DTC | NR | Patients, 33 Controls, 33 | DEXA (lumbar spine) | BMD (g/cm2) | 1.2 |
| Tournis et al (Greece)38 | Patients, 56.7 (5.9) Controls, 57.8 (6.1) | DTC | Total | Patients, 40 Controls, 60 | DEXA (lumbar spine, femoral neck) | BMD (mg/cm3)§ | 5.0 |
| Moon et al (Korea)39 | Patients, 61.4 (7.6) Controls, 61.4 (7.6) | DTC | NR | Patients, 74 Controls, 222 | DEXA (lumbar spine, femoral neck) | BMD (g/cm2) | 5.2 |
| Kim et al (Korea)40 | Patients, 53 Controls, 55 | DTC | Total | Patients, 36 Controls, 94 | DEXA (lumbar spine) | BMD (g/cm2) | 4.9 |
*This study which involved subjects that underwent subtotal thyroidectomy was excluded from the total versus near-total subgroup analysis.
†This study involved patients with non-medullary thyroid carcinoma without any kind of drug treatment known to influence bone turnover or diseases affecting calcium metabolism.
‡These studies presented the mean or median age of the total study population, including premenopausal and postmenopausal women.
§This value was calculated with the method of volumetric BMD. For more information, refer to Tournis et al.38
BMD, bone mineral density; DEXA, dual-energy X-ray absorptiometry; DPA, dual photon absorptiometry; DTC, differentiated thyroid carcinoma; NR, not reported.;