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Understanding the characteristics of idiopathic osteoporosis by a systematic review and meta-analysis

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Abstract

Purpose

To understand the pathophysiology of idiopathic osteoporosis (IOP) better, we conducted a systematic review and meta-analysis of bone mineral density (BMD), hormones, and bone turnover markers (BTMs) between IOP patients and healthy controls.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an appropriate search query was created, and three databases, including PubMed, ScienceDirect, and Google Scholar, were searched for screening relevant original articles. Feasible information, both qualitative and quantitative, was extracted and used to conduct meta-analyses. Publication bias and heterogeneity among studies were evaluated using appropriate statistical tools.

Results

A total of 21 studies were included in the meta-analysis. There was reduced BMD at the lumbar spine (LS) (pooled: SDM: −2.38, p-value: 0.0001), femoral neck (FN) (pooled: SDM: −1.75 p-value: 0.0001), total hip (TH) (pooled: SDM: −1.825, p-value: 0.0001) and distal radius (DR) (pooled: SDM of −0.476, p-value: 0.0001), of which LS was the most affected site. There was no significant change in BTMs compared with healthy controls. Total estradiol (SDM: −1.357, p-value: 0.003) was reduced, and parathyroid hormone (PTH) (SDM: 1.51, p-value: 0.03) and sex hormone-binding globulin (SHBG) (SDM: 1.454, p-value: 0.0001) were elevated in IOP patients compared with healthy controls.

Conclusion

Our meta-analysis, the first of its kind on IOP, defines it as showing BMD decline maximally at LS compared with healthy controls without any alterations in the BTMs. Further studies are required to understand gender differences and the significance of altered hormonal profiles in this condition.

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Author contributions

S.S. conducted literature screening and statistical analyses of the extracted data and wrote the manuscript; ShS performed statistical analyses of the extracted data and wrote the manuscript; S.R., A.M., and N.C. conceived the idea, conducted literature screening, and finalized the manuscript.

Funding

Council of Scientific and Industrial Research, Government of India (MLP-2035).

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Authors and Affiliations

  1. Division of Endocrinology and Centre for Research in Anabolic Skeletal Targets in Health and Illness (ASTHI), CSIR-Central Drug Research Institute, Lucknow, India

    Sreyanko Sadhukhan, Shruti Sethi, Singh Rajender & Naibedya Chattopadhyay

  2. Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India

    Sreyanko Sadhukhan, Shruti Sethi, Singh Rajender & Naibedya Chattopadhyay

  3. Endocrinology & Diabetes, Max Super Speciality Hospital, Delhi, India

    Ambrish Mithal

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  1. Sreyanko Sadhukhan
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Sadhukhan, S., Sethi, S., Rajender, S. et al. Understanding the characteristics of idiopathic osteoporosis by a systematic review and meta-analysis. Endocrine 82, 513–526 (2023). https://doi.org/10.1007/s12020-023-03505-5

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