Objective To evaluate the effect of TSH-suppressive therapy on bone mineral density(BMD) in patients with differentiated thyroid carcinoma(DTC).

Methods The cross-sectional, cohort, prospective controlled, and case-control studies on the BMD change in patients with DTC after TSH-suppressive therapy from databases were searched, including PubMed, Medline, Wanfang Database, VIP, China National Knowledge Infrastructure, and CBM. The effect of TSH-suppressive therapy on the BMD of lumbar, femoral neck, femoral greater trochanter, and Ward triangle were analyzed. Data from the date of database establishment to October 2017 were all reviewed. Meta-analysis was performed with RevMan 5.3 software after two reviewers independently screened the date. The categorical variables were expressed as odds ratios, and numerical variables were expressed as weighted mean or standardized mean differences. Based on the heterogeneity of the study, a comprehensive analysis was performed by using fixed or random effect models.

Results A total of 14 studies involving 588 patients with differentiated thyroid cancer were included. No significant difference in the BMD of lumbar indications between the experimental and control groups was observed: SMD=−0.00, 95%CI −0.26, 0.26, P=0.98. The BMD of femoral neck indications: SMD=−0.00, 95%CI −0.15, 0.14, P=0.96. A significant difference between the experimental and control groups in the BMD of femoral trochanter indications was observed: SMD=−0.30, 95%CI −0.53, −0.06, P=0.01. The BMD of Ward's triangle indications: SMD=−0.35, 95%CI −0.63, −0.08, P=0.01.

Conclusions TSH-suppressive therapy in patients with DTC mainly reduces proximal femur BMD, and BMD must be followed-up regularly.