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Meta-Analysis
. 2018 Nov 14:12:3929-3935.
doi: 10.2147/DDDT.S179568. eCollection 2018.

Effectiveness of thiazides on serum and urinary calcium levels and bone mineral density in patients with osteoporosis: a systematic review and meta-analysis

Lei Cheng  1 , Keyan Zhang  1 , Zhenyong Zhang  2
Affiliations
Meta-Analysis

Effectiveness of thiazides on serum and urinary calcium levels and bone mineral density in patients with osteoporosis: a systematic review and meta-analysis

Lei Cheng et al. Drug Des Devel Ther. .

Abstract

Objective: Osteoporosis is the most common metabolic bone disease and a major public health problem worldwide. Thiazides are widely used as antihypertensive agents with good tolerability and efficacy. Furthermore, thiazides have long been regarded as candidates for the prevention of postmenopausal bone loss. However, there is insufficient evidence that thiazides have a sustained beneficial effect on preserving bone mass and preventing osteoporosis to date.

Materials and methods: We searched the PubMed, the Cochrane Library, and Embase in June 2018 for randomized controlled trials on the use of thiazides to treat osteoporosis. Continuous outcomes are presented as the standardized mean difference (SMD) and 95% CI. Furthermore, P-values <0.05 were considered significant.

Results: Five trials with 756 patients were randomly assigned in the five trials included in this meta-analysis. Serum calcium level was higher in the thiazide group than in the control group (SMD 0.33, 95% CI [0.16, 0.50]), and urinary calcium level was significantly lower in the thiazide group (SMD -0.35, 95% CI [-0.52, -0.17]). There was no significant difference in bone mineral density between the two groups (SMD 0.19, 95% CI [-0.16, 0.54]).

Conclusion: Thiazides might play a role in preserving bone mass and be effective in the prevention and treatment of osteoporosis. Future high-quality trials are needed to confirm our findings in the future.

Keywords: bone mineral density; osteoporosis; serum calcium; thiazides; urinary calcium.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the search and selection of the studies included in this meta-analysis.
Figure 2
Figure 2
Risk of bias summary. Note: Red with a minus means high risk of bias; yellow with a question mark means unclear; and green with a plus means low risk of bias.
Figure 3
Figure 3
Forest plot for serum calcium. Note: A comparison of thiazide treatment with placebo treatment on serum calcium in patients with osteoporosis.
Figure 4
Figure 4
Forest plot for urinary calcium. Note: A comparison of thiazide treatment with placebo treatment on urinary calcium in patients with osteoporosis.
Figure 5
Figure 5
Forest plot for bone mineral density. Note: A comparison of thiazide treatment with placebo treatment on bone mineral density in patients with osteoporosis.
See this image and copyright information in PMC

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