Higher Concentrations of Parathyroid Hormone (PTH) are Associated with Reduced Gait Velocity in Adults: A Systematic Review

Abstract

Introduction/objectives: High serum concentrations of parathyroid hormone (PTH) have been associated with osteoporosis, sarcopenia and osteosarcopenia. Gait velocity is a predictor of adverse outcomes. This systematic review aimed to assess the observational evidence studying the association of PTH concentrations with gait velocity in adults.

Methods: We searched PubMed, Embase (Ovid interface) and Cochrane (CENTRAL) for published studies evaluating circulating PTH in human adults aged >20 years, without date or language restriction. We excluded studies with patients on dialysis and if PTH was measured following any intervention having a potential effect on its concentrations. Primary outcome was gait velocity, defined as the time needed to walk a predetermined distance or distance walked during a fixed period at usual pace or fast pace. Two independent researchers conducted data extraction and evaluated the risk of bias. A third reviewer resolved disagreements. Risk of bias assessment was done using the National Heart, Lung and Blood Institute quality assessment tool.

Results: A total of 681 articles were retrieved from the systematic search. Following full-text review and risk of bias assessment, 8 studies were included for final analysis. Of the included studies, three demonstrated a significant inverse association between high PTH concentrations and gait velocity, one study showed an indirect association, and two studies showed a non-significant association of increasing PTH levels with declining gait speed. Two studies showed no relation. In addition, three of the studies also highlighted a negative correlation between PTH levels and muscle strength.

Conclusion: Our review of published studies suggests that higher concentrations of PTH are associated with reduced gait velocity in adults. This relationship deserves further exploration with RCTs designed to assess the effects of correcting abnormal circulating PTH levels on physical performance in adults.

Keywords: Parathyroid hormone; falls; fractures; gait velocity; osteosarcopenia.