Serum parathyroid hormone and risk of sarcopenia: a meta-analysis

Parathyroid hormone plays a key role in muscle metabolism and function, yet its precise association with sarcopenia remains controversial. This meta-analysis evaluated the relationship between serum parathyroid hormone levels and the risk of sarcopenia.

We systematically searched PubMed, Embase, and Web of Science until April 2025 for observational studies on the link between parathyroid hormone levels and sarcopenia. Using random-effects models, we derived pooled odds ratios with 95% confidence intervals and conducted subgroup analyses. Sensitivity analyses were performed to ensure robustness by excluding small or low-quality studies. Study quality was assessed with modified Newcastle-Ottawa scales, and publication bias was checked using funnel plot symmetry.

This meta-analysis included 11 studies involving 4,759 participants, with mean ages ranging from 57.5 to 76.4 years and 50.37% of participants being female. Our meta-analysis showed a positive association between serum parathyroid hormone levels and the risk of sarcopenia (odds ratios = 1.10, 95% confidence intervals 1.03-1.17, P < 0.001). Subgroup analyses indicated a consistently positive association across diagnostic definitions and study settings, although the effect size was greater in studies using alternative diagnostic criteria (OR = 1.94, 95% confidence intervals 1.21-3.13) and in hospital-based populations (OR = 2.19, 95% confidence intervals 1.27-3.77). Sensitivity analysis confirmed the stability of these findings, with no publication bias detected.

This meta-analysis suggests a potential positive association between elevated parathyroid hormone levels and sarcopenia risk. However, given the substantial heterogeneity and the observational nature of the included studies, these findings should be interpreted with caution. Further large-scale, prospective investigations are warranted to clarify the causal relationship and to explore whether targeting parathyroid hormone could contribute to sarcopenia prevention or management.