Parathyroid hormone level is associated with sarcopenia: a meta-analysis

Background Parathyroid hormone plays a key role in muscle metabolism and function, yet its precise association with sarcopenia remains controversial. This meta-analysis systematically examines the relationship between serum parathyroid hormone levels and the prevalence of sarcopenia. Methods We systematically searched PubMed, Embase, and Web of Science until April 2025 for observational studies on the link between parathyroid hormone levels and sarcopenia prevalence. 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. Results 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 observed a positive association between serum parathyroid hormone levels and the prevalence of sarcopenia (odds ratios = 1.10, 95% confidence intervals 1.03–1.17, P  < 0.001). Subgroup analysis showed consistent results across standard (odds ratios = 1.05, 95% confidence intervals 1.03–1.08) and alternative (odds ratios = 1.94, 95% confidence intervals 1.21–3.13) sarcopenia diagnoses, as well as in community (odds ratios = 1.05, 95% confidence intervals 1.03–1.08) and hospital settings (odds ratios = 2.19, 95% confidence intervals 1.27–3.77). Sensitivity analysis confirmed the stability of these findings, with no publication bias detected. Conclusions This meta-analysis demonstrates a significant positive association between high parathyroid hormone levels and increased sarcopenia risk. This study identifies modifiable risk factors for sarcopenia and offers initial evidence to guide endocrine therapies for high-risk groups.