Preoperative vitamin D level as a post-total thyroidectomy hypocalcemia predictor: a prospective study

Soares, Carlos Segundo Paiva; Tagliarini, José Vicente; Mazeto, Gláucia Maria Ferreira da Silva

doi:10.1016/j.bjorl.2019.07.001

Cited by 12 publications

(19 citation statements)

References 16 publications

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“…Some studies showed that low postoperative PTH level was predictive of postthyroidectomy hypocalcemia, as an independent predictor or in combination with low preoperative vitamin D. Soares et al prospectively evaluated 47 patients who were undergoing total thyroidectomy and reported that postoperative hypocalcemia was significantly associated with low postoperative PTH level [19]. Kim et al demonstrated that low vitamin D level in conjunction with postoperative PTH <15 pg/mL increased risk of symptomatic hypocalcemia [15].…”

Section: Resultsmentioning

confidence: 99%

“…Some studies concluded that low preoperative serum 25(OH)D level was a risk factor for postoperative hypocalcemia [13][14][15][16]. However, other studies have refuted this correlation [17][18][19]. Both preoperative 25(OH)D level and postoperative PTH level have been reported as independent predictors for postthyroidectomy hypocalcemia.…”

Section: Introductionmentioning

confidence: 99%

“…Kim et al found that preoperative 25(OH)D level <10 ng/mL in subgroup of patients with postoperative PTH level <15 pg/mL after thyroidectomy had 9.6 times higher risk of symptomatic hypocalcemia [15]. Interestingly, one study showed that postoperative PTH level, rather than preoperative 25(OH)D status, was a predictor of postoperative hypocalcemia [19]. Based on these diverse results, we aimed to accurately investigate the role of low 25(OH)D level in developing hypocalcemia by eliminating PTH level as a confounder.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Preoperative Vitamin D Deficiency on Hypocalcemia in Patients with Acute Hypoparathyroidism after Thyroidectomy

Vibhatavata

Pisarnturakit

Boonsripitayanon

et al. 2020

International Journal of Endocrinology

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Postoperative hypoparathyroidism is a common complication of total or completion thyroidectomy. The association between preoperative vitamin D deficiency (VDD) and the development of more severe postoperative hypocalcemia is still unclear. Objectives. To evaluate the effect of preoperative VDD on severity of hypocalcemia in patients with hypoparathyroidism following thyroidectomy. Methods. Patients who developed acute hypoparathyroidism after total or completion thyroidectomy, defined as postoperative parathyroid hormone (PTH) level <15 pg/mL and albumin-adjusted calcium level <8.6 mg/dL, were prospectively recruited. Patients were divided into two groups according to their preoperative vitamin D status (VDD group: 25-hydroxyvitamin D (25(OH)D) level <20 ng/mL; non-VDD group: 25(OH) level ≥20 ng/mL). The primary outcome was severity of hypocalcemia in postoperative hypoparathyroidism. Significant hypocalcemia was defined as calcium level ≤7.5 mg/dL. Results. Forty-three patients (21 VDD, 22 non-VDD) were enrolled. Serum total albumin-adjusted calcium level was significantly lower in the VDD group (7.71 ± 0.5 vs. 8.16 ± 0.4 mg/dL, p<0.01), and the incidence of symptomatic hypocalcemia was significantly higher in the VDD group (43% vs. 9%, p=0.01). The median maximal daily supplementary dose of elemental calcium was significantly higher in the VDD group (2,400 vs. 1,500 mg/day, p=0.02). Length of hospital stay was nonsignificantly longer in the VDD group (p=0.06). Preoperative vitamin D level <19.6 ng/mL could predict significant and symptomatic hypocalcemia in postoperative hypoparathyroidism with sensitivity of 90% and 82% and specificity of 70% and 69%, respectively. Conclusion. VDD is an independent risk factor for both significant and symptomatic hypocalcemia in hypoparathyroidism patients after thyroid surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Preoperative Vitamin D Deficiency on Hypocalcemia in Patients with Acute Hypoparathyroidism after Thyroidectomy

Vibhatavata

Pisarnturakit

Boonsripitayanon

et al. 2020

International Journal of Endocrinology

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“…Soares et al showed that postoperative hypocalcemia was associated only with parathyroid hormone and the preoperative vitamin D levels of patients were no different in those with or without hypocalcemia. In that study serum 25(OH)D concentrations were not found to be predictors for hypocalcemia 22 . Falcone et al concluded that 25(OH)D did not predict postoperative hypocalcemia 23 .…”

Section: Discussionmentioning

confidence: 65%

“…Interestingly, in the current study, a relationship was observed between postparathyroidectomy transient hypocalcemia and preoperative 25(OH)D levels, and the 25(OH)D level was seen to predict hypocalcemia in patients with primary hyperparathroidism after parathyroidectomy. Theoretically, patients with reduced serum Vitamin D levels are more prone to develop hypocalcemia due to a higher dependency on PTH-induced bone and renal re-absorption mechanisms 22 . Decreased serum calcium due to functional hypoparathyroidism causes reductions in bone reabsorption and increases in bone formation and an increased influx of calcium into bone.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Vitamin D Levels as a Predictor of Transient Hypocalcemia and Hypoparathyroidism After Parathyroidectomy

Ünsal

Çalapkulu

Sencar

et al. 2020

Sci Rep

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Hypocalcemia is a common problem after parathyroidectomy and/or thyroidectomy. The complication may be transient or permanent. Most cases occur as a result of removal of the parathyroid glands or damage to the glands during neck surgery. The purpose of this study was to evaluate the effect of preoperative vitamin D deficiency in predicting transient hypocalcemia and hypoparathyroidism after parathyroidectomy.Retrospective evaluation was made of 180 patients with primary hyperparathyroidism in respect of serum 25(OH)D, calcium and parathyroid hormone before and after parathyroidectomy. Transient hypocalcemia was defined as corrected calcium ≤ 8.4 mg/dL, and these cases were then evaluated for preoperative 25(OH)D values. Transient hypoparathyroidism has been described as low PTH level immediately after surgery before beginning any supplementation. Permanent hypoparathyroidism is accepted as the need for medical treatment is necessary over 12 months.Both transient hypocalcemia and hypoparathyroidism developed at statistically significantly higher rates in patients with preoperative vitamin D deficiency and vitamin D insufficiency.Vitamin D deficiency is an independent contributor to transient hypocalcemia and hypoparathyroidism following parathyroidectomy.

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Development of a tool to calculate the probability of hypocalcemia after total thyroidectomy: a prospective study

Soares,

Koga,

Moriguchi

et al. 2024

Langenbecks Arch Surg

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Preoperative vitamin D level as a post-total thyroidectomy hypocalcemia predictor: a prospective study

Cited by 12 publications

References 16 publications

Effect of Preoperative Vitamin D Deficiency on Hypocalcemia in Patients with Acute Hypoparathyroidism after Thyroidectomy

Effect of Preoperative Vitamin D Deficiency on Hypocalcemia in Patients with Acute Hypoparathyroidism after Thyroidectomy

Preoperative Vitamin D Levels as a Predictor of Transient Hypocalcemia and Hypoparathyroidism After Parathyroidectomy

Development of a tool to calculate the probability of hypocalcemia after total thyroidectomy: a prospective study

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