The Relationship Of Magnesium Level With The Recovery Of Parathyroid Function In Post-Thyroidectomy Hypoparathyroidism

Abstract

Objectives: Hypocalcemia is the most common complication and acute parathyroid gland insufficiency is the main cause of it after thyroidectomy. In this study, we aimed to evaluate the relationship between the recovery time of parathyroid gland function and patient characteristics, preoperative and postoperative electrolyte changes, and intraoperative parathyroid findings in patients with postoperative hypoparathyroidism. Methods: Patients who underwent total thyroidectomy (TT) with or without central neck dissection ± lateral neck dissection with a parathyroid hormone (PTH) value of <15 pg/mL within the postoperative 4th hour were included in this study. Postoperative calcium level of <8mg/dL was defined as biochemical hypocalcemia and a PTH value of <15 pg/mL was defined as hypoparathyroidism. The patients were divided into three groups according to the time of PTH recovery (>15 pg/mL); within the first 24 hours, between one day and 30 days, after 30 days, respectively. Results: One hundred eleven patients (mean age, 49.3±14.4 years) consisted of Groups 1, 2 and 3, including 19 (16F, 3M), 67 (54F, 13M) and 25 (19F, 6M), respectively. Vitamin D deficiency rates for Groups 1, 2, 3 were 41.7%, 53.1% and 88.2%, respectively (p=0.018). Postoperative day 0 PTH values were 11.69±2.79pg/mL, 6.92±3.45 pg/mL, 4.99±2.36 pg/mL, (p<0.001). Biochemical hypocalcemia rates of Groups 1, 2, 3 on postoperative day 1 were 15.8%, 53.7%, 64%, (p=004) respectively, and calcium values were 8.68±0.67 mg/dL, 8.15±0.66 mg/dL, 7.75±1 mg/dL, (p=0.014), respectively. Magnesium values on postoperative day 1 and 7 for Groups 1, 2, 3 were 1.85±0.1 mg/dL, 1.77±0.17 mg/dL, 1.64±0.17 mg/dL, (p=0.005), and 1.86±0.16mg/dL, 1.82±0.21mg/dL, 1.59±0.15mg/dL (p=0.001), respectively. PTH values on postoperative day 1 and 7 in Groups 1, 2, 3 were 20.5±6.4 pg/mL, 7.06±4.35 pg/mL, 4.66±3.26 pg/mL (p<0.001), and 31.04±10.54pg/mL, 18.72±13.84pg/mL, 4.55±4.9pg/mL (p<0.0001), respectively. Parathyroid function improved in 106 patients, and permanent hypoparathyroidism developed in five patients (4.5%). Conclusion:Hypoparathyroidism can recover rapidly in the first 24 hours in patients with a PTH value of around 10 pg/mL at postoperative 4th hour. As the number of preserved parathyroids increased, recovery time decreased. In patients with postoperative hypoparathyroidism, postoperative low magnesium levels may be associated with delayed recovery of parathyroid function.

The reality of hypoparathyroidism after thyroidectomy: which risk factors are effective? Single center study

“…The PTH values of patients with PTH <15 ng/L at the 4 th h can recover at the 24 th h in approximately 20% of the patients. [ 40 ]…”

The impact of maternal obesity on newborn and maternal health status

“…The sample size of the study was 95% probability (α=0.05), effect power w=0.3 (moderate), Df=2 and power=0.80 (80%) for chi-square analysis G Power 3.1.10 statistical program was used, the total was calculated as 108. In order to increase the power of the research as a result of possible losses and analyzes in the data collection process, the number of samples was increased to reach 315 women [20].…”

“…The women who could not be reached in the first call were called for the second and third times or by calling the phone numbers of their husbands and trying to reach them all. The body mass index (BMI) was obtained by dividing the body weight [20] by the square of the height (m 2 ) and it was used for the evaluation of obesity .…”

PTH after Thyroidectomy as a Predictor of Post-Operative Hypocalcemia

“…The major criticism is the lack of a clear PTH threshold for both calcium and vitamin D supplementation. Some authors suggest that PTH may not be the only determinant for the development of hypocalcemia and that other factors may play a major role such as vitamin D deficiency [40], dietary habits [41], and other metabolic disorders such as hypomagnesemia [42,43]. Hypomagnesemia is frequently associated with the use of drugs such as aminoglycosides, cyclosporine, cisplatin, amphotericin B, ACE inhibitors, proton pump inhibitors, and some diuretics (thiazides and loop) [44].…”