Do Low Preoperative Vitamin D Levels Reduce the Accuracy of Quick Parathyroid Hormone in Predicting Postthyroidectomy Hypocalcemia?
Background Although some studies have suggested that low preoperative 25-hydroxyvitamin D (25-OHD) levels may increase the risk of hypocalcemia and decrease the accuracy of single quick parathyroid hormone in predicting hypocalcemia after total thyroidectomy, the literature remains scarce and incons...
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| Veröffentlicht in: | Annals of surgical oncology 2013-03, Vol.20 (3), p.739-745 |
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| container_title | Annals of surgical oncology |
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| creator | Lang, Brian Hung-Hin Wong, Kai Pun Cowling, Benjamin J. Fong, Yuen Ki Chan, Desmond Kwan-Kit Hung, Grace Kin-Yee |
| description | Background
Although some studies have suggested that low preoperative 25-hydroxyvitamin D (25-OHD) levels may increase the risk of hypocalcemia and decrease the accuracy of single quick parathyroid hormone in predicting hypocalcemia after total thyroidectomy, the literature remains scarce and inconsistent. Our study aimed to address these issues.
Methods
Of the 281 consecutive patients who underwent a total/completion total thyroidectomy, 244 (86.8 %) did not require any oral calcium and/or calcitriol supplements (group 1), while 37 (13.2 %) did (group 2) at hospital discharge. 25-OHD level was checked 1 day before surgery, and postoperative quick parathyroid hormone (PTH) was checked at skin closure (PTH-SC). Postoperative serum calcium was checked regularly. Hypocalcemia was defined by the presence of symptoms or adjusted calcium of |
| doi_str_mv | 10.1245/s10434-012-2666-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3574563</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2893340961</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-ba9ca9e21c42381d8cde331b548afe6517c1ad9671b054d0246cdcb9d578ea8c3</originalsourceid><addsrcrecordid>eNp1kU-P0zAQxSMEYpeFD8AFWeLCJeA_seNcQKtdoEiVKAi4Ws542npJ4mInRTnzxXHVslqQuNiW5_feePyK4imjLxmv5KvEaCWqkjJecqVUOd8rzpnMN5XS7H4-U6XLhit5VjxK6YZSVgsqHxZnnDdKCynPi1_XgSzDT7KKGHYY7ej3SL750fZ-INdkiXvsEvmMbgIk4xbJJcAULcwkrMmnycN3srJZtp1j8I4sQuzDgCSLs6PzMPphQ1YhjScCYQz9TBbzLoDtAHtv3zwuHqxtl_DJab8ovr57--VqUS4_vv9wdbksQVIxlq1twDbIGVRcaOY0OBSCtbLSdo1KshqYdY2qWUtl5SivFDhoGydrjVaDuCheH313U9ujAxzGaDuzi763cTbBevN3ZfBbswl7I2RdSSWywYuTQQw_Jkyj6X0C7Do7YJiSyd_LtdBK1Rl9_g96E6Y45PEM41qzw0IzxY4UxJBSxPXtYxg1h4jNMWKTIzaHiM2cNc_uTnGr-JNpBvgRSLk0bDDeaf1f19_N2LUF</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1288112880</pqid></control><display><type>article</type><title>Do Low Preoperative Vitamin D Levels Reduce the Accuracy of Quick Parathyroid Hormone in Predicting Postthyroidectomy Hypocalcemia?</title><source>MEDLINE</source><source>SpringerLink Journals (MCLS)</source><creator>Lang, Brian Hung-Hin ; Wong, Kai Pun ; Cowling, Benjamin J. ; Fong, Yuen Ki ; Chan, Desmond Kwan-Kit ; Hung, Grace Kin-Yee</creator><creatorcontrib>Lang, Brian Hung-Hin ; Wong, Kai Pun ; Cowling, Benjamin J. ; Fong, Yuen Ki ; Chan, Desmond Kwan-Kit ; Hung, Grace Kin-Yee</creatorcontrib><description>Background
Although some studies have suggested that low preoperative 25-hydroxyvitamin D (25-OHD) levels may increase the risk of hypocalcemia and decrease the accuracy of single quick parathyroid hormone in predicting hypocalcemia after total thyroidectomy, the literature remains scarce and inconsistent. Our study aimed to address these issues.
Methods
Of the 281 consecutive patients who underwent a total/completion total thyroidectomy, 244 (86.8 %) did not require any oral calcium and/or calcitriol supplements (group 1), while 37 (13.2 %) did (group 2) at hospital discharge. 25-OHD level was checked 1 day before surgery, and postoperative quick parathyroid hormone (PTH) was checked at skin closure (PTH-SC). Postoperative serum calcium was checked regularly. Hypocalcemia was defined by the presence of symptoms or adjusted calcium of <1.90 mmol/L. Significant factors for hypocalcemia were determined by univariate and multivariate analyses. The accuracy of PTH-SC in predicting hypocalcemia was measured by area under a receiver operating characteristic curve (AUC), and the AUC of PTH-SC was compared between patients with preoperative 25-OHD <15 and ≥15 ng/mL via bootstrapping.
Results
Preoperative 25-OHD level was not significantly different between groups 1 and 2 (13.1 vs. 12.5 ng/mL,
p
= 0.175). After adjusting for other significant factors, PTH-SC (odds ratio 2.49, 95 % confidence interval 1.52–4.07,
p
< 0.001) and parathyroid autotransplantation (odds ratio 3.23, 95 % confidence interval 1.22–8.60,
p
= 0.019) were the two independent factors for hypocalcemia. The AUC of PTH-SC was similar between those with 25-OHD <15 and ≥15 ng/mL (0.880 vs. 0.850,
p
= 0.61)
Conclusions
Low 25-OHD was not a significant factor for hypocalcemia and did not lower the accuracy of quick PTH in predicting postthyroidectomy hypocalcemia.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-012-2666-y</identifier><identifier>PMID: 22968355</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Calcium - metabolism ; Endocrine Tumors ; Female ; Follow-Up Studies ; Humans ; Hypocalcemia - blood ; Hypocalcemia - diagnosis ; Hypocalcemia - etiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Parathyroid Hormone - blood ; Postoperative Period ; Preoperative Care ; Prognosis ; Risk Factors ; Surgery ; Surgical Oncology ; Thyroid Neoplasms - complications ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Vitamin D - blood ; Young Adult</subject><ispartof>Annals of surgical oncology, 2013-03, Vol.20 (3), p.739-745</ispartof><rights>The Author(s) 2012</rights><rights>Society of Surgical Oncology 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-ba9ca9e21c42381d8cde331b548afe6517c1ad9671b054d0246cdcb9d578ea8c3</citedby><cites>FETCH-LOGICAL-c503t-ba9ca9e21c42381d8cde331b548afe6517c1ad9671b054d0246cdcb9d578ea8c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-012-2666-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-012-2666-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22968355$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lang, Brian Hung-Hin</creatorcontrib><creatorcontrib>Wong, Kai Pun</creatorcontrib><creatorcontrib>Cowling, Benjamin J.</creatorcontrib><creatorcontrib>Fong, Yuen Ki</creatorcontrib><creatorcontrib>Chan, Desmond Kwan-Kit</creatorcontrib><creatorcontrib>Hung, Grace Kin-Yee</creatorcontrib><title>Do Low Preoperative Vitamin D Levels Reduce the Accuracy of Quick Parathyroid Hormone in Predicting Postthyroidectomy Hypocalcemia?</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Although some studies have suggested that low preoperative 25-hydroxyvitamin D (25-OHD) levels may increase the risk of hypocalcemia and decrease the accuracy of single quick parathyroid hormone in predicting hypocalcemia after total thyroidectomy, the literature remains scarce and inconsistent. Our study aimed to address these issues.
Methods
Of the 281 consecutive patients who underwent a total/completion total thyroidectomy, 244 (86.8 %) did not require any oral calcium and/or calcitriol supplements (group 1), while 37 (13.2 %) did (group 2) at hospital discharge. 25-OHD level was checked 1 day before surgery, and postoperative quick parathyroid hormone (PTH) was checked at skin closure (PTH-SC). Postoperative serum calcium was checked regularly. Hypocalcemia was defined by the presence of symptoms or adjusted calcium of <1.90 mmol/L. Significant factors for hypocalcemia were determined by univariate and multivariate analyses. The accuracy of PTH-SC in predicting hypocalcemia was measured by area under a receiver operating characteristic curve (AUC), and the AUC of PTH-SC was compared between patients with preoperative 25-OHD <15 and ≥15 ng/mL via bootstrapping.
Results
Preoperative 25-OHD level was not significantly different between groups 1 and 2 (13.1 vs. 12.5 ng/mL,
p
= 0.175). After adjusting for other significant factors, PTH-SC (odds ratio 2.49, 95 % confidence interval 1.52–4.07,
p
< 0.001) and parathyroid autotransplantation (odds ratio 3.23, 95 % confidence interval 1.22–8.60,
p
= 0.019) were the two independent factors for hypocalcemia. The AUC of PTH-SC was similar between those with 25-OHD <15 and ≥15 ng/mL (0.880 vs. 0.850,
p
= 0.61)
Conclusions
Low 25-OHD was not a significant factor for hypocalcemia and did not lower the accuracy of quick PTH in predicting postthyroidectomy hypocalcemia.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Area Under Curve</subject><subject>Calcium - metabolism</subject><subject>Endocrine Tumors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypocalcemia - blood</subject><subject>Hypocalcemia - diagnosis</subject><subject>Hypocalcemia - etiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Parathyroid Hormone - blood</subject><subject>Postoperative Period</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Thyroid Neoplasms - complications</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy</subject><subject>Vitamin D - blood</subject><subject>Young Adult</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU-P0zAQxSMEYpeFD8AFWeLCJeA_seNcQKtdoEiVKAi4Ws542npJ4mInRTnzxXHVslqQuNiW5_feePyK4imjLxmv5KvEaCWqkjJecqVUOd8rzpnMN5XS7H4-U6XLhit5VjxK6YZSVgsqHxZnnDdKCynPi1_XgSzDT7KKGHYY7ej3SL750fZ-INdkiXvsEvmMbgIk4xbJJcAULcwkrMmnycN3srJZtp1j8I4sQuzDgCSLs6PzMPphQ1YhjScCYQz9TBbzLoDtAHtv3zwuHqxtl_DJab8ovr57--VqUS4_vv9wdbksQVIxlq1twDbIGVRcaOY0OBSCtbLSdo1KshqYdY2qWUtl5SivFDhoGydrjVaDuCheH313U9ujAxzGaDuzi763cTbBevN3ZfBbswl7I2RdSSWywYuTQQw_Jkyj6X0C7Do7YJiSyd_LtdBK1Rl9_g96E6Y45PEM41qzw0IzxY4UxJBSxPXtYxg1h4jNMWKTIzaHiM2cNc_uTnGr-JNpBvgRSLk0bDDeaf1f19_N2LUF</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Lang, Brian Hung-Hin</creator><creator>Wong, Kai Pun</creator><creator>Cowling, Benjamin J.</creator><creator>Fong, Yuen Ki</creator><creator>Chan, Desmond Kwan-Kit</creator><creator>Hung, Grace Kin-Yee</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7QP</scope><scope>5PM</scope></search><sort><creationdate>20130301</creationdate><title>Do Low Preoperative Vitamin D Levels Reduce the Accuracy of Quick Parathyroid Hormone in Predicting Postthyroidectomy Hypocalcemia?</title><author>Lang, Brian Hung-Hin ; Wong, Kai Pun ; Cowling, Benjamin J. ; Fong, Yuen Ki ; Chan, Desmond Kwan-Kit ; Hung, Grace Kin-Yee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-ba9ca9e21c42381d8cde331b548afe6517c1ad9671b054d0246cdcb9d578ea8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Area Under Curve</topic><topic>Calcium - metabolism</topic><topic>Endocrine Tumors</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypocalcemia - blood</topic><topic>Hypocalcemia - diagnosis</topic><topic>Hypocalcemia - etiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Parathyroid Hormone - blood</topic><topic>Postoperative Period</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Thyroid Neoplasms - complications</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroidectomy</topic><topic>Vitamin D - blood</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lang, Brian Hung-Hin</creatorcontrib><creatorcontrib>Wong, Kai Pun</creatorcontrib><creatorcontrib>Cowling, Benjamin J.</creatorcontrib><creatorcontrib>Fong, Yuen Ki</creatorcontrib><creatorcontrib>Chan, Desmond Kwan-Kit</creatorcontrib><creatorcontrib>Hung, Grace Kin-Yee</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lang, Brian Hung-Hin</au><au>Wong, Kai Pun</au><au>Cowling, Benjamin J.</au><au>Fong, Yuen Ki</au><au>Chan, Desmond Kwan-Kit</au><au>Hung, Grace Kin-Yee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do Low Preoperative Vitamin D Levels Reduce the Accuracy of Quick Parathyroid Hormone in Predicting Postthyroidectomy Hypocalcemia?</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>20</volume><issue>3</issue><spage>739</spage><epage>745</epage><pages>739-745</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Although some studies have suggested that low preoperative 25-hydroxyvitamin D (25-OHD) levels may increase the risk of hypocalcemia and decrease the accuracy of single quick parathyroid hormone in predicting hypocalcemia after total thyroidectomy, the literature remains scarce and inconsistent. Our study aimed to address these issues.
Methods
Of the 281 consecutive patients who underwent a total/completion total thyroidectomy, 244 (86.8 %) did not require any oral calcium and/or calcitriol supplements (group 1), while 37 (13.2 %) did (group 2) at hospital discharge. 25-OHD level was checked 1 day before surgery, and postoperative quick parathyroid hormone (PTH) was checked at skin closure (PTH-SC). Postoperative serum calcium was checked regularly. Hypocalcemia was defined by the presence of symptoms or adjusted calcium of <1.90 mmol/L. Significant factors for hypocalcemia were determined by univariate and multivariate analyses. The accuracy of PTH-SC in predicting hypocalcemia was measured by area under a receiver operating characteristic curve (AUC), and the AUC of PTH-SC was compared between patients with preoperative 25-OHD <15 and ≥15 ng/mL via bootstrapping.
Results
Preoperative 25-OHD level was not significantly different between groups 1 and 2 (13.1 vs. 12.5 ng/mL,
p
= 0.175). After adjusting for other significant factors, PTH-SC (odds ratio 2.49, 95 % confidence interval 1.52–4.07,
p
< 0.001) and parathyroid autotransplantation (odds ratio 3.23, 95 % confidence interval 1.22–8.60,
p
= 0.019) were the two independent factors for hypocalcemia. The AUC of PTH-SC was similar between those with 25-OHD <15 and ≥15 ng/mL (0.880 vs. 0.850,
p
= 0.61)
Conclusions
Low 25-OHD was not a significant factor for hypocalcemia and did not lower the accuracy of quick PTH in predicting postthyroidectomy hypocalcemia.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22968355</pmid><doi>10.1245/s10434-012-2666-y</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2013-03, Vol.20 (3), p.739-745 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3574563 |
| source | MEDLINE; SpringerLink Journals (MCLS) |
| subjects | Adult Aged Aged, 80 and over Area Under Curve Calcium - metabolism Endocrine Tumors Female Follow-Up Studies Humans Hypocalcemia - blood Hypocalcemia - diagnosis Hypocalcemia - etiology Male Medicine Medicine & Public Health Middle Aged Oncology Parathyroid Hormone - blood Postoperative Period Preoperative Care Prognosis Risk Factors Surgery Surgical Oncology Thyroid Neoplasms - complications Thyroid Neoplasms - surgery Thyroidectomy Vitamin D - blood Young Adult |
| title | Do Low Preoperative Vitamin D Levels Reduce the Accuracy of Quick Parathyroid Hormone in Predicting Postthyroidectomy Hypocalcemia? |
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