Vitamin D Deficiency as a Predictive Factor of Transient Hypocalcemia after Total Thyroidectomy

Bove, Aldo; Rocini, C Dei; Renzo, Raffaella Maria Di; Farrukh, Maira; Palone, Gino; Chiarini, S; Staniscia, Tommaso

doi:10.1155/2020/8875257

Cited by 9 publications

(20 citation statements)

References 26 publications

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“…Filippo et al reported a nearly 3-fold higher hypocalcemia risk in patients who underwent total thyroidectomy than in patients who underwent lobectomy [ 18 ]. Vitamin D plays a pivotal role in regulating calcium metabolism, and a recent study showed a significant association between postoperative hypocalcemia and low preoperative vitamin D levels in patients after total thyroidectomy [ 19 ]. Many studies have reported on the correlation between vitamin D deficiency and decreased clinical pregnancy and live birth rates after IVF/ICSI [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of thyroid cancer treatment on assisted reproductive technology outcomes in women with infertility

Zeng

Yan

Chi

et al. 2021

J Assist Reprod Genet

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Purpose We investigated the effect of different surgical procedures and radioactive iodine treatment (RAIT) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and evaluated whether possible risk factors, including age, thyroid-stimulating hormone (TSH) levels, and thyroid antibody positivity, were associated with adverse IVF/ICSI outcomes. Methods This retrospective study included 76 women with infertility who had received thyroid cancer (TC) treatment among 137,698 infertile women who underwent IVF/ICSI cycles at the Peking University Third Hospital between 2010 and 2019. Clinical pregnancy and live birth rates were assessed. Results We found that the clinical pregnancy and live birth rates in women who underwent partial thyroidectomy were 7- and 6-fold higher, respectively, than those in women who underwent total thyroidectomy. We observed no significant differences in the clinical pregnancy and live birth rates between the RAIT and non-RAIT groups, even after adjusting for age, TSH levels, surgical treatment, and thyroid antibody positivity. Multivariate logistic regression analysis showed that age and TSH levels were not associated with decreased clinical pregnancy and live birth rates. Women with thyroid antibody positivity had significantly lower clinical pregnancy and live birth rates than women without thyroid antibody positivity. Conclusion Our study showed lower clinical pregnancy and live birth rates in women who underwent total thyroidectomy than in women who underwent partial thyroidectomy. Thyroid antibody positivity is an important risk factor for adverse IVF/ICSI outcomes in women who have received TC treatment.

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Section: Discussionmentioning

confidence: 99%

Impact of thyroid cancer treatment on assisted reproductive technology outcomes in women with infertility

Zeng

Yan

Chi

et al. 2021

J Assist Reprod Genet

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“…In a meta-analysis of 115 observational studies of bilateral thyroid surgery, age was not significantly associated with postoperative transient hypocalcemia, while female gender and Graves' disease were independent risk factors [ 20 ]. Several studies have suggested that autoimmune thyroiditis and higher cancer stages could be related to a higher risk of postoperative hypoparathyroidism, but there are conflicting reports [ 4 , 9 , 11 , 20 ]. In our study, gender, age, Hashimoto's thyroiditis, tumor size, and N stage were not significantly associated with postoperative hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported that low preoperative 25OHD was associated with postoperative hypoparathyroidism or hypocalcemia [ 11 , 21 – 23 ]. Bove et al [ 11 ] analyzed clinical and lab data of 177 patients who underwent total thyroidectomy and found preoperative vitamin D deficiency (<25 ng/mL) was an independent risk factor in the development of hypocalcemia (OR: 14.8, 95% CI: 1.59–59.70, p = 0.012). Recently, a meta-analysis was published by Vaitsi et al [ 24 ] which included 39 observational studies of patients undergoing thyroidectomy with preoperative vitamin D status and postoperative hypoparathyroidism data.…”

Section: Discussionmentioning

confidence: 99%

“…e relationship of vitamin D and postoperative hypoparathyroidism or hypocalcemia has been evaluated in a number of studies, but the results are controversial. Several studies reported that low preoperative 25OHD was associated with postoperative hypoparathyroidism or hypocalcemia [11,[21][22][23]. Bove et al [11] analyzed clinical and lab data of 177 patients who underwent total thyroidectomy and found preoperative vitamin D deficiency (<25 ng/mL) was an independent risk factor in the development of hypocalcemia [24].…”

Section: Discussionmentioning

confidence: 99%

“…Given its importance in calcium absorption and PTH interaction, some scholars assume that vitamin D deficiency is another potential risk factor of postoperative hypoparathyroidism. A number of studies have found a significant influence of vitamin D deficiency on postoperative hypoparathyroidism, while others did not observe this association [ 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D Insufficiency Predicts Susceptibility of Parathyroid Hormone Reduction after Total Thyroidectomy in Thyroid Cancer Patients

Zhang

Zheng

Huang

et al. 2021

International Journal of Endocrinology

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Objective. Given its role in the regulation of calcium and PTH levels, vitamin D was presumed as a potential predictor of postoperative hypoparathyroidism. However, the reports about their association were controversial. This study aims to reveal the relationship between preoperative vitamin D and postoperative parathyroid hormone (PTH). Methods. A total of 242 papillary thyroid cancer (PTC) patients who underwent total thyroidectomy (TT) during the period from June 2016 to December 2017 at our hospital were enrolled. Patients were divided into two groups, HypoP and Non-HypoP groups, based on postoperative PTH < 15.0 or ≥15.0 pg/mL, and ΔPTH50+ and ΔPTH50− groups, based on postoperative PTH reduction ratio ≥ 50% or <50%. Clinicopathological features and laboratory data were compared between two sets of groups. Results. Preoperative PTH level was lower in the HypoP group than in the Non-HypoP group (42.83 vs. 47.52 pg/mL, p = 0.018 ). No significant difference of vitamin D insufficiency was found between the HypoP and Non-HypoP groups (80.8% vs. 74.1%, p = 0.226 ). The rate of vitamin D insufficiency was higher in the ΔPTH50+ group than in the ΔPTH50− group (82.6% vs. 68.4%, p = 0.010 ). By multivariate logistic regression analysis, vitamin D insufficiency was an independent predictor of postoperative PTH reduction ratio ≥ 50% (OR = 2.2, p = 0.017 ). Conclusion. Vitamin D insufficiency is not associated with postoperative PTH in PTC patients undergoing TT. However, vitamin D insufficiency is an independent predictor of postoperative PTH reduction ratio.

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Preoperative Calcium or Vitamin D Supplement in Thyroidectomy: A Systematic Review and Meta‐Analysis

Jullamusi,

Ratanaprasert,

Pongsapich

et al. 2024

The Laryngoscope

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ObjectivesThe objective of this systematic review and meta‐analysis was to assess the role of preoperative calcium and vitamin D supplementation in patients who underwent total thyroidectomy.Data SourcesThe search for randomized controlled trials was performed in the OVID Medline and Embase databases.Review MethodsThe last search was made on September 16, 2024. Three independent reviewers evaluated full‐text articles from relevant reports based on eligibility criteria. The quality of the included studies was assessed by two reviewers according to the ROB 2 tool.ResultsThis systematic review and meta‐analysis considered 13 studies with 1504 participants. There were positive results in treatment outcomes including the mean postoperative calcium level (MD, 0.30 mg/dL: 95% CI, 0.15 to 0.44); the 48 h of postoperative hypocalcemia (OR, 0.41; 95% CI, 0.27 to 0.62); the postoperative symptomatic hypocalcemia (OR, 0.38; 95% CI, 0.24 to 0.62); the IV calcium supplementation (OR, 0.32; 95% CI, 0.18 to 0.58); and length of hospital stays (MD, −0.29; 95% CI, −0.51 to −0.07) as compared to the control group. Readmission rates showed no significant differences between the groups (OR, 0.15; 95% CI, 0.01 to 3.08).ConclusionsPreoperative calcium and vitamin D supplementation in patients who underwent total thyroidectomy results in reduction of postoperative symptomatic hypocalcemia. The finding is critical because it offers a feasible and effective solution that could improve patient care while potentially reducing the burden of numerous blood tests during the postoperative period.RegistrationThis systematic review protocol was registered with PROSPERO (registration number CRD42021278859).Level of EvidenceLevel 1 Laryngoscope, 2024

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Vitamin D Deficiency as a Predictive Factor of Transient Hypocalcemia after Total Thyroidectomy

Cited by 9 publications

References 26 publications

Impact of thyroid cancer treatment on assisted reproductive technology outcomes in women with infertility

Impact of thyroid cancer treatment on assisted reproductive technology outcomes in women with infertility

Vitamin D Insufficiency Predicts Susceptibility of Parathyroid Hormone Reduction after Total Thyroidectomy in Thyroid Cancer Patients

Preoperative Calcium or Vitamin D Supplement in Thyroidectomy: A Systematic Review and Meta‐Analysis

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