World Journal of Surgery

, Volume 37, Issue 7, pp 1592–1598 | Cite as

Does Preoperative 25-Hydroxyvitamin D Status Significantly Affect the Calcium Kinetics after Total Thyroidectomy?

  • Brian Hung-Hin Lang
  • Kai Pun Wong
  • Chung Yeung Cheung
  • Yuen Ki Fong
  • Desmond Kwan-Kit Chan
  • Grace Kin-Yee Hung
Article
First Online:

Abstract

Background

Although previous studies have suggested that low preoperative 25-hydroxyvitamin D (25-OHD) is a risk factor for hypocalcemia after total thyroidectomy, the impact of preoperative 25-OHD on calcium (Ca)/parathyroid hormone (PTH) kinetics in the immediate postoperative period remains unclear. The study compared the postoperative Ca/PTH kinetics between different preoperative 25-OHD levels.

Patients

A total of 281 patients who underwent a total thyroidectomy were analyzed. Serum Ca was measured preoperatively within 1 h after surgery (Ca-D0) and on the following morning (Ca-D1). Preoperative 25-OHD was also measured after overnight fasting while postoperative PTH was checked at skin closure on day 0 (PTH-D0) and on the following morning on day 1 (PTH-D1). The Ca/PTH kinetics were compared between three groups (group I: preoperative 25-OHD < 10 ng/mL; group II: 25-OHD = 10–20 ng/mL; group III: 25-OHD > 20 ng/mL).

Results

Group I had significantly lower preoperative Ca (p = 0.016) and Ca-D0 (p = 0.036) but higher PTH-D1 (p = 0.015) than groups II and III. PTH-D0, Ca-D1, and the rate of clinically significant hypocalcemia were similar in the three groups. Group I had a significantly smaller Ca drop (−0.02 vs. 0.01 and 0.02 mmol/L, p = 0.011) and a tendency for a significantly smaller PTH drop (0.4 vs. 0.5 and 1.0 pmol/L, p = 0.073) than groups II and III. PTH-D1 (OR = 1.550) and 25-OHD (OR = 0.958) were independent factors for Ca drop from day 0 to day 1.

Conclusions

Although group I began with lower serum Ca, those patients tended to have a greater PTH response to Ca drop and so preoperative 25-OHD did not significantly affect the overall Ca kinetics from preoperative to day 1.

Keywords

Parathyroid Gland Total Thyroidectomy Severe Vitamin Postoperative Hypocalcemia Preoperative Vitamin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Acknowledgments

We thank Ben Cowling for editing the manuscript.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Brian Hung-Hin Lang
    • 1
  • Kai Pun Wong
    • 1
  • Chung Yeung Cheung
    • 1
  • Yuen Ki Fong
    • 1
  • Desmond Kwan-Kit Chan
    • 1
  • Grace Kin-Yee Hung
    • 1
  1. 1.Division of Endocrine Surgery, Department of SurgeryUniversity of Hong Kong, Queen Mary HospitalHong Kong SARChina

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