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

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.

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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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