Calcium and its regulating hormones in patients with graves disease: sex differences and relation to postoperative tetany.

Abstract

OBJECTIVE:

To find out why female sex is the most important risk factor for tetany, as calcium and bone metabolism may differ between the sexes.

DESIGN:

Prospective study.

SETTING:

Thyroid centre, Japan.

PATIENTS AND METHODS:

45 men (mean age 35 years, SD 13) and 178 women (mean age 33 years, SD 12) with Graves disease treated by subtotal thyroidectomy.

INTERVENTIONS:

Measurement of serum concentrations of intact parathyroid hormone (iPTH), calcium, electrolytes, 25-hydroxyvitamin D (25 (OH) D), and 1,25-dihydroxyvitamin D (1,25 (OH) 2D).

MAIN OUTCOME MEASURES:

Mean values of these substances, together with reductions in serum calcium concentration, relative youth, increased alkaline phosphatase activity, large goitre, and increased serum TSH binding inhibitory globulin concentration.

RESULTS:

Women had significantly lower calcium concentrations than men (mean (SD) 2.37 (0.13) compared with 2.43 (0.07), p = 0.003). Serum calcium concentrations correlated significantly with concentrations of 25 (OH) D (p < 0.001). 121 of the women (68%) compared with 13 (29%) of men had vitamin D deficiency as defined as 25 (OH) D < 25 nmol/l (p < 0.05). 15 patients (8%) developed tetany postoperatively compared with I man (2%, p = 0.2).

CONCLUSION:

Women with Graves disease are more susceptible to calcium and vitamin D deficiency than men, which may account for the higher incidence of postoperative tetany among women with the disease.

• Authors: H Yamashita, S Noguchi, T Murakami, S Uchino, S Watanabe, A Ohshima, H Kawamoto, M Toda, H Yamashita
• Journal: The European journal of surgery = Acta chirurgica (Eur J Surg) Vol. 166 Issue 12 Pg. 924-8 (Dec 2000) ISSN: 1102-4151 [Print] England
• PMID: 11152251 (Publication Type: Journal Article)

Chemical References

• Parathyroid Hormone
• 25-Hydroxyvitamin D 2
• Calcium

Topics

• 25-Hydroxyvitamin D 2 (blood)
• Adult
• Calcium (blood)
• Female
• Graves Disease (surgery)
• Humans
• Male
• Middle Aged
• Parathyroid Hormone (blood)
• Postoperative Complications
• Prospective Studies
• Risk Factors
• Sex Factors
• Tetany (blood, etiology, physiopathology)
• Thyroidectomy