Abstract | BACKGROUND: MATERIALS AND METHODS: Data were collected prospectively between September 2012 and May 2013. A total of 267 consecutive thyroid cancer patients who underwent TT with CCND were analyzed. Patients were divided into two groups--VDD or non-VDD--by preoperative vitamin D level of <10 or ≥10 ng/mL. Symptomatic hypocalcemia was defined as serum calcium <8.2 mg/dL and symptoms or signs of hypocalcemia. The rates of postoperative symptomatic hypocalcemia and clinicopathological features were compared between the two patient groups. RESULTS: The rate of postoperative symptomatic hypocalcemia was higher in the VDD group than in the non-VDD group (43.8% vs. 30.4%, p=0.043). By logistic regression analysis, predictive factors for postoperative symptomatic hypocalcemia included a preoperative vitamin D level of <10 ng/mL (p=0.007; odds ratio=3.00). In patients who had postoperative intact parathyroid hormone (iPTH) levels <15 pg/mL, symptomatic hypocalcemia was more common in the VDD group than in the non-VDD group (77.5% vs. 53.2%, p=0.008). The findings show that a preoperative vitamin D threshold level of >20 ng/mL reduced the risk of symptomatic hypocalcemia by 72% when compared with patients with VDD (p=0.003). CONCLUSION: VDD is significantly associated with postoperative symptomatic hypocalcemia in thyroid cancer patients undergoing TT plus CCND. VDD was predictive for symptomatic hypocalcemia when patients had postoperative serum iPTH levels <15 pg/mL. Thus, preoperative supplementation with oral vitamin D should be considered to minimize postoperative symptomatic hypocalcemia.
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Authors | Won Woong Kim, So-Hyang Chung, Eun Jeong Ban, Cho Rok Lee, Sang-Wook Kang, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung, Cheong Soo Park |
Journal | Thyroid : official journal of the American Thyroid Association
(Thyroid)
Vol. 25
Issue 8
Pg. 911-8
(Aug 2015)
ISSN: 1557-9077 [Electronic] United States |
PMID | 26061175
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Parathyroid Hormone
- Vitamin D
- Calcium
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Topics |
- Adult
- Calcium
(blood)
- Dietary Supplements
- Female
- Humans
- Hypocalcemia
(blood, pathology)
- Inpatients
- Linear Models
- Male
- Middle Aged
- Neck Dissection
- Parathyroid Glands
(pathology)
- Parathyroid Hormone
(blood)
- Postoperative Complications
- Postoperative Period
- Preoperative Period
- Prospective Studies
- Retrospective Studies
- Risk Factors
- Thyroid Neoplasms
(blood, surgery)
- Thyroidectomy
- Vitamin D
(metabolism)
- Vitamin D Deficiency
(blood)
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