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Context: Hypoparathyroidism is the most frequent complication after total thyroidectomy (PT-hypoPTH). After 1 year, most patients recover parathyroid function; however, the implicated physiologic dynamics remain unknown. Vitamin D deficiency (VDD) is the main cause of secondary hyperparathyroidism. Whether this compensatory hyperparathyroidism could influence parathyroid function recovery (PFR) in the setting of PT-hypoPTH has not been studied.
Objective: This work aimed to evaluate the effect of preoperative VDD on PFR.
Methods: A retrospective study was conducted with a prospectively maintained database including patients undergoing a total thyroidectomy between May 2014 and June 2019. Preoperative vitamin D (25(OH)D) less than 20 mg/mL was defined as VDD. Intact PTH less than 14 pg/mL on postoperative day 1 was defined as PT-hypoPTH. Transient PT-hypoPTH displayed PFR within the first year (early recovery: < 30 days; protracted recovery: > 30 days) whereas definite PT-hypoPTH did not. Survival analysis evaluated the effect of preoperative VDD on PFR, and a binary logistic regression model identified associated factors.
Results: A total of 397 patients were identified. The observed rates of transient, protracted, and definite PT-hypoPTH were 32.9%, 15.1%, and 5.2%, respectively. Rates of VDD were higher in the early-recovery PT-hypoPTH group (55.2% vs 31.5%; = .01). Preoperative VDD was associated with faster PFR (19 vs 35 days; = .03) and behaved as a protective factor for protracted PT-hypoPTH (odds ratio 0.47; 95% CI, 0.25-0.881; = .016) in the multivariable analysis.
Conclusion: Preoperative VDD could act as a preconditioning factor of the parathyroid glands prior to the surgical aggression exerted against them during surgery aiding PFR. Basic research studies and prospective clinical trials are needed to explain the underlying physiological mechanisms and to provide further evidence to improve clinical management.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9747583 | PMC |
http://dx.doi.org/10.1210/jendso/bvac174 | DOI Listing |
Malays Orthop J
November 2024
Department of Clinical Research, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, India.
Introduction: Hypovitaminosis D plays an important role in post-operative bone pain and muscle strength in arthroplasty surgeries. Its role in unicompartmental knee arthroplasty (UKA) has not been elucidated yet. The objective of this study was to determine the impact of hypovitaminosis D and its correction on post-operative bone pain after UKA.
View Article and Find Full Text PDFHeart Rhythm
July 2024
Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
Heart Rhythm
July 2024
Department of Cardiovascular Medicine, Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago, Japan.
Background: Based on historical studies of leadless pacemakers (LPs), high atrioventricular synchrony (AVS) with mechanical sensing-based VDD pacing is largely influenced by A4 amplitude. A limited study investigated the predictors of A4 amplitude using clinical and echocardiographic parameters.
Objective: The purpose of this study was to investigate the predictors of A4 amplitude preoperatively to select patients who could benefit the most from AVS among patients with VDD LPs (Micra-AV, Medtronic).
J Endocr Soc
November 2022
Endocrine and Metabolic Surgery Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Marañón, 28007, Madrid, Spain.
Context: Hypoparathyroidism is the most frequent complication after total thyroidectomy (PT-hypoPTH). After 1 year, most patients recover parathyroid function; however, the implicated physiologic dynamics remain unknown. Vitamin D deficiency (VDD) is the main cause of secondary hyperparathyroidism.
View Article and Find Full Text PDFJ Clin Anesth
August 2022
Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan. Electronic address:
Study Objective: Despite vitamin D deficiency (VDD) associated with cognitive dysfunction in the general population, the impacts of preoperative VDD on postoperative delirium (POD) and cognitive dysfunction (POCD) remain to be clarified.
Design: Meta-analysis of cohort studies.
Setting: Postoperative care.
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