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A novel index to predict postoperative hypocalcemia in primary hyperparathyroidism.
Harmantepe, Ahmet Tarik; Bas, Enes; Akdeniz, Yesim; Kucuk, Ali; Bayhan, Zulfu; Kocer, Havva Belma.
Afiliación
  • Harmantepe AT; Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey.
  • Bas E; Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey.
  • Akdeniz Y; Department of General Surgery, Bandirma Onyedi Eylul University Faculty of Medicine, Balikesir, Turkey.
  • Kucuk A; Department of Surgical Oncology, Balikesir Ataturk City Hospital, Balikesir, Turkey.
  • Bayhan Z; Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey. zulfubayhan@gmail.com.
  • Kocer HB; Department of General Surgery, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Ir J Med Sci ; 193(3): 1261-1266, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38253945
ABSTRACT
BAKGROUND Vitamin D (Vit D) deficiency is common in patients with hyperparathyroidism, but the importance of replacement before surgery is controversial. It can be predicted that hypocalcemia risk will be higher in patients with high bone turnover.

AIM:

In this study, the effect of preoperative ALP/Vit D ratio on postoperative hypocalcemia was investigated.

METHODS:

Among the primary hyperparathyroidism cases who were operated between 2015 and 2022, 158 patients with complete data were included in the study. Preoperative laboratory results, radiological images, and pathology reports of the patients were evaluated retrospectively. The cross-sectional value of the ALP/Vit D value predicting hypocalcemia was calculated. The effect of these parameters on postoperative hypocalcemia was investigated.

RESULTS:

The mean age of our patients was 54 (21-81 years). When factors affecting postoperative hypocalcemia were evaluated by univariable analysis, Vit D deficiency and insufficiency (p < 0.001), ALP (p < 0.001), ALP/Vit D ratio (p < 0.001), and T score (p = 0.026) found to be factors affecting postoperative hypocalcemia. In multivariate analysis, the ALP/Vit D ratio was found to be an independent variable in predicting hypocalcemia. It was found that hypocalcemia was 45 times more common in patients with ALP/Vit D > 6.34 (p < 0.001). ALP/Vit D ratio predicts patients who will develop postoperative hypocalcemia with 87.2% sensitivity and 87.1% specificity.

CONCLUSIONS:

Vit D deficiency increases the risk of postoperative hypocalcemia, but it is not sufficient alone to predict it. The risk increases more in patients with high bone turnover. The preoperative ALP/Vit D ratio is the strongest predictor of postoperative hypocalcemia risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vitamina D / Deficiencia de Vitamina D / Hiperparatiroidismo Primario / Hipocalcemia Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ir J Med Sci Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vitamina D / Deficiencia de Vitamina D / Hiperparatiroidismo Primario / Hipocalcemia Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ir J Med Sci Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Irlanda