Konstantina D Vaitsi1,2, Panagiotis Anagnostis1,2, Stavroula Veneti3, Theodosios S Papavramidis4, Dimitrios G Goulis1. 1. Unit of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. 2. Department of Endocrinology, Police Medical Center of Thessaloniki, Thessaloniki, Greece. 3. Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece. 4. Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract
CONTEXT: Whether pre-operative vitamin D deficiency (VDD) contributes to post-operative hypoparathyroidism (hypoPT) risk is unknown. OBJECTIVE: To meta-analyze the best available evidence regarding the association between pre-operative vitamin D status and hypoPT risk.Data Sources: A comprehensive literature search was conducted in PubMed, CENTRAL and Scopus databases, up to October 31, 2020. STUDY SELECTION: Patients undergoing thyroidectomy with pre-operative vitamin D status and post-operative hypoPT data. DATA EXTRACTION: Two researchers independently extracted data from eligible studies. DATA SYNTHESIS: Data were expressed as risk ratio (RR) with 95% confidence interval (CI). The I 2 index was employed for heterogeneity. RESULTS: Thirty-nine studies were included in the quantitative analysis (61,915 cases with transient and 5,712 with permanent hypoPT). Patients with VDD demonstrated a higher risk for transient hypoPT compared with those with pre-operative vitamin D sufficiency (RR 1.92, 95% CI 1.50-2.45, I 2 85%). These results remained significant for patients with pre-operative 25(OH)D concentrations ≤20 ng/ml (mild VDD; RR 1.46, 95% CI 1.10-1.94, I 2 88%) and ≤10 ng/ml (severe VDD; RR 1.98, 95% CI 1.42-2.76, I 2 85%). The risk of permanent hypoPT was increased only in cases with severe VDD (RR 2.45, 95% CI 1.30-4.63, I 2 45%). No difference was evident in subgroup analysis according to study design or quality. CONCLUSIONS: Patients with pre-operative VDD are at increased risk of transient hypoPT following thyroidectomy. The risk for permanent hypoPT is increased only for those with severe VDD.
CONTEXT: Whether pre-operative vitamin D deficiency (VDD) contributes to post-operative hypoparathyroidism (hypoPT) risk is unknown. OBJECTIVE: To meta-analyze the best available evidence regarding the association between pre-operative vitamin D status and hypoPT risk.Data Sources: A comprehensive literature search was conducted in PubMed, CENTRAL and Scopus databases, up to October 31, 2020. STUDY SELECTION: Patients undergoing thyroidectomy with pre-operative vitamin D status and post-operative hypoPT data. DATA EXTRACTION: Two researchers independently extracted data from eligible studies. DATA SYNTHESIS: Data were expressed as risk ratio (RR) with 95% confidence interval (CI). The I 2 index was employed for heterogeneity. RESULTS: Thirty-nine studies were included in the quantitative analysis (61,915 cases with transient and 5,712 with permanent hypoPT). Patients with VDD demonstrated a higher risk for transient hypoPT compared with those with pre-operative vitamin D sufficiency (RR 1.92, 95% CI 1.50-2.45, I 2 85%). These results remained significant for patients with pre-operative 25(OH)D concentrations ≤20 ng/ml (mild VDD; RR 1.46, 95% CI 1.10-1.94, I 2 88%) and ≤10 ng/ml (severe VDD; RR 1.98, 95% CI 1.42-2.76, I 2 85%). The risk of permanent hypoPT was increased only in cases with severe VDD (RR 2.45, 95% CI 1.30-4.63, I 2 45%). No difference was evident in subgroup analysis according to study design or quality. CONCLUSIONS:Patients with pre-operative VDD are at increased risk of transient hypoPT following thyroidectomy. The risk for permanent hypoPT is increased only for those with severe VDD.
Authors: Laura Guglielmetti; Sina Schmidt; Mirjam Busch; Joachim Wagner; Ali Naddaf; Barbara Leitner; Simone Harsch; Andreas Zielke; Constantin Smaxwil Journal: J Clin Med Date: 2022-06-03 Impact factor: 4.964