Is Preoperative Vitamin D Deficiency a Risk Factor for Postoperative Symptomatic Hypocalcemia in Thyroid Cancer Patients Undergoing Total Thyroidectomy Plus Central Compartment Neck Dissection?
Open accessAbstract
BACKGROUND: Although some studies have reported that preoperative vitamin D deficiency (VDD) is a risk factor for hypocalcemia after total thyroidectomy (TT) in patients with nontoxic multinodular goiter or Graves' disease, the association between VDD and postoperative hypocalcemia in thyroid cancer patients undergoing TT plus central compartment neck dissection (CCND) remains unclear. This study evaluated whether preoperative VDD was associated with postoperative symptomatic hypocalcemia. 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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In thyroid cancer surgery, preoperative serum 25-hydroxy vitamin D levels >20 ng/mL are associated with a reduction in postoperative symptomatic hypocalcemia.
“Another study that focused on postoperative hypocalcemia after thyroid surgery for thyroid cancer, not hyperthyroidism, identified a reduction in postoperative symptomatic hypocalcemia when patients have preoperative serum 25-hydroxy vitamin D levels >20 ng/mL (> 8 nmol/L) prior to the operating room (190).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [190]
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- Authors
- Kim, W. W., Chung, S.-H., Ban, E. J., Lee, C. R., Kang, S.-W., Jeong, J. J., Nam, K.-H., Chung, W. Y., & Park, C. S.
- Affiliations
- Yonsei University Health System (KR)
- The Catholic University of Korea Seoul St. Mary's Hospital (KR)
- Corresponding author
- Nam, Kee-Hyun
- ORCID
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2015-08
- Volume
- 25
- Issue
- 8
- Pages
- 911-918
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W1610080041
- Cited by
- 49
- References
- 39
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 2 · 2023: 2 · 2022: 8 · 2021: 12 · 2020: 4 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 4
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Funders
- American Thyroid Association
- Yonsei University College of Medicine
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- vitamin D deficiency, postoperative hypocalcemia, thyroid cancer, total thyroidectomy, central neck dissection, intact parathyroid hormone, risk factors, parathyroid hormone deficiency, hypoparathyroidism, parathyroidectomy, multinodular goiter, Graves' disease, parathyroid hormone replacement therapy
- MeSH terms
- Adult, Calcium, Female, Humans, Hypocalcemia, Inpatients, Male, Middle Aged, Parathyroid Glands, Parathyroid Hormone, Postoperative Complications, Postoperative Period, Prospective Studies, Retrospective Studies, Risk Factors, Thyroid Neoplasms, Thyroidectomy, Vitamin D, Vitamin D Deficiency, Linear Models, Dietary Supplements, Neck Dissection, Preoperative Period
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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