Endocrine Abstracts

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 I² index was employed for heterogeneity.

Results

Thirty-nine studies were included in the quantitative analysis (61 915 cases with transient and 5712 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, I² 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, I² 88%) and ≤10 ng/ml (severe VDD; RR 1.98, 95% CI 1.42–2.76, I² 85%). The risk of permanent hypoPT was increased only in cases with severe VDD (RR 2.45, 95% CI 1.30–4.63, I² 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.