Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Καρατζάς Θεόδωρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ.
Δοντά Ισμήνη – Νίκη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ.
Νικητέας Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ.
Καλτσάς Γρηγόριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ.
Κασσή Ευανθία, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ.
Χρονόπουλος Ευστάθιος, Αναπληρωτής Καθηγητής, Iατρική Σχολή, ΕΚΠΑ.
Ναξάκης Στέφανος, Καθηγητής, Ιατρική Σχολή, Πανεπιστημίου Πατρών.
Original Title:
Προοπτική μελέτη της επίδρασης της βραχυχρόνιας μεταβολής των επιπέδων της παραθορμόνης στην τιμή της σκληροστίνης ορού σε ασθενείς με ολική θυρεοειδεκτομή
Translated title:
Prospective study of the effect of the short-term change in parathormone levels on the sclerostin levels in patients with total thyroidectomy
Summary:
Background/Aim: Postsurgical hypoparathyroidism (PostHypo) is a common complication after total thyroidectomy. In the present study, we studied the risk factors that are associated with PostHypo and the response of different biochemical parameters including sclerostin and PTH in the setting of acute PostHypo .
Materials and Methods/ Patients and Methods: The study included 109 women, (mean age: 50.7±10.75 years) who underwent total thyroidectomy for thyroid diseases.
Results: Based on the development of biochemical hypocalcemia on the first postoperative day following total thyroidectomy, (cCa<8.4 mg/dl), 37 women developed PostHypo and 72 did not. Younger age, a lower preoperative corrected calcium and the presence of parathyroid glands in the specimens were related to the development of PostHypo. Τhe 51.4% of all patients had a vitamin D deficiency. A parathyroid hormone (PTH) value ≤ 9.4 pg/ml was 84.9% sensitive and 71.4% specific to predict PostHypo on the 1st postoperative day. A 50% reduction of the PTH value on the 1st postoperative day from the preoperative level could identify patients who develop PostHypo with 76% sensitivity and 75% specificity. Sclerostin levels increased in both groups but to a lower degree to the patients with PostHypo who received VitD analogues and Calcium supplementation.
Conclusion: VitD and Ca supplementation preoperatively can reduce the risk of PostHypo. PTH postoperative measurement and its alteration from the preoperative level can be used to identify patients who are at increased risk to develop PostHypo. Sclerostin responds in the acute drop of PTH and increases in the early postoperative days.
Main subject category:
Health Sciences
Keywords:
Postsurgical hypoparathyroidism, Total thyroidectomy, Parathormone, Sclerostin
Number of references:
216
File:
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Kakava Kassiani PhD.pdf
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