title: [Effect of vitamin D deficiency on hypocalcaemia after total thyroidectomy due to benign goitre].
abstract: BACKGROUND
  The purpose of this study was to analyse the relationship between preoperative serum levels of vitamin D and postoperative hypocalcaemia after total thyroidectomy.
  
  
  METHODS
  A prospective observational study was conducted on 113 patients treated by total thyroidectomy due to benign disease. Preoperative vitamin D serum levels and postoperative albumin-corrected calcium and parathormone (PTH) levels were determined. Sensitivity, specificity, positive predictive value and negative predictive value of vitamin D and PTH levels, respectively, in the diagnosis of postoperative hypocalcaemia were calculated.
  
  
  RESULTS
  Hypocalcaemia was diagnosed in 44 (38.9%) patients. Vitamin D levels were significantly higher in the group of patients with normal postoperative calcium (median: 25.4pg/mL; range: 4-60), compared to those who developed hypocalcaemia (median: 16.4pg/mL; range: 6.3-46.9) (P=.001). Postoperative hypocalcaemia was more frequent in patients with vitamin D < 30ng/mL (39/78) (50%), than among those with normal levels (5/35) (14.2%) (P=.001). Sensitivity, specificity, positive predictive value and negative predictive value were 88% and 68%, 43% and 82%, 50% and 71%, and 85% and 80% for vitamin D and PTH, respectively. Vitamin D and PTH showed independent prognostic values on the risk of hypocalcaemia. The OR associated with vitamin D < 30ng/mL was 4.25 (95% CI: 1.31-13.78) (P=.016), and the OR of PTH<13pg/mL was 15.4 (95% CI: 4.83-49.1) (P<.001).
  
  
  CONCLUSIONS
  Vitamin D deficiency is a risk factor of hypocalcaemia after total thyroidectomy for benign goitre. The vitamin D level provides independent prognostic information, which is complementary to that given by PTH.
authors.affiliation: Servicio de Cirugía General, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Madrid, Spain. mdiez.hupa@salud.madrid.org
authors.forename: Manuel
authors.initials: M
authors.lastname: Díez
authors.forename: Cristina
authors.initials: C
authors.lastname: Vera
authors.forename: Tomás
authors.initials: T
authors.lastname: Ratia
authors.forename: Lucía
authors.initials: L
authors.lastname: Diego
authors.forename: Fernando
authors.initials: F
authors.lastname: Mendoza
authors.forename: Paloma
authors.initials: P
authors.lastname: Guillamot
authors.forename: Rosario
authors.initials: R
authors.lastname: San Román
authors.forename: José M
authors.initials: JM
authors.lastname: Mugüerza
authors.forename: Angel
authors.initials: A
authors.lastname: Rodríguez
authors.forename: Carlos
authors.initials: C
authors.lastname: Medina
authors.forename: Beatriz
authors.initials: B
authors.lastname: Gómez
authors.forename: Javier
authors.initials: J
authors.lastname: Granell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006042:Goiter / Q000150:complications*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000379:methods; D014808:Vitamin D Deficiency / Q000150:complications*; D055815:Young Adult