A Meta-Analysis of Risk Factors for Transient and Permanent Hypocalcemia After Total Thyroidectomy

BackgroundAs hypocalcemia is the most common complication of total thyroidectomy, identifying its risk factors should guide prevention and management. The purpose of this study was to determine the risk factors for postthyroidectomy hypocalcemia.MethodsWe searched PubMed, Web of Science and EMBASE through January 31, 2019, and assessed study quality using the Newcastle–Ottawa Scale.ResultsFifty studies with 22,940 patients met the inclusion criteria, of which 24.92% (5716/22,940) had transient hypocalcemia and 1.96% (232/11,808) had permanent hypocalcemia. Significant (P < 0.05) predictors of transient hypocalcemia were: younger age, female, parathyroid autotransplantation (PA), inadvertent parathyroid excision (IPE), Graves’ disease (GD), thyroid cancer, central lymph node dissection, preoperative severe Vitamin D deficiency, preoperative Vitamin D deficiency and a lower postoperative 24 h parathyroid hormone (PTH) level. Preoperative magnesium, preoperative PTH and Hashimoto’s thyroiditis were not significant predictors of transient hypocalcemia. IPE, GD, and thyroid cancer were associated with an increased rate of permanent hypocalcemia, but gender and PA did not predict permanent hypocalcemia.ConclusionImportant risk factors for transient and permanent hypocalcemia were identified. However, given the limited sample size and heterogeneity of this meta-analysis, further studies are required to confirm our preliminary findings.

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Risk Factors for Vitamin D Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

10.5152/tjg.2021.20614 ◽

2021 ◽

Vol 32 (6) ◽

pp. 508-518

Author(s):

Shanzhen Shi ◽

◽

Jiaxing Feng ◽

Lixiang Zhou ◽

Yu Li ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Inflammatory Bowel Disease ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Bowel Disease ◽

Meta Analysis ◽

Inflammatory Bowel

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Vitamin D deficiency as a risk factor for thyroid cancer: A meta-analysis of case-control studies

Nutrition ◽

10.1016/j.nut.2018.04.015 ◽

2019 ◽

Vol 57 ◽

pp. 5-11 ◽

Cited By ~ 12

Author(s):

Junyu Zhao ◽

Haipeng Wang ◽

Zhongwen Zhang ◽

Xiaojun Zhou ◽

Jinming Yao ◽

...

Keyword(s):

Vitamin D ◽

Risk Factor ◽

Thyroid Cancer ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Case Control ◽

Case Control Studies

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The Prevalence of Hypovitaminosis D and Its Associated Risk Factors Among Women of Reproductive Age in Saudi Arabia: A Systematic Review and Meta-Analysis

Clinical Medicine Insights Women s Health ◽

10.1177/1179562x18767884 ◽

2018 ◽

Vol 11 ◽

pp. 1179562X1876788 ◽

Cited By ~ 1

Author(s):

Riyadh A Alzaheb

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Saudi Arabia ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Hypovitaminosis D ◽

Reproductive Age ◽

Vitamin D Status ◽

Women Of Reproductive Age ◽

Associated Risk Factors

Vitamin D deficiency is currently a worldwide epidemic. Middle Eastern countries, including Saudi Arabia, have high vitamin D deficiency prevalence, most prominently among women, despite their plentiful year-round sunshine. Previous research investigating vitamin D status among Saudi women of reproductive age (15-49 years) is scarce, and no study has used a nationally representative sample, so this review quantified overall hypovitaminosis D prevalence among women in Saudi Arabia and explored the associated risk factors. The Web of Science, Scopus, and Medline databases were searched for prior studies in Saudi Arabia exploring vitamin D status among women of reproductive age, published between January 1, 2000 and May 25, 2017. Data were extracted from the identified studies, and a random effects model meta-analysis established the overall hypovitaminosis D prevalence. The initial search yielded 223 possibly relevant articles; 13 were confirmed as eligible, with samples totaling 2877 women aged between 15 and 49 years. Meta-analysis revealed a mean serum 25-hydroxyvitamin D, 25(OH)D, level of 13.1 ng/mL (95% confidence interval [CI]: 11.6-14.6) and an overall prevalence of hypovitaminosis D, defined as 25(OH)D < 30 ng/mL, of 77.4% (95% CI: 63.2-87.3), mostly due to insufficient sunlight exposure and low dietary vitamin D intake. There is therefore a need for a national strategy to raise vitamin D levels among women in Saudi Arabia by advising them on natural vitamin D sources, and recommending the timing and duration of sun exposure, while also defining a national approach to vitamin D fortification and supplementation.

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Relationship of Vitamin D Deficiency and Intraoperative Parathyroid Hormone Elevation in Completion and Total Thyroidectomy

Otolaryngology ◽

10.1177/0194599818825467 ◽

2019 ◽

Vol 160 (4) ◽

pp. 612-615 ◽

Cited By ~ 1

Author(s):

Bradley R. Lawson ◽

Andrew M. Hinson ◽

Jacob C. Lucas ◽

Donald L. Bodenner ◽

Brendan C. Stack

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Secondary Hyperparathyroidism ◽

Total Thyroidectomy ◽

Vitamin D Deficiency ◽

Case Series ◽

Hormone Levels ◽

Parathyroid Autotransplantation ◽

Vitamin D Levels ◽

Intraoperative Parathyroid Hormone

Objective To quantify how frequently intraoperative parathyroid hormone levels increase during thyroid surgery and to explore a possible relationship between secondary hyperparathyroidism due to vitamin D deficiency and elevation in intraoperative parathyroid hormone. Study Design Case series with chart review. Setting Tertiary academic center. Subjects and Methods A total of 428 consecutive patients undergoing completion and total thyroidectomy by the senior author over a 7-year period were included for analysis. All patients had baseline and postexcision intraoperative parathyroid hormone levels as well as vitamin D levels from the same laboratory. Institute of Medicine criteria were employed for vitamin D stratification (>30, normal; 20-29.9, insufficient; <20, deficient) . Other data analyzed include sex, age, neck dissection status, and parathyroid autotransplantation. Results A total of 118 patients (27.6%) had an intraoperative parathyroid hormone elevation above baseline. Patients with vitamin D deficiency were significantly more likely to experience hormone elevation ( P = .04). When parathyroid hormone rose, it did so by a mean 32.1 pg/mL. Patients with vitamin D deficiency demonstrated significantly larger hormone increases ( P = .03). Conclusion Elevation in intraoperative parathyroid hormone levels above baseline after completion and total thyroidectomy occurs in over one-fourth of cases and is significantly associated with vitamin D deficiency. This study is the first to report this observation. We hypothesize that vitamin D deficiency in these patients may create a subclinical secondary hyperparathyroidism that leads to intraoperative parathyroid hormone elevation when the glands are manipulated. Additional studies will be needed to explore this physiologic mechanism and its clinical significance.

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Association between Vitamin D Level and Acne, and Correlation with Disease Severity: A Meta-Analysis

Dermatology ◽

10.1159/000517514 ◽

2021 ◽

pp. 1-8

Author(s):

Yusuf Hasamoh ◽

Kunlawat Thadanipon ◽

Premjit Juntongjin

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Inverse Association ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Newcastle Ottawa Scale ◽

25 Hydroxyvitamin D ◽

The Relationship ◽

Ottawa Scale

Background: Vitamin D deficiency is frequently associated with several medical conditions. However, a comprehensive meta-analysis assessing the association between vitamin D level and acne is lacking. Objective: To determine the relationship between vitamin D level and acne, and to assess the association between vitamin D level and acne severity. Methods: This meta-analysis was assessed by using the PubMed, EMBASE, Cochrane, and Scopus databases following the PRISMA guidelines. Serum/plasma 25-hydroxyvitamin D (25[OH]D) level, vitamin D deficiency, and the severity association between acne patients and healthy controls (HCs) were evaluated. The quality assessment was performed by using the Newcastle-Ottawa Scale. Results: Thirteen articles with a total of 1,362 acne patients and 1,081 HCs were included. The circulating 25(OH)D levels were significantly lower in patients with acne than in HCs (pooled MD = –9.02 ng/mL, 95% CI = –13.22 to –4.81, p < 0.0001). Vitamin D deficiency was more prevalent in acne patients than in HCs (pooled OR = 2.97, 95% CI = 1.68–5.23, I2 = 72%). Also, vitamin D levels were negatively correlated with acne severity. Conclusion: This meta-analysis demonstrated the significantly low vitamin D levels in acne patients. Also, there was evidence of an inverse association between vitamin D levels and acne severity. Therefore, vitamin D might be involved in the pathogenesis of acne.

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