Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus, Denmark.
Endocrine. 2019 Apr;64(1):176-183. doi: 10.1007/s12020-019-01858-4. Epub 2019 Feb 20.
The reported incidence of post surgical hypoparathyroidism (HypoPT) varies greatly. Previous research suggests that the definition of HypoPT is not consistent in the literature. We therefore conducted a systematic review to investigate how HypoPT is defined and whether this definition, as well as the selected threshold for hypocalcemia affects the incidence.
Using a predefined search string we identified all articles in PubMed reporting on the incidence of postsurgical HypoPT from 1st January 2010 to January 2017.
We identified 89 articles that employed 20 different definition of HypoPT. The incidence of HypoPT varied from 0.0% to 20.2%. The definitions were not associated with incidence of HypoPT. Use of prophylactic post-operative calcium supplements, however decreased the risk of HypoPT (p = 0.03), and there was a trend towards a lower risk of HypoPT when using a definition of hypocalcemia below lower limit of the reference range (p = 0.09).
The large number of definitions of HypoPT, as well as the huge variation in incidence point to a problem suggests that the awareness of HypoPT should be raised. Use of prophylactic post-operative calcium supplements may decrease risk of HypoPT. This, however, may be due to reverse causality as awareness of the risk of HypoPT may promote the use of calcium supplementation.
术后甲状旁腺功能减退症（HypoPT）的报告发病率差异很大。先前的研究表明，文献中 HypoPT 的定义并不一致。因此，我们进行了系统评价，以调查 HypoPT 的定义方式，以及这种定义以及选定的低钙血症阈值是否会影响发病率。
使用预定义的搜索字符串，我们在 PubMed 中确定了从 2010 年 1 月 1 日至 2017 年 1 月报道术后 HypoPT 发病率的所有文章。
我们确定了 89 篇采用 20 种不同 HypoPT 定义的文章。HypoPT 的发病率从 0.0％到 20.2％不等。定义与 HypoPT 的发病率无关。然而，预防性术后钙补充剂的使用降低了 HypoPT 的风险（p=0.03），并且当使用低于参考范围下限的低钙血症定义时，HypoPT 的风险呈降低趋势（p=0.09）。
大量的 HypoPT 定义以及发病率的巨大差异表明存在问题，这表明应该提高对 HypoPT 的认识。预防性术后钙补充剂的使用可能会降低 HypoPT 的风险。然而，这可能是由于反向因果关系，因为对 HypoPT 风险的认识可能会促进钙补充剂的使用。
