Hadi Mahsa, Mansouri Asieh, Seyedyousefi Sarah, Salehidoost Rezvan
Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
PhD of Epidemiology, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Endocrinol (Oxf). 2025 Sep;103(3):311-316. doi: 10.1111/cen.15268. Epub 2025 May 12.
Hungry bone syndrome (HBS) characterised by prolonged hypocalcemia, occurs commonly following parathyroidectomy in patients with primary hyperparathyroidism (PHPT). Although this complication is common, research in this field is very scarce. This study aimed to determine the incidence, characteristics of patients with HBS, and the effect of preoperative biochemical parameters on HBS.
In this retrospective study we enroled 144 patients with PHPT who underwent successful parathyroidectomy from January 2010 to January 2020. Preoperative and postoperative laboratory parameters were assessed. Logistic regression analysis was used to identify factors affecting the incidence of HBS.
One hundred six patients (73.6%) were women and the female-to-male ratio was 2.8-1. The median (IQR) age of all patients was 54 (19) years. HBS developed in 25 (17.36%) patients (5 men and 20 women, p = 0.425). Total calcium and parathyroid hormone preoperatively were significantly higher in patients with HBS, while serum phosphorus and magnesium levels did not differ statistically between the two groups. The resected parathyroid gland volume was higher in those with HBS compared to those without. Postoperatively, patients with HBS had longer hospital stays and lower serum phosphorus levels. However, these variables could not predict the occurrence of HBS after surgery in the performed regression model.
The patients with HBS had higher levels of calcium and parathyroid hormone preoperatively, along with larger resected parathyroid glands. Nevertheless, preoperative parameters were unable to predict HBS. Therefore, biochemical monitoring after surgery seems necessary to detect HBS and protect patients from severe hypocalcemia.
饥饿骨综合征（HBS）以持续性低钙血症为特征，常见于原发性甲状旁腺功能亢进症（PHPT）患者甲状旁腺切除术后。尽管这种并发症很常见，但该领域的研究非常匮乏。本研究旨在确定HBS的发生率、患者特征以及术前生化参数对HBS的影响。
在这项回顾性研究中，我们纳入了2010年1月至2020年1月期间成功接受甲状旁腺切除术的144例PHPT患者。评估术前和术后的实验室参数。采用逻辑回归分析来确定影响HBS发生率的因素。
106例患者（73.6%）为女性，男女比例为2.8:1。所有患者的中位（IQR）年龄为54（19）岁。25例（17.36%）患者发生了HBS（5例男性和20例女性，p = 0.425）。HBS患者术前的总钙和甲状旁腺激素水平显著更高，而两组之间的血清磷和镁水平在统计学上无差异。与未发生HBS的患者相比，发生HBS的患者切除的甲状旁腺体积更大。术后，发生HBS的患者住院时间更长，血清磷水平更低。然而，在进行的回归模型中，这些变量无法预测术后HBS的发生。
发生HBS的患者术前钙和甲状旁腺激素水平更高，切除的甲状旁腺也更大。然而，术前参数无法预测HBS。因此，术后进行生化监测似乎有必要，以检测HBS并防止患者发生严重低钙血症。
