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Osteoporotic fracture risk in hypoparathyroidism following total thyroidectomy: a retrospective nationwide cohort study

医学 甲状旁腺机能减退 回顾性队列研究 危险系数 内科学 入射(几何) 骨质疏松症 队列研究 甲状腺切除术 甲状腺癌 倾向得分匹配 置信区间 四分位间距 外科 队列 甲状腺 物理 光学
作者
Eu Jeong Ku,Won Sang Yoo,Yu Been Hwang,Subin Jang,Jooyoung Lee,Shinje Moon,Eun Kyung Lee,Hwa Young Ahn
出处
期刊:European journal of endocrinology [Oxford University Press]
卷期号:193 (1): 39-47 被引量:1
标识
DOI:10.1093/ejendo/lvaf128
摘要

Abstract Objective Hypoparathyroidism is an uncommon but significant complication of total thyroidectomy. As the incidence of thyroid cancer increases, the prevalence of hypoparathyroidism also increases. However, its effect on the risk of osteoporotic fractures remains poorly understood. We aimed to evaluate the risk of osteoporotic fractures in patients with postoperative hypoparathyroidism compared with that in a matched control group. Design This retrospective cohort study included 417 patients with hypoparathyroidism who had undergone total thyroidectomy for thyroid cancer (TC with hypoP) and 2085 matched controls from the Korean National Health Insurance Service-National Sample Cohort. Methods The osteoporotic fracture rates and associated risk factors were analyzed in comparison after propensity score matching. Results During a median follow-up period of 5.07 years (interquartile range 2.19-7.38), postoperative hypoparathyroidism was not associated with a significantly greater risk of osteoporotic fractures than that in the control group (hazard ratio [HR] 0.86, 95% confidence interval [CI], 0.59-1.24, P = .406). Age-specific analysis showed a trend toward higher fracture incidence in patients aged <50 years (HR 1.31, 95% CI, 0.53-3.22, P = .558) and a decreasing trend in those aged ≥50 years (HR 0.75, 95% CI, 0.51-1.12, P = .163), although the differences were not statistically significant. No significant differences in fracture risk were observed between the TC with and without hypoP groups across all fracture sites. The frequency of osteoporotic medication use was higher in the TC with hypoP group than in the control group, particularly among women aged <50 years. Conclusions Hypoparathyroidism after total thyroidectomy does not appear to increase the risk of osteoporotic fractures compared with that in matched controls in clinical practice.
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