Posthemithyroidectomy hypothyroidism. Prevalence and predictive markers. Comparison between patients with euthyroid and hyperthyroid nodular goitre

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2024-08-01 DOI:10.1016/j.endien.2024.05.003

Luis García Pascual , Carlos Puig-Jové , Andreu Simó-Servat , Lluís García-González

{"title":"Posthemithyroidectomy hypothyroidism. Prevalence and predictive markers. Comparison between patients with euthyroid and hyperthyroid nodular goitre","authors":"Luis García Pascual , Carlos Puig-Jové , Andreu Simó-Servat , Lluís García-González","doi":"10.1016/j.endien.2024.05.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objective</h3><p>Posthemithyroidectomy hypothyroidism (PHH) is a relatively common complication (22%–30%) for which we have no published information from our country. The objective of the study is to determine the prevalence of PHH and evaluate its predictive markers by comparing patients who had euthyroidism with those who had hyperthyroidism before hemithyroidectomy.</p></div><div><h3>Patients and method</h3><p>Retrospective observational cross-sectional study on 106 patients, 88 euthyroid before hemithyroidectomy and 18 hyperthyroid.</p></div><div><h3>Results</h3><p>Prevalence of PHH in euthyroid patients 42% (89.2% subclinical hypothyroidism; 10.8% manifest hypothyroidism) and in hyperthyroid patients 50% (77.8% subclinical hypothyroidism; 22.2% manifest hypothyroidism). Predictive markers in euthyroid patients: preoperative thyrotropin ≥ 2.2 mIU/L (OR: 4.278, 95% CI: 1.689−10.833; sensitivity: 54.1%, 95% CI: 38%–70.1%; specificity: 78.4%, 95% CI: 67.1%–89.7%), age ≥50 years (OR: 3.509, 95% CI: 1.438–8.563; sensitivity: 64.9%, 95% CI: 49.5%–80.3%; specificity: 64.7%, 95% CI: 51.6%–77.8%) and percentage of remainder lobe ≤ 19.6% (OR: 1.024, 95%: 1.002–1.046; sensitivity: 70.2%, 95% CI: 55.5%–84.9%; specificity: 48.6%, 95% CI: 34.9%–62.3%). Predictive marker in hyperthyroid patients: weight >70 kg (OR: 28, 95% CI: 2.067–379.247; sensitivity: 88.9%, 95% CI: 68.4%–100%; specificity: 88.9%, 95% CI: 68.4%–100%).</p></div><div><h3>Conclusions</h3><p>This is the first study in our country that demonstrates a prevalence of PHH above the average in euthyroid patients, which is slightly higher and more intense in hyperthyroid patients, and that recognizes the classic predictive markers in euthyroid patients but highlights a novel predictive marker marker in hyperthyroid patients, useful to assess a different risk of PHH when indicating hemithyroidectomy and to establish closer control of postoperative hormonal evolution.</p></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 7","pages":"Pages 298-307"},"PeriodicalIF":1.8000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrinologia Diabetes Y Nutricion","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2530018024000866","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objective

Posthemithyroidectomy hypothyroidism (PHH) is a relatively common complication (22%–30%) for which we have no published information from our country. The objective of the study is to determine the prevalence of PHH and evaluate its predictive markers by comparing patients who had euthyroidism with those who had hyperthyroidism before hemithyroidectomy.

Patients and method

Retrospective observational cross-sectional study on 106 patients, 88 euthyroid before hemithyroidectomy and 18 hyperthyroid.

Results

Prevalence of PHH in euthyroid patients 42% (89.2% subclinical hypothyroidism; 10.8% manifest hypothyroidism) and in hyperthyroid patients 50% (77.8% subclinical hypothyroidism; 22.2% manifest hypothyroidism). Predictive markers in euthyroid patients: preoperative thyrotropin ≥ 2.2 mIU/L (OR: 4.278, 95% CI: 1.689−10.833; sensitivity: 54.1%, 95% CI: 38%–70.1%; specificity: 78.4%, 95% CI: 67.1%–89.7%), age ≥50 years (OR: 3.509, 95% CI: 1.438–8.563; sensitivity: 64.9%, 95% CI: 49.5%–80.3%; specificity: 64.7%, 95% CI: 51.6%–77.8%) and percentage of remainder lobe ≤ 19.6% (OR: 1.024, 95%: 1.002–1.046; sensitivity: 70.2%, 95% CI: 55.5%–84.9%; specificity: 48.6%, 95% CI: 34.9%–62.3%). Predictive marker in hyperthyroid patients: weight >70 kg (OR: 28, 95% CI: 2.067–379.247; sensitivity: 88.9%, 95% CI: 68.4%–100%; specificity: 88.9%, 95% CI: 68.4%–100%).

Conclusions

This is the first study in our country that demonstrates a prevalence of PHH above the average in euthyroid patients, which is slightly higher and more intense in hyperthyroid patients, and that recognizes the classic predictive markers in euthyroid patients but highlights a novel predictive marker marker in hyperthyroid patients, useful to assess a different risk of PHH when indicating hemithyroidectomy and to establish closer control of postoperative hormonal evolution.

查看原文本刊更多论文

甲状腺切除术后甲状腺功能减退症。发病率和预测指标。甲状腺功能亢进和甲状腺功能亢进结节性甲状腺肿患者的比较。

背景和目的：甲状腺半月切除术后甲状腺功能减退症（PHH）是一种相对常见的并发症（22%-30%），我国尚无这方面的公开信息。本研究的目的是通过比较甲状腺半切除术前甲状腺功能亢进的患者和甲状腺功能正常的患者，确定 PHH 的发病率并评估其预测指标：对106例患者进行回顾性观察横断面研究，其中88例在甲状腺半切除术前为甲状腺功能亢进，18例为甲状腺功能亢进：甲状腺功能亢进患者中PHH的患病率为42%（89.2%为亚临床甲减；10.8%为明显甲减），甲状腺功能亢进患者中PHH的患病率为50%（77.8%为亚临床甲减；22.2%为明显甲减）。甲状腺功能亢进患者的预测指标：术前甲状腺素≥2.2 mIU/L（OR：4.278，95% CI：1.689-10.833；敏感性：54.1%，95% CI：38%-70.1%；特异性：78.4%，95% CI：67.1%-89.7%）、年龄≥50 岁（OR：3.509，95% CI：1.438-8.563；敏感性：64.9%，95% CI：49.5%-80.3%；特异性：64.7%，95% CI：51.6%-77.8%）和余叶百分比≤19.6%（OR：1.024，95%：敏感性：70.2%，95% CI：55.5%-84.9%；特异性：48.6%，95% CI：34.9%-62.3%）。甲亢患者的预测指标：体重大于 70 千克（OR：28，95% CI：2.067-379.247；敏感性：88.9%，95% CI：68.4%-100%；特异性：88.9%，95% CI：68.4%-100%）：这是我国第一项显示甲状腺功能亢进患者PHH发病率高于平均水平的研究，甲状腺功能亢进患者的PHH发病率略高且更高，该研究认可甲状腺功能亢进患者的经典预测标记物，但强调了甲状腺功能亢进患者的新型预测标记物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.