Osteocalcin is an Independent Predictor for Hungry Bone Syndrome After Parathyroidectomy

Background Hungry bone syndrome is characterized by prolonged and severe hypocalcemia following parathyroidectomy. Previously, we reported that preoperative alkaline phosphatase is a major factor predicting prolonged hospital stay. Nonetheless, some patients with low alkaline phosphatase levels pres...

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Bibliographic Details
Published in:World journal of surgery 2020-03, Vol.44 (3), p.795-802
Main Authors: Ko, Wen-Ching, Liu, Chien-Liang, Lee, Jie-Jen, Liu, Tsang-Pai, Wu, Chih-Jen, Cheng, Shih-Ping
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Alkaline phosphatase
Alkaline Phosphatase - blood
Biomedical materials
Calcium
Cardiac Surgery
Dialysis
Female
General Surgery
Humans
Hunger
Hyperparathyroidism
Hyperparathyroidism, Secondary - blood
Hyperparathyroidism, Secondary - surgery
Hypocalcemia
Hypocalcemia - etiology
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Original Scientific Report
Osteocalcin
Osteocalcin - blood
Parathyroidectomy
Parathyroidectomy - adverse effects
Patients
Phosphatase
Regression analysis
Renal Dialysis
Supplements
Surgery
Thoracic Surgery
Vascular Surgery
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Summary:Background Hungry bone syndrome is characterized by prolonged and severe hypocalcemia following parathyroidectomy. Previously, we reported that preoperative alkaline phosphatase is a major factor predicting prolonged hospital stay. Nonetheless, some patients with low alkaline phosphatase levels presented with hungry bone syndrome, suggesting that additional factors may play a role. Methods From September 2010 to December 2017, consecutive dialysis patients who underwent parathyroidectomy for secondary hyperparathyroidism were analyzed. Length of hospital stay was used as a surrogate marker for postoperative bone hunger. Results A total of 260 patients were included in the study. The median postoperative hospital stay was 3 days, and 69 (27%) patients had a stay longer than 3 days. Multivariate logistic regression analysis revealed that alkaline phosphatase (odds ratio [OR] = 1.005), osteocalcin (OR = 1.001), and subtotal parathyroidectomy (OR = 0.061) were associated with prolonged hospital stay. Multivariate linear regression analysis indicated that age ( β  = − 0.170), alkaline phosphatase ( β  = 0.430), and osteocalcin ( β  = 0.166) were correlated with the length of stay. After surgery, the median osteocalcin level increased from 264 to 478 ng/mL ( P  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-019-05251-0