Endocrine Abstracts

Introduction: Hypoparathyroidism (hypoPTH) is one of the most feared iatrogenic complications of the surgical treatment for thyroid cancer (TC). Despite supplementation with calcium salts and calcitriol, hypoPTH seems to be associated with a negative impact on quality of life (QoL), which has not been evaluated in the Portuguese patients.

Objectives: To evaluate the impact of hypoPTH on the QoL of Portuguese patients with TC and its correlation with serum analytical parameters.

Material and methods: Cross-sectional study of patients diagnosed with TC and chronic hypoPTH (persistent one year after surgery), randomly selected, compared to a control group of patients submitted to surgery for TC without hypoPTH. QoL was assessed using the SF-36v2 health questionnaire, validated for the Portuguese population (which includes eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH)). The levels of ionized and total calcium, albumin, phosphorus, magnesium, creatinine, urea, PTH, vitamin D, TSH and free T4 were measured. Hypothyroid patients were excluded. The information collected was analysed in SPSS®. Data was analysed with Independent Samples t Test and Pearson’s correlation test.

Results: Of the 164 patients surveyed, 49 (29.9%) had hypoPTH and 78.7% were female. The mean age was 53.7±14.7 years. Patients with hypoPTH had statistically significant lower scores on the BP scales (55.8%±22.7 vs 63.4%±28.6;P=0.050) and SF (69.4%±25.5 vs 78. 6%±21.8;P=0.040) when compared to patients without hypoPTH. Regarding patients with hypoPTH, there was an inverse correlation between phosphorus levels and the scores of the GH (P=0.016), PF (P=0.006) and RP (P=0.020) scales; between age and scores of BP (P=0.017) and PF (P=0.019) scales. In these patients, lower PTH values were equally associated with worse results on BP scale (P=0.013).

Conclusions: This was the first study to assess the impact of hypoPTH on QoL in Portuguese patients. The results obtained suggest a relationship between phosphorus levels and QoL in patients with hypoPTH. Its monitoring seems particularly important in this population in order to identify more vulnerable patients, who may benefit from additional measures.