Background: Hypocalcemia is a common event after parathyroidectomy for primary hyperparathyroidism (PHPT). This study aimed to explore the incidence of hypocalcemia, determine risk factors, and identify serum biomarkers associated with the development of this condition.

Methods: A retrospective study that included 116 patients with PHPT who underwent parathyroidectomy at a tertiary care facility in Jordan over 16 years (2006-2022) in this study. Patients were classified as having postoperative hypocalcemia if they developed serum calcium levels < 2.15 mmol/L within the first week following parathyroidectomy. Logistic regression analysis was performed to determine predictors of hypocalcemia. Spearman's rank correlation coefficient and ROC curves were used to assess relationships between variables as well as determine cutoffs for these predictors.

Results: Of the 116 patients studied, 57.7% developed hypocalcemia after parathyroidectomy. High preoperative alkaline phosphatase (ALP), low preoperative corrected calcium, high preoperative parathyroid (PTH), and younger age were shown to be significantly higher in patients who developed hypocalcemia after parathyroidectomy. Multivariate logistic regression showed a low preoperative corrected calcium level was an independent predictor of postoperative hypocalcemia (p = 0.036). A high level of preoperative alkaline phosphatase was also considered an independent predictor of hypocalcemia development (OR = 1.007, 95% CI: 1.002-1.012). Patients who had pre-operative ALP less than 208.5 U/L were unlikely to develop postoperative hypocalcemia.

Conclusion: Our study identified higher preoperative ALP, lower pre-operative corrected calcium, higher pre-operative PTH levels, and younger age as risk factors for postoperative hypocalcemia. Preoperative ALP and preoperative corrected calcium were shown to be independent predictors of hypocalcemia development.

Keywords: alkaline phosphatase; corrected calcium; hypocalcemia; parathyroid hormone; parathyroidectomy; primary hyperparathyroidism.

© 2025 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

背景：低钙血症是甲状旁腺切除术后常见的事件，该手术用于治疗原发性甲状旁腺功能亢进（PHPT）。本研究旨在探讨低钙血症的发生率，确定风险因素，并识别与这种状况发展相关的血液标志物。

方法：这项回顾性研究包括了在约旦一家三级医疗机构接受甲状旁腺切除术的116名原发性甲状旁腺功能亢进患者的数据（2006-2022年）。如果术后第一周内患者的血清钙水平低于2.15 mmol/L，则被分类为发生低钙血症。使用逻辑回归分析来确定低钙血症的预测因素。Spearman等级相关系数和ROC曲线用于评估变量之间的关系以及这些预测因素的临界值。

结果：在116名研究患者中，57.7%在甲状旁腺切除术后发生了低钙血症。高术前碱性磷酸酶（ALP）、低术前校正钙、高术前甲状旁腺激素（PTH）和年轻年龄与发生低钙血症的患者的水平显著较高。多元逻辑回归显示，术前校正钙水平较低是术后低钙血症的独立预测因素（p = 0.036）。较高的术前碱性磷酸酶也被认为是低钙血症发展的独立预测因素（OR = 1.007, 95% CI: 1.002-1.012）。术前ALP低于208.5 U/L的患者不太可能发生术后低钙血症。

结论：我们的研究确定了较高的术前碱性磷酸酶、较低的术前校正钙、较高的术前甲状旁腺激素水平以及年轻年龄是术后低钙血症的风险因素。术前碱性磷酸酶和术前校正钙被证明是独立预测低钙血症发展的因素。

关键词：碱性磷酸酶；校正钙；低钙血症；甲状旁腺激素；甲状旁腺切除术；原发性甲状旁腺功能亢进。

© 2025 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.