ICJIM

The Intercontinental Journal of Internal Medicine aims to publish issues related to all fields of internal medicine of the highest scientific and clinical value at an international level and accepts articles on these topics.

EndNote Style
Index
Original Article
Evaluation of mineralization balance in patients with hypoparathyroidism
Aims: Surgical complications play a major role in the etiology of hypoparathyroidism. Calcium and phosphorus metabolisms are disrupted by hypoparathyroidism. As a result, bone mineralization is impaired and may cause many pathologies. In clinical practice, parathyroid transplantation is not possible in every patient. In this study, we aimed to evaluate whether it would be possible to prevent the complications caused by hypoparathyroidism with mineral-supplemented medical therapy, even if we could not replace the lost parathyroid tissue.
Methods: A total of 79 individuals with hypoparathyroidism (parathormone levels below the reference range for more than one year) secondary to thyroidectomy admitted to our hospital were included in the study. Calcium, phosphorus, alkaline phosphatase (ALP), vitamin D, and creatinine levels were recorded in the last three controls. The relationship between parathormone levels, mineral levels, and ALP, which is an indicator of bone turnover, was analyzed.
Results: The mean calcium value was 8.57±0.90 and the mean phosphorus value was 4.46±0.99 in individuals diagnosed as hypoparathyroid with biochemical data. When the relationship between parathormone and the average of the last three calcium values, the relationship between the average phosphorus value, and the relationship between ALP and vitamin D were examined, no significant difference was found (p<0.05). When the relationship between the calcium phosphorus product and its effect on bone mineralization was examined, the mean calcium phosphorus product was 37.64±7.37, and no statistically significant difference was found with parathormone level (p<0.05).
Conclusion: Preservation of parathyroid tissue is important for calcium-phosphorus metabolism. Although loss of parathyroid tissue is irreversible, it may be possible to prevent complications with mineral supplementation. As long as calcium and phosphorus balance are maintained externally, bone turnover will be preserved, along with many pathologies caused by hypocalcemia. No matter how low the parathormone level is, the bone mineralization problem caused by hypoparathyroidism can be reduced or even eliminated with mineral levels normalized with medical treatment.


1. Yavuz D. Hipoparatiroidi: etiyoloji, klinik ve tanıya gidiş. AkademisyenKitabevi; 2023.
2. Çakır B. Paratiroid Hastalıkları. Akademisyen Kitabevi; 2023.
3. Bölükbaşı H, Akbulut S, Özel TM, at al. Genel cerrahidekomplikasyonlar ve yönetimi. Livre de Lyon; 2023.
4. Zeybek Ö. Ex vivo gen terapisiyle hipoparatiroidizm tedavisi modelioluşturma. Bezmialem Vakıf Üniversitesi Doktora Tezi, İstanbul, 2022.
5. Salepcioğlu H, Göncü B, Karatoprak U, et al. Paratiroit naklibekleyen hipoparatiroidi hastalarının nakil bekleme sürelerinindeğerlendirilmesi. SHED. 2021;5(2):48-52.
6. Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Osteoporozve Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu. 11. Baskı.Ankara, 2022:155-160.
7. Aslan F. Cerrah gözünden tiroidektomi komplikasyonları. İKSADYayıncılık; 2023:110-112.
8. Karakoç Kumsar A, Taşkın Yılmaz F. Troidektomi sonrasıhipoparatiroidizm ve etkileri. Balıkesir Sag Bil Derg. 2019;8(1):41-48.
9. Ulutaş F, Ardıç F. Paratiroid hastalıklarında kas iskelet sistemisorunları. In Balcı N, eds. Endokrin hastalıklarında kas iskelet sistemitutulumu. 1. Baskı. Ankara: Türkiye Klinikleri; 2021:p.52-59.
10. Yazdan Balçık O, Bora F, Köksoy S, Ersoy FF. Evre 3-5 kronik böbrekhastalarında hematopoetik hücrelerdeki vitamin D reseptör düzeyiile inflamasyon belirteçlerinin değerlendirilmesi. Akdeniz Tıp Derg.2022;8(3):333-341.
11. Kartal G, Haspolat YK, Taş FF. Gastroenteroloji’de kemik tutulumuve osteoporoz. In: Haspolat YK. Aktar F, Küçüköner M, Tekin R, eds.Çocuk ve ergenlerde kemik sağlığı. Orient Yayınları: 2018:355-402.
12. Demir FGU, Çalış M, Çalış HT, Uhluhizarci K, Bolat ES, Mıstık S.Yerleşmiş osteoporozda teriparatid tedavisinin spinal deformite indeksiüzerine etkisi. Türk Osteoporoz Derg. 2019:25(1);6-19.
13. Topaloğlu Ö, Şahin B, Şahin İ. Gebelikte ve laktasyonda mineralmetabolizması ve hipoparatiroidizm. Kocaeli Tıp Derg. 2021;10(2):194-204.
14. Özdemir Gürel B. Mikroenkapsüle edilen paratiroid hücrelerininomentuma naklinde hiperterminin etkisi. Bezmialem VakıfÜniversitesi Yüksek Lisans Tezi, İstanbul, 2022.
15. Kanımdan E, Yücesan, E, Göncü B, et al. Sıçanlarda immünsupresyonsuzxenotransplantasyon uygulamasının etkililiği. Çukurova Med J.2019;44(3):782-787.
16. İdiz UO, Yücesan E, Göncü B, Özdemir B, Aysan E, Gürol AO. Theimportance of cryopreserved parathyroid tissue autotransplantationin the hypoparathyroidism treatment after secondaryhyperparathyroidism surgery. İstanbul Med J. 2021;22(4):275-279.
17. Gökyürek M. 3D bioprinting of parathyroid tissue. Department ofBiomedical Engineering Master of Science Thesis, Graduate School ofNatural and Aplied Sciences, Ankara University, 2020.
18. Yüksel S, Ferlengez E, Çıtlak G. Bilateral total tiroidektomi uygulananhastalarda hipokalsemiyi etkileyen faktörler. İstanbul Haseki Eğit AraşHasta Haseki Tıp Bülteni. 2019;57:245-248.
19. Güleç Şen Ö, Kaçar E, Şen TA. Psödohipoparatiroidi tip 2: olgusunumu. Genel Tıp Derg. 2021;31(2):185-188.
20. Amaç O, Öztürk Ö, Uslu N, et al. Tiroidektomi sonrası gelişen geçici vekalıcı hipokalsemi, hipoparatiroidi ve ses kısıklığı komplikasyonlarınınretrospektif incelenmesi. Med J West Black Sea. 2019;3(3):75-83.
Volume 1, Issue 4, 2023
Page : 76-79
_Footer