Magnesemia: an independent risk factor of hypocalcemia after thyroidectomy
Received 3 June 2019
Accepted for publication 7 August 2019
Published 3 September 2019 Volume 2019:11 Pages 8135—8144
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Sanjeev Srivastava
Wenlong Wang*, Chaoyang Meng*, Qianhui Ouyang, Jing Xie, Xinying Li
Division of Thyroid, General Surgery Department, Xiangya Hospital, Central South University, Changsha 410008, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xinying Li
Division of Thyroid, General Surgery Department, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha 410008, People’s Republic of China
Tel +86 07 318 975 3710
Background: This study was designed to investigate the impact of serum magnesium (Mg) levels on hypocalcemia after thyroidectomy.
Patients and methods: In total, 242 patients with differentiated thyroid cancer were retrospectively analyzed.
Results: Multivariate regression analysis showed hypomagnesemia was an independent risk factor for hypocalcemia (P<0.001). While Mg in low levels (0.66 mmol/L ≤ Po-Mg ≤0.74 mmol/L) increased the risk of hypocalcemia, postoperative serum Ca (Po-Ca) levels were significantly lower in patients with hypomagnesemia than in patients with normomagnesemia (P=0.01), and the former patients suffered significant decreases in serum Ca (P=0.02). Compared to patients with a mild decline of serum Mg after surgery (ΔMg <0.17), serum Ca decline significantly increased (P<0.001) in patients with a severe decline of serum Mg (ΔMg ≥0.17), while the change in amounts of parathyroid hormone (PTH) after surgery was similar between the two groups (P>0.05). In patients with normal Po-Ca levels, hypomagnesemia increased the risk of symptoms related to hypocalcemia by 4.478 times (OR =5.478, 95% CI 1.724–17.403).
Conclusion: Hypomagnesemia, or even a low serum Mg level within the normal range, can increase the risk of hypocalcemia. After excluding the potential effects of PTH on serum magnesium and calcium, serum Mg reduction is one of the most important factors that influences postoperative serum Ca reduction. What’s more, hypomagnesemia is closely linked with symptoms.
Keywords: hypocalcemia, hypomagnesemia, thyroidectomy, magnesium, calcium
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