sdü tıp fak derg Medical Journal of Süleyman Demirel University 2602-2109 Süleyman Demirel Üniversitesi 10.17343/sdutfd.1413088 Endocrinology Endokrinoloji Primer Hiperparatiroidi Tanılı Hastalarda Hematolojik İnflamatuar Belirteçler ile Postoperatif Hipokalsemi Arasındaki İlişki The Relationship Between Hematological Inflammatory Markers and Postoperative Hypocalcemia in Patients with Primary Hyperparathyroidism https://orcid.org/0000-0002-5340-6106 Gezer Emre KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES https://orcid.org/0009-0004-4142-3605 Zekey Ömer KOCAELI UNIVERSITY, SCHOOL OF MEDICINE https://orcid.org/0000-0002-0537-3127 Yaprak Bayrak Büşra KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF PATHOLOGY https://orcid.org/0000-0001-7114-2565 Cantürk Zeynep KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES https://orcid.org/0000-0002-8041-8161 Çetinarslan Berrin KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES https://orcid.org/0000-0002-0646-8697 Selek Alev KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES https://orcid.org/0000-0002-8428-1115 Sözen Mehmet KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES https://orcid.org/0000-0002-6349-2976 Köksalan Damla KOCAELI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES 09 29 2024 31 3 205 211 01 01 2024 07 03 2024 Copyright © 1994, Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1994 Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Amaç: Primer hiperparatiroidizm (PHPT), hiperkalsemi ile karakterize olan ve sıklıkla paratiroid adenomu (PTA) ile ilişkili yaygın bir endokrin hastalığıdır. Hipokalsemi PHPT'li hastalarda sık görülen bir postoperatif komplikasyondur. Nötrofil-lenfosit oranı (NLR) ve platelet-lenfosit oranı (PLR) ucuz hematolojik inflamatuar belirteçlerdir. PHPT'li hastalarda erken postoperatif hipokalsemi için hemogramdan türetilmiş inflamatuar belirteçler dahil olmak üzere potansiyel prediktif risk faktörlerini araştırmayı amaçladık.Gereç ve Yöntem: PHPT tanısı alan, paratiroidektomi uygulanan ve histopatolojik olarak tek PTA’dan kaynaklandığı gösterilen hastalar çalışmaya dahil edildi.Bulgular: NLR, parathormon (PTH) ile, PLR ise sadece NLR ile anlamlı düzeyde ilişkiliydi. Gland ağırlığı ve hacmi ile kalsiyum (Ca) ve PTH düzeyleri arasında anlamlı pozitif korelasyon gösterildi. Postoperatif hipokalseminin yaş, ameliyat öncesi Ca, PTH ve NLR ile anlamlı bir korelasyonu da gösterilmiştir.Sonuç: Postoperatif hipokalsemi gelişen PHPT'li hastalarda NLR'nin anlamlı derecede yüksek olduğunu bulduk; ancak regresyon analizimizde yüksek NLR'nun postoperatif hipokalsemi için anlamlı bir prediktif risk faktörü olmadığı gösterildi. Bildiğimiz kadarıyla bu, PHPT'li hastalarda hemogramdan türetilen inflamatuar belirteçler ile postoperatif hipokalsemi gelişimi ve preoperatif nefrolitiazis varlığı gibi klinik parametreler arasındaki ilişkiyi araştıran ilk çalışmadır.

Objective: Primary hyperparathyroidism (PHPT) is a common endocrine disease that is characterized by hypercalcemia and commonly associated with parathyroid adenoma (PTA). Hypocalcemia is a common postoperative complication in patients with PHPT. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inexpensive hematological inflammatory markers. We aimed to investigate the potential predictive risk factors, including the hemogram-derived inflammatory markers for early postoperative hypocalcemia in patients with PHPT.Material and Method: Patients diagnosed with PHPT, underwent parathyroidectomy and histopathologically shown to be caused by a single PTA were included.Results: NLR was significantly correlated with parathormone (PTH), while PLR was related considerably with only NLR. A significant positive correlation was shown between gland weight, volume, calcium (Ca), and PTH levels. A significant correlation of postoperative hypocalcemia with age, preoperative Ca, PTH, and NLR was also demonstrated.Conclusion: We found that NLR was significantly higher in patients with PHPT who developed postoperative hypocalcemia; however, our regression analysis did not find elevated NLR as a significant predictive risk factor for postoperative hypocalcemia. To the best of our knowledge, this is the first study investigating the relationship between hemogram-derived inflammatory markers and clinical parameters, such as the development of postoperative hypocalcemia and preoperative nephrolithiasis, in patients with PHPT.Keywords: Hyperparathyroidism, Hypocalcemia, Neutrophils, Lymphocytes, Platelets

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