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Related Concept Videos

The Parathyroid Glands00:59

The Parathyroid Glands

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
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Hormones and Bone Tissue01:17

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
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Skeleton and Calcium Homeostasis01:21

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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Synthesis and Functions of Calcitonin00:51

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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Related Experiment Video

Updated: May 30, 2025

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
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Day zero parathyroid hormone levels predict cure after parathyroidectomy.

Brodie D Laurie1, David Leong1, Hieu Nguyen1

  • 1Endocrine Surgery, Sir Charles Gairdner Hospital, 11/13 Bridge Street, Wilson, Western Australia, 6107, Australia.

ANZ Journal of Surgery
|January 31, 2025
PubMed
Summary

Post-operative parathyroid hormone (PTH) levels on day zero reliably predict cure for primary hyperparathyroidism (pHPT) after surgery. A PTH level below 3 pmol/L indicates a successful parathyroidectomy, potentially reducing the need for extensive follow-up monitoring.

Keywords:
PTHdiagnostic accuracyparathyroid hormoneparathyroidectomypersistent hyperparathyroidismprimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Diagnostic Accuracy Studies

Background:

  • Primary hyperparathyroidism (pHPT) is a common endocrine disorder often treated with parathyroidectomy.
  • Accurate assessment of surgical success is crucial for patient management and minimizing recurrence.
  • Early post-operative biochemical markers can aid in determining surgical outcomes.

Purpose of the Study:

  • To assess the predictive value of day zero post-operative parathyroid hormone (PTH) levels for cure in patients with pHPT.
  • To establish an optimal PTH cut-off value for predicting successful parathyroidectomy.
  • To evaluate the diagnostic accuracy of early post-operative PTH levels in confirming cure.

Main Methods:

  • A multicentre, retrospective diagnostic accuracy study involving patients who underwent parathyroidectomy for pHPT.
  • Day zero post-operative PTH levels were analyzed as the predictor variable.
  • Cure at 6 months (normocalcaemia) was the outcome measure; diagnostic parameters were calculated using ROC curve analysis and Youden's index.

Main Results:

  • Of 291 patients, 95.5% achieved cure at 6 months.
  • An optimal PTH cut-off of <3 pmol/L was identified.
  • Patients with day zero PTH <3 pmol/L (77.7% of cohort) showed 100% cure rate, with 81.3% sensitivity and 100% specificity.

Conclusions:

  • Day zero post-operative PTH level <3 pmol/L is a reliable indicator of cure for pHPT following parathyroidectomy.
  • This PTH cut-off effectively identifies cured patients, potentially reducing the need for prolonged biochemical monitoring.
  • Early post-operative PTH measurement offers a valuable tool for assessing parathyroidectomy success.