Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism
ObjectiveWe aimed to construct a predictive scoring model for the factors influencing serum phosphorus reduction following total parathyroidectomy (tPTX) in secondary hyperparathyroidism (SHPT) and provide a reference for identifying patients who can successfully correct hyperphosphatemia before sur...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1584602/full |
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| author | Yingnan Feng Yingnan Feng Yinghui Zhou Xiaodong Feng Qila Sa Qila Sa Ningyuan Zhang Ningyuan Zhang Wantao Xie Wantao Xie Bailiang Liu Fengyang Chen Guangming Cheng Wei Zhang |
| author_facet | Yingnan Feng Yingnan Feng Yinghui Zhou Xiaodong Feng Qila Sa Qila Sa Ningyuan Zhang Ningyuan Zhang Wantao Xie Wantao Xie Bailiang Liu Fengyang Chen Guangming Cheng Wei Zhang |
| author_sort | Yingnan Feng |
| collection | DOAJ |
| description | ObjectiveWe aimed to construct a predictive scoring model for the factors influencing serum phosphorus reduction following total parathyroidectomy (tPTX) in secondary hyperparathyroidism (SHPT) and provide a reference for identifying patients who can successfully correct hyperphosphatemia before surgery.MethodsThe clinical data of 529 patients with SHPT who underwent tPTX were retrospectively analyzed according to the inclusion and exclusion criteria. Univariate and multivariate analyses were conducted to determine the independent factors and establish a predictive scoring model. The receiver operating characteristic curve (ROC) was applied to verify the model in the training and validation groups, respectively.ResultsIn the whole group, 315 patients had a significant decrease in serum phosphorus after tPTX. Univariate and multivariate analysis showed that preoperative alkaline phosphatase (AKP), intact parathyroid hormone (iPTH) and free triiodothyronine (FT3) were independent influencing factors to promote the decrease of serum phosphorus after tPTX; Serum phosphorus and bone pain were inhibitory factors (all P<0.05). According to the cut-off value, AKP>193.33 U/L, iPTH>1808 pg/mL, FT3>2.825 pg/mL, serum phosphorus>2.285 mmol/L and bone pain were used to establish the predictive scoring model for serum phosphorus decline. The results showed that the success rate of serum phosphorus reduction was 67.55% at 10~14 points and 95.35% at 15~24 points. The area under ROC curves (AUC) for the training and validation group were 0.818 (95% CI=0.775~0.861) and 0.840 (95% CI=0.780~0.901, both P<0.05).ConclusionThe established prediction score model for serum phosphorus decrease has a good prediction efficiency which is helpful for the early identification. The model provides important clinical guidance for the postoperative management and treatment of SHPT. |
| format | Article |
| id | doaj-art-ee0d501e9f394775bab745d52ce2a5df |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-ee0d501e9f394775bab745d52ce2a5df2025-08-20T03:12:47ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15846021584602Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidismYingnan Feng0Yingnan Feng1Yinghui Zhou2Xiaodong Feng3Qila Sa4Qila Sa5Ningyuan Zhang6Ningyuan Zhang7Wantao Xie8Wantao Xie9Bailiang Liu10Fengyang Chen11Guangming Cheng12Wei Zhang13Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaPostgraduate College, Dalian Medical University, Dalian, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaPostgraduate College, Dalian Medical University, Dalian, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaPostgraduate College, China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaPostgraduate College, China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaDepartment of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, ChinaObjectiveWe aimed to construct a predictive scoring model for the factors influencing serum phosphorus reduction following total parathyroidectomy (tPTX) in secondary hyperparathyroidism (SHPT) and provide a reference for identifying patients who can successfully correct hyperphosphatemia before surgery.MethodsThe clinical data of 529 patients with SHPT who underwent tPTX were retrospectively analyzed according to the inclusion and exclusion criteria. Univariate and multivariate analyses were conducted to determine the independent factors and establish a predictive scoring model. The receiver operating characteristic curve (ROC) was applied to verify the model in the training and validation groups, respectively.ResultsIn the whole group, 315 patients had a significant decrease in serum phosphorus after tPTX. Univariate and multivariate analysis showed that preoperative alkaline phosphatase (AKP), intact parathyroid hormone (iPTH) and free triiodothyronine (FT3) were independent influencing factors to promote the decrease of serum phosphorus after tPTX; Serum phosphorus and bone pain were inhibitory factors (all P<0.05). According to the cut-off value, AKP>193.33 U/L, iPTH>1808 pg/mL, FT3>2.825 pg/mL, serum phosphorus>2.285 mmol/L and bone pain were used to establish the predictive scoring model for serum phosphorus decline. The results showed that the success rate of serum phosphorus reduction was 67.55% at 10~14 points and 95.35% at 15~24 points. The area under ROC curves (AUC) for the training and validation group were 0.818 (95% CI=0.775~0.861) and 0.840 (95% CI=0.780~0.901, both P<0.05).ConclusionThe established prediction score model for serum phosphorus decrease has a good prediction efficiency which is helpful for the early identification. The model provides important clinical guidance for the postoperative management and treatment of SHPT.https://www.frontiersin.org/articles/10.3389/fendo.2025.1584602/fullsecondary hyperparathyroidismtotal parathyroidectomyhyperphosphatemiarisk factorspredictive model |
| spellingShingle | Yingnan Feng Yingnan Feng Yinghui Zhou Xiaodong Feng Qila Sa Qila Sa Ningyuan Zhang Ningyuan Zhang Wantao Xie Wantao Xie Bailiang Liu Fengyang Chen Guangming Cheng Wei Zhang Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism Frontiers in Endocrinology secondary hyperparathyroidism total parathyroidectomy hyperphosphatemia risk factors predictive model |
| title | Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism |
| title_full | Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism |
| title_fullStr | Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism |
| title_full_unstemmed | Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism |
| title_short | Construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism |
| title_sort | construction and validation of a predictive model for the serum phosphorus reduction after total parathyroidectomy in patients with secondary hyperparathyroidism |
| topic | secondary hyperparathyroidism total parathyroidectomy hyperphosphatemia risk factors predictive model |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1584602/full |
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