{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:28:06Z","timestamp":1790306886225,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Bone &amp; Mineral Res"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Postoperative hypoparathyroidism (PO\u2010hypoPT) is an uncommon complication of total thyroidectomy in thyroid cancer patients. Although long\u2010term hypoPT causes characteristic changes in bone metabolism, the risk of fractures in hypoPT remains inconclusive. We investigated the risk of fractures in Korean thyroid cancer patients with PO\u2010hypoPT. This was a retrospective cohort study using data from the Korea Central Cancer Registry and Korean National Health Insurance Service. We analyzed 115,821 thyroid cancer patients aged \u226518\u2009years, who underwent total thyroidectomy between 2008 and 2016. The risk of any fractures, including vertebral, hip, humerus, and wrist fractures, according to parathyroid function after total thyroidectomy, was analyzed using the multivariable Cox proportional hazard model. The PO\u2010hypoPT and preserved parathyroid function groups included 8789 (7.6%) and 107,032 (92.4%) patients, respectively. Over a mean follow\u2010up duration of 4.8\u2009years, 159 (1.8%) and 2390 (2.2%) fractures occurred in the PO\u2010hypoPT and preserved parathyroid function groups, respectively. The risk of any fractures was significantly lower in the PO\u2010hypoPT group than in the preserved parathyroid function group (hazard ratio [HR] =\u20090.83; 95% confidence interval [CI] 0.70\u20130.98;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.037) after adjusting for confounders. Regarding the fracture site, only the risk of vertebral fractures was significantly lower in the PO\u2010hypoPT group compared with the preserved parathyroid function group (HR\u2009=\u20090.67; 95% CI 0.47\u20130.96;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.028) after adjusting for confounders. Subgroup analyses showed that bone mineral density measurements and calcium supplementation interacted with the relationship between PO\u2010hypoPT and the risk of any fractures (\n                    <jats:italic>p<\/jats:italic>\n                    for interactions\u2009=\u20090.010 and 0.017, respectively). PO\u2010hypoPT was associated with a lower risk of fractures in thyroid cancer patients, especially at the vertebra. The relatively low bone turnover caused by PO\u2010hypoPT and appropriate management for PO\u2010hypoPT with active vitamin D and calcium may prevent the deterioration of skeletal health in thyroid cancer patients who can easily be exposed to long\u2010term overtreatment with levothyroxine. \u00a9 2023 American Society for Bone and Mineral Research (ASBMR).\n                  <\/jats:p>","DOI":"10.1002\/jbmr.4871","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T11:34:35Z","timestamp":1687260875000},"page":"1268-1277","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Risk of Fractures in Thyroid Cancer Patients With Postoperative Hypoparathyroidism: A Nationwide Cohort Study in Korea"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2558-2118","authenticated-orcid":false,"given":"Seong Hee","family":"Ahn","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Inha University Hospital, Inha University School of Medicine  Incheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Center for Thyroid Cancer National Cancer Center  Goyang South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seongbin","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Inha University Hospital, Inha University School of Medicine  Incheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Wee","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University Bundang Hospital, Seoul National University College of Medicine  Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye Jhin","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Statistics Yonsei University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bit\u2010Na","family":"Yoo","sequence":"additional","affiliation":[{"name":"National Evidence\u2010based Healthcare Collaboration Agency (NECA)  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Chan","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery BUMIN Hospital  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Kyung","family":"Bak","sequence":"additional","affiliation":[{"name":"National Evidence\u2010based Healthcare Collaboration Agency (NECA)  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Gangneung Asan Hospital, University of Ulsan College of Medicine  Gangneung South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6564-4294","authenticated-orcid":false,"given":"Young\u2010Kyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Seoul National University Bundang Hospital, Seoul National University College of Medicine  Seongnam South 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