Long-Term Postsurgical Hypoparathyroidism: Subtle Musculoskeletal Alterations and Marked Quality-of-Life Impairment

Abstract

Background: Postsurgical hypoparathyroidism (hypoPT) is associated with hypocalcemia and musculoskeletal complaints, yet its long-term impact on muscle function and quality of life remains poorly defined. This study aimed to evaluate muscle function, physical performance, and quality of life in patients with long-standing postsurgical hypoPT, in comparison with individuals with hypothyroidism (hypoT) and healthy controls.

Methods: The study included 90 participants: 30 with postsurgical hypoparathyroidism and hypothyroidism (hypoPT + T), 30 with postsurgical hypothyroidism alone (hypoT), and 30 healthy controls. Muscle strength was evaluated using BIODEX concentric isokinetic dynamometry and handgrip testing. Functional performance was assessed with the timed up and go (TUG) and repeated chair stand (RCS) tests. Body composition was measured by bioimpedance analysis, and quality of life was evaluated using the short form questionnaire-36 version 2 (SF-36v2) and World Health Organization Five Welfare Index questionnaire (WHO-5) questionnaires.

Results: Fat-free mass (FFM) was lower in the hypoPT + T group compared with controls (P < 0.01), although objective muscle strength did not differ significantly between groups. HypoPT + T patients exhibited prolonged TUG and RCS times and significantly lower SF-36v2 physical function scores (P < 0.01) compared with both hypoT patients and controls. WHO-5 scores were also reduced in the hypoPT + T group (P < 0.01), indicating impaired well-being independent of hypoT.

Conclusions: Long-standing postsurgical hypoPT is associated with impaired functional performance and reduced quality of life, despite preserved objective muscle strength. These findings highlight the need for management strategies that address patient-reported outcomes and physical function, beyond conventional biochemical control.