To analyze the predictive value of serum macrophage migration inhibitory factor (MMIF) combined with perioperative indicators [interleukin-6 (IL-6), parathyroid hormone (PTH)] for early postoperative hypoparathyroidism in patients undergoing total thyroidectomy.

A prospective study was conducted on 130 patients who underwent total thyroidectomy from January 2021 to January 2025. All patients were followed up postoperatively and divided into the hypoparathyroidism group (n=40, serum calcium level <2.1mmol/L) and the normal group (n=90, serum calcium level ≥2.1mmol/L) based on fasting serum calcium levels (referring to ionized calcium^[1]) at 1 month after surgery. A combined prediction model with MMIF, IL-6, and PTH as variables was constructed using Logistic regression analysis. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of postoperative MMIF, IL-6, and PTH levels for early hypoparathyroidism.

The levels of postoperative MMIF and IL-6 in the hypoparathyroidism group were higher than those in the normal group, while the PTH level was lower (P<0.05). Logistic regression analysis showed that postoperative MMIF, IL-6, and PTH were predictive indicators of hypoparathyroidism, and the combined prediction model was Logit(P) = -4.440 + 2.178 × MMIF + 0.189 × IL-6 - 0.257 × PTH. ROC curve analysis revealed that the area under the curve (AUC) of the combined prediction of early postoperative hypoparathyroidism by MMIF, IL-6, and PTH was 0.892, with a sensitivity of 82.5% and a specificity of 92.2%. The combined prediction efficacy was superior to that of each indicator alone (P<0.05).

Postoperative MMIF, IL-6, and PTH levels in patients undergoing total thyroidectomy have certain predictive value for early postoperative hypoparathyroidism, and the combined detection of the three can improve the predictive efficacy. Clinically, early postoperative screening of these indicators may be considered, and timely prevention and treatment measures can be taken to reduce parathyroid function damage.