Body mass index and post-thyroidectomy hypocalcemia: a protective effect of overweight through non-surgical mechanisms—a propensity score-matched study

Abstract Background Postoperative hypocalcemia is a common complication after total thyroidectomy (TT). Recent studies suggest that body mass index (BMI) may influence its occurrence. This study aimed to investigate whether overweight reduces postoperative hypocalcemia after TT and to investigate the impact of surgical and non-surgical factors on postoperative hypocalcemia in patients undergoing total thyroidectomy. Methods A retrospective analysis was conducted on 228 patients who underwent TT for papillary thyroid carcinoma between January 2021 and January 2024. Patients were categorized into overweight (BMI ≥ 25 kg/m2, n = 96) and non-overweight groups (BMI