Fernando M Mendonça1,2, João S Neves3,4, Maria M Silva3,4, Marta Borges-Canha3,4, Cláudia Costa3,5, Pedro M Cabral6, Vanessa Guerreiro3,4, Rita Lourenço7, Patrícia Meira7, Maria J Ferreira3,4, Daniela Salazar3,4, Jorge Pedro3,4, Sara Viana8, Selma Souto3,4, Ana Varela3,4, Sandra Belo3, Eva Lau3,4, Paula Freitas3,4,9, Davide Carvalho3,4,9. 1. Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar e Universitário de S. João, Porto, Portugal. fernandomiguel_92@hotmail.com. 2. Faculdade de Medicina, Universidade do Porto, Porto, Portugal. fernandomiguel_92@hotmail.com. 3. Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar e Universitário de S. João, Porto, Portugal. 4. Faculdade de Medicina, Universidade do Porto, Porto, Portugal. 5. Serviço de Endocrinologia, Instituto Português de Oncologia do Porto, Porto, Portugal. 6. Serviço de Patologia Clínica, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal. 7. Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal. 8. Unidade Local de Saúde do Norte Alentejano, Portalegre, Portugal. 9. Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
Abstract
INTRODUCTION: Bariatric surgery (BS) is the most effective therapeutic approach to obesity. It is associated with great gastrointestinal anatomic changes, predisposing the patients to altered nutrient absorption that impacts phosphocalcium metabolism. This study aimed to clarify the prevalence of secondary hyperparathyroidism (SHPT) and its predictors in patients submitted to BS. METHODS: Retrospective study of 1431 patients who underwent metabolic surgery between January 2010 and June 2017 and who were followed for at least 1 year. We compared the clinical and biochemical characteristics of patients with and without secondary hyperparathyroidism (considering SHPT a PTH ˃ 69 pg/mL). Two different analyses were performed: (1) paired analysis of participants before and 1 year after surgery (N = 441); (2) Cross sectional analysis of participants submitted to bariatric surgery before (N = 441), 1 year after (N = 1431) and 4 years after surgery (N = 333). Multiple logistic regression models were used to evaluate possible predictors of SHPT after BS. RESULTS: The overall prevalence of SHPT was 24.9% before surgery, 11.2% 1 year after surgery and 21.3% 4 years after surgery. Patients submitted to LAGB had the highest prevalence of SHPT 1 year after surgery (19.4%; vs RYGB, 12.8%, vs SG, 5.3%). Four years after surgery, RYGB had the highest prevalence of SHPT (27.0%), followed by LAGB (13.2%) and SG (6.9%). Higher body mass index and age, decreased levels of vitamin D and RYGB seem to be independent predictors of SHPT 1 year after surgery. The only independent predictor of SHPT 4 years after surgery was RYGB. CONCLUSION: The prevalence of SHPT is higher before and 4 years after BS than 1 year after surgery. This fact raises some questions about the efficacy of the implemented follow-up plans of vitamin D supplementation on the long term, mainly among patients submitted to RYGB.
INTRODUCTION: Bariatric surgery (BS) is the most effective therapeutic approach to obesity. It is associated with great gastrointestinal anatomic changes, predisposing the patients to altered nutrient absorption that impacts phosphocalcium metabolism. This study aimed to clarify the prevalence of secondary hyperparathyroidism (SHPT) and its predictors in patients submitted to BS. METHODS: Retrospective study of 1431 patients who underwent metabolic surgery between January 2010 and June 2017 and who were followed for at least 1 year. We compared the clinical and biochemical characteristics of patients with and without secondary hyperparathyroidism (considering SHPT a PTH ˃ 69 pg/mL). Two different analyses were performed: (1) paired analysis of participants before and 1 year after surgery (N = 441); (2) Cross sectional analysis of participants submitted to bariatric surgery before (N = 441), 1 year after (N = 1431) and 4 years after surgery (N = 333). Multiple logistic regression models were used to evaluate possible predictors of SHPT after BS. RESULTS: The overall prevalence of SHPT was 24.9% before surgery, 11.2% 1 year after surgery and 21.3% 4 years after surgery. Patients submitted to LAGB had the highest prevalence of SHPT 1 year after surgery (19.4%; vs RYGB, 12.8%, vs SG, 5.3%). Four years after surgery, RYGB had the highest prevalence of SHPT (27.0%), followed by LAGB (13.2%) and SG (6.9%). Higher body mass index and age, decreased levels of vitamin D and RYGB seem to be independent predictors of SHPT 1 year after surgery. The only independent predictor of SHPT 4 years after surgery was RYGB. CONCLUSION: The prevalence of SHPT is higher before and 4 years after BS than 1 year after surgery. This fact raises some questions about the efficacy of the implemented follow-up plans of vitamin D supplementation on the long term, mainly among patients submitted to RYGB.
Authors: Maria Luger; Renate Kruschitz; Christian Kienbacher; Stefan Traussnigg; Felix B Langer; Gerhard Prager; Karin Schindler; Enikö Kallay; Friedrich Hoppichler; Michael Trauner; Michael Krebs; Rodrig Marculescu; Bernhard Ludvik Journal: Obes Surg Date: 2017-05 Impact factor: 4.129
Authors: Claudio Casella; Sarah Molfino; Francesco Mittempergher; Carlo Cappelli; Nazario Portolani Journal: Int J Endocrinol Date: 2018-03-06 Impact factor: 3.257