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01-07-2018 | Original Contributions

Serum Parathyroid Hormone and 25-Hydroxyvitamin D Concentrations Before and After Biliopancreatic Diversion

Authors: Vanessa Tardio, Jean-Philippe Blais, Anne-Sophie Julien, Pierre Douville, Stefane Lebel, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Claudia Gagnon

Published in: Obesity Surgery | Issue 7/2018

Abstract

Background

Biliopancreatic diversion with duodenal switch (BPD-DS) decreases vitamin D and calcium absorption, which may result in secondary hyperparathyroidism. This study aimed at evaluating the prevalence of vitamin D deficiency and secondary hyperparathyroidism before and after BPD-DS.

Methods

A retrospective analysis of patients who had undergone BPD-DS at a tertiary bariatric center between 2003 and 2010 and for whom simultaneous measurements of serum 25-hydroxyvitamin D and parathyroid hormone were available within 5 years post-op was performed. The prevalence of vitamin D deficiency (< 20 ng/ml) and secondary hyperparathyroidism (> 65 pg/mL) at different time points was calculated.

Results

Included were 1436 patients (mean ± SD, age 42.7 ± 10.4 years; BMI 51.5 ± 8.6 kg/m²; 69.8% women). Prevalence of vitamin D deficiency decreased up to 6–12 months after surgery (from 35.8% at baseline down to 6–9%) then rose progressively, plateauing at 15.5% after 36 months. Prevalence of hyperparathyroidism was 28.5% before surgery and rose progressively after surgery, reaching 68.6% at 5 years. Mean serum corrected calcium increased from 0 to 6 months then decreased up to 36 months. Preoperatively, the prevalence of hypocalcemia was 7.3%. It increased after 12 months, attaining 26.9% at 48 months.

Conclusions

Prevalence of vitamin D deficiency and secondary hyperparathyroidism is high before BPD-DS. Despite a low prevalence of vitamin D deficiency after surgery, prevalence of hyperparathyroidism increased steadily 1 year after surgery, preceded by a decrease in serum calcium. Factors explaining the high prevalence of secondary hyperparathyroidism after BPD-DS and its long-term impact on bone health should be addressed.

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Title: Serum Parathyroid Hormone and 25-Hydroxyvitamin D Concentrations Before and After Biliopancreatic Diversion
Authors: Vanessa Tardio
Jean-Philippe Blais
Anne-Sophie Julien
Pierre Douville
Stefane Lebel
Laurent Biertho
Simon Marceau
Frédéric-Simon Hould
Claudia Gagnon
Publication date: 01-07-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 7/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3101-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Serum Parathyroid Hormone and 25-Hydroxyvitamin D Concentrations Before and After Biliopancreatic Diversion

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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