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01-08-2021 | Sleeve Gastrectomy | Original Contributions

Secondary Hyperparathyroidism Among Bariatric Patients: Unraveling the Prevalence of an Overlooked Foe

Authors: Fernando M. Mendonça, João S. Neves, Maria M. Silva, Marta Borges-Canha, Cláudia Costa, Pedro M. Cabral, Vanessa Guerreiro, Rita Lourenço, Patrícia Meira, Maria J. Ferreira, Daniela Salazar, Jorge Pedro, Sara Viana, Selma Souto, Ana Varela, Sandra Belo, Eva Lau, Paula Freitas, Davide Carvalho, CRIO group

Published in: Obesity Surgery | Issue 8/2021

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.

Graphical abstract

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Title: Secondary Hyperparathyroidism Among Bariatric Patients: Unraveling the Prevalence of an Overlooked Foe
Authors: Fernando M. Mendonça
João S. Neves
Maria M. Silva
Marta Borges-Canha
Cláudia Costa
Pedro M. Cabral
Vanessa Guerreiro
Rita Lourenço
Patrícia Meira
Maria J. Ferreira
Daniela Salazar
Jorge Pedro
Sara Viana
Selma Souto
Ana Varela
Sandra Belo
Eva Lau
Paula Freitas
Davide Carvalho
CRIO group
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Sleeve Gastrectomy
Bariatric Surgery
Hyperparathyroidism
Bariatric Surgery
Published in: Obesity Surgery / Issue 8/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-021-05495-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Secondary Hyperparathyroidism Among Bariatric Patients: Unraveling the Prevalence of an Overlooked Foe

Abstract

Introduction

Methods

Results

Conclusion

Graphical abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Graphical abstract

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