Determinants of Secondary Hyperparathyroidism in Bariatric Patients after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy: A Pilot Study

الملخص EN

Objective.

Nutritional deficiencies are common after bariatric surgery.

We aimed to assess the prevalence and possible predictors of secondary hyperparathyroidism (SHPT) in bariatric patients.

Methods.

A total of 95 patients who had undergone Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were assessed after a median of 3 years after surgery.

Anthropometric/demographic and weight-loss parameters were compared according to the presence of SHPT, independently for men/premenopausal women and postmenopausal women.

Results.

SHPT was highly prevalent (men/premenopausal women, 52.1%; postmenopausal women, 31.9%).

Among men/premenopausal women, multivariate analysis indicated that SHPT was predicted by (a) 25-hydroxyvitamin D levels (Exp(B) = 0.869, P-value = 0.037), independently of age, sex, smoking; (b) calcium (Exp(B) = 0.159, P-value = 0.033) and smoking, independently of age and sex; (c) magnesium (Exp(B) = 0.026, P-value = 0.046) and smoking, independently of age and sex.

Among postmenopausal women, SHPT was predicted by menopausal age independently of age, smoking, and levels of 25-hydroxyvitamin D or calcium.

The development of SHPT was not associated with the type of surgery.

Conclusions.

RYGB and SG exhibited similar effects regarding the regulation of the hypothalamus-pituitary-parathyroid axis after surgery.

Vitamin D status and menopausal age appear to determine SHPT on the long term.

SHPT should be sought and vigorously treated with calcium and vitamin D supplementation.