Calcium and vitamin D supplementation after gastric bypass should be individualized to improve or avoid hyperparathyroidism
Abstract
Background Precise calcium (Ca) and vitamin D intestinal absorption after gastric bypass (GB) remains unknown. We evaluated the effect of receiving or not Ca and vitamin D supplementation on Ca, PTH, and vitamin D axis in patients undergoing GB.Methods Two hundred twenty-two patients were evaluated prior to GB and at 1 year. Baseline characteristics were registered, and bone metabolism markers were determined before surgery and at 12 months. After surgery, oral calcium carbonate (1,200 mg/daily) and vitamin D3 (800 IU) were prescribed with PTH >70 pg/ml.Results In the whole group, before surgery and at 1 year, 36 and 30% had hyperparathyroidism (HPT), respectively. Baseline vitamin D deficiency (<50 nmol/L) was observed in 52% with insufficiency (50-75 nmol/L) in 28%. Linear regression analysis showed a significant positive relationship between PTH and excess body weight (EBW) (r 0.190) with a significant negative relationship between PTH and 25 (OH) D (r-0.243). Only EBW was independently associated with HPT on multivariate logistic regression. PTH and 25 (OH) D significantly improved at 1 year with Ca supplementation, but HPT continued in 35 and in 71%, 25 (OH) D was <75 nmol/L. 25 (OH) D only increased 11.5 nmol/L with supplementation. Without Ca supplementation, both PTH and 25 (OH) D increased. HPT developed in 15% with 25 (OH) D < 75 nmol/L in 66%.Conclusions Ca and vitamin D supplementation after GB should be universal and individualized to overcome mal-absorption and improve previous 25 (OH) D deficiency.
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One study found an inverse correlation between total fat mass and BMD.
“One study found an inverse correlation between total fat mass and BMD.18”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [18]
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- Authors
- Flores, L., Martínez Osaba, M. J., Andreu, A., Moizé, V., Rodríguez, L., & Vidal, J.
- Venue
- Obesity Surgery
- Published
- 2010-04-06
- Volume
- 20
- Issue
- 6
- Pages
- 738-743
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2039354866
- Cited by
- 62
- References
- 26
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 10 · 2013: 3 · 2012: 5
- FWCI
- 4.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Keywords
- gastric bypass, calcium supplementation
- MeSH terms
- Adult, Antacids, Calcium, Calcium Carbonate, Female, Humans, Hyperparathyroidism, Male, Prospective Studies, Reference Values, Vitamin D, Vitamin D Deficiency, Vitamins, Gastric Bypass, Treatment Outcome, Dietary Supplements, Clinical Chemistry Tests
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