Secondary hyperparathyroidism, vitamin D sufficiency, and serum calcium 5 years after gastric bypass and duodenal switch
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Background The prevalence of secondary hyperparathyroidism (SHPT) is high after bariatric surgery. Vitamin D is supplied to counteract SHPT and bone disease, and we studied vitamin D associations with SHPT.Methods We measured serum levels of 25-OH vitamin D and parathyroid hormone (PTH) 5 years after gastric bypass and duodenal switch. One hundred twenty-five patients were included, of whom 114 (91 %) had undergone gastric bypass and 11 (9 %) had undergone duodenal switch. SHPT was defined as PTH > 7.0 pmol/l in the absence of hypercalcemia. 25-OH vitamin D levels were divided into three categories: <50, 50-74, and ≥75 nmol/l. Serum ionized calcium, magnesium, phosphate, and creatinine were divided into tertiles.Results Mean age ± SD was 44 ± 9 years at 5 years follow-up. Ninety out of 125 (72 %) patients were women. SHPT was present in 45 out of 114 (40 %) gastric bypass patients and in 11 out of 11 (100 %) duodenal switch patients. The prevalence was high in all vitamin D categories studied. An inverse association between ionized calcium and PTH was found. For the gastric bypass patients, the odds ratio for SHPT in the upper two tertiles of ionized calcium was 0.35; 95 % CI, 0.15-0.79; p = 0.011, compared with the lowest tertile. Supplements of vitamin D and calcium were not associated with a lower prevalence of SHPT at 5 years follow-up.Conclusions The prevalence of SHPT was high 5 years after gastric bypass and duodenal switch. SHPT was inversely associated with serum ionized calcium, but not with vitamin D. The supplementation used was insufficient to compensate for the impaired calcium absorption after surgery.
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After BPD/DS, more than 50% of patients have vitamin D deficiency and estimates of secondary hyperparathyroidism range from 60% to 100% even with aggressive supplementation.
“After BPD/DS more than 50% of patients have vitamin D deficiency and estimates of secondary hyperparathyroidism range from 60-100% even with aggressive supplementation75, 77-79.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [75]
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- Authors
- Hewitt, S., Søvik, T. T., Aasheim, E. T., Kristinsson, J., Jahnsen, J., Birketvedt, G. S., Bøhmer, T., Eriksen, E. F., & Mala, T.
- Affiliations
- Oslo University Hospital (NO)
- Corresponding author
- Hewitt, Stephen
- Venue
- Obesity Surgery
- Published
- 2012-09-28
- Volume
- 23
- Issue
- 3
- Pages
- 384-390
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2015310456
- Cited by
- 70
- References
- 35
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 10 · 2013: 3
- FWCI
- 6.51
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (ACF-2011-14-008)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- secondary hyperparathyroidism, vitamin D sufficiency
- MeSH terms
- Adult, Calcium, Cross-Sectional Studies, Duodenum, Female, Humans, Hyperparathyroidism, Secondary, Male, Middle Aged, Norway, Obesity, Morbid, Postoperative Complications, Postoperative Period, Risk Factors, Time Factors, Vitamin D, Cohort Studies, Gastroplasty, Prevalence, Treatment Outcome
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