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Calcium and Vitamin D Depletion and Elevated Parathyroid Hormone following Biliopancreatic Diversion
Abstract
Background Biliopancreatic diversion (BPD) is associated with a 70% excess weight loss (EWL) at 10 years, but there are concerns regarding long-term nutritional sequelae. Metabolic bone disease has been documented following Roux-en-Y gastric bypass.Methods Patients who underwent a BPD from 1998 to 2001 were studied. A questionnaire was designed to review BPD patients and collect information on weight loss, frequency of gastrointestinal disturbances and compliance with multivitamin recommendations. The review included a blood test for vitamin D, parathyroid hormone (PTH), alkaline phosphatase (ALP) and calcium.Results Of the 82 patients who underwent BPD during this period, the median %EWL at 36 months was 73.0%. 75.6% suffered diarrhea. At median follow-up of 32 months (18-50), 25.9% of patients were hypocalcemic, 50% had low vitamin D, 23.8% had elevated ALP, and 63.1% had elevated PTH, despite 82.9% taking multivitamins.Conclusion BPD results in significant weight loss. However, 1 in 4 patients are hypocalcemic, and 1 in 2 have a low vitamin D, despite multivitamin supplementation. BPD patients require routine calcium and vitamin D supplementation for life. Long-term sequelae from these abnormal serum levels are not known.
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“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 [77]
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Metadata
- Authors
- Newbury, L., Dolan, K., Hatzifotis, M., Low, N., & Fielding, G.
- Affiliations
- Royal Brisbane and Women's Hospital (AU)
- Venue
- Obesity Surgery
- Published
- 2003-12-01
- Volume
- 13
- Issue
- 6
- Pages
- 893-895
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2078290451
- Cited by
- 156
- References
- 10
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 8 · 2014: 8 · 2013: 3 · 2012: 9
- FWCI
- 9.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- biliopancreatic diversion, parathyroid hormone
- MeSH terms
- Alkaline Phosphatase, Anastomosis, Roux-en-Y, Bone Diseases, Metabolic, Calcium, Female, Gastrectomy, Humans, Hypocalcemia, Male, Middle Aged, Obesity, Morbid, Parathyroid Hormone, Vitamin D, Vitamin D Deficiency, Gastric Bypass, Biliopancreatic Diversion
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