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

CRIO group

doi:10.1007/s11695-021-05495-7

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

CRIO group

ECTS - School of Health Sciences and Technologies

Centro de Responsabilidade Integrada em Obesidade
Centro Hospitalar e Universitário de S. João
University of Porto
Instituto Português de Oncologia do Porto Francisco Gentil E.P.E.
Centro Hospitalar Universitário Cova da Beira
Unidade Local de Saúde do Norte Alentejano

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

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: [Figure not available: see fulltext.].

Original language	English
Pages (from-to)	3768-3775
Number of pages	8
Journal	Obesity Surgery
Volume	31
Issue number	8
DOIs	https://doi.org/10.1007/s11695-021-05495-7
Publication status	Published - Aug 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Funding

We would like to thank the important contribution of several members of CRIO group: John Preto, Eduardo Lima da Costa, Hugo Sousa, André Pinho, Eva Lau, Selma Souto, Carla Galego, Flora Correia, Cidália Gil, Diva Melim, Eduardo Pinto, Marco Silva, Cristina Martins, Luis Miguel Pereira, Inês Magalhães, Isabel Brandão, Sertório Manuel Andrade, Patrícia Nunes. No grant support to declare.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Bariatric surgery
Calcium
Secondary Hyperparathyroidism
Supplementation
Vitamin D

Access to Document

10.1007/s11695-021-05495-7

Cite this

@article{483b872f4ec04783a81ce05fdb566887,

title = "Secondary Hyperparathyroidism Among Bariatric Patients: Unraveling the Prevalence of an Overlooked Foe",

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: [Figure not available: see fulltext.].",

keywords = "Bariatric surgery, Calcium, Secondary Hyperparathyroidism, Supplementation, Vitamin D",

author = "\{CRIO group\} and Mendon{\c c}a, \{Fernando M.\} and Neves, \{Jo{\~a}o S.\} and Silva, \{Maria M.\} and Marta Borges-Canha and Cl{\'a}udia Costa and Cabral, \{Pedro M.\} and Vanessa Guerreiro and Rita Louren{\c c}o and Patr{\'i}cia Meira and Ferreira, \{Maria J.\} and Daniela Salazar and Jorge Pedro and Sara Viana and Selma Souto and Ana Varela and Sandra Belo and Eva Lau and Paula Freitas and Davide Carvalho and John Preto and \{da Costa\}, \{Eduardo Lima\} and Hugo Sousa and Andr{\'e} Pinho and Carla Galego and Flora Correia and Cid{\'a}lia Gil and Diva Melim and Eduardo Pinto and Marco Silva and Cristina Martins and Pereira, \{Luis Miguel\} and In{\^e}s Magalh{\~a}es and Isabel Brand{\~a}o and Andrade, \{Sert{\'o}rio Manuel\} and Patr{\'i}cia Nunes",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2021",

month = aug,

doi = "10.1007/s11695-021-05495-7",

language = "English",

volume = "31",

pages = "3768--3775",

journal = "Obesity Surgery",

issn = "0960-8923",

publisher = "Springer",

number = "8",

}

TY - JOUR

T1 - Secondary Hyperparathyroidism Among Bariatric Patients

T2 - Unraveling the Prevalence of an Overlooked Foe

AU - CRIO group

AU - Mendonça, Fernando M.

AU - Neves, João S.

AU - Silva, Maria M.

AU - Borges-Canha, Marta

AU - Costa, Cláudia

AU - Cabral, Pedro M.

AU - Guerreiro, Vanessa

AU - Lourenço, Rita

AU - Meira, Patrícia

AU - Ferreira, Maria J.

AU - Salazar, Daniela

AU - Pedro, Jorge

AU - Viana, Sara

AU - Souto, Selma

AU - Varela, Ana

AU - Belo, Sandra

AU - Lau, Eva

AU - Freitas, Paula

AU - Carvalho, Davide

AU - Preto, John

AU - da Costa, Eduardo Lima

AU - Sousa, Hugo

AU - Pinho, André

AU - Galego, Carla

AU - Correia, Flora

AU - Gil, Cidália

AU - Melim, Diva

AU - Pinto, Eduardo

AU - Silva, Marco

AU - Martins, Cristina

AU - Pereira, Luis Miguel

AU - Magalhães, Inês

AU - Brandão, Isabel

AU - Andrade, Sertório Manuel

AU - Nunes, Patrícia

PY - 2021/8

Y1 - 2021/8

N2 - 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: [Figure not available: see fulltext.].

AB - 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: [Figure not available: see fulltext.].

KW - Bariatric surgery

KW - Calcium

KW - Secondary Hyperparathyroidism

KW - Supplementation

KW - Vitamin D

UR - https://www.scopus.com/pages/publications/85108236622

U2 - 10.1007/s11695-021-05495-7

DO - 10.1007/s11695-021-05495-7

M3 - Article

C2 - 34120309

AN - SCOPUS:85108236622

SN - 0960-8923

VL - 31

SP - 3768

EP - 3775

JO - Obesity Surgery

JF - Obesity Surgery

IS - 8

ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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Cite this