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
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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 - http://www.scopus.com/inward/record.url?scp=85108236622&partnerID=8YFLogxK
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 -