Hyperparathyroidism and Vitamin D Deficiency after Laparoscopic Gastric Bypass. Discussion

Hyperparathyroidism (HPT) can occur after gastric bypass because of the alteration in vitamin D and calcium absorption. Adequate serum vitamin D concentrations have not been clearly defined in this patient population. Vitamin D (Vit D) and parathyroid hormone (PTH) were assessed 1 year after laparos...

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Main Authors: CLEMENTS, Ronald H, YELLUMAHANTHI, Kishore, WESLEY, Mary, BALLEM, Naveen, BLAND, Kirby I, NELSON, Sperry, STALL, Richard
Format: Conference Proceeding
Language:English
Subjects:
Biological and medical sciences
Bone density
Calcium
Endocrinopathies
Gastrointestinal surgery
General aspects
Medical sciences
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)
Patients
Race
Racial differences
Regression analysis
Skin
Vitamin D
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Summary:Hyperparathyroidism (HPT) can occur after gastric bypass because of the alteration in vitamin D and calcium absorption. Adequate serum vitamin D concentrations have not been clearly defined in this patient population. Vitamin D (Vit D) and parathyroid hormone (PTH) were assessed 1 year after laparoscopic gastric bypass (LGB). The prevalence of HPT and Vit D deficiency were determined and their association was evaluated using Fisher's exact test. Ninety-three patients (aged 44 ± 1.1 years, 49.6 ± 0.67 kg/m^sup 2^ body mass index, 79.6% female, 69.6% white) were evaluated. The prevalence of Vit D deficiency (less than 20 ng/mL) and HPT (greater than 65 pg/mL) was 23.6 per cent (n = 22) and 25.7 per cent (n = 28), respectively. Among patients with HPT, only eight of 28 (28.6%) had Vit D deficiency, and of those with Vit D deficiency, only eight of 22 (36.4%) had HPT. There was a weak inverse correlation (r = -0.37) between PTH and Vit D. Blacks are at higher risk for Vit D deficiency. There was no significant association between Vit D deficiency and HPT, Vit D deficiency and Roux limb length, or HPT and Roux limb length. After LGB, Vit D deficiency and hyperparathyroidism occur commonly. Body mass index and Roux limb length are not associated with these two conditions, but racial differences do exist. There is a weak inverse correlation between Vit D and PTH. Further research is needed to elucidate the causes, treatments, and significance of HPT after LGB. [PUBLICATION ABSTRACT]
ISSN:0003-1348
1555-9823