Hyperparathyroidism and vitamin D deficiency after laparoscopic gastric bypass.
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/m2 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.
Clements
Ronald H
RH
Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama-Birmingham, Birmingham, Alabama, USA. rhcmd@uab.edu
Yellumahanthi
Kishore
K
Wesley
Mary
M
Ballem
Naveen
N
Bland
Kirby I
KI
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000209:etiology*
D010281:Parathyroid Hormone; D014807:Vitamin D