title: Determinants of Secondary Hyperparathyroidism in Bariatric Patients after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy: A Pilot Study.
abstract: Objective. Nutritional deficiencies are common after bariatric surgery. We aimed to assess the prevalence and possible predictors of secondary hyperparathyroidism (SHPT) in bariatric patients. Methods. A total of 95 patients who had undergone Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were assessed after a median of 3 years after surgery. Anthropometric/demographic and weight-loss parameters were compared according to the presence of SHPT, independently for men/premenopausal women and postmenopausal women. Results. SHPT was highly prevalent (men/premenopausal women, 52.1%; postmenopausal women, 31.9%). Among men/premenopausal women, multivariate analysis indicated that SHPT was predicted by (a) 25-hydroxyvitamin D levels (Exp(B) = 0.869, P-value = 0.037), independently of age, sex, smoking; (b) calcium (Exp(B) = 0.159, P-value = 0.033) and smoking, independently of age and sex; (c) magnesium (Exp(B) = 0.026, P-value = 0.046) and smoking, independently of age and sex. Among postmenopausal women, SHPT was predicted by menopausal age independently of age, smoking, and levels of 25-hydroxyvitamin D or calcium. The development of SHPT was not associated with the type of surgery. Conclusions. RYGB and SG exhibited similar effects regarding the regulation of the hypothalamus-pituitary-parathyroid axis after surgery. Vitamin D status and menopausal age appear to determine SHPT on the long term. SHPT should be sought and vigorously treated with calcium and vitamin D supplementation.
authors.affiliation: 1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Tsoka
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.affiliation: Hormonal Laboratory, Aretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.affiliation: 1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Diamantis
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Areti
authors.initials: A
authors.lastname: Augoulea
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Panoulis
authors.affiliation: 1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Liakakos
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, 76 Vas. Sofias Avenue, 11528 Athens, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki