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Secondary Hyperparathyroidism Before and After Bariatric Surgery: a Prospective Study with 2-Year Follow-Up

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Abstract

Purpose

Secondary hyperparathyroidism (SHPT) is linked to obesity. Bariatric surgery may be associated with calcium and vitamin D deficiencies leading to SHPT. This study aimed to detect the prevalence of SHPT before and after bariatric surgery.

Methods

This prospective study assessed the prevalence of SHPT after sleeve gastrectomy (SG, n = 38) compared to one-anastomosis gastric bypass (OAGB, n = 86). All patients were followed up for 2 years. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry.

Results

Of the 124 patients, 71 (57.3%) were females, and 53 (42.7%) were males, with a mean age of 37.5 ± 8.8 years. Before surgery, 23 patients (18.5%) suffered from SHPT, and 40 (32.3%) had vitamin D deficiency. The prevalence of SHPT increased to 29.8% after 1 year and 36.3% after 2 years. SHPT was associated with lower levels of vitamin D and calcium and higher reduction of BMD in the hip but not in the spine. After 2 years, SHPT was associated with a significantly lower T-score in the hip. SHPT and vitamin D deficiency were significantly more common in patients subjected to OAGB compared to SG (p = 0.003, and p < 0.001, respectively). There is a strong negative correlation between vitamin D levels and parathormone levels before and after surgery.

Conclusion

Prevalence of SHPT is high in obese patients seeking bariatric surgery, especially with lower vitamin D levels. Bariatric surgery increases the prevalence of SHPT up to 2 years. Gastric bypass is associated with a higher risk of developing SHPT compared to SG.

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Author information

Authors and Affiliations

  1. General Surgery Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt

    Mohamed AbdAlla Salman, Ahmed AbdAlla, Mohammed Khattab, Ahmed Refaat, Ehab Fathy, Usama Shaker Mohamed, Khaled Noureldin, Mohamed Said Elmarzouky, Mohamed Nasr Shazly & Haitham S. E. Omar

  2. Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt

    Ahmed Salman & Ahmed Rabiee

  3. General Surgery Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt

    Ahmed Elewa

  4. General Surgery Department, Great Western Hospital, NHS Foundation Trust, Swindon, UK

    Mohamed Tourky

  5. Gastroenterology and Hepatology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt

    Hossam El-Din Shaaban

  6. Prince Charles Hospital, Myrthyer Tydfil, Cardiff, UK

    Mohamed Issa

  7. Endemic Medicine and Hepatology Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt

    Ahmed Moustafa

  8. Department of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt

    Abd Al-Kareem Elias

Authors
  1. Mohamed AbdAlla Salman
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  2. Ahmed Salman
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  11. Ehab Fathy
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  15. Abd Al-Kareem Elias
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  16. Mohamed Said Elmarzouky
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  18. Haitham S. E. Omar
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Corresponding author

Correspondence to Mohamed AbdAlla Salman.

Ethics declarations

Ethics Approval

All performed procedures were in accordance with the ethical standards of the institutional research committee and with the Helsinki declaration.

Informed Consent

Informed consent was obtained from all patients included in this study.

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The authors declare no competing interests.

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Key Points

• Prevalence of SHPT is high in obese patients seeking bariatric surgery.

• Bariatric surgery increases the prevalence of SHPT up to 2 years.

• Gastric bypass is associated with a higher risk of developing SHPT compared to SG.

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Salman, M.A., Salman, A., Elewa, A. et al. Secondary Hyperparathyroidism Before and After Bariatric Surgery: a Prospective Study with 2-Year Follow-Up. OBES SURG 32, 1141–1148 (2022). https://doi.org/10.1007/s11695-022-05902-7

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