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Secondary hyperparathyroidism prevalent after bariatric surgery
Adults who underwent Roux-en-Y gastric bypass who were also vitamin D deficient had an increased risk for secondary hyperparathyroidism 2 years after surgery compared with those who had sufficient vitamin D levels, according to study findings published in Clinical Endocrinology.
Stephen Hewitt, MD, of the department of endocrinology, morbid obesity and preventive medicine at Oslo University Hospital in Norway, and colleagues evaluated data on adults (mean age, 46 years; mean BMI, 32 kg/m2) attending 2-year follow-up after Roux-en-Y gastric bypass at Oslo University Hospital to determine the prevalence of secondary hyperparathyroidism and its association with vitamin D status. Participants were recruited from June 2010 to May 2013; follow-up was a mean of 26 months.
Participants had mean serum 25-hydroxyvitamin D level of 62 nmol/L and mean parathyroid hormone level of 6.4 pmol/L.
Thirty-four percent of participants had secondary hyperparathyroidism. The prevalence of secondary hyperparathyroidism was highest among participants with serum 25-(OH)D levels less than 25 nmol/L (71%); the prevalence was 45% among those with 25-(OH)D levels less than 50 nmol/L. Parathyroid hormone levels (P = .007) and the prevalence of secondary hyperparathyroidism (RR = 0.53; 95% CI, 0.21-1.33) were lower among participants with 25-(OH)D levels at least 100 nmol/L compared with levels between 50 and 99 nmol/L. Participants with low vitamin D levels had the lowest serum ionized calcium levels, and these levels increased with increasing 25-(OH)D levels.
“The overall prevalence of [secondary hyperparathyroidism] was high, and is comparable to other studies, which may raise concerns about current substitution regimens and future bone health in this population,” the researchers wrote. – by Amber Cox
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