Noah J Switzer1, Gabriel Marcil2, Shalvin Prasad2, Estifanos Debru2, Neal Church2, Philip Mitchell2, Emma Billington3, Richdeep Gill2. 1Department of Surgery, University of Alberta, Edmonton, Alberta, Canada, 2Department of Surgery, University of Calgary, Calgary, Alberta, Canada, 3Division of Endocrinology & Metabolism, Department of Medicine, University of Calgary, Alberta, Canada
INTRODUCTION: Pre-operative Vitamin D deficiency is markedly prevalent in prospective bariatric surgery patients. While bariatric surgery leads to significant weight-loss, it can exacerbate or prolong Vitamin D deficiency. We systematically reviewed the literature to assess whether secondary hyperparathyroidism is maintained in the medium to long-term in patients following the roux-en-Y gastric bypass.
METHODS: A comprehensive literature search was conducted through Medline, Embase, Scopus, Web of Science, Dare, Cochrane library, and HTA database. The search terms used were bariatric surgery, gastric bypass and hyperparathyroidism.
RESULTS: Fourteen studies were included (n=2688 subjects) in this systematic review. The average patient age was 44.8 + 8 years. All studies had mean follow-up intervals between 24 and 132 months.
Parathyroid hormone levels rose gradually over 5 year follow-up from a weighted mean pre-operative level of 5.69 + 1.2 pmol/L to 6.36 + 0.77 pmol/L, 7.59 + 0.73 pmol/L, and 8.29 + 1.41 pmol/L at 2 years, between 2-5 years, and beyond 5 years respectively. Vitamin D levels, while initially rising post-surgery from a weighted mean of 18.27 + 3.65 ng/mL to 24.66 + 2.30 ng/mL at 2 years, slowly fell to a weighted mean of 20.50 + 4.37 ng/mL and 20.76 + 3.80 ng/mL between follow-up intervals 2-5 years, and beyond 5 respectively.
CONCLUSION: It appears that hyperparathyroidism persists at 5 year follow-up after gastric bypass, despite most patients being supplemented with calcium and Vitamin D.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79913
Program Number: P546
Presentation Session: Poster (Non CME)
Presentation Type: Poster
