Long‐term hypovitaminosis D and secondary hyperparathyroidism outcomes of the Roux‐en‐Y gastric bypass: a systematic review. (8th March 2017)

• Record Type: Journal Article
• Authors: Switzer, N. J.; Marcil, G.; Prasad, S.; Debru, E.; Church, N.; Mitchell, P.; Billington, E. O.; Gill, R. S.
• Is Part Of: Obesity reviews. Volume 18:Number 5(2017:May)
• Page Start: 560
• Page End: 566
• Publication Date: 2017-03-08
• Subjects: Gastric bypass -- hyperparathyroidism -- hypovitaminosis D -- long‐term outcomes; Obesity -- Periodicals; 616.398005
• DOI: 10.1111/obr.12525
• Languages: English
• ISSNs: 1467-7881

Abstract

Summary: 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). Parathyroid hormone levels rose gradually from a 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 and 5 years, and beyond 5 years, respectively. Vitamin D levels slowly fell to a 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.