Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy

Esraa Altawil,1,&ast; Hadeel Alkofide,2,&ast; Husam Alamri,3 Noura Alhassan,4 Hamad Alsubaie,3 Awadh Alqahtani,3 Omar Alobaid4 1Pharmacy Department, Clinical Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, College of Pharmacy, Kin...

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Autores principales:	Altawil E, Alkofide H, Alamri H, Alhassan N, Alsubaie H, Alqahtani A, Alobaid O
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	bariatric surgery morbid obesity hyperparathyroidism calcium vitamin d Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/2b69c9048a454b6f867c689dee1b188e
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spelling	oai:doaj.org-article:2b69c9048a454b6f867c689dee1b188e2021-12-02T15:03:23ZSecondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy1178-7007https://doaj.org/article/2b69c9048a454b6f867c689dee1b188e2021-09-01T00:00:00Zhttps://www.dovepress.com/secondary-hyperparathyroidism-in-obese-patients-post-sleeve-gastrectom-peer-reviewed-fulltext-article-DMSOhttps://doaj.org/toc/1178-7007Esraa Altawil,1,&ast; Hadeel Alkofide,2,&ast; Husam Alamri,3 Noura Alhassan,4 Hamad Alsubaie,3 Awadh Alqahtani,3 Omar Alobaid4 1Pharmacy Department, Clinical Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Department of Surgery, King Saud University, College of Medicine, Riyadh, Saudi Arabia; 4Department of Surgery, Colorectal Research Chair, King Saud University, College of Medicine, Riyadh, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Omar AlobaidDepartment of Surgery, Colorectal Research Chair, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi ArabiaTel +966 558670000Email oalobaid@ksu.edu.saIntroduction: Bariatric surgery provides an effective option for the management of morbid obesity. Several studies have investigated the association between bariatric surgery and secondary hyperparathyroidism (SHPT). This study aims to compare the levels of blood biomarkers, specifically, calcium (Ca), vitamin D, and phosphate (PO4), and their association with parathyroid hormone (PTH) levels pre- and post-bariatric surgery. In addition, it aims to assess the prevalence of hyperparathyroidism post-bariatric surgery in a tertiary care hospital in Saudi Arabia.Material and Methods: A prospective cohort study was conducted at a large tertiary care hospital between May 2017 and April 2019. The study included adult obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Patients were excluded if they were known to have any comorbidities, receiving vitamin supplements, and those who had undergone bariatric procedures previously. Routine blood tests, including PTH, vitamin D, Ca, and PO4, were collected at baseline, and post-surgery.Results: A total of 143 patients who underwent LSG were included in the study. Hyperparathyroidism was observed in 15.4% of patients at baseline and in 36.4% of patients’ post-surgery (p < 0.001). Low vitamin D levels, which were highly prevalent before surgery, decreased sustainably (66.4% pre-operative and 28% at follow-up after surgery, P=0.032). Baseline hypocalcemia was observed in 20.3% of patients compared to 8.4% post-surgery (P=0.546). Hypophosphatemia was present in 60.8% of subjects at baseline, while the percentage dropped to 21.7% post-surgery. There was a significant association between PO4 and PTH levels at baseline. Post-operatively, there was a significant correlation between PTH and both vitamin D and calcium levels.Conclusion: Our study showed that the higher levels of PTH post LSG can be related to vitamin D deficiency and lower calcium levels, despite patients following the provided recommendations for supplementation. This study also emphasizes the importance of routine testing for hyperparathyroidism both before and after bariatric surgery.Keywords: bariatric surgery, morbid obesity, hyperparathyroidism, calcium, vitamin DAltawil EAlkofide HAlamri HAlhassan NAlsubaie HAlqahtani AAlobaid ODove Medical Pressarticlebariatric surgerymorbid obesityhyperparathyroidismcalciumvitamin dSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 14, Pp 4059-4066 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bariatric surgery morbid obesity hyperparathyroidism calcium vitamin d Specialties of internal medicine RC581-951
spellingShingle	bariatric surgery morbid obesity hyperparathyroidism calcium vitamin d Specialties of internal medicine RC581-951 Altawil E Alkofide H Alamri H Alhassan N Alsubaie H Alqahtani A Alobaid O Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy
description	Esraa Altawil,1,&ast; Hadeel Alkofide,2,&ast; Husam Alamri,3 Noura Alhassan,4 Hamad Alsubaie,3 Awadh Alqahtani,3 Omar Alobaid4 1Pharmacy Department, Clinical Pharmacy Services, King Saud University Medical City, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Department of Surgery, King Saud University, College of Medicine, Riyadh, Saudi Arabia; 4Department of Surgery, Colorectal Research Chair, King Saud University, College of Medicine, Riyadh, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Omar AlobaidDepartment of Surgery, Colorectal Research Chair, College of Medicine, King Saud University, P.O. Box 7805, Riyadh, 11472, Saudi ArabiaTel +966 558670000Email oalobaid@ksu.edu.saIntroduction: Bariatric surgery provides an effective option for the management of morbid obesity. Several studies have investigated the association between bariatric surgery and secondary hyperparathyroidism (SHPT). This study aims to compare the levels of blood biomarkers, specifically, calcium (Ca), vitamin D, and phosphate (PO4), and their association with parathyroid hormone (PTH) levels pre- and post-bariatric surgery. In addition, it aims to assess the prevalence of hyperparathyroidism post-bariatric surgery in a tertiary care hospital in Saudi Arabia.Material and Methods: A prospective cohort study was conducted at a large tertiary care hospital between May 2017 and April 2019. The study included adult obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Patients were excluded if they were known to have any comorbidities, receiving vitamin supplements, and those who had undergone bariatric procedures previously. Routine blood tests, including PTH, vitamin D, Ca, and PO4, were collected at baseline, and post-surgery.Results: A total of 143 patients who underwent LSG were included in the study. Hyperparathyroidism was observed in 15.4% of patients at baseline and in 36.4% of patients’ post-surgery (p < 0.001). Low vitamin D levels, which were highly prevalent before surgery, decreased sustainably (66.4% pre-operative and 28% at follow-up after surgery, P=0.032). Baseline hypocalcemia was observed in 20.3% of patients compared to 8.4% post-surgery (P=0.546). Hypophosphatemia was present in 60.8% of subjects at baseline, while the percentage dropped to 21.7% post-surgery. There was a significant association between PO4 and PTH levels at baseline. Post-operatively, there was a significant correlation between PTH and both vitamin D and calcium levels.Conclusion: Our study showed that the higher levels of PTH post LSG can be related to vitamin D deficiency and lower calcium levels, despite patients following the provided recommendations for supplementation. This study also emphasizes the importance of routine testing for hyperparathyroidism both before and after bariatric surgery.Keywords: bariatric surgery, morbid obesity, hyperparathyroidism, calcium, vitamin D
format	article
author	Altawil E Alkofide H Alamri H Alhassan N Alsubaie H Alqahtani A Alobaid O
author_facet	Altawil E Alkofide H Alamri H Alhassan N Alsubaie H Alqahtani A Alobaid O
author_sort	Altawil E
title	Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy
title_short	Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy
title_full	Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy
title_fullStr	Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy
title_full_unstemmed	Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy
title_sort	secondary hyperparathyroidism in obese patients post sleeve gastrectomy
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/2b69c9048a454b6f867c689dee1b188e
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Secondary Hyperparathyroidism in Obese Patients Post Sleeve Gastrectomy

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