The significance of elevated levels of parathyroid hormone in patients with morbid obesity before and after bariatric surgery

被引:86
作者
Hamoui, N [1 ]
Kim, K [1 ]
Anthone, G [1 ]
Crookes, PF [1 ]
机构
[1] Univ So Calif, Dept Surg, Los Angeles, CA 90033 USA
关键词
D O I
10.1001/archsurg.138.8.891
中图分类号
R61 [外科手术学];
学科分类号
摘要
Hypothesis: The risk of hyperparathyroidism after the duodenal switch operation is related to the length of the common channel. Design: A retrospective analysis of patients following the duodenal switch operation from October 2, 2000, through February 1, 2002. Setting: Academic tertiary referral hospital. Patients: One hundred sixty-five consecutive patients underwent the duodenal switch operation, performed for morbid obesity, with common channel lengths of 75 cm (n = 103 [group A]) and 100 cm (n = 62 [group B]). Main Outcome Measures: Weight loss and parathyroid hormone, corrected calcium, and 25-hydroxyvitamin D (25-OH D) levels were compared between groups A and B. Values were determined preoperatively, early postoperatively (3-6 months), and late postoperatively (9-18 months). Results: Both groups exhibited a slight reduction in serum calcium concentration, with one quarter decreasing below the normal range. Hyperparathyroidism was more common in group A than group B preoperatively (38.9% vs 14.9%), reflecting the higher body mass index of patients in group A. Hyperparathyroidism was also more frequent in the early (54.9% vs 30.9%) and late (49.4% vs 20.5%) postoperative periods in group A vs group B. New-onset hyperparathyroidism was also more common in group A than group B (42.0% vs 13.3%). After 1 year, subnormal 25-OH D levels were found in 17.0% of the patients in group A and in 10.0% of the patients in group B. Median 25-OH D levels increased in both groups, but tended to be higher in group B. Conclusions: Patients with shorter common channels had a higher risk of developing hyperparathyroidism. This may be related to limited 25-OH D absorption.
引用
收藏
页码:891 / 896
页数:6
相关论文
共 9 条
  • [1] SECONDARY HYPERPARATHYROIDISM OF MORBID-OBESITY REGRESSES DURING WEIGHT-REDUCTION
    ANDERSEN, T
    MCNAIR, P
    HYLDSTRUP, L
    FOGHANDERSEN, N
    NIELSEN, TT
    ASTRUP, A
    TRANSBOL, I
    [J]. METABOLISM-CLINICAL AND EXPERIMENTAL, 1988, 37 (05): : 425 - 428
  • [2] AVIOLI LV, 1972, ARCH INTERN MED, V129, P345, DOI 10.1001/archinte.129.2.345
  • [3] Laparoscopic biliopancreatic diversion with duodenal switch:: Technique and initial experience
    Baltasar, A
    Bou, R
    Miró, J
    Bengochea, M
    Serra, C
    Pérez, N
    [J]. OBESITY SURGERY, 2002, 12 (02) : 245 - 248
  • [4] BELL NH, 1985, J CLIN INVEST, V76, P1, DOI 10.1172/JCI111930
  • [5] EVIDENCE FOR ALTERATION OF THE VITAMIN-D-ENDOCRINE SYSTEM IN OBESE SUBJECTS
    BELL, NH
    EPSTEIN, S
    GREENE, A
    SHARY, J
    OEXMANN, MJ
    SHAW, S
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1985, 76 (01) : 370 - 373
  • [6] Chapin BL, 1996, ARCH SURG-CHICAGO, V131, P1048
  • [7] COMPSTON JE, 1984, GASTROENTEROLOGY, V87, P350
  • [8] Feng John J, 2002, Semin Laparosc Surg, V9, P125, DOI 10.1053/slas.2002.126332
  • [9] Does bone change after biliopancreatic diversion?
    Marceau, P
    Biron, S
    Lebel, S
    Marceau, S
    Hould, FS
    Simard, S
    Dumont, M
    Fitzpatrick, LA
    [J]. JOURNAL OF GASTROINTESTINAL SURGERY, 2002, 6 (05) : 690 - 698