Prevalence of secondary hyperparathyroidism following bariatric surgery

Background: Although bariatric surgery is one of the most efficient therapies in morbidly obese patients for losing weight, it may result in nutritional deficiencies, secondary hyperparathyroidism, and other complications. Objective: This study aimed to assess hyperparathyroidism in morbidly obese patients that underwent different types of bariatric surgeries. Method: In this cohort-study, patients were divided into two groups based on the outcome: patients who developed secondary hyperparathyroidism (SHPT) and those who did not develop SHPT. Factors including parathyroid hormone (PTH), calcium, and 25-hydroxyvitamin D (25(OH) D3), were examined preoperatively and one, and five years after the surgery. Result: Of the 120 patients enrolled between January 2015 and September 2020, the numbers of patients that underwent sleeve gastrectomy (GS), Roux-en-Y gastric bypass (RYGB), single anastomosis sleeve ileal (SASI) and One Anastomosis Gastric Bypass (OAGB) were 90, 15, 3 and 12, respectively. Obese subjects that underwent bariatric surgeries achieved significant Body mass index (BMI) change. During the first follow up, BMI, PTH, vitamin D, calcium, HbA1c, cholesterol, and triglyceride significantly differed between the two groups. In the next follow up, vitamin D, PTH, calcium remained significantly different. Although patients that underwent SG, lost lesser weight and had fewer side effects from the surgery in comparison to other types of bariatric surgeries. Conclusion: SG provides a safer biochemical profile than other bariatric procedures and a significantly lower number of hyperparathyroid cases, however, reduction in weight loss is also significantly lesser. The postoperative hyperparathyroid was significantly correlated to VDD, calcium deficiency, and less weight loss. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of Surgical Associates Ltd.