Document Detail


Risk Factors for Secondary Hyperparathyroidism after Bariatric Surgery: A Comparison of 4 Different Operations and of Vitamin D-receptor-polymorphism.
MedLine Citation:
PMID:  23073920     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
To determine the relative frequency of secondary hyperparathyroidism after 1 of 4 standard bariatric surgical procedures, with respect to vitamin D-receptor (VDR) Bsm1 genotype-polymorphism (VDRP).Included were 141 obese men and women [aged 44.6±10.4 years, body mass index (BMI) 44.4±5.4 kg/m2], who had undergone either gastric banding (GB; n=39), laparoscopic sleeve-gastrectomy (LSG; n=31), Roux-en-Y-gastric-bypass (RYGB; n=43), or biliopancreatic-diversion with "duodenal switch" (BP-DS; n=28)]. They were tested for VDR-genotype (Bsm1), vitamin D, and serum-PTH-levels postoperatively.Analysis of Covariance revealed a treatment effect, showing statistically significantly higher PTH-levels after BP-DS than after GB (mean difference=32.14, p<0.001), after SG (mean difference=25.18, p=0.001), or after RYGB (mean difference=18.15, p=0.020). VDR-BSM1-genotype did not influence PTH-levels and vitamin-D postoperatively. Logistic regression indicated that the risk of developing SHPT after BP-DS was 12.5 times higher than after GB and 16.7 times higher than after SG. Beside other variables, VDR-genotype and the interaction between VDR-genotype and type of surgery did not attain statistical significance.In a comparison of the 4 most frequently performed bariatric operations vitamin-D-receptor polymorphism (VDRP) had no influence on the development of postoperative secondary hyperparathyroidism (SHPT) and is not useful as a predictor. SHPT occurs most often after BP-DS. Operation type, gender, VDRP, preoperative BMI, and relative postoperative BMI-loss, however, only explain 24% of the variance in postoperative PTH levels. Other gastral or intestinal factors physiologically promoting calcium-turnover and PTH regulation are postulated.
Authors:
P Toelle; R Peterli; I Zobel; C Noppen; C Christoffel-Courtin; T Peters
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-16
Journal Detail:
Title:  Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association     Volume:  -     ISSN:  1439-3646     ISO Abbreviation:  Exp. Clin. Endocrinol. Diabetes     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505926     Medline TA:  Exp Clin Endocrinol Diabetes     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Department of Rheumatology, Bethesdaspital, Basel, Switzerland.
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