Document Detail

Role of calcium malabsorption in the development of secondary hyperparathyroidism after biliopancreatic diversion.
MedLine Citation:
PMID:  19092286     Owner:  NLM     Status:  MEDLINE    
Secondary hyperparathyroidism (SH) is a frequent metabolic complication of bariatric surgery. Around 70%of patients who undergo biliopancreatic diversion (BPD) have this complication in the long term. The aim of this study was to evaluate the relative influence of vitamin D deficiency and calcium malabsorption in the development of SH in patients who underwent BPD. We reviewed the mean values of PTH throughout the post-operative follow-up and of related biochemical data (25-hydroxyvitamin D, calcium, magnesium) of 121 patients who underwent BPD at our institute from November 1996 to November 2004 (mean follow-up 66 months). Mean PTH correlated negatively with mean 25-hydroxyvitamin D (r=-0.27, p=0.003) and with urinary calcium(r=-0.19, p=0.047), and positively with age (r=0.22, p=0.018). However, a high mean PTH was found in 48.7% patients with mean 25-hydroxyvitamin D >or=30 ng/ml and in 80.0% patients with mean 25-hydroxyvitamin D between 20 and 30 ng/ml. The mean PTH was normal in 5 patients without calcium supplements at present, and progressively increased in parallel to the calcium dose in the rest of patients, although mean 25-hydroxyvitamin D levels were not related to the calcium dose. Our data suggest that individual differences in active and/or passive calcium absorption determine intractable SH after BPD in around half of the patients who have normal levels of 25-hydroxyvitamin D and in 80% of patients with 25-hydroxyvitamin D levels between 20 and 30 ng/ml after BPD, worsening with age.
J A Balsa; J I Botella-Carretero; R Peromingo; I Zamarrón; F Arrieta; T Muñoz-Malo; C Vázquez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  31     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-12-18     Completed Date:  2009-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  845-50     Citation Subset:  IM    
Department of Endocrinology and Clinical Nutrition, Ramón y Cajal Hospital, Madrid, Spain.
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MeSH Terms
Bariatric Surgery / adverse effects
Biliopancreatic Diversion / adverse effects*
Calcium / metabolism*,  urine
Hyperparathyroidism, Secondary / etiology*
Magnesium / blood
Malabsorption Syndromes / complications*
Middle Aged
Obesity, Morbid / surgery
Parathyroid Hormone / metabolism
Sex Factors
Vitamin D / analogs & derivatives,  blood
Vitamin D Deficiency / complications*
Reg. No./Substance:
0/Parathyroid Hormone; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D; 7439-95-4/Magnesium; 7440-70-2/Calcium

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