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Determinants of Secondary Hyperparathyroidism 1 Year After One-Anastomosis Gastric Bypass or Sleeve Gastrectomy

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Abstract

Purpose

Bariatric surgery alters the anatomic and physiological structure of the gastrointestinal tract, predisposing patients to the malabsorption of nutrients. The purpose of this study was to determine the prevalence and determinants of secondary hyperparathyroidism (SHPT) in the patients undergoing either one-anastomosis gastric bypass (OAGB) or sleeve gastrectomy (SG).

Materials and Methods

A total of 517 patients (without SHPT at the baseline) who had undergone OAGB or SG were prospectively assessed 1 year after the surgery. Anthropometric parameters, calcium, intact parathyroid hormone (iPTH), and 25(OH)D levels were compared according to the surgery type before and 1 year after surgery. Multiple logistic regression models were used to evaluate possible SHPT predictors after bariatric surgery.

Results

The overall prevalence of SHPT was 12.6% after surgery, significantly different between the OAGB and SG groups (17.1 vs. 9.9%, respectively). The serum levels of albumin-corrected calcium and 25(OH)D were not significantly different between the two groups. The patients undergoing OAGB had significantly higher serum levels of ALP (198.2 vs. 156.6) compared to the subjects undergoing SG. Higher iPTH levels preoperatively, lower 1-year excess weight loss%, and OAGB surgery seemed to be independent predictors for SHPT 1 year after surgery.

Conclusion

Morbidly-obese patients undergoing OAGB had a higher risk of SHPT than their counterparts undergoing SG, whereas 25(OH)D deficiency and calcium levels did not differ between the two groups. The OAGB procedure, preoperative iPTH levels, and 1-year weight loss were predictors of postoperative SHPT development.

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Data Availability

The datasets used and analyzed in the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank the hospital staff, assistants, and coordinators who took part in this research. Also, special thanks to Mohammadreza Golsibi for his assistance and support of the electronic data collection system. This article was derived from the disease registry entitled “Registration of patients in Tehran Obesity Treatment Center” and approved under the ethical code of “IR.SBMU.ENDOCRINE.REC1397.059” (date: 2018-05-08) by the local ethics committee. The study was supported by the deputy of research and technology of Shahid Beheshti University of Medical Sciences (http://dregistry.sbmu.ac.ir).

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Author notes

  1. Maryam Barzin and Amir Ebadinejad have contributed equally to this work.

Authors and Affiliations

  1. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Maryam Barzin, Amir Ebadinejad, Maryam Mahdavi, Majid Valizadeh & Farhad Hosseinpanah

  2. Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran

    Alireza Khalaj

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  1. Maryam Barzin
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Contributions

MB: study design, data collection, the coordination of patients’ issues and manuscript preparation, and the final approval of the manuscript. AE: study design, data collection, literature review, and manuscript preparation. AK: study design, performing surgical operations, and the final approval of the manuscript. MM: data analysis, interpretation, and manuscript preparation, MV: final approval of the manuscript. FH: study design, revising, and the final approval of the manuscript: All authors reviewed and approved the final draft of the manuscript.

Corresponding author

Correspondence to Farhad Hosseinpanah.

Ethics declarations

Ethical Approval

All the procedures performed in the study were approved by Research Ethics Committee of the Research Institute for Endocrine Sciences of Shahid Beheshti University of Medical Sciences (IR.SBMU.ENDOCRINE.REC.1401.055) and were in accordance with the ethical standards of the institutional Human Research Review Committee and the 1964 Helsinki Declaration and its later amendments.

Consent to Participate

Informed written consent was obtained from all individual participants included in the study.

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Not applicable.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• Postoperative SHPT was 9.9% and 17.1% in the SG and OAGB.

• The patients undergoing OAGB had significantly higher serum levels of alkaline phosphatase.

• Calcium and 25(OH)D levels did not differ between the two groups.

• Individuals with a higher preoperative iPTH level and lower 1-year EWL% undergoing OAGB were more likely to develop SHPT.

Supplementary Information

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Supplementary file1 (DOCX 16 KB)

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Barzin, M., Ebadinejad, A., Khalaj, A. et al. Determinants of Secondary Hyperparathyroidism 1 Year After One-Anastomosis Gastric Bypass or Sleeve Gastrectomy. OBES SURG 33, 156–163 (2023). https://doi.org/10.1007/s11695-022-06337-w

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