Long‐term hypovitaminosis D and secondary hyperparathyroidism outcomes of the Roux‐en‐Y gastric bypass: a systematic review

• Published in: Obesity reviews Vol. 18; no. 5; pp. 560 - 566
• Main Authors: Switzer, N. J., Marcil, G., Prasad, S., Debru, E., Church, N., Mitchell, P., Billington, E. O., Gill, R. S.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2017
• Subjects: bariatric surgery; calcium; Gastric bypass; Gastric Bypass - adverse effects; Humans; hyperparathyroidism; Hyperparathyroidism, Secondary - blood; Hyperparathyroidism, Secondary - epidemiology; hypovitaminosis D; long‐term outcomes; Non-Randomized Controlled Trials as Topic; parathyroid hormone; patients; Randomized Controlled Trials as Topic; systematic review; Time Factors; Vitamin D; vitamin D deficiency; Vitamin D Deficiency - blood; Vitamin D Deficiency - epidemiology; weight loss; hyperparathyroidism; hypovitaminosis D; long-term outcomes; Gastric bypass
• ISSN: 1467-7881; 1467-789X
• DOI: 10.1111/obr.12525

Summary Introduction Pre‐operative Vitamin D deficiency is markedly prevalent in prospective bariatric surgery patients. While bariatric surgery leads to significant weight loss, it can exacerbate or prolong Vitamin D deficiency. We systematically reviewed the literature to assess whether secondary hyperparathyroidism is maintained in the medium to long term in patients following the Roux‐en‐Y gastric bypass. Methods A comprehensive literature search was conducted through Medline, Embase, Scopus, Web of Science, Dare, Cochrane library and HTA database. The search terms used were bariatric surgery, gastric bypass and hyperparathyroidism. Results Fourteen studies were included (n = 2688 subjects). Parathyroid hormone levels rose gradually from a mean pre‐operative level of 5.69 ± 1.2 pmol/L to 6.36 ± 0.77 pmol/L, 7.59 ± 0.73 pmol/L and 8.29 ± 1.41 pmol/L at 2 years, between 2 and 5 years, and beyond 5 years, respectively. Vitamin D levels slowly fell to a mean of 20.50 ± 4.37 ng/mL and 20.76 ± 3.80 ng/mL between follow‐up intervals 2–5 years and beyond 5, respectively. Conclusion It appears that hyperparathyroidism persists at 5‐year follow‐up after gastric bypass, despite most patients being supplemented with calcium and Vitamin D.