Secondary Hyperparathyroidism After Bariatric Surgery: Treatment Is With Calcium Carbonate or Calcium Citrate?

Baretta, Giórgio Alfredo Pedroso; Cambi, Maria Paula Carlini; Rodrigues, A.; Mendes, Silvana Aparecida

doi:10.1590/s0102-6720201500s100013

Cited by 13 publications

(11 citation statements)

References 17 publications

(18 reference statements)

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“…Due to high rates of failure in clinical treatment of obesity, the number of surgical procedures for the treatment of this disease is growing exponentially. Bariatric surgery has an important therapeutic success in relation to weight loss, in addition to a substantial improvement in several co-morbidities 6 , 2 , 27 , 30 . The procedure however, can lead to significant nutritional deficiencies such as malnutrition, vitamin deficiencies, and changes in the metabolism of calcium and vitamin D. These changes are arising mainly from the low food intake and the intestinal malabsorption caused by the surgery 4 , 18 , 29 , 32 .…”

Section: Introductionmentioning

confidence: 99%

Impact of Deficient Nutrition in Bone Mass After Bariatric Surgery

Costa

Paganoto

Radominski

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: Essential nutrients are considered for the prevention of the bone loss that occurs after bariatric surgery. Aim: Evaluate nutrients involved in bone metabolism, and relate to serum concentrations of calcium, vitamin D, and parathyroid hormone, and the use of supplements and sun exposure on the bone mass of patients who had undergone gastric bypass surgery. Methods: An observational study, with patients who had undergone the surgery 12 or more months previously, operated group (OG), compared to a control group (CG). Results: Were included 56 in OG and 27 in the CG. The mean age was 36.4±8.5 years. The individuals in the OG, compared to CG, consumed inadequate amounts of protein and daily calcium. The OG had a higher prevalence of low sun exposure, lower levels of 25OH Vitamin D (21.3±10.9 vs. 32.1±11.8 ng/dl), and increased serum levels of parathyroid hormone (68.1±32.9 vs. 39.9±11.9 pg/ml, p<0.001). Secondary hyperparathyroidism was present only in the OG (41.7%). The mean lumbar spine bone mineral density was lower in the OG. Four individuals from the OG had low bone mineral density for chronological age, and no one from the CG. Conclusion: The dietary components that affect bone mass in patients undergoing bariatric surgery were inadequate. The supplementation was insufficient and the sun exposure was low. These changes were accompanied by secondary hyperparathyroidism and a high prevalence of low bone mass in lumbar spine in these subjects.

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Section: Introductionmentioning

confidence: 99%

Impact of Deficient Nutrition in Bone Mass After Bariatric Surgery

Costa

Paganoto

Radominski

et al. 2016

ABCD, arq. bras. cir. dig.

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“…The latter mentioned result is still to be verified in a long‐term setting. Finally, a Brazilian study investigated the effect of either calcium carbonate or calcium citrate in 20 RYGB operated patients naïve to supplementation and found both supplements equally successful . However, the effect of the two supplements was difficult to isolate from the effect of the co‐administered vitamin D supplement.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, a Brazilian study investigated the effect of either calcium carbonate or calcium citrate in 20 RYGB operated patients naïve to supplementation and found both supplements equally successful. 23 However, the effect of the two supplements was difficult to isolate from the effect of the co-administered vitamin D supplement. Neither of the two acute, single-dose studies report vitamin D levels of the study participants, which might be important when interpreting the results.…”

Section: Discussionmentioning

confidence: 99%

“…According to a small single‐dose study, calcium citrate may be superior to calcium carbonate as supplement in RYGB individuals . A small Brazilian Study investigated the use of calcium carbonate and calcium citrate and vitamin D for 60 days in calcium and vitamin D deficient RYGB operated patients, and found both supplements effective . Long‐term randomized controlled trials comparing supplements seem warranted …”

Section: Introductionmentioning

confidence: 99%

“…22 A small Brazilian Study investigated the use of calcium carbonate and calcium citrate and vitamin D for 60 days in calcium and vitamin D deficient RYGB operated patients, and found both supplements effective. 23 Long-term randomized controlled trials comparing supplements seem warranted. 24 Hence, we performed a clinical, double-blinded, randomized trial investigating the impact of either calcium carbonate or calcium citrate on plasma PTH levels in vitamin D sufficient patients with elevated PTH following RYGB.…”

Section: Introductionmentioning

confidence: 99%

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Effect of calcium citrate vs calcium carbonate on elevated parathyroid hormone after Roux‐en‐Y gastric bypass. A double‐blinded, randomized trial

Madsen

Espersen

Rejnmark

et al. 2018

Clinical Endocrinology

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The Effect of Roux‐en‐Y Gastric Bypass on Bone Marrow Adipose Tissue and Bone Mineral Density in Postmenopausal, Nondiabetic Women

Beekman

Akkerman

Streekstra

et al. 2021

Obesity

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Objectives This study aimed to determine the effect of bariatric surgery‐induced weight loss on bone marrow adipose tissue (BMAT) and bone mineral density (BMD) in postmenopausal, nondiabetic women. Methods A total of 14 postmenopausal, nondiabetic women with obesity who were scheduled for laparoscopic Roux‐en‐Y gastric bypass surgery (RYGB) were included in this study. Vertebral bone marrow fat signal fraction was determined by quantitative chemical shift magnetic resonance imaging, and vertebral volumetric BMD (vBMD) was determined by quantitative computed tomography before surgery and 3 and 12 months after surgery. Data were analyzed by linear mixed model. Results Body weight [mean (SD)] decreased after surgery from 108 (13) kg at baseline to 89 (12) kg at 3 months and 74 (11) kg at 12 months (P < 0.001). BMAT decreased after surgery from 51% (8%) at baseline to 50% (8%) at 3 months and 46% (7%) at 12 months (P = 0.004). vBMD decreased after surgery from 101 (26) mg/cm3 at baseline to 94 (28) mg/cm3 at 3 months (P = 0.003) and 94 (28) mg/cm3 at 12 months (P = 0.035). Changes in BMAT and vBMD were not correlated (ρ = −0.10 and P = 0.75). Calcium and vitamin D concentrations did not change after surgery. Conclusions RYGB decreases both BMAT (after 12 months) and vBMD (both after 3 months and 12 months) in postmenopausal, nondiabetic women. Changes in BMAT and vBMD were not correlated. These findings suggest that BMAT does not contribute to bone loss following RYGB.

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Secondary Hyperparathyroidism After Bariatric Surgery: Treatment Is With Calcium Carbonate or Calcium Citrate?

Cited by 13 publications

References 17 publications

Impact of Deficient Nutrition in Bone Mass After Bariatric Surgery

Impact of Deficient Nutrition in Bone Mass After Bariatric Surgery

Effect of calcium citrate vs calcium carbonate on elevated parathyroid hormone after Roux‐en‐Y gastric bypass. A double‐blinded, randomized trial

The Effect of Roux‐en‐Y Gastric Bypass on Bone Marrow Adipose Tissue and Bone Mineral Density in Postmenopausal, Nondiabetic Women

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