Calcium and Vitamin D Status in Morbidly Obese Patients and in Patients After Biliopancretic Diversion/Duodenal Switch

Abstract

Objective:The objective was to estimate the prevalence of inadequate vitamin D status and secondary hyperparathyroidism (SHPT) in morbidly obese patients and in patients who underwent biliopancreatic diversion/duodenal switch surgery (BPD/DS) Design: We compared 3 groups in the cross-sectional study: group 1-morbidly obese (MO) patients with BMI > 40 and without type 2 diabetes mellitus (n=22), group 2-patients in the long-term period after BPD/DS (n=23); group 3-healthy normal weight controls (n=22). Results: 25(OH)D levels were significantly different in the controls (21.8 ng/ml), in the MO (8.8 ng/ml) and in the BPD/DS patients (8.6 ng/ml). Parathyroid hormone (PTH) elevation was found in 4 (18%) MO patients, in 12(52%) patients after BPD/DS, and was not detected in the control group. The frequency of SHPT was significantly higher in the operated group (52%) in comparison with the MO group (18%) (p=0.029). Conclusion:Vitamin D deficiency and secondary hyperparathyroidism are significantly more prevalent in MO patients than in normal weight subjects. In the long-term period after BPD, secondary hyperparathyroidism is more frequent than in MO and is not always accompanied by vitamin D depletion. Particular attention should be paid to adequate control of calcium metabolism and supplementation by calcium and vitamin D.