SECONDARY HYPERPARATHYROIDISM AFTER BARIATRIC SURGERY: TREATMENT IS WITH CALCIUM CARBONATE OR CALCIUM CITRATE?

Background : Bariatric surgery, especially Roux-en-Y gastric bypass, can cause serious nutritional complications arising from poor absorption of essential nutrients. Secondary hyperparathyroidism is one such complications that leads to increased parathyroid hormone levels due to a decrease in calcium and vitamin D, which may compromise bone health. Aim : To compare calcium carbonate and calcium citrate in the treatment of secondary hyperparathyroidism. Method : Patients were selected on the basis of their abnormal biochemical test and treatment was randomly done with citrate or calcium carbonate. Results : After 60 days of supplementation, biochemical tests were repeated, showing improvement in both groups. Conclusion : Supplementation with calcium (citrate or carbonate) and vitamin D is recommended after surgery for prevention of secondary hyperparathyroidism.

Download Full-text

VITAMIN D DEFICIENCY AND PARATOHOMMONIUM INCREASE IN LATE POSTOPERATIVE GASTRIC BYPASS IN ROUX-EN-Y

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020180001e1407 ◽

2018 ◽

Vol 31 (4) ◽

Cited By ~ 2

Author(s):

Daniela Vicinansa MÔNACO-FERREIRA ◽

Vânia Aparecida LEANDRO-MERHI ◽

Nilton César ARANHA ◽

Andre BRANDALISE ◽

Nelson Ary BRANDALISE

Keyword(s):

Vitamin D ◽

Gastric Bypass ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Serum Calcium ◽

Calcium Metabolism ◽

Calcium Deficiency ◽

Ionized Calcium ◽

Nutritional Deficiencies ◽

Biochemical Tests

ABSTRACT Background : Roux-en-Y gastric bypass patients can experience changes in calcium metabolism and hyperparathyroidism secondary to vitamin D deficiency. Aim : To evaluate nutritional deficiencies related to the calcium metabolism of patients undergoing gastric bypass with a 10-year follow-up. Method : This is a longitudinal retrospective study of patients submitted to Roux-en-Y gastric bypass at a multidisciplinary clinic located in the Brazilian southeast region. The study investigated the results of the following biochemical tests: serum calcium, ionized calcium, vitamin D, and parathormone (PTH). The generalized estimating equations (GEE) determined the nutritional deficiencies using a significance level of 5%. Results : Among the patients who finished the study (120 months), 82.86% (n=29) had vitamin D deficiency, and 41.94% (n=13) had high PTH. Postoperative time had a significant effect on PTH (p=0.0059). The percentages of patients with vitamin D, serum calcium, and ionized calcium deficiencies did not change significantly over time. Conclusion : One of the outcomes was vitamin D deficiency associated with secondary hyperparathyroidism. These findings reaffirm the importance of monitoring the bone metabolism of patients submitted to Roux-en-Y gastric bypass. HEADINGS: Calcium deficiency. Vitamin D deficiency. Secondary hyperparathyroidism.

Download Full-text

Reviewing the Analeptic Activity of Calcium Citrate Malate

International Journal of Pharmaceutical Sciences Review and Research ◽

10.47583/ijpsrr.2021.v70i02.036 ◽

2021 ◽

Vol 70 (2) ◽

Author(s):

Bharat Kwatra ◽

Chelsea Rumao ◽

Hiya Abrol ◽

Ishika Gulati ◽

Pankaj Pradeep ◽

...

Keyword(s):

Vitamin D ◽

Calcium Carbonate ◽

Bone Fracture ◽

Bone Health ◽

Acidic Environment ◽

Calcium Citrate ◽

Food Fortification ◽

Age Group ◽

Calcium Retention ◽

Aged People

Calcium Citrate Malate’s (CCM) health benefits were patented over three decades ago. It is involved in calcium retention, in children and adolescents. In adulthood, it is seen to promote the maintenance of bone health. In conjunction with vitamin D, CCM also decreases the risk of bone fracture in aged people and ensures that postmenopausal women’s health is made better. CCM, unlike other supplements, does not need to be taken along with a meal and is seen to deliver benefits to individuals of any age group. CCM is usually used when the person has achlorhydria where the gastric acid secretion is reduced and there is an absence of an acidic environment (required by calcium carbonate). Calcium citrate Malate possesses outstanding bioavailability properties and is a useful extension to the calcium available presently, either for direct supplementation or for food fortification.

Download Full-text

MON-346 Secondary Hyperparathyroidism and Other Complications in a Post-Roux-En-Y Patient: A Case Report

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1915 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Jessica Michelle Chan ◽

Bradley S Havins

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Gastric Bypass ◽

Case Report ◽

Vitamin B12 ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

The United States ◽

American Society ◽

Metabolic And Bariatric Surgery

Abstract Roux-en-y Gastric Bypass is a very common surgical procedure in managing morbid obesity. Approximately 303,890 roux-en-y surgeries were performed in the United States in between the years of 2012 to 2017, and the number is steadily increasing as more Americans are diagnosed with obesity.i This featured case report describes a 52-year-old female presenting with complications seven years following Roux-en-y gastric bypass. Four years post-operatively, she presented to the ER with a pelvis fracture. It was incidentally found that she had osteoporosis with a t-score of -2.9. It was also found that her bone mineral density (BMD) for women for her age was low with a z-score of -3.5 and her 10-year probability of getting fractures was high with a Fracture Risk Assessment Tool (FRAX) score of 6.2%. Seven years following Roux-en-y gastric bypass, she presented to our primary care office with Vitamin B12 deficiency and secondary hyperparathyroidism due to Vitamin D deficiency. We attempted to correct the deficiencies with high dose of Vitamin D, Vitamin B12, and calcium citrate. Eight months later, the B12 levels was normalized, but the secondary hyperparathyroidism and Vitamin D deficiency were not corrected. This case illustrates the complications that can occur following a Roux-en-y Gastric Bypass, importance of supplement compliance, and proper follow-up with Roux-en-y patients. Endnotes i American Society for Metabolic and Bariatric Surgery. (2018). Estimate of Bariatric Surgery Numbers, 2011-2017 | American Society for Metabolic and Bariatric Surgery. [online] Available at: https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers [Accessed 31 Oct. 2019].

Download Full-text

Effects of Bariatric Surgery on Vitamin D Status and Secondary Hyperparathyroidism: A Prospective Study

Obesity Surgery ◽

10.1381/096089205774859182 ◽

2005 ◽

Vol 15 (10) ◽

pp. 1389-1395 ◽

Cited By ~ 47

Author(s):

Joan Sánchez-Hernández ◽

Juan Ybarra ◽

Ignasi Gich ◽

Alberto De Leiva ◽

Xavier Rius ◽

...

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Prospective Study ◽

Secondary Hyperparathyroidism ◽

Vitamin D Status ◽

A Prospective Study

Download Full-text

The Clinical Dilemma of Calcium Supplementation After Bariatric Surgery: Calcium Citrate or Calcium Carbonate That Is the Question?

Obesity Surgery ◽

10.1007/s11695-016-2346-2 ◽

2016 ◽

Vol 26 (11) ◽

pp. 2781-2782 ◽

Cited By ~ 4

Author(s):

H.J.M. Smelt ◽

S. Pouwels ◽

J.F. Smulders

Keyword(s):

Bariatric Surgery ◽

Calcium Carbonate ◽

Calcium Supplementation ◽

Calcium Citrate ◽

Clinical Dilemma

Download Full-text

Anthropometric Measurements and Correlations to Glucometabolic and Cardiovascular Risk in Obese Patients Undergoing Gastric Bypass Surgery

Journal of Obesity ◽

10.1155/2021/6647328 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Erica Aldenbäck ◽

Hans-Erik Johansson

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Gastric Bypass ◽

Fasting Glucose ◽

Gastric Bypass Surgery ◽

Cost Effective ◽

Morbidly Obese ◽

Obese Patients ◽

Inclusion Criteria ◽

Sagittal Abdominal Diameter

Abdominal obesity is associated with hypertension, increased fasting glucose, HbA1c, and cholesterol. Body mass index (BMI) is frequently used to measure and define obesity and as inclusion criteria for bariatric surgery. Sagittal abdominal diameter (SAD) has been suggested to predict the amount of visceral fat, metabolic traits, and cardiometabolic risk superior to BMI. The aim was to test whether SAD has stronger correlations to glucometabolic traits compared to BMI. One hundred and fifty-five (108 women, 47 men) morbidly obese patients undergoing bariatric surgery were evaluated before (baseline), 6 and 12 months after Roux-en-Y gastric bypass (RYGBP). BMI was reduced from 43.7 kg/m2 (baseline) to 31.3 kg/m2 (12 months) and SAD from 32.6 to 23.2 cm (both p <0 .001 ). SAD correlated with CRP ( p = 0.04 ), fasting glucose ( p = 0.008 ), HbA1c ( p = 0.016 ), triglycerides ( p = 0.017 ), systolic blood pressure ( p = 0.032 ), and vitamin D ( p = 0.027 ). BMI correlated with CRP ( p = 0.006 ), triglycerides ( p = 0.016 ), vitamin D ( p = 0.002 ), and magnesium ( p = 0.037 ). Despite RYGBP surgery, vitamin D was significantly increased. Liver enzymes were significantly lowered after RYGBP and the change over time in SAD correlated with gamma-glutamyltransferase. SAD was superior to BMI to predict glucose disturbance and dyslipidemia implying increased use of SAD as it is cost effective and simple to perform in the clinic and could be of value when considering patients for bariatric surgery.

Download Full-text