The effect of sleeve gastrectomy on rates of hyperparathyroidism in a cohort of patients living with severe obesity in NL

Abstract

Purpose: Multiple studies show an association between hyperparathyroidism and obesity. The purpose of this study was to determine the effect of laparoscopic sleeve gastrectomy (LSG) on rates of hyperparathyroidism and its different subtypes in patients living with severe obesity. Methods: The rates of primary, normocalcemic, and secondary hyperparathyroidism were derived from a cohort of 200 patients before and after LSG. Laboratory data and Vitamin supplementation were collected at an initial clinic visit (ICV) where lifestyle modification and supplementation were advocated, at a surgical pre-admission clinic visit (PACV), and at the last follow-up visit after surgery (LFV). Results: The rates of primary, normocalcemic, and secondary hyperparathyroidism at ICV (n=134) were 2.23 % (n=3), 20.15% (n=27), and 17.91% (n=24), respectively. The same rates were 1.52% (n=3), 17.17% (n=34), and 10.10% (n=20) at PACV (n=198), and 0.72% (n=1), 25.90% (n=36), and 5.04% (n=7) at LFV (n=139). The rates of Vitamin D insufficiency at the ICV, PACV, and LFV were 41.84% (58/141), 19% (38/200), and 10.79% (15/139) respectively. 58% (n=116) of patients were taking supplements of Vitamin D, Multivitamin, or both at PACV. Conclusions: The percentage of patients with primary and normocalcemic hyperparathyroidism peri-operatively remained stable. The percentage of patients with secondary hyperparathyroidism declined from ICV to LFV, as did the percentage of patients with Vitamin D insufficiency; the greatest change occurred between ICV and PACV. The results suggest that supplementation and lifestyle modification may impact secondary hyperparathyroidism and Vitamin D insufficiency in this population, and that LSG is not associated with a worsening of these conditions.