Abstract | OBJECTIVE: METHODS: Included were 141 obese men and women [aged 44.6±10.4 years, body mass index (BMI) 44.4±5.4 kg/m²], who had undergone either gastric banding (GB; n = 39), laparoscopic sleeve- gastrectomy (LSG; n = 31), Roux-en-Y-gastric-bypass (RYGB; n=43), or biliopancreatic-diversion with "duodenal switch" (BP-DS; n = 28)]. They were tested for VDR-genotype (Bsm1), vitamin D, and serum-PTH-levels postoperatively. RESULTS: Analysis of Covariance revealed a treatment effect, showing statistically significantly higher PTH-levels after BP-DS than after GB (mean difference = 32.14, p<0.001), after SG (mean difference = 25.18, p=0.001), or after RYGB (mean difference = 18.15, p=0.020). VDR-BSM1-genotype did not influence PTH-levels and vitamin-D postoperatively. Logistic regression indicated that the risk of developing SHPT after BP-DS was 12.5 times higher than after GB and 16.7 times higher than after SG. Beside other variables, VDR-genotype and the interaction between VDR-genotype and type of surgery did not attain statistical significance. CONCLUSIONS: In a comparison of the 4 most frequently performed bariatric operations vitamin-D-receptor polymorphism (VDRP) had no influence on the development of postoperative secondary hyperparathyroidism (SHPT) and is not useful as a predictor. SHPT occurs most often after BP-DS. Operation type, gender, VDRP, preoperative BMI, and relative postoperative BMI-loss, however, only explain 24% of the variance in postoperative PTH levels. Other gastral or intestinal factors physiologically promoting calcium-turnover and PTH regulation are postulated.
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Authors | P Toelle, R Peterli, I Zobel, C Noppen, C Christoffel-Courtin, T Peters |
Journal | Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
(Exp Clin Endocrinol Diabetes)
Vol. 120
Issue 10
Pg. 629-34
(Nov 2012)
ISSN: 1439-3646 [Electronic] Germany |
PMID | 23073920
(Publication Type: Comparative Study, Journal Article)
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Copyright | © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York. |
Chemical References |
- PTH protein, human
- Parathyroid Hormone
- Receptors, Calcitriol
- VDR protein, human
- Vitamin D
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Topics |
- Adult
- Bariatric Surgery
(adverse effects, methods)
- Biliopancreatic Diversion
(adverse effects, methods)
- Cohort Studies
- Cross-Sectional Studies
- Female
- Genetic Association Studies
- Humans
- Hyperparathyroidism, Secondary
(epidemiology, etiology, genetics, metabolism)
- Incidence
- Male
- Middle Aged
- Mutation
- Parathyroid Hormone
(blood)
- Postoperative Complications
(epidemiology, etiology, genetics, metabolism)
- Postoperative Period
- Receptors, Calcitriol
(genetics, metabolism)
- Retrospective Studies
- Risk Factors
- Switzerland
(epidemiology)
- Vitamin D
(blood)
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