Clements Ronald H, Yellumahanthi Kishore, Wesley Mary, Ballem Naveen, Bland Kirby I
Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama-Birmingham, Birmingham, Alabama, USA.
Am Surg. 2008 Jun;74(6):469-474; discussion 474-5.
Hyperparathyroidism (HPT) can occur after gastric bypass because of the alteration in vitamin D and calcium absorption. Adequate serum vitamin D concentrations have not been clearly defined in this patient population. Vitamin D (Vit D) and parathyroid hormone (PTH) were assessed 1 year after laparoscopic gastric bypass (LGB). The prevalence of HPT and Vit D deficiency were determined and their association was evaluated using Fisher's exact test. Ninety-three patients (aged 44 +/- 1.1 years, 49.6 +/- 0.67 Kg/m2 body mass index, 79.6% female, 69.6% white) were evaluated. The prevalence of Vit D deficiency (less than 20 ng/mL) and HPT (greater than 65 pg/mL) was 23.6 per cent (n = 22) and 25.7 per cent (n = 28), respectively. Among patients with HPT, only eight of 28 (28.6%) had Vit D deficiency, and of those with Vit D deficiency, only eight of 22 (36.4%) had HPT. There was a weak inverse correlation (r = -0.37) between PTH and Vit D. Blacks are at higher risk for Vit D deficiency. There was no significant association between Vit D deficiency and HPT, Vit D deficiency and Roux limb length, or HPT and Roux limb length. After LGB, Vit D deficiency and hyperparathyroidism occur commonly. Body mass index and Roux limb length are not associated with these two conditions, but racial differences do exist. There is a weak inverse correlation between Vit D and PTH. Further research is needed to elucidate the causes, treatments, and significance of HPT after LGB.
由于维生素D和钙吸收的改变，胃旁路术后可能会发生甲状旁腺功能亢进（HPT）。在这一患者群体中，血清维生素D的充足浓度尚未明确界定。在腹腔镜胃旁路术（LGB）1年后评估维生素D（Vit D）和甲状旁腺激素（PTH）。确定HPT和Vit D缺乏的患病率，并使用Fisher精确检验评估它们之间的关联。对93例患者（年龄44±1.1岁，体重指数49.6±0.67kg/m²，79.6%为女性，69.6%为白人）进行了评估。Vit D缺乏（低于20ng/mL）和HPT（高于65pg/mL）的患病率分别为23.6%（n = 22）和25.7%（n = 28）。在HPT患者中，28例中只有8例（28.6%）有Vit D缺乏，而在Vit D缺乏的患者中，22例中只有8例（36.4%）有HPT。PTH和Vit D之间存在弱负相关（r = -0.37）。黑人患Vit D缺乏的风险更高。Vit D缺乏与HPT、Vit D缺乏与Roux袢长度、或HPT与Roux袢长度之间均无显著关联。LGB术后，Vit D缺乏和甲状旁腺功能亢进很常见。体重指数和Roux袢长度与这两种情况无关，但种族差异确实存在。Vit D和PTH之间存在弱负相关。需要进一步研究以阐明LGB术后HPT的病因、治疗方法及意义。
