Unit of Obesity Surgery and Unit of Clinical Nutrition and Dietetics, Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Obes Surg. 2010 Oct;20(10):1415-21. doi: 10.1007/s11695-010-0144-9.
Secondary hyperparathyroidism is a frequent metabolic complication of bariatric surgery. Individual differences in calcium absorption determine chronic secondary hyperparathyroidism after biliopancreatic diversion in half of the patients who have normal levels of 25-hydroxyvitamin D. We aimed to evaluate if certain vitamin D receptor polymorphisms may be responsible for the latter. Cases and controls study including 57 patients after biliopancreatic diversion with a mean serum 25-hydroxyvitamin D above 20 ng/mL, separated into those with secondary hyperparathyroidism (n = 26, cases) and those without it (n = 31, controls).
Genotyping for restriction-length-fragment polymorphisms of the vitamin D receptor gene was carried out for FOK1, BSM1, APA1, and TAQ1, and haplotype structure was also constructed.
There were no differences in the allelic or genotypes distribution of the four studied polymorphisms between patients and controls (P = 0.352 and P = 0.301 for FOK1, P = 0.733 and P = 0.924 for BSM1, P = 0.974 and P = 0.992 for APA1, and P = 0.995 and P = 0.928 for TAQ1, respectively). Haplotype analysis showed no differences between patients and controls (P = 0.495 for BAT, P = 1.000 for BAt, P = 0.508 for Bat and P = 0.924 for bAT haplotypes, respectively). Furthermore, haplotypes were not associated with serum PTH levels or with the ratio between serum PTH and 25-hydroxyvitamin D levels.
Chronic secondary hyperparathyroidism after biliopancreatic diversion in patients with normal levels of 25-hydroxyvitamin D is not dependent on vitamin D receptor gene polymorphisms.
继发性甲状旁腺功能亢进是减重手术的常见代谢并发症。半数接受胆胰分流术的患者，尽管 25-羟维生素 D 水平正常，但由于钙吸收个体差异，会导致慢性继发性甲状旁腺功能亢进。我们旨在评估某些维生素 D 受体多态性是否与其相关。本病例对照研究纳入 57 例胆胰分流术后患者，血清 25-羟维生素 D 均值＞20ng/ml，其中 26 例（病例组）发生继发性甲状旁腺功能亢进，31 例（对照组）未发生。
对维生素 D 受体基因 FOK1、BSM1、APA1 和 TAQ1 的限制性片段长度多态性进行基因分型，并构建单体型结构。
病例组和对照组之间四个研究多态性的等位基因或基因型分布无差异（FOK1 的 P 值分别为 0.352 和 0.301，BSM1 的 P 值分别为 0.733 和 0.924，APA1 的 P 值分别为 0.974 和 0.992，TAQ1 的 P 值分别为 0.995 和 0.928）。单体型分析显示病例组和对照组之间也无差异（BAT 的 P 值为 0.495，BAt 的 P 值为 1.000，Bat 的 P 值为 0.508，bAT 的 P 值为 0.928）。此外，单体型与血清 PTH 水平或血清 PTH 与 25-羟维生素 D 水平比值均无关。
25-羟维生素 D 水平正常的胆胰分流术后患者发生慢性继发性甲状旁腺功能亢进与维生素 D 受体基因多态性无关。
