Mineral metabolism and vitamin D status before and up to five years following highly selective vagotomy in duodenal ulcer patients.

The influence of highly selective vagotomy (HSV) upon mineral metabolism was investigated in patients with duodenal ulcer (DU). Data obtained before HSV were compared with those from healthy control subjects and, additionally, with data from pre- and post-HSV observations. In DU the function of the parathyroid glands is unsettled because of decreased renal phosphate threshold, normal serum parathyroid hormone and decreased nephrogenous urinary cAMP. HSV decreases the phosphate threshold further, but does not change parathyroid hormone, calcitonin, or nephrogenous cAMP. Conversely, besides hypergastrinemia, HSV accounts for a decrease in total calcium in serum in the presence of an increase of the intestinal calcium absorption, while the bone mineral content is stable up to 5 years following HSV. Moreover, HSV normalizes the decreased serum concentration of 25-hydroxyvitamin D found pre-operatively in DU, while that of 24,25-dihydroxyvitamin D, known to be effective upon bone and gut, remains unaltered. A classification according to pre-operative gastric acid secretion (normo- and hypersecretors) does not provide further insights into variables of mineral metabolism encountered in DU pre- and post-HSV.