Introduction: After gastric bypass, gastric secretion decreased and resorption of minerals and vitamins may be compromised. Lower resorpion of serum calcium and vitamin D could stimulate PTH secretion after restictive and malabsorptive bariatric procedures.
Methods: We have measured serum calcium, D vitamin and PTH in patients (n=50, 17 males and 33 females) 6 and 12 months after R en Y gastric bypass, 38.6±12.6 years of age, with BMI 43±9.2kg/m2. Exclusion criteria were thyroid dysfunction and previous primary or secondary osteoporosis. All patients were supplemented with calcium and vitamin D after bariatric surgery under the recommendations from European guideline for bariatric surgery. The supplements were contained 1250mg of calcium carbonate and 400IU of vitamin D in the first 2 months after surgery, and 600mg of calcium citrate and 200IU of vitamin D from the 3rd month to 1 year after gastric bypass.
Results: Serum calcium was 2.39±0.93mmol/l after 6 months and 2.41±0.10mmol/l after 12 months. The difference of −0.02mmol/l was no significant (P=0.83). The serum level of vitamin D was 53.79±24.60ng/ml after 6 months and 46.73±15.83ng/ml after 12 months. The difference of 7.02 was no significant (P=1.34). After 6 months the mean PTH was 56.288±25.429pg/ml, after 12 months 46.646±21.056pg/ml, and that difference also was no significant (P=0.94).
Conclusion: One year after gastric bypass there was no significant changes in serum calcium, vitamin D and PTH level. Dietary supplements with calcium carbonate and D vitamin in the first 2 months, and with calcium citrate and vitamine D after that period in obese patients after restrictive and malapsorptive bariatric surgery procedures, is sufficiant supplementation model without increasing PTH and risk for bone resorption.
27 Apr - 01 May 2013
European Society of Endocrinology