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CALCIUM AND VITAMIN D STATUS IN MORBIDLY OBESE PATIENTS AND IN PATIENTS AFTER BILIOPANCRETIC DIVERSION/DUODENAL SWITCH

Natalya Mazurina, Ekaterina Troshina, Natalya Ogneva, Yury Yashkov, Alexander Iliyn, Galina Melnichenko, Ivan Dedov.

Abstract
Objective: The objective was to estimate the prevalence of inadequate vitamin D status and secondary hyperparathyroidism (SHPT) in morbidly obese patients and in patients who underwent biliopancreatic diversion/duodenal switch surgery (BPD/DS)
Design: 3 groups were included in the cross-sectional comparative study: group 1 - morbidly obese (MO) patients with BMI > 40 and without type 2 diabetes mellitus (n=22), group 2 patients in the long-term period after BPD/DS (n=23); group 3 healthy normal weight controls (n=22).
Results: 25(OH)D levels were significantly different in the controls (21.8 ng/dl), in the MO (8.8 ng/dl) and in the BPD/DS patients (8.6 ng/dl). Parathyroid hormone (PTH) elevation was found in 4 (18%) MO patients, in 12 (52 %) patients after BPD/DS, and was not detected in the control group. The frequency of SHPT was significantly higher in the operated group (52 %) in comparison with the MO group (18 %) (р=0.029).
Conclusions: Vitamin D deficiency and secondary hyperparathyroidism are significantly more prevalent in MO patients than in normal weight subjects. In the long-term period after BPD secondary hyperthyroidism is more frequent than in MO and is not always accompanied by vitamin D depletion. Special attention should be paid for adequate control of calcium metabolism and supplementation by calcium and vitamin D.

Key words: obesity, bariatric surgery, vitamin D, secondary hyperparathyroidism



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