Bariatric surgery and secondary hyperparathyroidism: a meta-analysis

Area of Science:

• Endocrinology
• Surgical Oncology
• Public Health

Background:

• Obesity is linked to numerous health issues, and while weight loss from metabolic and bariatric surgery (MBS) is studied, its impact on parathyroid function is unclear.
• Secondary hyperparathyroidism (SHPT) is a potential complication, necessitating investigation into its relationship with MBS procedures.

Approach:

• A comprehensive meta-analysis was conducted, systematically reviewing four major databases (PubMed, Embase, Web of Science, Cochrane Library) up to May 2022.
• Nine studies comprising 5585 patients were analyzed to assess SHPT risk before and after MBS, using odds ratios and confidence intervals.

Key Points:

• Overall, MBS did not significantly alter SHPT risk (OR = 1.34, 95% CI 0.81-2.20).
• Within two years post-surgery, gastric bypass (GB) (OR = 1.42) and sleeve gastrectomy (OR = 0.39) showed no increased SHPT risk.
• Long-term follow-up revealed a significant increase in SHPT risk after GB (OR = 6.06) compared to biliopancreatic diversion with duodenal switch (OR = 0.29).

Conclusions:

• Gastric bypass (GB) surgery is associated with an increased risk of secondary hyperparathyroidism (SHPT).
• Patients considering MBS should be informed about the potential risk of SHPT.
• Further large-scale studies are recommended to fully understand the long-term outcomes and risks associated with MBS.