Bariatric surgery and secondary hyperparathyroidism: a meta-analysis |
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| Affiliation: | 1. National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China;2. Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China;3. Department of Biliopancreatic and Metabolic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China;4. Department of Metabolism and Endocrinology, Zhuzhou Central Hospital/Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, Hunan, China;1. Department of Visceral Surgery, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland;2. Faculty of Biology and Medicine, Lausanne University (UNIL), Lausanne, Switzerland;3. Division of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland;4. Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland;1. Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Cracow, Poland;2. Department of General Surgery, Specialist Hospital, Legnica, Poland;3. Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland;4. Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland;5. First Department of General and Endocrinological Surgery, Medical University of Bialystok, Bialystok, Poland;6. Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland |
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| Abstract: | BackgroundObesity increases the risk of obesity-related medical problems. Weight loss after metabolic and bariatric surgery (MBS) has been well studied. However, the effects of MBS on parathyroid function remain unclear.ObjectiveThe objective of this study was to perform a meta-analysis to examine the impact of MBS on the risk of secondary hyperparathyroidism (SHPT).SettingThe Second Xiangya Hospital, Central South University, Changsha, Hunan, China.MethodsThe PubMed, Embase, Web of Science, and the Cochrane Library databases were systematically reviewed from inception to May 2022 to identify studies reporting quantitative measurements of SHPT risk pre-MBS and post-MBS. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated and compared. Effects were pooled using a random-effects or fixed-effects model. Subgroup analyses were performed according to the follow-up time and surgical procedure.ResultsThe final meta-analysis included 9 studies with a total of 5585 patients. The mean follow-up time was 3.5 years (range 0.25–5). Overall, MBS appears to does not affect SHPT risk (OR = 1.34, 95% CI 0.81–2.20, I2 = 95%). Follow-up data showed no evidence of SHPT within 2 years following gastric bypass (GB) and sleeve gastrectomy procedures (OR = 1.42, 95% CI 0.66–3.07 for GB, OR = 0.39, 95% CI 0.09–1.62 for sleeve gastrectomy ). At the 2-year and long-term follow-up intervals, a marked increase in SHPT was detected for GB (OR = 6.06, 95% CI 3.39–10.85 for GB). In addition, the surgical procedure for GB decreased the likelihood of SHPT compared with the surgical procedure for biliopancreatic diversion with duodenal switch (OR = 0.29, 95% CI 0.17–0.49).ConclusionsOur meta-analysis indicated that GB appears to increase SHPT risk. Patients undergoing MBS should be aware of the risk of SHPT. Larger studies are needed to evaluate the outcomes and side effects and may eventually provide a better and more comprehensive understanding of the risks. |
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| Keywords: | Bariatric surgery Hyperparathyroidism Meta-analysis |
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