Calcium And Vitamin D Depletion And Elevated

Calcium and Vitamin D Depletion and Elevated
Parathyroid Hormone following Biliopancreatic
DiversionObesity Surgery, 13, 893-895

Calcium and Vitamin D Depletion and Elevated Parathyroid Hormonefollowing Biliopancreatic Diversion
Leyanne Newbury, B Hlth Sc (Nut & Diet), B Nurs1; Kevin Dolan, FRCS2; Michael Hatzifotis, MBBS2; Nadeen Low, MBBS2; George Fielding, FRACS2
1 Department

ofNutrition and Dietetics, 2Department of Surgery, Royal Brisbane Hospital, Herston, Brisbane, Australia
Background: Biliopancreatic diversion (BPD) is associated with a 70% excess weight loss (EWL) at 10years, but there are concerns regarding long-term nutritional sequelae. Metabolic bone disease has been documented following Roux-en-Y gastric bypass. Methods: Patients who underwent a BPD from 1998to 2001 were studied. A questionnaire was designed to review BPD patients and collect information on weight loss, frequency of gastrointestinal disturbances and compliance with multivitaminrecommendations. The review included a blood test for vitamin D, parathyroid hormone (PTH), alkaline phosphatase (ALP) and calcium. Results: Of the 82 patients who underwent BPD during this period, the median%EWL at 36 months was 73.0%. 75.6% suffered diarrhea. At median followup of 32 months (18-50), 25.9% of patients were hypocalcemic, 50% had low vitamin D, 23.8% had elevated ALP, and 63.1% had elevatedPTH, despite 82.9% taking multivitamins. Conclusion: BPD results in significant weight loss. However, 1 in 4 patients are hypocalcemic, and 1 in 2 have a low vitamin D, despite multivitaminsupplementation. BPD patients require routine calcium and vitamin D supplementation for life. Long-term sequelae from these abnormal serum levels are not known.

Introduction
Biliopancreatic diversion(BPD), as described by Scopinaro, has been a surgical therapy for morbid obesity for over 25 years1 and is an effective operation for achieving long-term weight loss. 2 Patients who have undergone BPD to...