Effect of calcium citrate vs calcium carbonate on elevated parathyroid hormone after Roux‐en‐Y gastric bypass. A double‐blinded, randomized trial

Madsen, Lene R.; Espersen, Rasmus; Rejnmark, Lars; Richelsen, Bjørn

doi:10.1111/cen.13836

Cited by 11 publications

(6 citation statements)

References 28 publications

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“…Calcium carbonate was used as calcium supplement. Calcium carbonate is best absorbed in an acidic environment, and absorption is possibly lower after RYGB (42,43), although other studies have shown no difference between calcium carbonate and calcium citrate supplementation on PTH and BMD after RYGB (44,45). Generalizability of our results is limited, as we only included Caucasian women.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Roux‐en‐Y Gastric Bypass on Bone Marrow Adipose Tissue and Bone Mineral Density in Postmenopausal, Nondiabetic Women

Beekman

Akkerman

Streekstra

et al. 2021

Obesity

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Objectives This study aimed to determine the effect of bariatric surgery‐induced weight loss on bone marrow adipose tissue (BMAT) and bone mineral density (BMD) in postmenopausal, nondiabetic women. Methods A total of 14 postmenopausal, nondiabetic women with obesity who were scheduled for laparoscopic Roux‐en‐Y gastric bypass surgery (RYGB) were included in this study. Vertebral bone marrow fat signal fraction was determined by quantitative chemical shift magnetic resonance imaging, and vertebral volumetric BMD (vBMD) was determined by quantitative computed tomography before surgery and 3 and 12 months after surgery. Data were analyzed by linear mixed model. Results Body weight [mean (SD)] decreased after surgery from 108 (13) kg at baseline to 89 (12) kg at 3 months and 74 (11) kg at 12 months (P < 0.001). BMAT decreased after surgery from 51% (8%) at baseline to 50% (8%) at 3 months and 46% (7%) at 12 months (P = 0.004). vBMD decreased after surgery from 101 (26) mg/cm3 at baseline to 94 (28) mg/cm3 at 3 months (P = 0.003) and 94 (28) mg/cm3 at 12 months (P = 0.035). Changes in BMAT and vBMD were not correlated (ρ = −0.10 and P = 0.75). Calcium and vitamin D concentrations did not change after surgery. Conclusions RYGB decreases both BMAT (after 12 months) and vBMD (both after 3 months and 12 months) in postmenopausal, nondiabetic women. Changes in BMAT and vBMD were not correlated. These findings suggest that BMAT does not contribute to bone loss following RYGB.

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Section: Discussionmentioning

confidence: 99%

The Effect of Roux‐en‐Y Gastric Bypass on Bone Marrow Adipose Tissue and Bone Mineral Density in Postmenopausal, Nondiabetic Women

Beekman

Akkerman

Streekstra

et al. 2021

Obesity

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“…PTH levels and bone turnover markers can stay elevated years after both sleeve gastrectomy and RYGB [ 39 ]. Treatment includes calcium and vitamin D. Calcium as citrate may be more easily absorbed in this setting [ 40 ]; however, it may be difficult to normalize PTH levels in these patients with calcium citrate or carbonate [ 41 ]. Interestingly, there have been reports of PHPT with hypercalcemia after RYBG [ 42 ].…”

Section: Casesmentioning

confidence: 99%

The Eucalcemic Patient With Elevated Parathyroid Hormone Levels

Shaker

Wermers

2023

Journal of the Endocrine Society

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Primary hyperparathyroidism (PHPT) is classically characterized by hypercalcemia with elevated or inappropriately normal parathyroid hormone (PTH) levels. Elevated PTH levels in the presence of normal calcium levels are not infrequently found during the evaluation of metabolic bone disorders or kidney stone disease. This can be caused by secondary hyperparathyroidism (SHPT) or normocalcemic primary hyperparathyroidism (NPHPT). NPHPT is due to autonomous parathyroid function whereas SHPT is caused by a physiologic stimulation to PTH secretion. Many medical conditions and medications can contribute to SHPT, and differentiation between SHPT and NPHPT may be difficult. Cases are presented to illustrate examples. In this paper, we review the distinction between SHPT and NPHPT as well as end organ effects of NPHPT and outcomes of surgery in NPHPT. We suggest that the diagnosis of NPHPT be made only after careful exclusion of causes of SHPT and consideration of medications that can increase PTH secretion. Further, we advise a conservative approach to surgery in NPHPT.

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“…1600mg daily) composed of citrate or carbonate forms, did not show any significant difference in PTH and vitamin D levels. Noteworthy, the citrate form was associated with reduced bone turnover markers suggesting less bone resorption [54], yet BMD was not assessed.…”

Section: Effects Of Supplementation On Vitamin Status and Clinical Oumentioning

confidence: 99%

A place for vitamin supplementation and functional food in bariatric surgery?

Aron‐Wisnewsky

Clément

2019

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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 Purpose of review: This article summarizes the recent literature concerning vitamin deficiency and required supplementation post bariatric surgery (BS), with a focus on vitamin (and associated clinical adverse effect on bone loss) and on the potential implication of the gut microbiota.  Recent findings: BS improves health outcomes in terms of weight loss and metabolic alterations yet with major inter-individual variability. Indeed, although BS is efficient in most patients, some display poor response (i.e. patients with the lowest weight loss at one year or weight regain afterwards, or patients who do not undergo metabolic disease remission). Furthermore, despite systematic vitamin supplementation post-BS, some patients develop vitamin deficiencies leading to poor clinical outcomes. Specifically, a major recently described adverse outcome is vitamin D deficiency associated in part with observed bone mass loss and fractures. Recent mechanistic studies have been performed to better understand the involved physiopathology. Furthermore, different intervention studies tested on top of BS (using vitamin supplementation, diet or nutrients acting as functional food) have evaluated whether they could improve these nutritional adverse outcomes and are summarized herein. Importantly, gut microbiota involved in food digestion and metabolization as well as vitamin synthesis, is largely perturbed during severe obesity and is partially restored post-BS, yet again with large inter-individual variability. Whether differential modification of the gut microbiota could be associated with those vitamin deficiencies is an open question.  Summary: Future clinical research studies will need to evaluate whether add-on intervention to BS using vitamin, diet or specific food items could help prevent nutritional deficiencies and improve clinical response observed post-BS. More importantly, personalizing the add-on intervention after BS upon gut microbiota composition should be tested in predicted poor responders to BS as already performed during diet intervention to further improve metabolic health.

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Effect of calcium citrate vs calcium carbonate on elevated parathyroid hormone after Roux‐en‐Y gastric bypass. A double‐blinded, randomized trial

Cited by 11 publications

References 28 publications

The Effect of Roux‐en‐Y Gastric Bypass on Bone Marrow Adipose Tissue and Bone Mineral Density in Postmenopausal, Nondiabetic Women

The Effect of Roux‐en‐Y Gastric Bypass on Bone Marrow Adipose Tissue and Bone Mineral Density in Postmenopausal, Nondiabetic Women

The Eucalcemic Patient With Elevated Parathyroid Hormone Levels

A place for vitamin supplementation and functional food in bariatric surgery?

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