Effect of Laparoscopic Sleeve Gastrectomy on Calcium Metabolism Parameters, Vitamin D, and Parathyroid Hormone in Morbidly Obese Patients: Short-Term Results

Abstract

Objective: Sleeve gastrectomy (SG) is a widely utilized bariatric surgical procedure. It may affect various aspects of nutritional and metabolic health, including calcium (Ca) metabolism, vitamin D levels, and parathyroid hormone (PTH) secretion. We aimed to investigate the effect of laparoscopic SG (LSG) on Ca metabolism parameters, vitamin D, and PTH in morbidly obese patients. Materials and methods: This single-center, retrospective cohort study was conducted at the Department of General Surgery, Avrupa Safak Hospital, Istanbul, between March 2021 and November 2023. A total of 78 patients were included in the study. The procedure involved the resection of approximately 80% of the stomach, creating a tubular gastric sleeve. All patients underwent postoperative follow-up at six and 12 months. Results: Of the 78 patients, 49 (62.8%) were females and 29 (37.1%) were males. The mean age of the patients was 31.2±9.8 years. The mean weight was 126±12.2 kg and the mean BMI was 47±6.9 kg/m2. There was a significant decrease in the BMI values following surgery ( p <0.01). Vitamin D level was found to be 18.7±4.2 ng/mL at baseline, which increased to 37.6±2.5 ng/mL at 12 months after surgery ( p <0.01). Before surgery, the PTH level was 69.1±8.7 pg/mL, which decreased to 39.3±5.5 pg/mL at 12 months postoperatively ( p <0.01). The mean serum Ca level at baseline was 9.2±1.4 mg/dL, which increased to 10.1±0.4 mg/dL at 12 months after operation ( p <0.01). Conclusion: Our study results suggest that low vitamin D levels are commonly observed in patients undergoing bariatric surgery. Administering vitamin D as a standard postoperative treatment regimen may be helpful in reducing this deficiency. We, therefore, recommend continuous monitoring of vitamin D, PTH, and serum Ca levels after surgery to manage these issues effectively.